青少年早期同伴拒绝、同伴侵害与抑郁的关系：交叉滞后分析

采用间隔1年的追踪设计,使用结构方程建模对1068名青少年早期个体的同伴拒绝、同伴侵害与抑郁间的关系进行交叉滞后分析。结果发现,（1）在不同时间点上,同伴拒绝、同伴侵害和青少年抑郁之间存在显著正相关;（2）先前的抑郁水平对随后个体遭受的身体侵害和关系侵害均有显著预测作用,而先前的同伴侵害不能显著预测随后青少年的抑郁水平。抑郁对同伴拒绝、以及同伴拒绝对抑郁的预测作用均不显著。（3）同伴拒绝、同伴侵害与抑郁间的关系具有跨性别的一致性。这表明,青少年早期同伴侵害和抑郁间存在单向预测关系,抑郁导致同伴侵害。     

Specificity of peer difficulties to social anxiety in early adolescence: categorical and dimensional analyses with clinical and community samples

Background and Objectives: We investigated the specificity of social difficulties to social anxiety by testing associations of social anxiety and other anxiety presentations with peer acceptance and victimization in community and treatment-seeking samples of adolescents aged 12–14 years.

Design: Cross-sectional, quantitative survey.

Methods: Adolescents from the community (n?=?116) and a clinical setting (n?=?154) completed ratings of anxiety symptoms, perceived social acceptance, and peer victimization. Their parents also completed ratings of the adolescents’ anxiety and social acceptance.

Results: Social acceptance was lowest among adolescents with social anxiety disorder (SAD) and lower among adolescents with other anxiety disorders than in the community sample. Anxiety symptoms were negatively correlated with social acceptance, but these associations were not unique to social anxiety symptoms. Girls in the community sample reported more overt victimization than girls with SAD and with other anxiety diagnoses. Relational victimization was associated with social and nonsocial anxiety symptoms only in the community sample.

Conclusions: Our findings supplement recent laboratory-based observational studies on social functioning among adolescents with SAD and other anxiety disorders. Although social anxiety may be associated with unique social skill deficits and impairment, concerns about peer relations should also be considered among adolescents with other anxiety symptoms.     

Reactivity to Exclusion Prospectively Predicts Social Anxiety Symptoms in Young Adults

Peer victimization leads to negative outcomes such as increased anxiety and depression. The prospective relationship between peer victimization and social anxiety in children and adolescents is well established, and adults with social anxiety disorder (SAD) are more likely than individuals with other anxiety disorders to report a history of teasing. However, a crucial bridge between these findings (peer victimization in young adults) is missing. We manipulated perceptions of peer exclusion in a young adult sample (N = 108) using the Cyberball Ostracism Task. Reactivity to exclusion prospectively predicted social anxiety symptoms at a 2-month follow-up, whereas self-reported teasing during high school and current relational victimization did not. This research suggests that reactions to peer victimization may be a worthwhile target for clinical interventions in young adults. Targeting how young adults react to stressful social interactions such as exclusion may help prevent the development of SAD. Future research should test if reactivity to exclusion plays a role in the relationship between other disorders (e.g., depression) and peer victimization.     

The Role of Emotion Dysregulation in the Links Between Sibling Victimization and Internalizing Symptoms in Middle Childhood

Despite sibling victimization being a relatively common occurrence, there is a dearth of research examining the outcomes associated with this interpersonal stressor, including internalizing symptoms. The current study sought to advance the literature by longitudinally examining the links from sibling victimization to depression and anxiety symptoms while also considering peer victimization in a sample of elementary school-age youth (51.8% boys, M age?=?8.72) who were initially in 3rd and 4th grade. Further, emotion dysregulation was examined as a mediator of these associations. Youth provided self-reports at three separate time points approximately 6 months apart. Path analysis models indicated that emotion dysregulation mediated the association between sibling, but not peer, victimization and increased depression symptoms. However, neither sibling nor peer victimization were associated with anxiety symptoms over time. Results suggest the importance of attending to sibling victimization for the prevention of emotion dysregulation difficulties and ultimately early symptoms of depression. Youth assessments need to include questions about both sibling and peer victimization, and sibling victimization needs to be included as a target of prevention and intervention for subsequent internalizing difficulties.

