The relationship between emotion awareness and somatic complaints in children and adolescents: Investigating the mediating role of anxiety and depression

The objective of this study was to examine if emotion awareness in children and adolescents (age 7-18 years old) is directly related to somatic complaints, and if this relationship holds when considering symptoms of anxiety and depression as mediating factors. A number of questionnaires measuring emotion awareness, symptoms of anxiety and depression and somatic complaints were administered to Dutch schoolchildren (N?=?617). A path model was constructed, with the use of structural equation modelling. The results showed that two aspects of emotion awareness (bodily awareness and differentiating between emotions) contributed to the prediction of somatic complaints. However, this was no longer the case when controlling for symptoms of anxiety and depression. Thus, in this study, no direct relation was found between emotion awareness and somatic complaints. Instead, the relation was perfectly mediated by symptoms of anxiety and depression. The results suggest that focusing only on the relation between emotion awareness and somatic complaints is an oversimplified perspective that falls short as a starting point to find therapeutic solutions for children who suffer from somatic complaints.     

Validation of the Portuguese emotion awareness questionnaire for children and adolescents

This study examined the construct and concurrent validity of the Portuguese version of the Emotion Awareness Questionnaire (EAQ) in 302 children and adolescents (mean age 13 years old). The EAQ is a self-report questionnaire that allows for analysis of how youth experience and understand their own and others’ emotions. Participants completed the EAQ along with questionnaires for Worry and Somatic Complaints. Results confirmed the expected six-factor structure, good psychometric properties, and good concurrent validity. The EAQ is a reliable questionnaire, suitable for examining emotion awareness in Portugal.     

Emotions and self‐esteem as indicators of somatic complaints in children

The literature on somatic complaints in children without a clear physical medical cause often demonstrates connections with various psychological factors, such as negative emotions and problems handling them, poor self‐image, and coping potential. We entered these elements into a structural model to elucidate the relationships among them and tested it on 330 children (mean age 10 years and 9 months). The results showed that mood balance contributed most to the prediction of self‐reported somatic complaints. Moreover, mood (in combination with anxiety and depression problems) had an indirect impact on children's somatic complaints by influencing self‐esteem. The influence and position of coping was less clear. The results are discussed in terms of the ‘symptom perception theory’. Copyright © 2006 John Wiley & Sons, Ltd.     

The mediating role of anxiety in self-reported somatic complaints of depressed adolescents

This study examined the mediating role of anxiety in the self-reports of somatic complaints in 96 depressed adolescent inpatients. Sixty-four subjects with major depressive episodes and comorbid anxiety disorders (MDE-A) determined from the Diagnostic Interview for Children and Adolescents-Revised (DICA-R) reported significantly more somatic complaints than 32 adolescents having major depressive episodes without comorbid anxiety (MDE). An analysis of covariance demonstrated that, with anxiety symptoms controlled, MDE and MDE-A groups did not differ significantly in somatic complaints. A hierarchical multiple-regression analysis revealed that, with demographic and anxiety symptoms controlled, depressive symptoms did not contribute to the explanation or prediction of somatic complaints. The results suggest that anxious, but not depressive symptoms, are independently associated with somatic complaints. The results are discussed in light of new affective models of psychopathology.     

The relationship between suppression and subsequent intrusions: the mediating role of peritraumatic dissociation and anxiety

Background and objectives: Although previous studies showed that thought and emotion suppression represent risk factors for intrusions development, the mechanisms that explain these relations were less explored. This study aims to examine the relationships between thought and emotion suppression and the symptoms of intrusion following the exposure to a trauma-related event. Moreover, we explored if these relationships would be mediated by peritraumatic state dissociation and state anxiety.

Design and methods: The trauma film paradigm was used and the participants were students (N?=?148) experimentally exposed to an aversive film to model a traumatic experience. Thought and emotion suppression were measured before the trauma exposure. After exposure, the participants completed scales for measuring state dissociation and state anxiety. Intrusive images and thoughts of the film were recorded in the subsequent week using an intrusion diary.

Results: Thought suppression predicted intrusive thoughts frequency, and this effect was mediated by the peritraumatic anxiety. State anxiety predicted both intrusive images and thoughts, while state dissociation only predicted intrusive images.

