Examining Youth Anxiety Symptoms and Suicidal Ideation in the Context of the Tripartite Model of Emotion

This study sought to clarify the relation of anxiety symptoms and suicidal ideation in children and adolescents by examining these variables in the context of depression and negative affect. As outlined in the tripartite model of anxiety and depression, negative affectivity is common to both emotional constructs; therefore negative affectivity may best explain the relation of each to suicidal ideation. Self report measures of generalized anxiety, depression, negative affectivity, and suicidal ideation were assessed in a primarily externalizing sample of children ages 7–18. Results suggested that the relation between anxiety and suicidal ideation was best accounted for by depression, not negative affectivity. Results also suggested that negative affectivity was associated with suicidal ideation but did not account for the relations among anxiety, depression, and suicidal ideation. Further, depression, negative affect, and anxiety all significantly contributed to the prediction of suicidal ideation scores (r ²  = .307, p < .01).     

Comorbidity of test anxiety and other anxiety disorders in children

Elementary school children with clinically significant test anxiety, as determined by self-report and a clinical interview, were assessed for the incidence of other fears and anxiety. The results indicated that test-anxious children reported more fears and general worries than their non-test-anxious peers. As expected, the test-anxious children experienced more negative cognitions and subjective distress when taking a test. Furthermore, the fear of negative evaluation was not limited to an actual test, since these children also reported identical symptoms when engaged in a second social-evaluative task. Finally, 60% of the testanxious sample met DSM-III criteria for an anxiety disorder. The results are discussed in terms of the relationship of text anxiety to more complex social-evaluative dysfunctions, more pervasive anxiety conditions, DSM-III anxiety disorders, and the utility of test anxiety as an indicator of the presence of these more pervasive anxiety states.This research is based on a dissertation conducted by the first author under the direction of the second author. Thanks are expressed to Stephen B. Manuck, Scott M. Monroe, Sharon Nelson-LeGall, and Saul Shiffman, who served as committee members. This study was supported in part by National Institute of Mental Health Grants No. 30915 and No. 16804, and a grant to the first author from the Sigma Xi Foundation.     

Mastery matters most: How mastery and positive relations link attachment avoidance and anxiety to negative emotions

Attachment avoidance and anxiety are associated with negative emotions. However, the mechanisms underlying these associations are not fully understood. We investigated environmental mastery and positive relations with others as two mechanisms behind the attachment–emotion link in a sample of 343 adults. As predicted, attachment avoidance and anxiety were related to greater fear, hostility, envy and depression through lower mastery. Contrary to our hypothesis, positive relations mediated only the attachment–depression link. In addition, by adopting a moderated mediation approach, we were able to show that mastery mattered most for individuals high on avoidance: The indirect effect of avoidance through lack of mastery on fear, hostility and depression (but not on envy) increased with higher avoidance scores. Contrary to our predictions, poor relationships did not matter more as sources of negative emotions as anxiety increased. These findings underscore that the emotional life of avoidantly attached individuals is especially jeopardised by poor mastery.     

Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.     

Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale

The practical significance of assessing disorders of emotion in children is well documented, yet few scales exist that possess conceptual if not empirical relevance to dimensions of DSM anxiety or depressive disorders. The current study evaluated an adaptation of a recently developed anxiety measure (Spence Children's Anxiety Scale; [Spence, S. H. (1997). Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology, 106, 280-297; Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545-566]), revised to correspond to dimensions of several DSM-IV anxiety disorders as well as major depression. This investigation involved initial evaluation of the factorial validity of the revised measure in a school sample of 1641 children and adolescents and reliability and validity in an independent sample of 246 children and adolescents. Results yielded an item set and factor definitions that demonstrated structure consistent with DSM-IV anxiety disorders and depression. The revised factor structure and definitions were further supported by the reliability and validity analyses. Some implications for assessment of childhood anxiety and depressive disorders are discussed.     

