Sixteen-Session Group Treatment for Children and Adolescents With Parental Alienation and Their Parents

This study reports the findings of a 16-session parallel group therapy program for 22 children with parental alienation and their parents. The children's level of anxiety and depression decreased significantly following the therapeutic intervention. Families who had participated in the treatment protocol were found to have improved practical parameters of parental collaboration 12 months following the completion of treatment than a control group of families with parental alienation treated with standard community treatment. Parental object relation scores were negatively correlated with children's level of anxiety and depression at pretreatment and with the decrease in anxiety and depression level along the treatment.     

A randomised wait list-controlled pre–post–follow-up trial of a gratitude diary with a distressed sample

In a randomised wait list-controlled trial with repeated measures pre-, post- and follow-up design, participants (N = 109) with a current self-reported diagnosis of an anxiety disorder and/or depression, took part in an internet-based study. After completing a three-week gratitude diary returning participants had lower scores on measures of depression, anxiety, stress and perceived sleep difficulties and higher scores on a measure of subjective well-being than immediately pre-intervention. At three-week follow-up depression and sleep scores for returning participants were no longer significantly different from pre-intervention, however, improvements for subjective well-being and stress at post-intervention were maintained. At follow-up anxiety scores had not only been maintained but had improved significantly beyond post-intervention results. Intention to treat analyses were conducted and provided support for most completer results. Differences between the two sets of analyses are discussed below. This trial provides support for the use of gratitude diaries as an intervention with distressed populations.     

Anxiety and depression as correlates of self-reported behavioural inhibition in normal adolescents

In a previous study, Muris, Merckelbach, Wessel, and Van de Ven [Psychopathological correlates of self-reported behavioural inhibition in normal children. Behav. Res. Ther. 37 (1999) 575-584] found that children who defined themselves as high on behavioural inhibition displayed elevated levels of psychopathological symptoms compared to children who defined themselves as low or middle on behavioural inhibition. The present study further examined the relationship between self-reported behavioural inhibition and anxiety disorders and depression symptoms in a large sample of adolescents aged 12-18 years (N=968). Adolescents completed a measure of behavioural inhibition and questionnaires of anxiety and depression. Results indicated that adolescents who classified themselves as high on behavioural inhibition had higher scores of anxiety and depression than adolescents who classified themselves as low or middle on behavioural inhibition. Structural equations modelling was employed to test hypothetical models on the role of behavioural inhibition in childhood anxiety and depression. It was found that a pathway in which behavioural inhibition results in anxiety, which in turn leads to depression, provided the best fit for the data.     

National Trends in Prayer Use as a Coping Mechanism for Depression: Changes from 2002 to 2007

To analyze national trends in the use of prayer among individuals with depression, we adopted a cross-sectional design with data from the adult Alternative Medicine supplement of the National Health Interview Survey 2002 and 2007. Prayer use and depression were combined into 4 categories: (a) prayed in the past 12 months and depressed; (b) prayed in the past 12 months and not depressed; (c) never prayed but depressed; and (d) never prayed and not depressed. Chi-square tests and multinomial logistic regressions were performed to analyze group differences. All analyses were adjusted for the complex sample design and conducted in SAS-callable SUDAAN. Use of prayer for depression was steady at 6.9 % across time; however, general prayer increased significantly between 2002 and 2007 (40.2 vs. 45.7). Women, aged 50–64, unmarried, with high school education were more likely to use prayer while depressed compared to those who were neither depressed nor prayed. Lifestyle behaviors (e.g. alcohol, smoking, exercise) were also associated with prayer use and depression. Prayer use for depression remained steady with unique relationships occurring among those who smoke, use alcohol, and have irregular exercise. Individuals’ use of prayer as a potential complementary treatment for depression suggests that it is critical for mental and physical health treatment providers to be aware of the use of prayer as a coping resource.     

Emotional Reactions and Attitudes Prior to In Vitro Fertilization: An Inter-Spouse Study

In this study, spouse's emotional responses and attitudes to in vitro fertilization (IVF) treatment were examined. The participants were 113 childless couples who suffered from infertility of unknown or mechanical (women) cause. Both partners were evaluated prior to IVF treatment. Incompatible emotional responses and attitudes to the treatment between the partners usually reflected the men reporting less distress and worries than women. Women had significantly higher state and trait anxiety and depression scores than normative levels, irrespective of whether they were successful in conceiving. Husbands of conceiving women scored higher on depression than husbands of nonconceiving women. The nonconceiving husbands had depression and trait anxiety scores significantly lower than the normative level. In addition, high emotional responses to the treatment, especially in men, were positively associated with treatment success. Recommendations for family assessment and counseling are suggested on the basis of these results.     

Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls

Hoarding is a symptom of obsessive compulsive disorder (OCD), as well as a diagnostic criterion for obsessive compulsive personality disorder (OCPD). One recent study suggests that people who suffer from compulsive hoarding report more general psychopathology than people who do not [Frost, R.O., Krause, M.S., & Steketee, G. (1996). Hoarding and obsessive compulsive symptoms. Behavior Modification, 20, 116-132]. The present study addressed whether persons with OCD hoarding exhibit more depression, anxiety, OCD and personality disorders symptoms than community controls, OCD nonhoarders, or other anxiety disorder patients. Disability was also examined. Hoarding subjects were older than the other three groups, but age did not account for any of the differences observed among the groups. Compared to controls, OCD hoarding, nonhoarding OCD and anxiety disorder patients showed elevated YBOCS scores, as well as higher scores on depression, anxiety, family and social disability. Compared to nonhoarding OCD and anxiety disorder patients, OCD hoarding patients scored higher on anxiety, depression, family and social disability. Hoarding subjects had greater personality disorder symptoms than controls. However, OCD hoarding subjects differed from OCD nonhoarding and anxiety disorder subjects only on dependent and schizotypal personality disorder symptoms. The findings suggest that hoarding is associated with significant comorbidity and impairment compared to nonhoarding OCD and other anxiety disorders.     

The Role of Coping Styles and Self-efficacy in the Development of Dysphoric Mood Among Nursing Students

Coping styles and self-efficacy have been recognized as important determinants of dysphoric mood. The objectives of this study were to determine the influence of these two factors on depression and anxiety in Japanese students. A set of questionnaires, including the Hospital Anxiety and Depression (HAD) Scale, the Coping Inventory for Stressful Situations (CISS), and the Self-efficacy Scale (SES) was distributed to 146 nursing students. Structural equation modelling was conducted to specify the relationships between measured variables. The HAD depression and anxiety scores were predicted by emotion-oriented coping. The HAD depression alone was predicted by avoidance-oriented coping. Self-efficacy scores predicted the emotion-oriented coping and HAD depression scores. Students’ dysphoric moods were influenced by emotional-oriented coping that mediated the effects of low self-efficacy, and self-efficacy also had a direct effect on depression.     

Emotional health predictors of substance use initiation during middle school

This study aimed to evaluate whether emotional health factors, including anxiety and depression, stress, and social support, are associated with earlier youth initiation of alcohol and illicit substances during middle school (from the sixth to the eighth grade). Data for this study were from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Discrete time survival analyses were used to assess the effects of depression, anxiety, stress, and support on initiation of substance use, measured every 6 months at five time points between sixth and eighth grade. Youth who had initiated prior to sixth grade had significantly higher levels of depressive symptoms. In multivariate survival analyses controlling for child race/ethnicity, gender, and socioeconomic status, and accounting for conduct problems, youth who reported higher levels of separation anxiety/panic symptoms were at decreased risk for early alcohol initiation. Children with higher levels of perceived teacher support had a significantly lower risk of alcohol initiation during early follow-up periods. Recent stressful life events in Grade 6 were associated with significantly greater risk of initiating an illicit substance by Grade 8. The current findings highlight the role of stress in the initiation of illicit substance use and suggest that teacher support is associated with lower risk for very early alcohol use. Future research examining anxiety as a predictor of substance use should distinguish between subtypes of anxiety.     

Does binge eating play a role in the self-regulation of moods?

Self-reported emotional experiences and eating behaviors were studied in college students in an attempt to determine what types of emotional experiences precede and follow binge eating and how specific types of compensatory behaviors modify these experiences. First-year male and female students (N=390) were surveyed for depression, anxiety, health status, life satisfaction, and eating attitudes (EAT-26). Those reporting recurrent binge eating episodes were asked to describe their emotional feelings before and after bingeing and before and after compensatory activities. EAT-26 scores corresponding to scores previously reported for eating disordered patients were found in 9.7% of students. Binge eating was nearly twice as frequent among females (16.4%) as males (8.6%). Among females, positive relationships were found between specific EAT-26 factors scores and both anxiety and depression scores. The emotional antecedents and consequences of binge eating and of compensatory activities were compared in three sub-groups of individuals who reported recurrent bingeing with loss of self-control during binges. The three sub-groups consisted of individuals who reported, 1) bingeing without engaging in compensatory activities, 2) bingeing and compensating by means other than vomiting (fasting, exercising, or use of laxatives or diuretics), and 3) bingeing and compensating by vomiting. Regardless of the type of activity, those individuals who engaged in compensatory activities reported greater negative affect preceding binge episodes than those who did not compensate. In addition, contrary to expectations, negative affect did not decrease, but instead increased significantly, following binge episodes and decreased immediately before and after compensatory activities.     

Does binge eating play a role in the self-regulation of moods?

