Internalizing Symptoms in Female Adolescents: Associations with Emotional Awareness and Emotion Regulation

The transition into adolescence involves a number of changes that for many adolescents result in increased negative affect and internalizing symptoms, especially for females. In the current study we examined the direct and indirect effects of emotional awareness on internalizing symptoms by exploring the extent to which certain emotion regulation strategies influence this relationship. Participants were 123 female adolescents aged 13–16 years (M = 14.51 years) who completed measures of emotional awareness, emotion regulation (emotional reappraisal and expressive suppression), and symptoms of depression and social anxiety. Two multiple indirect effect models were conducted including both reappraisal and suppression (one for each of the dependent variables, depression and social anxiety) via the bootstrapping method. Results found that reappraisal accounted for the effect of emotional awareness on depressive symptoms but suppression accounted for the effect of emotional awareness on social anxiety symptoms. Results suggest that emotion regulation strategies play an important role in determining depressive and social anxiety symptoms and are associated with an adolescent’s level of emotional awareness.     

Attachment and depressive symptoms in middle childhood and early adolescence: Testing the validity of the emotion regulation model of attachment

This research examines differential associations between attachment dimensions (anxiety and avoidance) and emotion regulation (ER) strategies (dysregulation and suppression) in middle childhood and early adolescence. Furthermore, the study investigates how attachment and ER relate to depressive symptoms and perceived parenting. Two cross‐sectional studies (N = 339 and N = 746) supported the hypothesized associations between attachment anxiety and avoidance and emotional dysregulation and suppression, respectively. Mixed evidence was found for ER as a mediator in associations between attachment and depressive symptoms. Study 2 found that parental responsiveness and autonomy‐support are related differentially to the attachment dimensions. The Discussion focuses on the dynamics involved in associations between parenting, attachment, ER, and depression and on directions for future research.     

A Meta-Analysis of Universal School-Based Prevention Programs for Anxiety and Depression in Children

Anxiety and depression are among the most common mental health issues experienced in childhood. Implementing school-based prevention programs during childhood, rather than adolescence, is thought to provide better mental health outcomes. The present meta-analysis aimed to investigate the efficacy of universal school-based prevention programs that target both anxiety and depression in children (aged 13 years or below), and examine three moderators (i.e., program type, primary target of program, and number of sessions) on prevention effects. PsycINFO, PubMED, and Google Scholar were systematically searched for relevant articles published up to and including January 2018. Fourteen randomised controlled trials, consisting of 5970 children, met eligibility criteria. Prevention programs led to significantly fewer depressive symptoms at post-program (g?=?0.172) and at long-term follow-up periods (g?=?0.180), but not at short-term follow-up. Programs were not found to prevent anxiety symptoms across any time point. Considerable heterogeneity was observed for all effects. Program type and length were found to moderate the relationship between prevention program and outcomes. Prevention programs were effective in preventing depressive symptoms at post-program and long-term follow-up, while no significant preventative effect on anxiety symptoms was observed. The FRIENDS Program and programs which contained a greater number of sessions showed beneficial effects on anxiety and depressive symptoms. Universal programs aimed at preventing both anxiety and depression in children are limited. Future research should investigate the long-term evaluation of school-based prevention programs for anxiety and depression in children.     

Trajectories of emotional well-being in mothers of adolescents and adults with autism

Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families.     

The role of rumination in depressive disorders and mixed anxiety/depressive symptoms

Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.     

Dependent and Self-Critical Depressive Experiences among Inner-City Adolescents

ABSTRACT The Adolescent Depressive Experiences Questionnaire was administered to 142 inner-city ninth graders. Based on theory, several potential correlates of dependency and self-criticism were selected for study, including depression, aspects of anxiety, locus of control, and facets of social behavior. Self-criticism showed stronger associations with depression and concerns about losing others' approval, while dependency showed stronger associations with diffuse tension and worry and sensitivity to others' behavior. The two depressive tendencies had comparable associations with physiological anxiety and external locus of control. These findings are discussed in terms of current perspectives on the symptomatic heterogeneity of depressive experiences.     