     

To Add Insight to Injury: Childhood Abuse,Abuse Perceptions,and the Emotional and Physical Health of Young Adults

Although childhood abuse is strongly associated with psychological difficulties, survivors may not perceive their experiences as abusive. Depression, anxiety, dissociation, and physical health complaints may decrease perceptions of abuse and may also be exacerbated by individuals' abuse perceptions. The current study examined abuse perceptions, abuse experiences, and current symptoms among 185 university students. Ninety-six participants repeated the study 1–2 years later. At Time 1, self-labeling as “abused” or “maltreated” was not related to psychological or physical health symptoms. At Time 2, self-labeling as “abused” or “maltreated” was positively related to depression, anxiety, and dissociation. Results indicate that abuse perceptions may change over time and may be connected with emotional and physical symptoms.     

Peer victimization during adolescence: concurrent and prospective impact on symptoms of depression and anxiety

Background: Peer victimization is ubiquitous across schools and cultures, and has the potential for long-lasting effects on the well-being of victims. To date, research has focused on the consequences of peer victimization during childhood but neglected adolescence. Peer relationships and approval become increasingly important during adolescence; thus, peer victimization at this age may have a damaging psychological impact. Methods: Participants were 5030 adolescents aged 11–16 recruited from secondary schools in the UK. Self-report measures of victimization and symptoms of anxiety and depression were administered on three occasions over a 12-month period. Latent growth models examined concurrent and prospective victimization-related elevations in anxiety and depression symptoms above individual-specific growth trajectories. Results: Peer victimization was associated with a concurrent elevation of 0.64 and 0.56 standard deviations in depression and anxiety scores, respectively. There was an independent delayed effect, with additional elevations in depression and anxiety (0.28 and 0.25 standard deviations) six months later. These concurrent and prospective associations were independent of expected symptom trajectories informed by individual risk factors. Conclusions: Adolescent peer victimization was associated with immediate and delayed elevations in anxiety and depression. Early intervention aimed at identifying and supporting victimized adolescents may prevent the development of these disorders.     

Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety

ABSTRACT

The aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame (only girls), positive reappraisal, and positive refocusing (the latter two inversely) were uniquely (and significantly) associated with depression symptoms; and after controlling for comorbid depression symptoms, catastrophising and other-blame were uniquely related to anxiety symptoms. The results supported the cognitive content-specificity model, in which anxiety is supposed to be uniquely characterised by thoughts concerning the overestimation of threats and harm, and depression is supposed to be uniquely characterised by negative evaluations of self, and of past and future events.     

The Interaction of Extraversion and Anxiety Sensitivity on Social Anxiety: Evidence of Specificity Relative to Depression

Neuroticism and extraversion have been linked to the etiologies and course of anxiety and mood disorders, such that neuroticism is broadly associated with numerous disorders and extraversion is most strongly associated with social anxiety and depression. While previous research has established the broad associations between temperament and emotional disorders, less is known about the specific, proximal factors that are associated with them, and very few studies have situated these risk factors into a larger etiological model that specifies how they may relate to one another. The current study examined the interaction of extraversion and anxiety sensitivity (AS) in predicting social anxiety symptoms in a large, diagnostically diverse clinical sample (N = 826). Symptoms were assessed with self-report and dimensional interview measures, and regression analyses were performed examining the main effects and interaction of extraversion and AS (examining both total and lower-order components) on social anxiety. Results showed that at higher levels of AS, the inverse relationship between extraversion and social anxiety was stronger, and the social concerns component of AS is responsible for this effect. This interaction was also observed with regard to depression symptoms, but the interaction was not present after accounting for shared variance (i.e., comorbidity) between depression and social anxiety symptoms. Clinical and theoretical implications of the results are discussed.     

