| 1. |
- Andrén, Per, et al.
(författare)
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Evaluating care pathways for pediatric anxiety disorders: Study protocol for a pilot randomized controlled trial of stepped care vs stratified care.
- 2023
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Konferensbidrag (refereegranskat)abstract
- Introduction: Anxiety disorders are common and debilitating in children and adolescents. Cognitive behavioral therapy (CBT), delivered both in-person and by the internet (ICBT), is efficacious, but access for young individuals is limited and it remains unclear how to structure the care pathway to maximize benefit.Methods: To inform a fully powered randomized controlled trial (RCT), a pilot RCT will be conducted where 50 youth with anxiety disorders are randomized to one out of two care pathways: stepped care or stratified care. Both pathways consist of up to two courses (A and B) of evidence-based treatment (12 weeks of either ICBT or in-person CBT). The two treatments share the same basic components (e.g., psychoeducation, exposure) but differ in their format of delivery, with in-person CBT enabling higher personalization and therapist-involvement, but to a higher cost. In stepped care, all participants are offered ICBT in course A and treatment non-responders are offered in-person CBT in course B. In stratified care, those with the highest risk of treatment non-response are offered in-person CBT in course A (~50%), while the other half are offered ICBT. As in stepped care, non-responders in stratified care are offered in-person CBT in course B. The primary endpoint is the outcome assessment after course B. The objectives of the pilot are to examine the feasibility, acceptability, and safety of the study procedures.Time plan: Recruitment for the study will begin in August 2023 and the final participant is expected to reach the primary endpoint in August 2024.
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| 2. |
- Armstrong, Gabrielle, et al.
(författare)
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Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia
- 2023
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - 2211-3649. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8–17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.
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| 3. |
- Aspvall, Kristina, et al.
(författare)
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Validity and clinical utility of the obsessive compulsive inventory - Child version : Further evaluation in clinical samples
- 2020
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder. Currently, the Obsessive Compulsive Inventory-Child Version (OCI-CV) is the only self-report measure that fully captures this symptom heterogeneity in children and adolescents. The psychometric properties of the OCI-CV are promising but evaluations in large clinical samples are few. Further, no studies have examined whether the measure is valid in both younger and older children with OCD and whether scores on the measure are elevated in youths with OCD compared to youths with other mental disorders. Methods: To address these gaps in the literature, we investigated the psychometric properties and validity of a Swedish version of the OCI-CV in a large clinical sample of youth aged 6-18 years with OCD (n = 434), anxiety disorders (n = 84), and chronic tic disorders (n = 45). Results: Internal consistency coefficients at the total scale and subscale level were consistent with the English original and in the acceptable range. Confirmatory factor analyses revealed an adequate fit for the original six-factor structure in both younger and older children with OCD. Correlations between total scores on the OCI-CV and the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were small at pre-treatment (r = 0.19) but large at post-treatment (r = 0.62). Youth with OCD scored higher than those with anxiety and chronic tic disorders, and the OCI-CV was sensitive to symptom change for youth undergoing treatment for OCD. Conclusions: This Swedish version of the OCI-CV appears to be a valid and reliable measure of the OCD symptom dimensions across age groups and has good clinical utility.
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| 4. |
- Barcaccia, Barbara, et al.
(författare)
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Mindfulness, Self-Compassion and Attachment: A Network Analysis of Psychopathology Symptoms in Adolescents
- 2020
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Ingår i: Mindfulness. - : Springer Science and Business Media LLC. - 1868-8535 .- 1868-8527. ; 11, s. 2531-2541
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesMindfulness, positive self-related attitudes and secure attachment have been shown to protect against psychopathology during adolescence, but it is unknown how these factors are related to each other and which are most strongly linked to psychopathology symptoms.MethodsA cross-sectional research design was used with a large sample of adolescents (aged 14 to 18 years; n = 1660) that completed validated measures of mindfulness, self-related attitudes, attachment, depression, anxiety and anger. We employed network analytic methods in order to better understand associations among these variables.ResultsMindfulness was linked to lower levels of depression and anxiety while self-reassurance was linked to lower levels of anxiety and higher levels of anger. Self-hate was linked to depression. In turn, self-reassurance and self-hate were differentially linked to facets of attachment, particularly trust in parents.ConclusionsInterventions combining mindfulness practice and clinical techniques based on attachment theory, which operate on different psychological levels, may improve self-related attitudes, which in turn can help ameliorate depression and anxiety in adolescents. Alternatively, interventions directly targeting self-related attitudes, particularly self-reassurance and self-inadequacy, hold promise to achieve positive effects on mental health among adolescents.