积极情绪对条件性恐惧泛化的抑制作用

恐惧的过度泛化是焦虑障碍的核心症状之一,表现为患者对与原危险刺激极不相似的安全刺激也产生恐惧反应。本研究采用经典条件恐惧范式,以US主观预期、回溯性恐惧评定、回溯性效价评定和皮电反应作为恐惧反应的指标,通过"最好自我"训练来诱发被试的积极情绪,考察了恐惧习得后的积极情绪对于恐惧泛化的影响。本研究发现,积极情绪能有效地抑制条件性恐惧的泛化,增强被试对安全信号的学习,并对消退后的恐惧重建现象起到预防作用。研究同时显示,恐惧泛化在主观评定指标和生理指标间出现了分离,这表明积极情绪对恐惧泛化的抑制作用是一个综合的过程,可能涉及到不同的作用机制。本研究结果提示可以通过诱发积极情绪,抑制条件性恐惧的泛化,对临床干预有一定的启发意义。     

Anxiety and Depression in Children: A Preliminary Examination of the Utility of the PANAS-C

Recent research has questioned the validity of identifying depression and anxiety as separate constructs in children. The current investigation examined the usefulness of the Positive and Negative Affect Schedule for Children (PANAS-C) in differentiating between anxiety and depression in children while also providing needed reliability and validity data on the PANAS-C. In addition, the relationship between positive and negative affect and coping was examined. Subjects included 110 third through fifth graders from a semirural public school setting. Children completed the PANAS-C, as well as self-report measures of depression, anxiety, and coping strategies. Moderate item–total correlations and high internal consistency indicated that the PANAS-C has good reliability. Validity results were mixed: a two-factor solution resembled previous studies, and negative affect was associated with avoidance coping strategies whereas positive affect was associated with approach coping strategies, as expected. However, correlations of positive and negative affect, anxiety, and depression scales suggest that positive and negative affectivity are negatively related in children as opposed to separate and independent constructs. Results of the present investigation question the validity of the use of the PANAS-C for differentiating anxiety and depression with this age group and lend support to the possibility that high overlap between anxiety and depression in this age group may be specific for childhood depression.     

On the hierarchical structure of mood and anxiety disorders: confirmatory evidence and elaboration of a model of temperament markers

The authors examined D. Watson's (2005) proposed reconceptualization of the diagnostic categories for mood and anxiety disorders for the Diagnostic and Statistical Manual of Mental Disorders--Fifth Edition (DSM-V) and tested an elaboration of the 2-factor (positive and negative activation) model of underlying temperament markers that incorporates A. Tellegen, D. Watson, & L. A. Clark's (1999a, 1999b) higher-order dimension of happiness-unhappiness (or demoralization; see A. Tellegen et al., 2003). In Study 1, 502 undergraduate students completed several symptom measures of mood and anxiety disorders and the Minnesota Multiphasic Personality Inventory-2 (J. N. Butcher et al., 2001). Using confirmatory factor analysis, the authors replicated Watson's distress and fear disorder model. Path analyses showed that demoralization was a primary marker of distress disorders, whereas dysfunctional negative emotions was a primary marker of fear disorders. Low positive emotions was a specific marker of depression and social phobia. This 3-factor path model was associated with better fit than was a 2-factor model excluding demoralization. In Study 2, the authors replicated the findings of Study 1 using data from an archival clinical sample of 636 Veterans Affairs hospital outpatients. The authors' findings provide evidence on the important role of demoralization in mood and anxiety disorders.     

Prevalence of anxiety and depression in Australian adolescents: comparisons with worldwide data

Data from two Australian studies were combined so that the prevalence of anxiety and depression in a large, normative sample of Australian adolescents could be investigated. The combined sample comprised 1,299 adolescents randomly selected from metropolitan and country schools in Melbourne, a large Australian city. The data were examined in order to ascertain the percentages of adolescents who scored above the clinical cut-off on two self-report instruments--the Revised Children's Manifest Anxiety Scale (C. R. Reynolds & B. O. Richmond, 1985) and the Reynolds Adolescent Depression Scale (W. M. Reynolds, 1986). The results of these analyses were then compared with previously reported prevalence rates from studies worldwide. This comparison revealed striking differences in the prevalence of anxiety and depression across different countries and cultures. Limitations attributable to different self-report measures and imposed-etic approaches are discussed. Issues pertaining to social and political climate are also raised.     