Relation of Depression and Anxiety to Self‐ and Peer‐Reported Relational Aggression

The primary purpose of this multimethod and multimeasure study was to identify how the peer relationships of Australian adolescents (ages 9–15 years; N = 335) at school, including relational aggression and victimization, correlated with their symptoms of depression and anxiety. Moreover, relational aggression and victimization were measured via both self‐ and peer report, and discrepancies between reports were considered as correlates of symptoms and peer relationship status. Adolescents who reported more symptoms of depression and anxiety also self‐reported more relational victimization and reported their peers as less trustworthy. Adolescents who overreported their own relational victimization and aggression compared with peer report had more symptoms compared with those who agreed with their peers or underreported their aggression and victimization. Adolescents who underreported their own aggression were not only more socially prominent but were also more disliked by their peers. When considered independent of self‐reports, no measure of peer‐reported peer status, aggression, or victimization was associated with depressive symptoms; but adolescents reported as more accepted by their peers had fewer anxiety symptoms. Longitudinal research should be conducted to examine adolescents' increasing socioemotional problems as correlates of discrepancies between self‐ and peer reports of relational aggression and victimization. Aggr. Behav. 38:16‐30, 2012. © 2011 Wiley Periodicals, Inc.     

The Emotional Experience Associated with Worrying in Adolescents

Among adults, both normal and pathological worrying has been found to be associated with a unique emotional syndrome involving irritability, restlessness, low frustration tolerance and difficulty relaxing. This emotional state is empirically distinguishable from anxiety and depression, and is reliably assessed by the Stress scale of the Depression Anxiety Stress Scales (DASS). The association between worry and ‘stress’ may have important implications for a better theoretical understanding of worrying in adults. Among youth, however, the emotional experience associated with worrying has not yet been clearly described. The present study aimed to explore whether a distinct, adult-like ‘stress’ syndrome can be assessed in adolescents via self-report, and whether, as in adults, stress has a specific association with worrying. A simplified version of the DASS was created to maximize its comprehension by adolescents. A group of 340 12–18-year-olds completed the simplified DASS and a self-report measure of worry. Factor analyses revealed a three-factor structure underlying the simplified DASS, similar to the original adult version. Further analyses showed that worry had a unique association with Stress, over and above its association with Depression and Anxiety. Adolescents who worry more excessively and uncontrollably also reported higher levels of irritability, restlessness and difficulty relaxing, while the autonomic arousal symptoms of anxiety had consistently low associations with worrying, especially in older adolescents. Results indicate that the proposed cognitive avoidance function of worrying may be present by adolescence.     

Treatment of Anxiety Disorders With Comorbid Depression: A Survey of Expert CBT Clinicians

Cognitive-behavioral therapy (CBT) is an empirically supported psychological treatment for anxiety disorders. These treatments have primarily been developed to target primary anxiety disorders, despite the fact that these disorders frequently co-occur with a diagnosis of depression. Empirical evidence provides guidance regarding how to treat an individual with a primary anxiety disorder with comorbid depression; however, there is limited data regarding how to translate these findings into clinical practice. Improving our understanding of how CBT is currently being used in practice among experts is integral to learning whether modifications to protocols lead to more or less effective treatments. Accordingly, we surveyed expert CBT clinicians about their assessment and treatment approaches and what challenges they face in formulating and treating mood and anxiety comorbidity. Most experts reported that their assessment includes a semistructured interview and self-report measures to determine breadth and hierarchical ordering of comorbidity severity. Symptom severity, client's goals, temporal onset of disorders, presence of suicide risk, and potential for early treatment success were reported as factors to consider when deciding where to begin treatment. Almost three quarters of experts surveyed indicated that they usually take some type of sequential treatment approach when treating primary anxiety disorders with comorbid depression. The top three reported challenges associated with treating comorbid presentations were client's motivation/energy, hopelessness/pessimism, and ongoing need for risk assessment. Implications for the nature and timing of CBT interventions in “real-world” clinical practice are discussed.     

