Experiential Avoidance and Anxiety Sensitivity: Independent and Specific Associations with Children’s Depression,Anxiety, and Social Anxiety Symptoms

Experiential avoidance (EA) is a key component in acceptance and commitment therapy (ACT) theory and research. EA is associated with a wide range of psychopathology in adults including anxiety, in particular social anxiety, and depression, yet little research exists on EA in youth. Anxiety sensitivity (AS), like EA, has been viewed as a form of distress tolerance or emotion regulation. In a sample of 124 children (age 10 to 12), this study examined the independent and specific relations of EA and AS to children’s depression, anxiety, and social anxiety symptoms, both before and after controlling for comorbid symptoms. EA and AS had independent associations with each of children’s depression, anxiety, and social anxiety; and EA had significantly stronger relations than AS with each of children’s social anxiety and anxiety. After controlling for depression, only EA (and not AS) was uniquely related to both children’s anxiety and social anxiety. After controlling for anxiety and social anxiety, only AS (and not EA) was uniquely related to depression. After controlling for depression and social anxiety, neither EA nor AS was significantly related to anxiety. In contrast, after controlling for depression and anxiety, EA (and not AS) showed a significant and unique relation to children’s social anxiety. These findings indicate: 1) there are distinctions between EA and AS; 2) EA and AS are overlapping yet independent correlates for each of depression, anxiety and social and anxiety; and 3) EA and AS show some differential relations with children’s depression, anxiety, and social anxiety when comorbid symptoms are considered. Theoretical and treatment implications are highlighted.     

Children’s Responses to Hypothetical Provocation by Peers: Coordination of Assertive and Aggressive Strategies

Children often respond to aggression by peers with assertive bids or aggressive retaliation. Little is known, however, about whether and how children coordinate these strategies across different types of provocation. The present study examined endorsement of aggressive and assertive responses to hypothetical physical, relational, and verbal provocation in a sample of lower-income children (N?=?402, M age?=?10.21, SD?=?1.46). Latent-profile analysis revealed 3-class models for both aggression and assertion, each reflecting low, moderate, and high levels of endorsement. There was no association between children’s reported use of aggression and assertion. For example, children who endorsed high levels of aggression were equally likely to be classified as low, moderate, or high on assertive responding. For both assertion and aggression, parental ratings of children’s externalizing behavior and social skills differed across the low and high groups. No such differences were found between the low and moderate groups, despite the latter groups endorsing markedly higher levels of assertive and aggressive responses. This pattern of findings may be due, in part, to the situation specificity of children’s responding. Our findings hint at the complexity of children’s behavioral repertoires and contribute to a growing literature that suggests the need for intervention models that consider both social skills and social situations.     

Transactional Associations Between Youths’ Responses to Peer Stress and Depression: The Moderating Roles of Sex and Stress Exposure

This study examined transactional associations between responses to peer stress and depression in youth. Specifically, it tested the hypotheses that (a) depression would predict fewer effortful responses and more involuntary, dysregulated responses to peer stress over time; and (b) fewer adaptive and more maladaptive responses would predict subsequent depression. Youth (M age = 12.41; SD = 1.19; 86 girls, 81 boys) and their maternal caregivers completed semi-structured interviews and questionnaires at three annual waves. Multi-group comparison path analyses were conducted to examine sex and stress-level differences in the proposed reciprocal-influence model. In girls and in youth exposed to high levels of peer stress, maladaptive stress responses predicted more depressive symptoms and adaptive stress responses predicted fewer depressive symptoms at each wave. These findings suggest the utility of preventive interventions for depression designed to enhance the quality of girls’ stress responses. In boys, depression predicted less adaptive and more maladaptive stress responses, but only at the second wave. These findings suggest that interventions designed to reduce boys’ depressive symptoms may help them develop more adaptive stress responses.     

Psychologists’ Evaluation of Bariatric Surgery Candidates Influenced by Patients’ Attachment Representations and Symptoms of Depression and Anxiety

This study examines whether patients self-reported attachment representations and levels of depression and anxiety influenced psychologists’ evaluations of morbidly obese patients applying for bariatric surgery. A sample of 250 patients (mean age 44, 84 % female) who were referred for bariatric surgery completed questionnaires to measure adult attachment and levels of depression and anxiety. Psychologists rated patients’ suitability for bariatric surgery using the Cleveland Clinic Behavioural Rating System (CCBRS), unaware of the results of the completed questionnaires. Attachment anxiety (OR = 2.50, p = .01) and attachment avoidance (OR = 3.13, p = .001) were found to be associated with less positive evaluations on the CCBRS by the psychologists, and symptoms of depression and anxiety mediated this association. This study strongly supports the notion that patients’ attachment representations influence a psychologist’s evaluation in an indirect way by influencing the symptoms of depression and anxiety patients report during an assessment interview. The clinical implications of these findings are discussed.     

