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Guts
\"Raina wakes up one night with a terrible upset stomach. Her mom has one, too, so it's probably just a bug. Raina eventually returns to school, where she's dealing with the usual highs and lows: friends, not-friends, and classmates who think the school year is just one long gross-out session. It soon becomes clear that Raina's tummy trouble isn't going away--and it coincides with her worries about food, school, and changing friendships. What's going on?\"--Dust jacket flap.
BOOK
Adaptation and Validation of the DSM 5 Youth Anxiety Scale—Part I (YAM-5-I) in Colombian Adolescents
Background/Objectives: In adolescence, anxiety disorders are the most prevalent, besides being highly comorbid, with a tendency to chronicity and persistence in adulthood; although there are different assessment measures with good psychometric properties, in Colombia there are no instruments that include the new international diagnostic classifications, aspects that may hinder accurate diagnosis and consequent care. This psychometric study aimed to adapt and validate the Anxiety Scale for Adolescents YAM-5, part I. Methods: A review of the items of the instrument was carried out, seeking to identify possible difficulties in the use of terms according to the culture; a sample of 536 adolescents linked to different public and private educational institutions from the five regions of the country was applied. The analysis of the instrument was based on the analysis of its reliability by means of Cronbach’s Alpha Coefficient, the construct validity by means of the Exploratory Factor Analysis using the principal components method, and, finally, the Confirmatory Factor Analysis using the Structural Equations technique. Results: An internal consistency of 0.93 and a structural validity with a construct of five correlated dimensions were identified, which best fitted the data collected. Conclusions: The structure examined provides high reliability and structural validity, highlighting benefits such as being of screening type, its low cost, and application aimed at non-clinical populations from the perspective of Colombian adolescents.
Journal Article
Bright young people : the lost generation of London's Jazz Age
A historical assessment of the bohemian socialites of 1920s London traces their half-century dominance over the Western world's social scene and the ways in which they inspired the works of such authors as Evelyn Waugh and Nancy Mitford, in an account that also explores their hidden struggles with wartime tragedies and addiction.
Book
The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial
Background
Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments.
Method
Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees (
N
= 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT.
Discussion
This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments.
Trial registration
This trial was registered on clinicaltrials.gov (
NCT04929262
) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered.
Journal Article
The role of school connectedness in the prevention of youth depression and anxiety: a systematic review with youth consultation
Background
School connectedness reflects the quality of students’ engagement with peers, teachers, and learning in the school environment. It has attracted attention from both the health and education sectors as a potentially modifiable protective factor for common mental health problems. However, the extent to which school connectedness may prevent the onset of youth depression or anxiety or promote their remission is unclear. This systematic review examined evidence for prospective relationships between school connectedness and depression and anxiety, and the effect of interventions to improve school connectedness on depression and anxiety.
Methods
We searched MEDLINE, PsycINFO, PubMed, and ERIC electronic databases for peer-reviewed quantitative longitudinal, or intervention studies published from 2011–21 in English examining relationships between school connectedness and anxiety and/or depression. Participants were 14–24 years old when depression and anxiety outcomes were assessed in any education setting in any country. We partnered with five youth advisers (aged 16–21 years) with lived experience of mental health problems and/or the schooling system in Australia, Indonesia, and the Philippines to ensure that youth perspectives informed the review.
Results
Our search identified 3552 unique records from which 34 longitudinal and 2 intervention studies were ultimately included. Studies were primarily from the United States of America (69.4%). Depression and anxiety outcomes were first measured at 14 years old, on average. Most studies found a significant protective relationship between higher levels of school connectedness and depressive and/or anxiety symptoms; more measured depression than anxiety. A few studies found a non-significant relationship. Both intervention studies designed to increase school connectedness improved depression, one through improvements in self-esteem and one through improvements in relationships at school.
Conclusions
These findings suggest that school connectedness may be a novel target for the prevention of depression and anxiety. We were not able to determine whether improving school connectedness promotes remission in young people already experiencing depression and anxiety. More studies examining anxiety, diagnostic outcomes, and beyond North America are warranted, as well as intervention trials.
Trial registration
PROSPERO 2021 CRD42021270967.
Journal Article
Does multifamily therapy help parents of adolescents with anxiety-based school refusal? A qualitative approach
Anxiety-based school refusal is a major public health problem among adolescents, with serious professional, social, and psychiatric consequences in adulthood. Family and especially parental involvement is essential. Multifamily therapy has been shown to be effective in the management of many psychological disorders including anxiety-related disorders. The aim of this qualitative study is to explore the experiences of parents who participated in the MULTI FAST program (a multifamily therapy focused on anxiety-based school refusal).
Participation in the study was offered to all families who participated in a MULTI FAST group in 2022 and 2023. A semi structured interview was conducted with each parent who agreed to participate, six months after the end of the multi-family therapy. The interviews were analyzed with a qualitative phenomenological method, Interpretative Phenomenological Analysis.
Thirty-one parents (out of 37, 84%) agreed to take part in the study: 19 mothers and 12 fathers. The mean age for fathers was 51.5 (SD = 6.45) and 48.7 (SD = 4.77) for mothers. Analysis of the interviews revealed four main themes. The first was changes in parents' representations of their adolescent, with a better understanding of their child's distress and needs. The second theme was parents looking at themselves in a new light, with less sense of abnormality, less guilt, and looking back at their own relation to school. The third theme was the expression of parental distress to their adolescents, and the fourth described better communication and stronger family groups after the multifamily therapy.