Prevention of anxiety symptoms in children: results from a universal school-based trial

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and adaptive functioning, coping strategies, social skills, and perfectionism before and after the 10-week FRIENDS program and at two follow-up assessments (6 and 12 months) or wait period. Children who participated in the FRIENDS program exhibited significantly fewer anxiety and depressive symptoms, and lower perfectionism scores than children in the control group at 12-month follow-up. Younger children (9-10-year-olds) displayed treatment gains immediately after the intervention, whereas older children (11-12-year-olds) showed anxiety reduction only at 6- and 12-month follow-up. Perfectionism and avoidant coping acted as mediators of pre- to postintervention changes in anxiety scores. This study provides empirical evidence for the utility of the FRIENDS program in reducing anxiety and depressive symptoms among German children.     

Adolescent Responses to Depressive Parental Behaviors in Problem-Solving Interactions: Implications for Depressive Symptoms

The purpose of this study was to explore the relations between child responses to interparental depressive behavior and subsequent child depressive symptomatology. Data were collected on 156 two-parent families. Families completed questionnaire data and participated in problem-solving interactions, which were coded using a microsocial observational system. Three potential child responses to interparental depressive behavior were examined: facilitative, aggressive, and depressive. Results indicated that for female adolescents the displays of facilitative and depressive behavior as well as the suppression of aggressive behavior in response to interparental depressive behavior were related to increases in depressive symptomatology. For males, on the other hand, the display of aggressive and depressive behavior in response to interparental depressive behavior was related to increases in depression. Results provide preliminary support both for the examination of child responses to conflictual marital behavior and for expanding the conceptualization of conflictual marital behaviors to include depressive as well as the more traditionally examined aggressive behaviors, in order to better understand the link between conflictual marital behavior and child depressive symptomatology.     

Attachment Anxiety,Depressive Symptoms,and Adolescent Dating Violence Perpetration: A Longitudinal Mediation Analysis

Adolescent dating violence (ADV) is a prevalent public health issue that has been linked to many negative effects, including attachment anxiety and depressive symptoms. Previous literature suggests that the negative mental states characteristic of attachment anxiety could be associated with dating violence perpetration. Similarly, the negative mental states characteristic of depression have also been linked to perpetration, and might potentially increase an anxiously attached individual’s likelihood of engaging in dating violence perpetration. This study used a 10-month longitudinal design with a sample of 140 middle school and high school students from Southern California. Participants ranged in age from 13 to 18 years and were ethnically diverse. The study aimed at exploring depressive symptoms as a potential mediator for the relationship between attachment anxiety and ADV perpetration. Positive associations were found between attachment anxiety and perpetration (10 months after), attachment anxiety and depressive symptoms (10 months after), and between depressive symptoms and perpetration (both 10 months after). Furthermore, depressive symptoms partially mediated the relationship between attachment anxiety and ADV perpetration (10 months after). These findings have implications for the development of empirically driven school-based prevention and intervention programs.     

Long-Term Outcome of a Cluster-Randomized Universal Prevention Trial Targeting Anxiety and Depression in School Children

The present study concerns a 3-year follow-up of a universal prevention trial targeting anxiety and depressive symptoms in school children. In addition to evaluating the long-term effect of the prevention program, we also examined attrition and its effect on the outcome. High rates of attrition have commonly been observed in studies in the field. However, the role of attrition is not sufficiently understood regarding internal and external validity biases. The current study comprised 695 children (aged 8–11 at baseline) from 17 schools in Sweden. Schools were cluster-randomized to either the intervention or control condition. Children completed measures of anxiety and depressive symptoms and parents completed measures of their child’s anxiety and general mental health. We found no evidence of long-term effects of the prevention program, except for a small effect regarding parent reports of child anxiety. However, that effect was not found to be of clinical significance. Regarding attrition, children with missing data at the 3-year follow-up displayed higher levels of psychiatric symptoms at baseline and increasing symptoms across time. Furthermore, children in the control condition with missing follow-up data were found to be significantly deteriorated across time compared to the corresponding children in the intervention condition regarding depressive symptoms and total difficulties. In other words, attrition served as a moderator of the effect, which suggests that the overall result was biased toward a null-result. Our study highlights that large and nonrandom attrition severely limits the validity of the results. Further, given the common problem of retaining participants in long-term evaluations of school-based prevention trials, previous studies may suffer from the same limitations as the current study.     