Conclusions: Intrusive images and intrusive thoughts are different phenomena and they are predicted by different variables. The practical implications of these results for posttraumatic stress disorder treatment and secondary traumatization are discussed.     

青少年的情绪调节策略对创伤后应激障碍和创伤后成长的影响:社会支持的调节作用

为了考察雅安地震后青少年的情绪调节策略、社会支持与创伤后应激障碍(PTSD)和创伤后成长(PTG)之间的关系,采用创伤暴露程度问卷、情绪调节策略问卷、社会支持问卷、儿童创伤后应激障碍症状量表和创伤后成长问卷对雅安市芦山县的315名中学生进行调查,结果发现:创伤暴露程度对认知重评和表达抑制的预测作用不显著,对PTSD和PTG具有显著的正向预测作用。青少年的认知重评策略可以显著地负向预测PTSD、正向预测PTG,表达抑制策略仅对PTSD有显著的正向预测作用、对PTG的预测作用不显著;社会支持可以显著地调节表达抑制策略对PTSD和PTG的作用,表现为表达抑制对PTSD的正向预测作用随着社会支持的增加而降低,并可随着社会支持的增加而对PTG发挥促进作用。     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

The potential mediating role of anxiety sensitivity in the impact of mindfulness training on anxiety and depression severity and impairment: A randomized controlled trial

The benefits of mindfulness-based interventions to alleviate anxiety and depression have been supported by many studies. Given the effectiveness of mindfulness-based interventions on anxiety and depression, the underlying mechanisms need to be explored. Using a randomized waitlist-controlled design, this study investigated whether anxiety sensitivity was a potential mechanism for the impact of mindfulness training on anxiety and depression. Participants with high psychological distress were randomly assigned to an eight-week mindfulness intervention (N = 35) or a wait-list control group (N = 34). Before and after the intervention or corresponding waitlist period, participants completed measures of anxiety and depression severity and impairment and anxiety sensitivity. Separate mixed ANOVA demonstrated significant group (intervention vs. control group) × time (pre- vs. post-test) interactions for anxiety sensitivity and overall anxiety severity and impairment and marginally significant interaction for overall depression severity and impairment. Moreover, simple mediation models showed that reductions of anxiety sensitivity from pre- to post-test mediated the impact of mindfulness training on changes in anxiety and depression severity and impairment. The findings suggest that anxiety sensitivity is a potential mechanism underlying the effect of mindfulness training on anxiety and depression, which provides a new perspective for the study of processes of change of mindfulness-based interventions.     

Cognitive appraisal mediating relationship between social anxiety and internet communication in adolescents

Research suggests that people with high social anxiety trait may be more inclined to interact through computer-mediated communication (CMC). The psychological underpinnings of this inclination however remained unclear. The present research thus examines if cognitive appraisal bias (i.e. heighten estimation of social risk and deflated self-efficacy) would mediate the relationship between social anxiety and one’s perception of CMC attributes, contributing to a differential pattern of responses in CMC use. Four hundred and ten adolescents aged 12-18 years completed a set of self-reported measures tapping social anxiety trait, cognitive appraisals, perception of CMC attributes, and pattern of CMC social responses. Structural equation modeling lent support to the mediating role of the cognitive appraisal factors. Those with higher social anxiety trait would attach higher self-relevance to the CMC attributes, and engage in a more socially-involved pattern of interpersonal responses in CMC. Implications of these findings are discussed.     

The impact of gratitude on depression and anxiety: the mediating role of criticizing,attacking, and reassuring the self

Gratitude significantly predicts less depression and anxiety symptoms in general population. Three types of self-relating processes as possible mediators of this relationship were evaluated. Trait gratitude, depression, anxiety, and three forms of self-relating (criticizing, attacking, and reassuring the self) were assessed in 410 Italian participants. Gratitude predicted less depression and anxiety symptoms, and the three forms of self-relating partially mediated the impact of gratitude on both depression and anxiety. Self-reassuring had a stronger mediation power than self-attacking in the prediction of anxiety symptoms. Gratitude is a protective factor against psychopathology not only due to its association with improved relationships with others, but also because it is connected to a less critical, less punishing, and more compassionate relationship with the self.     

