Long-term Consequences of Childhood Bullying in Adults who Stutter: Social Anxiety,Fear of Negative Evaluation,Self-esteem,and Satisfaction with Life

Purpose: Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter.Method: Participants were 36 adults who stutter and 36 adults who do not stutter (mean age = 21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales.Results: The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales.Conclusion: Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted.     

Body image in social anxiety disorder,obsessive–compulsive disorder,and panic disorder

Body dysmorphic disorder falls under the category of obsessive–compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive–compulsive disorder (OCD; n = 22), social anxiety disorder (SAD; n = 25), and panic disorder (PD; n = 21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.     

Metacognitive Therapy for Generalized Anxiety Disorder: Nature,Evidence and an Individual Case Illustration

Metacognitive therapy (MCT) is based on over 25 years of research focusing on the processes that contribute to the development and maintenance of psychological disorders. The approach identifies a common set of processes in psychopathology, and MCT shows promising results in effectively treating a range of disorders. This paper presents the central theoretical tenets of MCT and uses a clinical vignette to illustrate the structure and techniques of treatment based on Wells's (2009) manual as they relate to a specific case of generalized anxiety disorder.     

Temporomandibular disorders: evidence for significant overlap with psychopathology.

Data were analyzed for 277 acute and chronic temporomandibular disorder (TMD) patients to determine if there was a relationship between psychological and physical diagnoses. A significant (p < .01) relationship existed among the following: combined past or current mood disorder-personality disorder and muscle disorder; combined current mood, anxiety, or substance use disorder-personality disorder and muscle disorder; and combined current anxiety disorder-personality disorder and muscle disorder. This study further confirmed other research that has found that significant psychopathology exists in TMD. More important, this psychopathology appears to be linked primarily to muscle disorders, as opposed to disc or joint disorders, within the rubric of TMD.     

Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis

There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic review of the literature identified 31 studies involving 2,121 young people (aged <18 years) with ASD, and where the presence of anxiety disorder was assessed using standardized questionnaires or diagnostic interviews. Across studies, 39.6% of young people with ASD had at least one comorbid DSM-IV anxiety disorder, the most frequent being specific phobia (29.8%) followed by OCD (17.4%) and social anxiety disorder (16.6%). Associations were found between the specific anxiety disorders and ASD subtype, age, IQ, and assessment method (questionnaire versus interview). Implications for the identification and treatment of anxiety in young people with ASD are discussed.     

Selective Attention and Anxiety: A Perspective on Developmental Issues and the Causal Status

A plethora of studies on selective information processing in anxiety have been carried out over the past two decades. One of the most robust findings is that anxiety is associated with selective attention (SA) for threatening information. The rationale of research into SA is that it is assumed to play a vital role in the maintenance, and even in the etiology of anxiety disorders. It is the aim of this paper to explicate on the validity of this assumption. There is ample evidence that anxiety enhances SA. Although there is a lack of studies on the effect of SA on anxiety, there is now some evidence that SA increases the level of anxiety. This leads us to conclude that SA is not a by-product of anxiety only. Hence, the suggestion that SA plays a role in the maintenance of anxiety disorders seems to be justified. Studies on SA in children suggest that if SA plays any role at all in the development of anxiety disorders, it is not the SA in itself that is a vulnerability factor, but the continuation of this SA. Individuals who develop an anxiety disorder could have difficulty learning to inhibit this SA. Considering the finding that SA increases the level of anxiety, the authors suggest that anxiety in childhood causes failure to inhibit SA, which in turn enhances the vulnerability to anxiety disorder in adulthood.     

Mental Disorders, Religion and Spirituality 1990 to 2010: A Systematic Evidence-Based Review

Religion/spirituality has been increasingly examined in medical research during the past two decades. Despite the increasing number of published studies, a systematic evidence-based review of the available data in the field of psychiatry has not been done during the last 20 years. The literature was searched using PubMed (1990–2010). We examined original research on religion, religiosity, spirituality, and related terms published in the top 25 % of psychiatry and neurology journals according to the ISI journals citation index 2010. Most studies focused on religion or religiosity and only 7 % involved interventions. Among the 43 publications that met these criteria, thirty-one (72.1 %) found a relationship between level of religious/spiritual involvement and less mental disorder (positive), eight (18.6 %) found mixed results (positive and negative), and two (4.7 %) reported more mental disorder (negative). All studies on dementia, suicide, and stress-related disorders found a positive association, as well as 79 and 67 % of the papers on depression and substance abuse, respectively. In contrast, findings from the few studies in schizophrenia were mixed, and in bipolar disorder, indicated no association or a negative one. There is good evidence that religious involvement is correlated with better mental health in the areas of depression, substance abuse, and suicide; some evidence in stress-related disorders and dementia; insufficient evidence in bipolar disorder and schizophrenia, and no data in many other mental disorders.     