School absenteeism and mental health among sexual minority youth and heterosexual youth

Adolescent school absenteeism is associated with negative outcomes such as conduct disorders, substance abuse, and dropping out of school. Mental health factors, such as depression and anxiety, have been found to be associated with increased absenteeism from school. Sexual minority youth (youth who are attracted to the same sex or endorse a gay, lesbian, or bisexual identity) are a group at risk for increased absenteeism due to fear, avoidance, and higher rates of depression and anxiety than their heterosexual peers. The present study used longitudinal data to compare sexual minority youth and heterosexual youth on excused and unexcused absences from school and to evaluate differences in the relations between depression and anxiety symptoms and school absences among sexual minority youth and heterosexual youth. A total of 108 14- to 19-years-old adolescents (71% female and 26% sexual minority) completed self-report measures of excused and unexcused absences and depression and anxiety symptoms. Compared to heterosexual youth, sexual minority youth reported more excused and unexcused absences and more depression and anxiety symptoms. Sexual minority status significantly moderated the effects of depression and anxiety symptoms on unexcused absences such that depression and anxiety symptoms were stronger predictors of unexcused absences for sexual minority youth than for heterosexual youth. The results demonstrate that sexual minority status and mental health are important factors to consider when assessing school absenteeism and when developing interventions to prevent or reduce school absenteeism among adolescents.     

Measuring depression in children: a multimethod assessment investigation

The present investigation examined measures for the assessment of depressive symptomatology in children, as well as two related constructs (self-esteem and anxiety). The sample consisted of 166 elementary school children from grades 3 through 6. Two self-report depression measures, the Children's Depression Inventory (Kovacs, 1979) and the Child Depression Scale (Reynolds, in press), as well as anxiety and self-esteem scales, were completed by the children. Parents (mothers and fathers) evaluated their children on the depression and anxiety scales from the Personality Inventory for Children (Wirt, Lachar, Klinedinst, & Seat, 1977), and teachers provided global ratings of depression and academic performance. The results support the reliability and validity of both self-report children depression measures. Data obtained on the parent report measure do not recommend its use at this time for assessing depression in children, while results on teachers' global ratings of depression provide some evidence that teachers may be a good source of information regarding depression in children.The authors gratefully acknowledge the generous assistance provided by Al Holmquist, principal of Mazomanie Elementary School, and James Clark, principal of Oregon Elementary School, and their teachers. This research was funded in part by a Spencer Foundation Grant to the first author, through the School of Education, University of Wisconsin-Madison. The writing of this article was facilitated by a Wisconsin Alumni Research Foundation grant (135–1503) to the first author.     

The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders

The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a waitlist control/delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur.     

Prevalence of Anxiety and Depression in Australian Adolescents: Comparisons with Worldwide Data

Data from two Australian studies were combined so that the prevalence of anxiety and depression in a large, normative sample of Australian adolescents could be investigated. The combined sample comprised 1,299 adolescents randomly selected from metropolitan and country schools in Melbourne, a large Australian city. The data were examined in order to ascertain the percentages of adolescents who scored above the clinical cut-off on two self-report instruments-the Revised Children's Manifest Anxiety Scale (C. R. Reynolds & B. 0. Richmond, 1985) and the Reynolds Adolescent Depression Scale (W. M. Reynolds, 1986). The results of these analyses were then compared with previously reported prevalence rates from studies worldwide. This comparison revealed striking differences in the prevalence of anxiety and depression across different countries and cultures. Limitations attributable to different self-report measures and imposed-etic approaches are discussed. Issues pertaining to social and political climate are also raised.     

Maternal Depression and Adolescent Emotions: The Role of Family Functioning

Maternal depression may affect children through various mechanisms, including the stressful contexts of the children’s lives and maternal maladaptive affection, behaviors, and cognition, which affect the psychopathological development of children and contribute to disorders. The aims of the present study were to explore how family functioning mediates the relationship between maternal depression and the positive and negative emotions of adolescents. A total of 430 paired questionnaires were collected from junior high school students and their mothers. The mothers completed the Center for Epidemiologic Studies Depression Scale (CESD), and the adolescents completed the CESD, Mood and Anxiety Symptom Questionnaire, and Family Function Scale. The results revealed significant correlations among maternal depression, family functioning, and positive and negative emotions in the adolescents. The family functioning subscales of conflict and emotional expression partially mediated the relationship between maternal depression and the positive and negative emotions of the adolescents. Furthermore, the family functioning subscales of cohesion, problem solving, and responsibility fully mediated the relationship between maternal depression and positive moods in the adolescents. Analysis of the results for maternal depression, family functioning, and the emotional adjustment of the adolescents indicated that family functioning is the mediator between maternal depression and the positive and negative emotions of the adolescents. The current results suggest that adequate family functioning can prevent depression being transmitted from mothers to their adolescent children.     