Children’s Attitudes toward Aggression: Associations with Depression,Aggression, and Perceived Maternal/Peer Responses to Anger

Little is known about factors that influence children’s attitudes toward aggression, despite evidence that these attitudes are influential in promoting violent behaviors. The purpose of the present research was to examine the relation of self, peer, and parent social factors to school-age children’s maladaptive attitudes toward aggression. Specifically, symptoms of depression, peer overt aggression behaviors, and perceptions of maternal and peer responses to anger were evaluated as important factors associated with the use of aggression. These factors were examined separately for boys and girls, as research has consistently documented gender differences in the form and use of aggression. Hierarchical regression models were computed separately for boys and girls in grades three through five (N?=?167), with child-reported depression, peer-nominated overt aggression, and child-reported maternal and best friend responses to anger examined as predictors of maladaptive attitudes toward aggression. For girls, depressive symptoms positively predicted maladaptive attitudes toward aggression. For boys, the extent of peer-reported overt aggression (positively) and child-reported supportive maternal responses to the child’s anger (negatively) predicted maladaptive attitudes toward aggression. The value of examining social factors that relate to attitudes toward aggression is discussed as well as consideration of gender differences in these relations. In addition, discussion includes how these results highlight important targets for interventions that may be especially relevant for school-age girls and boys.     

Peer Victimization in Youth with Tourette’s Syndrome and Chronic Tic Disorder: Relations with Tic Severity and Internalizing Symptoms

The present study analyzed rates of peer victimization in children with a chronic tic disorder as compared to children with type 1 diabetes and healthy controls. The associations among peer victimization, tic symptom severity, and psychological symptoms, as well as the potential mediating relationship between peer victimization, tic severity, and child internalizing symptoms, were also explored. Children with tics displayed higher rates of peer victimization than control groups, and peer victimization in children with tics was positively correlated with tic symptom severity, loneliness, anxiety symptoms, and parent report of child internalizing symptoms. Results also supported the hypothesis that peer victimization mediates the relationship between tic symptom severity and loneliness. Findings highlight the importance of the assessment and treatment of psychosocial variables in children with chronic tic disorders, including social functioning and peer relationships.     

Children’s Depressive Symptoms in Relation to EEG Frontal Asymmetry and Maternal Depression

This study examined the relations of school-age children’s depressive symptoms, frontal EEG asymmetry, and maternal history of childhood-onset depression (COD). Participants were 73 children, 43 of whom had mothers with COD. Children’s EEG was recorded at baseline and while watching happy and sad film clips. Depressive symptoms were measured using parent-report of Children’s Depression Inventory. The key findings are the interaction effects between baseline and film frontal EEG asymmetry on child depressive symptoms. Specifically, relative right frontal EEG asymmetry while watching happy or sad film clip was associated with elevated depressive symptoms for children who also exhibited right frontal EEG asymmetry at baseline. Results suggest that right frontal EEG asymmetry that is consistent across situations may be an marker of depression-prone children.     

Person-Centered Maternal Emotion Socialization and Child Temperament: Relations to Children’s Emotion Regulation and Anxiety and Depressive Symptoms

Journal of Child and Family Studies - Maternal emotion socialization and children’s temperament are two foundations of children’s emotional development. Yet, emotion socialization and...     

The Role of Religious Orientations in Youth’s Posttraumatic Symptoms After Exposure to Terror

This study examined the effect of religiosity on youth’s posttraumatic symptoms resulting from exposure to terror. Participants consisted of 1,973 Israeli high school students. Objective and subjective exposure (fear) to terror were positively associated with posttraumatic symptoms. Intrinsic religiosity was negatively associated with posttraumatic symptoms and found to decrease the effects of objective exposure. Personal extrinsic orientation and social extrinsic orientation were positively associated with posttraumatic symptoms, having no mediating effect. Theoretical implications regarding religiosity as a coping mechanism in light of exposure to terror are discussed.     

Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

The Relation Between Early Adolescents’ Trust Beliefs in Peers and Reactions to Peer Provocation: Attributions of Intention and Retaliation

The authors examined the relation between early adolescents’ trust beliefs in peers and both their attributions for, and retaliatory aggression to, peer provocation. One hundred and eight-five early adolescents (102 male) from the United Kingdom (M age = 12 years, 2 months, SD = 3 months) completed the Children's Generalized Trust Beliefs in peer subscale (K. J. Rotenberg, C. Fox, et al., 2005) and reported the intentions of, and their retaliatory aggression to, hypothetical peer provocation. A curvilinear relation was found between trust beliefs in peers and retaliatory aggression but not for attributions of intention. Early adolescents with low and those with very high trust beliefs in peers reported greater retaliatory aggression than did early adolescents with the middle range of trust beliefs. The findings supported the conclusion that early adolescents who are high trusting, as well as those are very low trusting, are at risk for psychosocial maladjustment. Support was not obtained for a hostility attribution bias interpretation of those patterns.     