Emotion regulation in unipolar depression: the effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect

This study examined the effects of emotional suppression and acceptance in a depressed sample. Sixty participants with diagnoses of unipolar depression completed a questionnaire packet and participated in an experiment. The experiment utilized two conditions to explore correlates of the spontaneous use of emotion regulation strategies and the effects of an experimental manipulation of acceptance and suppression. Results demonstrated that suppression produced short-term reductions in sadness. Notably, anxiety about the experience of depressed mood influenced the efficacy of emotional suppression with findings showing that suppression was no longer effective at moderate and higher levels of anxiety about the experience of depressed mood. Implications of study findings for understanding emotion dysregulation in depressive disorders and the treatment of depression are discussed.     

生命早期双酚A暴露对子代成年小鼠焦虑和抑郁行为的影响及其神经机制

双酚A (bisphenol A, BPA)对脑和行为发育的影响已引起关注, 本研究探讨围生期不同发育阶段母体BPA暴露对仔鼠成年后焦虑和抑郁行为的影响。分别在妊娠期(妊娠第7天~出生)和哺乳期(出生第1~14天) 将母鼠暴露于BPA (0.4、4 mg/kg/day), 以旷场、明暗箱、镜子迷宫、高架十字迷宫等多种模型检测生后56天(postnatal day 56)仔鼠的焦虑行为, 以强迫游泳模型检测其抑郁行为。结果显示, 妊娠期BPA暴露的成年雌性仔鼠在所有4种模型中均检测到促焦虑作用, 而哺乳期BPA暴露的雌鼠、妊娠期或哺乳期BPA暴露的雄鼠仅在2种模型中检测到促焦虑作用。妊娠期BPA暴露显著加重雌雄仔鼠的抑郁行为, 而哺乳期仅高剂量BPA加重仔鼠的抑郁行为。进一步的Western blot分析显示, 妊娠期或哺乳期BPA暴露显著下调成年后雌雄仔鼠海马和杏仁核AMPA受体GluR1亚基的表达, 但对NMDA受体NR1亚基的影响不一致。以上结果提示, 妊娠期或哺乳期BPA暴露对成年雌雄仔鼠均有不同程度的促焦虑和抑郁作用, 其中妊娠期暴露对雌鼠的作用最显著, 海马和杏仁核AMPA受体活动的减弱可能与围生期BPA暴露加重仔鼠成年后的焦虑和抑郁行为有关。     

Emotional Dynamics in the Development of Early Adolescent Psychopathology: A One-Year Longitudinal Study

This study examined the role of the level and variability of happiness, anger, anxiety, and sadness in the development of adolescent-reported anxiety disorder symptoms, depressive symptoms, and aggressive behavior in 452 adolescents (250 male) followed from age 13 to 14. Level and between-day variability of emotions were assessed through adolescent report at 3-month intervals across a 1 year period. Level and variability of the four emotions contributed to changes in anxiety disorder and depressive symptoms more consistently than to changes in aggressive behavior. All four emotions were predictive of changes in internalizing problems, while anger played the most prominent role in the development of aggressive behavior. Variability of emotions contributed to changes in anxiety disorder symptoms, while heightened levels of negative emotions and diminished happiness contributed to changes in depression. Results suggested somewhat stronger effects of negative affect on aggressive behavior for females than for males. Results underscore the role of emotion dysregulation in the development of psychopathology.     