A cognitive‐behavioral model of anxiety disorders in children and adolescents

This study investigated a cognitive‐behavioral model of anxiety disorders in Japanese children and adolescents. Participants comprised 532 children from elementary schools and 751 adolescents from junior high schools as a community group, and 41 children and adolescents who fulfilled the criteria for childhood anxiety disorders as a clinical group. All participants completed three questionnaires about anxiety symptoms, self‐statements, and cognitive errors. While the clinical group showed more anxiety symptoms, negative self‐statements, and cognitive errors than the community group, there was no significant difference in positive self‐statements. Multigroup structural equation modeling found the presence of cognitive links for the community and clinical groups. Specifically, cognitive errors generated negative self‐statements, exacerbating a higher‐order factor (childhood anxiety) affecting six anxiety symptoms corresponding to the diagnostic criteria of psychological disorders. Mediated relationships were supported in only the community sample. Clinical implications for prevention and treatment of anxiety disorders in children and adolescents are discussed.     

The Strategy and Attribution Questionnaire: Psychometric properties of a Lithuanian translation in an adolescent sample

The present study provides a preliminary validation of the Lithuanian version of the Strategy and Attribution Questionnaire (SAQ, Nurmi, et al., 1995), a self-reported measure of social and cognitive behavioral strategies. An attempt to validate SAQ subscales was made by correlating them with the Youth Self-Report (Achenbach, 1991) and school grades. This was done with a sample of 14- to 17-year-old adolescents (N= 734). The results showed that although internal consistency reliabilities were good, they were lower when compared with the original version of SAQ. The SAQ subscales were moderately associated with various validity criteria, such as anxiety/depression, withdrawal, social problems and somatic complaints and school grades. Results also showed moderate correlations between similar strategic components across achievement and affiliative situations. The results provide preliminary evidence for concurrent validity of the Lithuanian version of SAQ.     

Investigating the relationship between social behaviors and phonological awareness in preschool children

Purpose

This study examined the longitudinal effects of social behaviors in predicting phonological awareness outcomes in 4-year-old children.

Method

One hundred two children (52 boys, 50 girls) were recruited from 11 schools serving low-income neighborhoods in a large metropolitan city and were assessed at the beginning and end of the preschool year. All children received assessments of their phonological awareness skills, expressive vocabulary, non-verbal IQ, and teachers completed behavioral ratings at pretest. At the end of the academic year, children participated in tests of phonological awareness using standardized assessments.

Results

The results of a multiple regression analysis indicated that being excluded by peers contributed up to 3% of the variance in negatively predicting phonological awareness outcomes after controlling for initial phonological awareness skills, expressive vocabulary, and cognition which is a small effect size.

Conclusion

Early peer exclusion can impact negatively on the acquisition of phonological awareness skills in 4-year-old children in preschool. The results of this study suggest that a child's overall behavioral competence and how they are treated by the peer group may play an important role in their ease of academic skill attainment. Given the link between peer exclusion and difficulties with phonological awareness outcomes, additional professional development programs that provide teachers with strategies to create inclusive classrooms may be warranted in preventing against the emergence of maladaptive behaviors at first entry into formal schooling.     

Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents

Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents’ symptom reporting. Participants (N = 33; 9–18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children – C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents’ reports of anxiety and depression symptoms and considering potential discrepancies between informants’ answers.     

The moderating role of emotional stability in the relationship between exposure to violence and anxiety and depression

This study investigated the associations among exposure to violence, emotional stability, and psychological symptoms. The moderating role of emotional stability in the relationship between exposure to violence and anxiety and depression was examined in a sample of 482 high school students in Hong Kong. Results showed that both witnessing violence and low levels of emotional stability were positively associated with symptoms of anxiety and depression. Low levels of emotional stability exacerbated the relation between witnessing violence and symptoms of anxiety and depression; the opposite pattern was found among adolescents with high levels of emotional stability. This study sheds light on the role of emotional stability in ameliorating the detrimental effects of witnessing violence on symptoms of anxiety and depression among adolescents. Findings of this study also have implications for the development of emotionally healthy personalities.     