Youth’s Help-Seeking Intentions for ADHD and Depression: Findings from a National Survey

This study investigates the role that youth-level factors play in predicting help-seeking intentions in a nationally representative sample. Eleven help-seeking intentions were examined separately by target conditions (ADHD and depression), gender, race/ethnicity, and self-reported diagnosed/non-diagnosed in respect to the target conditions, and interaction effects were tested. Using factor analysis, a traditional help-seeking scale was created, which captured four help-seeking items, and predictive power of youth-level factors in accounting for traditional help-seeking was tested. Study findings provide practitioners and researchers with fresh evidence on what youth-level factors are associated with which help-seeking intentions, and illustrate the challenges involved in better understanding the complexity of the help-seeking process among youth in the context of ADHD/Depression. With increased understanding of youth’s perceptions and the complexity of their help-seeking behavior, community-based efforts to develop effective strategies that support active help-seeking behavior and eliminate barriers to appropriate care can have a greater likelihood of success.     

Men’s Likely Responses to Clinical Depression: What Are They and Do Masculinity Norms Predict Them?

This study was designed to investigate (1) men’s most likely and least likely actions in response to a vignette describing an episode of depression, (2) whether conformity to masculine norms related to the likelihood of men’s responses, and (3) which masculinity norms were associated with men’s responses. One hundred fifty-three mostly White and heterosexual undergraduate men were asked to read a vignette describing an episode of major depression, reported the likelihood of taking 20 separate actions in response to those symptoms, and completed the Conformity to Masculine Norms Inventory (Mahalik et al., Psychology of Men and Masculinity, 4: 3–25, 2003b). Results identified the most likely and least likely responses to depression, indicated that global masculinity significantly related to four of the responses, and found three orthogonally distinct sets of relationships between specific masculinity norms and those four responses to symptoms of depression.     

Parental Depression and Child Externalizing and Internalizing Symptoms: Unique Effects of Fathers’ Symptoms and Perceived Conflict as a Mediator

Although a developing body of literature suggests that depressive symptoms in fathers are related to child psychopathology, little evidence suggests that paternal depression plays a unique role in children’s symptoms. We used a high-risk design involving children of mothers with and without histories of depression to test the unique mediating role of father–child conflict in the relations between fathers’ depressive symptoms and child externalizing and internalizing symptoms. In all regression analyses, mothers’ history of depression and current depressive symptoms were controlled. Depressive symptoms in fathers were associated with child externalizing and internalizing symptoms, and father–child conflict. Father–child conflict mediated relations between fathers’ depressive symptoms and child externalizing symptoms above and beyond the effects of maternal depression history and depressive symptoms. The results suggest that negative interpersonal consequences of parental depression on child psychopathology may not be limited to mothers.     

Caregiving for Patients in Vegetative and Minimally Conscious States: Perceived Burden as a Mediator in Caregivers’ Expression of Needs and Symptoms of Depression and Anxiety

Involvement of family members is crucial to provide daily informal caring to patients in vegetative state and minimally conscious state. Previous studies showed that perceived burden is a risk factor for informal caregivers as it increases psychophysical distress. This research further investigated the relationship between these factors and aimed at providing a model that thoroughly describes this mechanism of functioning. In the frame of a national survey on people with disorders of consciousness, 487 informal caregivers of children and adult patients in vegetative and minimally conscious state were administered measures of depression, anxiety, caregiver needs, and family strain. Regression models proposed by Baron and Kenny and the Sobel test were adopted to investigate the relationship between depressive and anxiety symptoms, perceived burden and needs expressed. Our study shows that the relation between those symptoms and needs is mediated by burden, where higher burden accentuates and lower burden mitigates the needs expressed by caregivers. Our findings demonstrate that psychosocial components of the burden perceived by caregivers of patients with disorders of consciousness play a key role in shaping those caregivers’ needs, especially their needs for information and communication. We recommend implementation of comprehensive steps to meet the needs of these caregivers, steps that incorporate improved economic and public health programs, social support, and use of psychological interventions to ameliorate caregivers’ psychological distress and decrease their burden.     

Children’s Feedback Preferences in Response to an Experimentally Manipulated Peer Evaluation Outcome: The Role of Depressive Symptoms

The present study examined the linkage between pre-adolescent children's depressive symptoms and their preferences for receiving positive vs. negative feedback subsequent to being faced with an experimentally manipulated peer evaluation outcome in real time. Participants (n = 142) ages 10 to 13, played a computer contest based on the television show Survivor and were randomized to either a peer rejection (i.e., receiving the lowest total 'likeability' score from a group of peer-judges), a peer success (i.e., receiving the highest score), or a control peer evaluation condition. Children's self-reported feedback preferences were then assessed. Results revealed that participants assigned to the negative evaluation outcome, relative to either the success or the control outcome, showed a significantly higher subsequent preference for negatively tuned feedback. Contrary to previous work and predictions derived from self-verification theory, children higher in depressive symptoms were only more likely to prefer negative feedback in response to the negative peer evaluation outcome. These effects for depression were not accounted for by either state mood at baseline or mood change in response to the feedback manipulation.