Role of stress, corticotrophin releasing factor (CRF) and amygdala plasticity in chronic anxiety

Stress initiates a series of neuronal responses that prepare an organism to adapt to new environmental challenges. However, chronic stress may lead to maladaptive responses that can result in psychiatric syndromes such as anxiety and depressive disorders. Corticotropin-releasing factor (CRF) has been identified as a key neuropeptide responsible for initiating many of the endocrine, autonomic and behavioral responses to stress. The amygdala expresses high concentrations of CRF receptors and is itself a major extrahypothalamic source of CRF containing neurons. Within the amygdala, the basolateral nucleus (BLA) has an important role in regulating anxiety and affective responses. During periods of stress, CRF is released into the amygdala and local CRF receptor activation has been postulated as a substrate for stress-induced alterations in affective behavior. Previous studies have suggested that synaptic plasticity in the BLA contributes to mechanisms underlying long-term changes in the regulation of affective behaviors. Several studies have shown that acute glutamate receptor-mediated activation, by either GABA-mediated disinhibition or CRF-mediated excitation, induces long-term synaptic plasticity and increases the excitability of BLA neurons. This review summarizes some of the data supporting the hypotheses that stress induced plasticity within the amygdala may be a critical step in the pathophysiology of the development of chronic anxiety states. It is further proposed that such a change in the limbic neural circuitry is involved in the transition from normal vigilance responses to pathological anxiety, leading to syndromes such as panic and post-traumatic stress disorders.     

Persistent Heightened Cortisol Awakening Response and Adolescent Internalizing Symptoms: A 3-year Longitudinal Community Study

An atypical Cortisol Awakening Response (CAR) has been related to adult anxiety and depression, but little is known about the association between long-term atypical CAR and adolescent anxiety and depression. This study aimed to longitudinally identify subgroups of adolescents with distinct levels of CAR (i.e., adolescents with and without persistent atypical CAR) and to examine their development of anxiety and depressive symptoms over 3 successive years. A community sample of 184 Dutch adolescents (M _age?=?14.99 at T₁, 57 % boys) completed annual salivary cortisol assessments at home at time of awakening, and 30 and 60 min post-awakening (i.e., CAR) for 3 successive years. Adolescents also reported annually on their anxiety and depressive disorder symptoms. Latent Class Growth Analysis suggested two subgroups of adolescents with respect to CAR: a “low” group with stable low levels of AUC_g (Area Under the Curve with respect to the ground) over time and a “high” group with high and increasing levels of AUC_g over time. Controlling for sex, the high and low CAR groups significantly differed in depressive symptoms only, but none of the anxiety disorder symptoms. More specifically, adolescents in the high CAR group showed significantly higher mean levels of depressive symptoms over time compared to adolescents in the low CAR group. These results suggest that persistent heightened CAR is a more consistent, yet modest, correlate of adolescent depressive symptoms than anxiety disorder symptoms.     

Worry and rumination: differential associations with anxious and depressive symptoms and coping behavior

Worry and rumination are closely allied cognitive processes that impact on the experience of anxious and depressive symptoms. Using a prospective design, this study examined overlapping and distinct features of worry and rumination in relation to symptoms and coping behavior in a nonclinical sample of Singaporean college students. Worry and rumination were highly correlated, but they retained distinct components that predicted anxious and depressive symptoms differentially within and across time. Specifically, worry was uniquely associated with anxious and depressive symptoms whereas rumination was uniquely related to depression. In comparison to rumination, worry emerged as the dominant cognitive vulnerability factor that predicted increments in symptoms over time. With regards to coping behavior, low perceived coping effectiveness partially mediated the relation between worry and increases in anxiety and depression. Conversely, rumination uniquely predicted higher disengagement from problems, which resulted in further exacerbation of depressive mood. These results demonstrated not only the distinct features of worry and rumination on coping behavior, but also the different coping pathways by which they differentially impact on subsequent symptoms.     