Maternal anxiety and toddler depressive/anxiety behaviors: The direct and moderating role of children's focused attention

Attention mechanisms have a pertinent role in shaping developmental pathways to anxiety and depressive disorders. The current study examined the direct and interactive associations between maternal anxiety symptoms, children's focused attention, and children’s anxiety and depression behaviors in early toddlerhood. Participants were 150 mother-child dyads (50 % female) that were assessed at two time points. At 12 months of child age, mothers reported about their anxiety symptoms and children's focused attention. Children's focused attention was also observed and rated from an individual play task. At 18 months of age, mothers reported about children's anxiety and depression behaviors. Focused attention predicted child anxiety and depressive behaviors, with different patterns of associations between observed and reported measures of attention. There was also a significant interaction between maternal anxiety symptoms and observed children's focused attention. A positive association between maternal anxiety symptoms and child anxiety and depression symptoms was evident only for children with above-average levels of observed focused attention during play. Results suggest that different aspects of focused attention play a role in maternal reported anxiety and depression behaviors in early development and may modulate the intergenerational transmission of anxiety.     

DRD2基因TaqIA多态性与同伴侵害对青少年早期抑郁的交互作用

本研究运用问卷法与DNA分型技术,对1063名青少年(初次测评年龄为12.32±0.47岁,50.3%女生)进行间隔2年的追踪调查,考察DRD2基因TaqIA多态性与同伴身体侵害和关系侵害对青少年早期抑郁的交互作用及其性别差异。结果发现,TaqIA多态性与身体侵害、关系侵害均对男青少年抑郁存在显著的交互作用。在携带A2A2基因型的男生中,身体侵害和关系侵害可以显著正向预测其抑郁水平,而在携带A1等位基因的男生中,同伴侵害对抑郁无预测作用。此外,TaqIA多态性与身体侵害、关系侵害对女生抑郁均无显著交互作用。研究结果提示,同伴侵害是一种重要的候选环境指标,与TaqIA多态性交互影响青少年早期抑郁,并且性别在这一基因×环境交互作用中起到重要的调节效应。     

Rumination and Excessive Reassurance Seeking: Mediators of the Relationship Between Social Anxiety and Depression?

Social anxiety and depression are highly comorbid conditions. Although this has led researchers to suggest that social anxiety may convey risk for depression, few studies have examined mechanisms of comorbidity between these two conditions. The current study tested two mechanisms of comorbidity between symptoms of these disorders: brooding and excessive reassurance seeking. The data were evaluated in an undergraduate sample assessed three times over a 2 month period. Results suggested that brooding mediated the relationship between social anxiety at Time 1 and depression at Time 3, although no evidence was found for excessive reassurance-seeking as a mediator of these two variables. These findings support recent research suggesting that brooding may be a transdiagnostic process. Theoretical and clinical implications are discussed.     

Integrating Etiological Models of Social Anxiety and Depression in Youth: Evidence for a Cumulative Interpersonal Risk Model

Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the diagnostic level. We find core risk factors of temperament, genetics, and parent psychopathology (i.e., depression and anxiety) are neither necessary nor sufficient for the development of social anxiety and/or depression. Instead, aspects of children’s relationships with parents and/or peers either mediates (i.e., explains) or moderates (i.e., interacts with) these core risks being related to social anxiety and/or depression. We then examine various parent- and peer-related constructs contained in the separate models of social anxiety and depression (i.e., parent–child attachment, parenting, social skill deficits, peer acceptance and rejection, peer victimization, friendships, and loneliness). Throughout our review, we report evidence for a Cumulative Interpersonal Risk model that incorporates both core risk factors and specific interpersonal risk factors. Most studies fail to consider comorbidity, thus little is known about the specificity of these various constructs to depression and/or social anxiety. However, we identify shared, differential, and cumulative risks, correlates, consequences, and protective factors. We then put forth demonstrated pathways for the development of depression, social anxiety, and their comorbidity. Implications for understanding comorbidity are highlighted throughout, as are theoretical and research directions for developing and refining models of social anxiety, depression, and their comorbidity. Prevention and treatment implications are also noted.     