Rumination in Children with Social Anxiety Disorder: Effects of Cognitive Distraction and Relation to Social Stress Processing

According to cognitive models of social anxiety disorder (SAD), both anticipatory processing and post-event processing are core mechanisms in disorder maintenance leading to dysfunctional coping with social situations through negative self-evaluation and increased anxiety. To date, little is known about these processes during late childhood, a critical period for disorder development. Further, it remains unclear if dysfunctional rumination in children can be altered through psychotherapeutic interventions such as cognitive distraction. In the current study, children aged 9 to 13 years with SAD and age- and gender-matched healthy controls (HCs, each: n?=?30) participated in an experimental laboratory social stress task while anticipatory processing, post-event processing, subjective anxiety, self-evaluations, and autonomic arousal (skin conductance level) were assessed. Further, the impact of a brief cognitive distraction intervention on post-event processing was assessed. Children with SAD reported more negative anticipatory and post-event processing compared to HC children. Further, negative anticipatory processing was associated with higher subjective anxiety and reduced subjective performance ratings during the social stress task. In the aftermath of the stressor, distraction led to reduced subjective anxiety in the group with SAD and lower autonomic arousal in all children but did not alter post-event processing. The current study suggests that both anticipatory and post-event processing already play a key role in the maintenance of SAD in childhood. While distraction may be beneficial in reducing prolonged subjective anxiety and autonomic arousal after social situations, more research on interventions targeting ruminative processes is needed.

     

Associations Among Anxiety Disorders and Non-anxiety Disorders,Functional Impairment and Medication in Children and Adolescents

This is a study of comorbid anxiety disorders and how they affect the clinical picture of comorbid cases. The sample consisted of 576 Spanish children aged 8 to 17 years receiving psychiatric outpatient consultation that were evaluated using a semi-structured diagnostic interview for both parents and children. A specific association of homotypic comorbidity among anxiety disorders that was independent of the presence of other disorders was found. There was heterotypic comorbidity between anxiety and depressive disorders, ADHD, anorexia and tic disorders. Relationships between non-anxiety disorders were, in general, independent of anxiety, but anxiety moderated the relationship between ADHD-Conduct disorder and Conduct disorder-enuresis. Comorbid anxiety increased difficulties in social interaction, was related with higher global impairment and had an impact on consultation and medication. Anxiety disorder comorbidity should be well recognized in order not to disregard the treatment of all present disorders.     

Behavioral Inhibition and Attentional Control in Adolescents: Robust Relationships with Anxiety and Depression

Behavioral inhibition (BI) has been associated with the development of internalizing disorders in children and adolescents. It has further been shown that attentional control (AC) is negatively associated with internalizing problems. The combination of high BI and low AC may particularly lead to elevated symptomatology of internalizing behavior. This study broadens existing knowledge by investigating the additive and interacting effects of BI and AC on the various DSM-IV based internalizing dimensions. A sample of non-clinical adolescents (N = 1806, age M = 13.6 years), completed the Behavioral Inhibition System/Behavioral Activation System Scales (BIS/BAS), the attentional control subscale of the Adult Temperament Questionnaire (ATQ) and the Revised Child Anxiety and Depression Scale (RCADS). As expected, BI was positively, and AC was negatively related to internalizing dimensions, with stronger associations of BI than of AC with anxiety symptoms, and a stronger association of AC than of BI with depressive symptoms. AC moderated the association between BI and all measured internalizing dimensions (i.e., symptoms of generalized anxiety disorder, social phobia, separation anxiety disorder, panic disorder, obsessive–compulsive disorder, and major depressive disorder). Since high AC may reduce the impact of high BI on the generation of internalizing symptoms, an intervention focused on changing AC may have potential for prevention and treatment of internalizing disorders.     

Anxiety Disorders in Childhood: Casting a Nomological Net

Empirical research highlights the need for improving the childhood anxiety disorder diagnostic classification system. In particular, inconsistencies in the stability estimates of childhood anxiety disorders and high rates of comorbidity call into the question the utility of the current DSM criteria. This paper makes a case for utilizing a nomological net⁴ model for advancing the understanding of childhood anxiety disorders. In this article, we discuss measurement and assessment issues related to improving the childhood anxiety disorder diagnostic system and show how these issues can be addressed by employing the nomological net of childhood anxiety. Because employing the nomological net involves drawing from etiological process theories to facilitate classification and assessment, an integrative model of childhood anxiety disorders is presented as a tentative heuristic. Then evidence for the existing symptom sets is discussed in the context of how process theory mechanisms may be utilized to improve classification and assessment. Testable hypotheses are presented. Measurement, disorder definition, treatment, and policy implications are also discussed.A nomological net can be briefly defined as the theoretical structure of a construct.     