Self-reported emotional experiences and eating behaviors were studied in college students in an attempt to determine what types of emotional experiences precede and follow binge eating and how specific types of compensatory behaviors modify these experiences. First-year male and female students (N=390) were surveyed for depression, anxiety, health status, life satisfaction, and eating attitudes (EAT-26). Those reporting recurrent binge eating episodes were asked to describe their emotional feelings before and after bingeing and before and after compensatory activities. EAT-26 scores corresponding to scores previously reported for eating disordered patients were found in 9.7% of students. Binge eating was nearly twice as frequent among females (16.4%) as males (8.6%) Among females, positive relationships were found between specific EAT-26 factors scores and both anxiety and depression scores. The emotional antecedents and consequences of binge eating and of compensatory activities were compared in three sub-groups of individuals who reported recurrent bingeing with loss of self-control during binges. The three sub-groups consisted of individuals who reported, 1) bingeing without engaging in compensatory activities, 2) bingeing and compensating by means other than vomiting (fasting, exercising, or use of laxatives or diuretics), and 3) bingeing and compensating by vomiting. Regardless of the type of activity, those individuals who engaged in compensatory activities reported greater negative affect preceding binge episodes than those who did not compensate. In addition, contrary to expectations, negative affect did not decrease, but instead increased significantly, following binge episodes and decreased immediately before and after compensatory activities.     

Suicidal Ideation in Elderly Bereaved: The Role of Complicated Grief

This study examined whether symptoms of complicated grief at baseline predicted suicidal ideation during a depressive episode in elderly bereaved individuals. Over a 17-month period, serial ratings of suicidal ideation, hopelessness, and symptoms of depression, anxiety, and complicated grief were obtained from 130 elderly participants who had lost their spouses within the past 2 years. Groups of active and passive suicidal ideators, as well as nonideator controls, were compared via analysis of variance (ANOVA) with respect to levels of complicated grief, depression, and anxiety. Elderly bereaved with both active and passive suicidal ideation were found to have higher symptomatic levels of depression, hopelessness, complicated grief, and anxiety, as well as lower levels of perceived social support, than nonideators at study entry. Fifty-seven percent of the patients with high complicated grief scores were found to be ideators during the follow-up versus 24% of the patients with low complicated grief scores. Patients with any suicidal ideation had higher symptom levels of depression, anxiety, and complicated grief when they were ideators as compared with periods when they denied ideation. Fifteen out of the 39 ideators had recurrent depressive episodes versus 5 of the 91 nonideators. Patients with a history of suicide attempts were more likely to be ideators after loss than other bereaved. Thus, the condition of having high levels of complicated grief symptoms and depressive symptoms appears to make bereaved individuals vulnerable to suicidal ideation. Detection of high levels of complicated grief could help clinicians identify patients who may be at heightened risk for suicide.     

Does the neighborhood context alter the link between youth's after-school time activities and developmental outcomes? A multilevel analysis

This article examines links between different measures of after-school time activity participation (5 specific activities and breadth) on youth's developmental outcomes (anxiety/depression, delinquency, and substance use) over 6 years and whether these links are moderated by neighborhood-level variables. The sample (N=1,315) of 9- and 12-year-old youth was drawn from the Project on Human Development in Chicago Neighborhoods (PHDCN), a multilevel, longitudinal study of youth from 80 Chicago neighborhoods. Findings revealed that different types of activities and patterns of participation over time were associated with outcomes for youth and that, to some extent, these outcomes varied with neighborhood characteristics. In brief, sports participation was associated with fewer anxious/depressed symptoms, higher average delinquency scores, and increased substance use-both average scores and growth over time. Participation in the arts and student government were negatively associated with average substance use and attenuated increases in usage over time. Participation in community-based clubs was positively associated with youth's anxiety/depression in violent neighborhoods only, whereas church groups were protective against substance use in nonviolent neighborhoods. The direction of the influence of breadth of participation was nonlinear for delinquency such that delinquency scores were highest among youth who engaged in an average number of activities.     

Migranten in sozial schwachen Stadtteilen von Berlin

Background

The aim of the present study was to compare psychological distress and substance use between migrant and non-migrant populations in a socially deprived area of Berlin.

Methods

A population-based random sample stratified for age (18?C57?years) and gender (50% female) was retrieved from the registration office. A total of 143 persons were included in the study. The participation rate was 48.5% when contact was established. Psychological distress was assessed using the General Health Questionnaire (GHQ-28) with its four subscales, somatic symptoms, anxiety/insomnia, social dysfunction and severe depression. Substance use was quantified using the Alcohol Use Identification Disorder Test (AUDIT) and the Fagerstr?m Test for Nicotine Dependence (FTND).

Results

Of the study population 51.3% were first or second generation migrants and lived more often in single households. Migrants had lower educational levels and lower employment rates. The mean scores of migrants and non-migrants did not differ on any of the subscales somatic symptoms, anxiety/depression, social dysfunction or severe depression of the GHQ-28. Non-migrants showed significantly higher risks regarding alcohol use.