The mediating role of mood in the relationship between perseverative cognition,sleep and subjective health complaints in music students

Objective: Subjective health complaints (SHC) are frequent in musicians. These complaints may be particularly distressing in this population because they are performance relevant. This paper aims at testing a model positing that (a) perseverative cognition (PC) predicts sleep duration/quality, (b) sleep duration/quality predicts SHC and (c) mood is a mediator of these associations.

Design: Participants were 72 music students (mean age (SD): 22.7 (3.0) years), and the assessment period consisted of seven consecutive days, with a solo performance on the fifth day.

Main outcome measures: Self-reported total sleep time (TST) and sleep quality were assessed 30?min after wake-up, and objective TST/sleep quality were assessed with an actigraphy watch. PC and mood were measured five times a day. Daily SHC were assessed at 9 p.m.

Results: PC did not significantly predict sleep duration/quality. Self-reported and objective TST and sleep quality were all significantly associated with SHC. Mood played a mediating role in each of these relationships with the exception of objective sleep quality.

Conclusion: The tested model on the association among PC, sleep and SHC and the mediating role of mood received partial support, highlighting the importance of sleep and mood in the emergence of SHC among university music students.     

The mediating role of state maladaptive emotion regulation in the relation between social anxiety symptoms and self-evaluation bias

Although social anxiety symptoms are robustly linked to biased self-evaluations across time, the mechanisms of this relation remain unclear. The present study tested three maladaptive emotion regulation strategies – state post-event processing, state experiential avoidance, and state expressive suppression – as potential mediators of this relation. Undergraduate participants (N?=?88; 61.4% Female) rated their social skill in an impromptu conversation task and then returned to the laboratory approximately two days later to evaluate their social skill in the conversation again. Consistent with expectations, state post-event processing and state experiential avoidance mediated the relation between social anxiety symptoms and worsening self-evaluations of social skill (controlling for research assistant evaluations), particularly for positive qualities (e.g. appeared confident, demonstrated social skill). State expressive suppression did not mediate the relation between social anxiety symptoms and changes in self-evaluation bias across time. These findings highlight the role that spontaneous, state experiential avoidance and state post-event processing may play in the relation between social anxiety symptoms and worsening self-evaluation biases of social skill across time.     

Worry and anxiety account for unique variance in the relationship between intolerance of uncertainty and depression

The evidence supporting the relationship between intolerance of uncertainty (IU), a cognitive construct well established in the anxiety literature, and depression is mixed. Some research has demonstrated a direct association between IU and depression, whereas other studies suggest that IU is either unrelated or indirectly related to depression through other pathways, including anxiety. The present study aimed to further elucidate the relationship between IU and depression in an undergraduate sample (N = 221). We posited a model in which worry and anxiety account for unique variance in the association between IU and depression. Results supported this hypothesis. Worry and trait anxiety significantly accounted for unique variance in the relationship between IU and depression. Furthermore, the model that best fit the data included two additional direct paths, from IU to anxiety and from worry to depression, and excluded the direct path from IU to depression. Our findings support the notion that IU and depression are indirectly related through worry and anxiety. Limitations and future directions are discussed.     

Comparison of the PAD and PANAS as models for describing emotions and for differentiating anxiety from depression

Positive (PA) and Negative (NA) Affect scales were analyzed using the Pleasure-Arousal-Dominance (PAD) Emotion Model. PA was weighted by high arousal, pleasure, and dominance (listed in order of beta weights), thus approximating exuberance in PAD space. NA and markers of somatic anxiety were weighted by displeasure, high arousal, and submissiveness, approximating anxiety in PAD space. PA (or exuberance) represented only one of four basic variants of positive affect (exuberant, relaxed, dependent, docile) and NA (or anxiety) represented only one of four basic categories of negative affect (hostile, anxious, disdainful, bored). Thus, PA and NA lacked validity as general and balanced measures of positive and negative affect, respectively. Indeed, the counterintuitive mutual independence of PA and NA was possible only because PA (and NA) dealt narrowly with selective aspects of positive (negative) affect. The PAD alternative to the tripartite model showed anxiety and depression shared unpleasant and submissive temperament characteristics but differed because anxiety involved more arousability than depression.