A Multifactorial Model for the Etiology of Anxiety in Non-Clinical Adolescents: Main and Interactive Effects of Behavioral Inhibition, Attachment and Parental Rearing

There has been limited research examining the additive and interactive effects of multiple factors on the development of anxiety symptoms and anxiety disorders in youths. This study was an attempt to examine the reciprocal connections among temperament, attachment, and rearing style, and their unique and interactive relations to anxiety symptoms. Six hundred forty-four non-clinical children aged 11–15 years (mean age = 12.7 years) completed questionnaires measuring behavioral inhibition, attachment, parental rearing behavior, and anxiety symptoms. Results indicated that there were small to moderate positive correlations among various risk factors. Furthermore, modest but significant positive correlations were found between behavioral inhibition, attachment quality, and anxious and controlling rearing behaviors on the one hand, and anxiety scores on the other hand. That is, higher levels of behavioral inhibition, insecure attachment, and parental control and anxious rearing were associated with higher levels of anxiety symptoms. Finally, behavioral inhibition, attachment quality, parental control and anxious rearing each accounted for a small but unique proportion of the variance of anxiety disorders symptomatology. Little support was found for interactive effects of these vulnerability factors on childhood anxiety.     

Predictors of Criminal Charges for Youth in Public Mental Health During the Transition to Adulthood

Dual involvement with the mental health system and justice system is relatively frequent for young adults with mental health problems, yet the research on factors predictive of dual involvement is incomplete. This study extends past research on predictors of criminal charges for people in the public mental health system in four ways. First, this study expands the longitudinal study period to include the time of transition to adulthood, from 16 to 25 years of age. Second, this study separately predicts specific types of criminal charges, including violent, property, drug, and nuisance charges. Third, this study examines whether residential treatment or inpatient hospitalization are predictive of criminal charges. Fourth, this study stratifies prediction by gender. Findings indicated high levels of dual involvement during this time period. In general, males and people diagnosed with substance use disorder or conduct disorder were more likely to have a criminal charge. Other predictors of specific criminal charges varied by gender. Residential treatment, inpatient hospitalization, and anxiety disorder were generally not related to criminal charges. Implications for cross-system collaboration and early intervention are discussed.     

Childhood maltreatment and adult personality disorder symptoms in a non‐clinical sample

It can be argued that the well‐substantiated relationship between childhood maltreatment and adult personality disorder (PD) symptoms may be confounded by comorbid symptoms of depression, anxiety or dysfunctional childhood family environments. Therefore, the current study was designed to test the hypothesis that retrospective reports of childhood maltreatment would still be significantly related to reports of more PD symptoms when statistically controlling for these factors. One hundred and seventy‐eight non‐clinical participants were divided into groups reporting childhood maltreatment (n = 54) or not (n = 124) according to scores on the Childhood Trauma Questionnaire. Participants also completed questionnaires measuring current depression, anxiety, and PD symptoms as well as retrospective reports of their childhood environment. Results showed that individuals reporting childhood maltreatment reported more symptoms of PD than those not reporting childhood maltreatment, even when statistically controlling for depression, anxiety and retrospective reports of dysfunctional family environment. These findings underscore the relevance and independent contribution of childhood maltreatment to the development of PDs, with important implications for further research and clinical practice.     

Coaching Approach Behavior and Leading by Modeling: Rationale,Principles, and a Session-by-Session Description of the CALM Program for Early Childhood Anxiety

Whereas the cognitive-behavioral treatment of childhood anxiety has been well-researched and empirically supported over the last 20 years, interventions for anxiety in young children (ages 7 and below) have garnered little attention. Because young children generally lack the required developmental skills to effectively engage in cognitive-behavioral treatment, a simple downward extension of treatments used for older children is inappropriate. The CALM program (Coaching Approach behavior and Leading by Modeling) was developed as a developmentally compatible intervention to treat anxiety disorders in young children ages 3 to 7. The CALM program is an adaptation of Parent-Child Interaction Therapy (PCIT), and an extension of Pincus, Eyberg, and Choate's (2000) adaptation of PCIT for young children with separation anxiety disorder. It is a parent-focused treatment that teaches parents skills to effectively reinforce their children's brave behavior and coaches the use of these skills during in-session parent-child interactions. The treatment emphasizes live, bug-in-the-ear coaching of parents during in vivo exposure sessions. This article describes the CALM program in detail.     