All parents who participated in the study emphasized the help that multifamily therapy had given them. This included an increased sense of parental self-efficacy, better mentalization, and a positive impact on family interactions, with changes in everyone's place in the family.
Journal Article
Assessing anxiety among adolescents in Hong Kong: psychometric properties and validity of the Generalised Anxiety Disorder-7 (GAD-7) in an epidemiological community sample
Background
The development of a valid and simple-to-use self-administered tool in Asian adolescents for clinical screening and intervention remains limited. The present study assessed the psychometric characteristics and validity of the Generalised Anxiety Disorder Scale-7 (GAD-7) among adolescents in Hong Kong.
Methods
Epidemiological data from 3,261 Hong Kong adolescents aged 15 - 24 years were analysed for the construct validity, criterion validity, concurrent validity, and Rasch Model. All analyses were age- and gender-weighted according to the distributions of Hong Kong’s general population.
Results
The GAD-7 showed high internal consistency and strong fit to the one-factor structure. The best cut-off value was set at 7 or more. Regression models found that the total scores of the scale were positively associated with symptoms of depression and hypomania, schizotypal personality and alcohol dependence. Rasch model analysis found that the separation index was 2.18 and 16.51 for the respondents and items, respectively and all residual pairs had small correlation coefficients (i.e., < 0.3).
Conclusions
All psychometric findings presented in this study support the use of the GAD-7 as a legitimate measure of anxiety severity. A cut-off score of 7 should indicate a potential diagnosable condition in Asian adolescents, which requires our attention but should not be used as a formal diagnostic screening tool. The findings revealed the local dependence of the items of the GAD-7 and that the scale can separate respondents into at least two groups and items into numerous groups according to the separation index.
Journal Article
Heightened Anxiety and Depression Among Autistic Adolescents with ADHD: Findings From the National Survey of Children’s Health 2016–2019
Data from the National Survey of Children’s Health 2016–2019 was used to examine the co-occurrence of autism and ADHD and the impact on anxiety and depression among adolescents age 12–17. Rates of anxiety and depression were up to ten-fold the prevalence of adolescents not diagnosed with autism or ADHD. Over half of autistic females (57%) and nearly half of autistic males (49%) are also diagnosed with ADHD. Autistic females with ADHD had the highest co-occurrence of anxiety at 72% followed by autistic males with ADHD at 69%. The prevalence of depression was highest among autistic adolescents with ADHD yet was consistent across genders (male/female) at 38–39%. Adolescents diagnosed with autism and/or ADHD are at heightened risk for anxiety and depression.
Journal Article
Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study
Common mental disorders in early life represent a major concern as they become more complex and intense with transition into adolescence. Despite global recognition of the significance of adolescent mental health, it remains a neglected area in research and health policy in Bangladesh. This study aimed to investigate the prevalence and factors associated with depression and anxiety among school going adolescents in Bangladesh.
A cross-sectional survey was conducted among 563 students aged 13-18 years at selected schools (secondary and higher secondary) in Dhaka City. After providing written informed consent, participants completed a survey examining socio-demographic variables, along with the PHQ-9 and GAD-7 scales. Logistic regression was used to examine associations between variables under examination.
The prevalence rates of moderate to severe levels of depression and anxiety were 26.5% and 18.1%, respectively. Based on multivariable analyses, unsatisfactory sleep (AOR = 3.17; 95% CI = 1.81-5.53, p < .001), cigarette smoking (AOR = 2.00; 95% CI = 1.01-3.97, p = .048), and anxiety (AOR = 10.47; 95% CI = 6.11-17.95, p < .001) were associated with depression. Anxiety was associated with being 15-16 years (AOR = 2.66; 95% CI = 1.18-6.00, p = .018), not having good perceived relationships with friends (AOR = 2.10; 95% CI = 1.24-3.56, p = .006) and depression (AOR = 10.22; 95% CI = 6.01-17.38, p < .001).
Depression and anxiety were prevalent among school going adolescents in Bangladesh. The findings suggest epidemiological data can direct policy-level decisions regarding evaluation, prevention, and intervention of mental health conditions among school going adolescents in Bangladesh.
Journal Article
Error-related negativity predicts increases in anxiety in a sample of clinically anxious female children and adolescents over 2 years
An increased neural response to making errors has emerged as a biomarker of anxiety. Error negativity (Ne) or error-related negativity (ERN) is an event-related potential generated when people commit errors; the Ne/ERN is greater among people with anxiety and predicts increases in anxiety. However, no previous study has examined whether the Ne/ERN can be used as a prognostic indicator among people with current anxiety. The present study addressed this gap by examining whether the Ne/ERN prospectively predicts increases in anxiety symptoms in clinically anxious children and adolescents.
The sample included 34 female participants between the ages of 8 and 14 years who met the criteria for a clinical anxiety disorder based on clinical interview. The Ne/ERN was measured using a flanker task.
Increased Ne/ERN at baseline predicted increases in total anxiety symptoms 2 years later, even when accounting for baseline symptoms. The Ne/ERN predicted increases in the symptom domains of generalized anxiety, social anxiety and harm avoidance/perfectionism, but not panic, separation anxiety, school avoidance or physical symptoms.
The sample size was small, which may have inflated the false discovery rate. To mitigate this possibility, we used multiple self-report measures, and the results for the 2 measures (as well as their symptom domains) converged.
These data suggest that the Ne/ERN can delineate specific risk trajectories, even among those who already meet the criteria for a clinical anxiety disorder. Considering the need for prognostic markers among people with clinical anxiety, the current findings are an important and novel extension of previous work.
Journal Article