Correlates of Depressive and Anxiety Symptoms Among the Caregivers of Leukemic Children

This study aims to reveal correlates of depressive and anxiety symptoms among the Turkish caregivers of leukemic children (n?=?100). The effects of demographic variables, satisfaction of the basic needs, performance on daily activities, and coping strategies on outcome variables were investigated by hierarchical regression. Accordingly, older age, lower reported income, higher number of other children to be looked after, lower levels of satisfaction of basic needs, and more use of emotion focused coping were associated with higher levels of both depressive and anxiety symptoms. Moreover, caregivers with lower education reported more depressive symptoms, and higher performance on daily activities predicted more anxiety symptoms.     

Social anxiety and positive emotions: a prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable

The purpose of the present study was to examine social anxiety as a predictor of positive emotions using a short-term prospective design. We examined whether the effects of social anxiety on positive emotions are moderated by tendencies to openly express or supress emotions. Over the course of a 3-month interval, people with excessive social anxiety endorsed stable, low levels of positive emotions. In addition, people with low social anxiety who frequently display their emotions openly, whether negative or positive, reported the greatest increases in positive emotions. Similar results were found when using a measure of emotion suppression (low social anxiety and less tendency to rely on these types of regulatory acts led to the greatest positive emotions). These social anxiety main and interactive effects could not be attributed to depressive symptoms. Our findings suggest that relations between social anxiety and positive emotional experiences over time are best understood in the context of meaningful individual differences such as affect regulatory strategies.     

Spanish version of Super Skills for Life: short- and long-term impact of a transdiagnostic prevention protocol targeting childhood anxiety and depression

ABSTRACT

Background and Objectives: Super Skills for Life (SSL) is a transdiagnostic protocol based on cognitive–behavioral therapy designed for children with internalizing problems. The present study examined for the first time the impact of the Spanish-adapted version of SSL in reducing anxiety and depressive symptoms in Spanish-speaking children.

Design: A quasi-experimental design with one group, pre- and posttest, and 1-year follow-up was conducted. Analyses were performed on an intent-to-treat basis.

Methods: Participants were 119 children (42.9% female; 8–12 years) recruited from nine schools. Children completed assessments of anxiety, depression, emotional and behavioral difficulties, and the extent to which anxiety interfered with life before and after receiving the 8-session SSL, and 12-months post-intervention.

Results: Anxiety and depressive symptoms were significantly reduced at post-test and 12-month follow-up assessments. SSL also had positive impact on other symptoms assessed (e.g., interference of anxiety with children’s life, peer problems, conduct problems). Overall, the long-term benefits of SSL appeared to be greater than the short-term benefits.

Conclusions: The results of this study suggest that SSL may be useful in reducing symptoms of anxiety and depression, and a broad range of other issues, in Spanish children.     

Internalizing behavior problems and scholastic achievement in children: cognitive and behavioral pathways as mediators of outcome.

Examined a conceptual model in which dual developmental pathways (behavioral and cognitive) are hypothesized to account for the relation among internalizing behavior problems, intelligence, and later scholastic achievement using a cross-sectional sample of 325 children. Classroom behavior and select aspects of cognitive functioning (vigilance, short-term memory) were hypothesized to mediate the relations among internalizing problems, IQ, and long-term scholastic achievement. Hierarchical tests applied to a nested series of models demonstrated that (a) individual differences in measured intelligence among children are associated with variations in classroom performance and cognitive functioning, (b) classroom performance and cognitive functioning make unique contributions to prediction of later achievement over and above the influence of intelligence, (c) anxious/depressive features are correlated but separable constructs, and (d) anxiety/depression and withdrawal contribute to prediction of classroom performance and cognitive functioning over and above the effects of intelligence. Classroom performance and cognitive functioning thus appear to mediate the effects of internalizing behaviors as well as intelligence. Particular attention to the presence and potential impact of social withdrawal on children's functioning, both alone and concomitant with anxiety/depression, appears warranted during the course of clinical evaluations owing to the strong continuity among these variables.