Negative Thoughts in Children with Symptoms of Anxiety and Depression

This study examined whether negative thoughts are different in anxious, depressed, and chronically ill children. Screening of 1,316 children on anxiety, depression, and asthma resulted in the selection of 118 children. Four groups were formed: (1) a high anxiety group, (2) a high anxiety/depression group, (3) an asthma group, and (4) a low anxiety, low depression, and no chronic disease (control) group. The data yielded no pure depression group. Subsequently, the Negative Affectivity Self-Statement Questionnaire (NASSQ) and a Worry scale were administered. Results showed that cognitive scores were different in all groups. Highest scores were obtained from the high anxiety/depression group, and lowest from the control group. Children with asthma scored high on anxiety, not on depression. High correlations between scores on negative thoughts and conventional measures of negative emotions suggested that negative thoughts provided no unique information about the problems underlying emotional states in different groups of children. Implications for cognitive assessment in emotionally disturbed children are discussed.     

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

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

Do I feel sadness,fear or both? Comparing self-reported alexithymia and emotional task-performance in children with many or few somatic complaints

Children with many somatic complaints seem to report problems with emotion identification and communication (‘alexithymia’). The aim of this study was to verify whether children with somatic complaints do indeed show signs of alexithymia. We compared 35 children (M age = 10.99, SD = 13 months) with many somatic complaints with 34 children (M age = 11.03, SD = 12 months) reporting few complaints on the basis of a self-report alexithymia scale and tasks that require the skill to identify and communicate emotions: an emotional attention task, a structured interview about own emotions, and a mixed-emotion task. Children were also asked about the intensity of the reported emotions. Compared to children with few complaints, children with many complaints seemed to have higher self-reports of alexithymia. However, these results were explained by difficulty in communicating negative internal states and experiencing indefinable internal states, rather than difficulty in identifying emotions. In addition, children with many complaints reported higher intensities of fear and sadness. The children did not differ in their attention to emotions or causes of emotions. Children with many somatic complaints more often described previous emotional experiences and showed better abilities in identifying multiple emotions. Children with many somatic complaints thus show more negative emotional processing, but the alexithymia-hypothesis was unsupported.     

Latent class analysis of anxiety and depressive symptoms of the Youth Self-Report in a general population sample of young adolescents

This study examined whether distinct groups of young adolescents with mainly anxiety or mainly depression could be identified in a general population sample. Latent class analysis was used on self-report ratings of DSM-IV symptoms of anxiety and depressive disorders, because it was hypothesized that these ratings provide a bigger chance to identify distinct groups than parent ratings of symptoms that are poorly associated with DSM-IV. Results from exploratory and confirmatory latent class analysis showed that only very small numbers of young adolescents had mainly anxiety or mainly depressive symptoms. Instead, a five-group model fitted the data best. These five groups contained young adolescents who either had a high, intermediate, or low probability to have comorbid symptoms of anxiety and depression. It was concluded that symptoms of DSM-IV anxiety and depressive disorders co-occur in young adolescents, and that latent class analysis on items that capture also severe symptoms like suicidal thoughts are needed to derive groups with specific comorbidity patterns in a general population sample.     

Cognitive biases in processing infant emotion by women with depression,anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review

Perinatal psychological problems such as post-natal depression are associated with poor mother–baby interaction, but the reason for this is not clear. One explanation is that mothers with negative mood have biased processing of infant emotion. This review aimed to synthesise research on processing of infant emotion by pregnant or post-natal women with anxiety, depression or post-traumatic stress disorder (PTSD). Systematic searches were carried out on 11 electronic databases using terms related to negative affect, childbirth and perception of emotion. Fourteen studies were identified which looked at the effect of depression, anxiety and PTSD on interpretation of infant emotional expressions (k = 10), or reaction times when asked to ignore emotional expressions (k = 4). Results suggest mothers with depression and anxiety are more likely to identify negative emotions (i.e., sadness) and less accurate at identifying positive emotions (i.e., happiness) in infant faces. Additionally, women with depression may disengage faster from positive and negative infant emotional expressions. Very few studies examined PTSD (k = 2), but results suggest biases towards specific infant emotions may be influenced by characteristics of the traumatic event. The implications of this research for mother–infant interaction are explored.