Comorbidity between SCARED anxiety factors and depressive symptomatology in 8- to 12-year-old children

The aim of this study was to examine the comorbidity between the SCARED anxiety factors and depressive symptoms in 8-12-year-old children. Participants were 792 girls and 715 boys, who completed: the 41-ítem version of the Screen for Child Anxiety Related Emotional Disorder (SCARED), the Children's Depression Inventory (CDI) and a Socio-demographic questionnaire. Of the sample, 47% showed anxiety symptoms and 11.5% showed depressive symptoms. Heterotypic comorbidity was 82% in children at risk of depression and 20% in children at risk of anxiety. Homotypic Comorbidity between anxiety factors was 87%. Homotypic comorbidity and heterotypic comorbidity were high; their early detection will prevent the continuity of an anxious disorder and the development of depression.     

Dietary patterns are associated with the prevalence of alexithymia

Recent evidence supports the association between healthy dietary patterns and a reduced risk of depression. The objective was: (1) to examine the associations between dietary patterns and alexithymic features; and (2) investigate whether these possible associations are explained by depressive symptoms in a cross‐sectional study among the Finnish general population aged 25–65 years. The study population was a part of the population‐based Kuopio Depression Study (KUDEP) conducted in central‐eastern Finland (n = 1747). Dietary data were collected using a food frequency questionnaire and dietary patterns from 22 predefined food groups, which were extracted by factor analysis. Alexithymia was assessed using the 20‐item Toronto Alexithymia Scale (TAS‐20) and depression using the 21‐item Beck Depression Inventory (BDI‐21). Altogether, 173 of the study subjects (9.9%) were alexithymic. Three dietary patterns were identified: “prudent,” “Western” and “traditional.” Lower scores for a healthy prudent dietary pattern and higher scores for an unhealthy Western dietary pattern were associated with an increased likelihood of belonging to the alexithymic group among subjects with elevated depressive symptoms. Among subjects without depressive symptoms, alexithymia was associated with lower scores in the prudent dietary pattern, but also with higher scores in the traditional dietary pattern. General population subjects with alexithymic features may have unhealthier dietary patterns than non‐alexithymic subjects.     

Overt and relational aggression in adolescents: social-psychological adjustment of aggressors and victims.

Examined the relative and combined associations among relational and overt forms of aggression and victimization and adolescents' concurrent depression symptoms, loneliness, self-esteem, and externalizing behavior. An ethnically diverse sample of 566 adolescents (55% girls) in Grades 9 to 12 participated. Results replicated prior work on relational aggression and victimization as distinct forms of peer behavior that are uniquely associated with concurrent social-psychological adjustment. Victimization was associated most closely with internalizing symptoms, and peer aggression was related to symptoms of disruptive behavior disorder. Findings also supported the hypothesis that victims of multiple forms of aggression are at greater risk for adjustment difficulties than victims of one or no form of aggression. Social support from close friends appeared to buffer the effects of victimization on adjustment.     

Comorbidity of anxiety-depression among Australian university students: implications for student counsellors

ABSTRACT

The incidence, factor structure and scale item differences in anxiety-depression comorbidity were investigated in a sample of Australian university students defined according to the presence of anxiety and/or depression. The incidence of anxiety-depression comorbidity was over 32%, about four times that for anxiety or depression alone. Participants with comorbidity had significantly higher Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) total and factor scores than those with anxiety or depression alone. The major differences between the comorbid and unitary disordered subgroups were for self-disintegration and autonomic arousal. Comorbidity of anxiety and depression is a more serious disorder than either anxiety or depression alone, and appears to exist in large proportions among university students. Assessment and treatment plans might benefit from inclusion of this comorbidity.