Childhood Anxiety/Withdrawal, Adolescent Parent–Child Attachment and Later Risk of Depression and Anxiety Disorder

Previous research has shown that children with high levels of early anxiety/withdrawal are at increased risk of later anxiety and depression. It has also been found that positive parent–child attachment reduces the risk of these disorders. The aim of this paper was to examine the extent to which positive parent–child attachment acted to mitigate the risk of later internalising disorders amongst children with high levels of early anxiety/withdrawal using data from a 30 years longitudinal study of a New Zealand birth cohort. The findings of this study showed that: (a) increasing rates of early anxiety/withdrawal were associated with an increased risk of later anxiety and depression; (b) positive parent–child attachment in adolescence was associated with a decline in the risk of later anxiety and depression; and (c) these associations persisted even after controlling for confounding factors. The implications of these findings for the role of parent–child attachment in mitigating the adverse effects of early anxiety/withdrawal are discussed. It is concluded that positive parent–child attachment in adolescence may act as a compensatory factor which buffers the adverse effects of childhood anxiety/withdrawal on risks of developing later anxiety and depression.     

A review on eye movement studies in childhood and adolescent psychiatry

The neural substrates of eye movement measures are largely known. Therefore, measurement of eye movements in psychiatric disorders may provide insight into the underlying neuropathology of these disorders. Visually guided saccades, antisaccades, memory guided saccades, and smooth pursuit eye movements will be reviewed in various childhood psychiatric disorders. The four aims of this review are (1) to give a thorough overview of eye movement studies in a wide array of psychiatric disorders occurring during childhood and adolescence (attention-deficit/hyperactivity disorder, oppositional deviant disorder and conduct disorder, autism spectrum disorders, reading disorder, childhood-onset schizophrenia, Tourette’s syndrome, obsessive compulsive disorder, and anxiety and depression), (2) to discuss the specificity and overlap of eye movement findings across disorders and paradigms, (3) to discuss the developmental aspects of eye movement abnormalities in childhood and adolescence psychiatric disorders, and (4) to present suggestions for future research. In order to make this review of interest to a broad audience, attention will be given to the clinical manifestation of the disorders and the theoretical background of the eye movement paradigms.     

The utility of screen for child anxiety related emotional disorders (scared) as a tool for identifying children at high risk for prevalent anxiety disorders

Abstract

The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used as the diagnostic standard. It was investigated whether SCARED scores are indicative for the presence of generalized anxiety disorder, separation anxiety disorder, and social phobia. Five-hundred-and-thirty-seven children aged 7–14 years completed the SCARED. From this sample, 82 children were selected on the basis of their SCARED scores. A subgroup of these children scored relatively high on the generalized anxiety disorder, separation anxiety disorder, and/or social phobia scale(s) of the SCARED. A comparison group of children scored relatively low on these SCARED scales. Both groups of children then received the semi-structured interview to assess to what extent they fulfilled the DSM-IV criteria for the relevant anxiety disorders. Results provided some support for the predictive validity of the SCARED generalized anxiety disorder and separation anxiety disorder subscales. The implications of these findings for the detection of anxiety disorders in normal children are briefly discussed.     

Worry and the anxiety disorders: A meta-analytic synthesis of specificity to GAD

Although worry is central to the diagnosis of generalized anxiety disorder (GAD), it is also commonly observed in other anxiety disorders. In this meta-analytic review, we empirically evaluated the extent to which worry is specific to GAD relative to patients with other anxiety disorders, those with other psychiatric disorders, and nonpsychiatric controls. A total of 47 published studies (N = 8,410) were included in the analysis. The results yielded a large effect size indicating greater severity/frequency of worry, meta-worry, and domains of worry among anxiety disorder patients v. nonpsychiatric controls (d = 1.64). In contrast to the many differences emerging from comparisons between anxiety disordered patients and nonpsychiatric controls, when anxiety disordered patients were compared to people with other psychiatric disorders they differed only on severity/frequency and not on meta-worry or domains of worry. A large effect size indicating greater severity/frequency of worry, meta-worry, and domains of worry among patients with GAD v. nonpsychiatric controls was also found (d = 2.05). However, differences between GAD and those with other psychiatric disorders also emerged for severity/frequency of worry. GAD was associated with greater worry difficulties than other anxiety disorders, which generally did not differ from those with other psychiatric disorders and each other. The implications of these findings for conceptualizing worry in GAD and other anxiety disorders, and the potentially moderating effects of age and gender are discussed.