Discussion

The present study did not reveal any differences regarding symptom profiles in the spectrum of anxiety and depression between non-migrants and migrants who lived in a socially deprived area. Migrants may compensate higher social risk profiles with lower risks regarding alcohol use. Larger samples have to inform on possible differences regarding smoking and other substances.     

Responsiveness of measures of attentional bias to clinical change in social phobia

This study examined responsiveness of the dot probe measure of attentional bias to standard cognitive-behaviour group therapy (CBGT) for social phobia. People who met criteria for social phobia were randomly allocated to either an immediate treatment condition or a waiting list control (WLC). All participants completed self-report measures of social anxiety, depression, and anxiety sensitivity, a verbal dot probe and a facial dot-probe task before and after eight weeks of standard CBGT was undertaken by the treatment group. On the first measurement occasion the two groups had similar scores on all measures. On the second measurement occasion the self-report scores for the CBGT group were lower than those of the WLC group. Performance on the dot-probe tasks for the CBGT group had also changed. The treatment group appeared to direct their attention away from social threat words and threatening faces after CBGT.     

Efficacy of brief guided self-help cognitive behavioral treatment for perfectionism in reducing perinatal depression and anxiety: a randomized controlled trial

Perfectionism has been proposed as a transdiagnostic process that maintains depression and anxiety through shared cognitive and behavioral processes. The purpose of this study was to investigate the efficacy of a brief, guided cognitive behavioral treatment (CBT) for perfectionism delivered via a self-help booklet in reducing perfectionism and symptoms of depression and anxiety during the antenatal period. Pregnant women in their third trimester were randomly allocated to self-help (n = 30) or waitlist control (n = 30). There were significant reductions in perfectionism and symptoms for participants who received CBT for perfectionism from pre- to post-treatment, which were maintained at 3-month follow-up, while the waitlist control group demonstrated no significant changes. Path analysis demonstrated a significant indirect effect of treatment condition on post-treatment depression and anxiety scores via perfectionism, controlling for pre-treatment scores, suggesting changes in perfectionism were associated with decreases in symptoms. The findings suggest that it would be useful for future research with larger samples to further investigate the efficacy of CBT for perfectionism for perinatal depression and anxiety.     

Norms and screening utility of the Dutch version of the Children's Depression Inventory in clinical and nonclinical youths

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals.     

Preliminary results of a pilot program on depression in patients with congestive heart failure

While the sample size is too small to warrant conclusions, these preliminary results suggest that assessment of depression would be worthwhile for patients diagnosed with congestive heart failure. 32 out of 54 patients with congestive heart failure scored positive for depression. When psychiatric treatment was given, there was a decrease in depressive symptoms for four of the six patients at the 6-mo, retest. A decrease in depressive symptoms was found for two of the six untreated patients, and the remaining four patients had worse scores on the Zung Depression Inventory. Primary care physicians, who typically meet with such patients regularly, are encouraged to screen for depression, as their clinical assessments in this study were associated with scores on the Zung Depression Inventory. These observations support a full scale investigation with a much larger sample size and a requisite medical cost comparison.     

Plasticity in attention: implications for stress response in children

Attention bias has been suggested as an etiological and maintaining factor in anxiety. However, empirical evidence establishing this causal association is scarce and has been provided only in adults. In this preliminary study, we tested whether an induction of attentional bias can cause changes in vulnerability to stress in children reporting normal anxiety levels. Twenty-six 7-12 year-old children were randomly assigned to two groups. One group was exposed to a training condition designed to induce an attentional bias away from threat. The other group was exposed to a training condition designed to induce an attentional bias toward threat. Children who were trained to attend to threat developed attentional vigilance to threat-related information. The training procedure was ineffective with children who were trained to avoid threat, and their attention remained unbiased. Children from both training groups reported elevated depression scores following stress-induction. However, only the children who were trained to attend to threat subsequently reported elevations in anxiety. The findings suggest that biased attentional responses to threat, among children, can exert a specific influence on the tendency to experience anxiety in the face of stress.     

Prenatal paternal depression

Prenatal depressive symptoms, anxiety, anger and daily hassles were investigated in 156 depressed and non-depressed pregnant women and their depressed and non-depressed partners (fathers-to-be). Depressed versus non-depressed fathers had higher depression, anxiety and daily hassles scores. Although the pregnant women in general had lower anxiety, anger and daily hassles scores than the men, the scores on the measures for depressed fathers and depressed mothers did not differ. Paternal depression appeared to have less effect than maternal depression on their partners’ scores. However, the similarity between the scores of depressed mothers and depressed fathers highlights the importance of screening for depression in fathers-to-be as well as mothers-to-be during pregnancy.