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| 5. |
- Barcaccia, Barbara, et al.
(författare)
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Purpose in life as an asset for well-being and a protective factor against depression in adolescents
- 2023
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Ingår i: Frontiers in Psychology. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Purpose in life, which is a central component of the eudaimonic paradigm of well-being, has been sparsely examined in adolescence. This is unfortunate as adolescence is characterised by identity development and is a key period for the onset of mental disorders. To inform future research on well-being and purpose in life in adolescents, we drew factors from several fields of research, including mental health and psychological factors, and explored which factors were most strongly associated with purpose in life. Data were collected in a sample of 444 Italian adolescents (Mage = 16.30 [SD = 1.50], range: 14 to 20 years; 58% girls) and associations with mental health (stress, anxiety, depression, anger), psychological traits (mindfulness, self-hate, self-inadequacy, self-reassurance, isolation), and sociodemographic variables (age, sex, place of birth) were examined. Regression, dominance, and network analyses indicated that a stronger sense of purpose in life was associated with lower depressive symptoms, higher levels of self-reassurance, and being born in Italy. Our findings suggest that purpose in life is an important asset for well-being in adolescents and may protect against depression. Future longitudinal and/or experimental research should examine the potential protective role of purpose in life in relation to adolescent depression and how self-reassurance and sociodemographic factors (e.g., immigrant background) are involved.
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| 6. |
- Barcaccia, Barbara, et al.
(författare)
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Whom are you mad at? : Anger and revenge in obsessive-compulsive symptoms during adolescence
- 2022
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has extensively explored the role of anxiety, disgust, guilt, and shame in obsessive-compulsive (OC) symptoms, but few studies have investigated anger and associated vengeful motivations, especially during adolescence, when OC symptoms typically onset. This is unfortunate as anger is a key human emotion linked to various aspects of behaviour. Our aim was to explore how anger and revenge motivations were associated with the most common OC subtypes in adolescents. Participants were 1035 high school students who completed a battery of questionnaires including the Obsessive-Compulsive Inventory-Child Version, the Children's Depression Inventory, the Transgression-Related Interpersonal Motivations Inventory-18 and the State-Trait Anger Expression Inventory for children and adolescents. Even when accounting for different aspects of anger, TRIMs and depression, trait anger (i.e., a stable tendency to experience anger) was uniquely associated with all types of OC symptoms (doubting/checking, obsessing, and ordering). Unique associations were also found between revenge motivation and doubting/checking and obsessing. Our findings show that adolescents with high OC symptoms may experience not only intense anger, but also vengeful feelings and motivations. Future research should examine how anger, vengeful motivations and OC symptoms co-develop over time. Clinicians should be aware that anger and vengeful motivations can be part of the clinical presentation of OCD, which can inform assessment and treatment.
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| 7. |
- Billot, Moana, et al.
(författare)
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Network Analysis Reveals Unique Associations of Mindfulness and Distress with Immunity in Māori and Non-Māori New Zealanders
- 2023
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Ingår i: Mindfulness. - 1868-8535. ; 14, s. 2211-2223
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesA healthy immune system is required to protect against viral infection and ensure the efficacy of vaccines. Psychological distress can threaten immune resilience, while mindfulness practices can be protective. In New Zealand, Māori experience significantly higher levels of distress compared to non-Māori. The aim of this study was to explore the role of ethnicity in the relations among immunity, depression, anxiety, stress, and mindfulness relate to each other.MethodNetwork analysis was used to explore unique relations among distress (depression, anxiety, stress), mindfulness facets, and immune status in matched (age, ranging from 19 to 88 years, sex, and self-classified socio-economic status) samples of Māori (n = 195) and non-Māori (n = 195) participants from New Zealand.ResultsThe networks of distress, mindfulness, and immune status were significantly different between Māori and non-Māori participants. The mindfulness facets Describe and Act with Awareness were more strongly positively linked in Māori, and Non-judge and Depression more strongly negatively linked in Māori, while Describe and Non-judge were more strongly positively linked in non-Māori. For both Māori and non-Māori, similarities included a negative link between anxiety and immune status, strong positive links between the distress variables, and positive links between the mindfulness facets of Non-judge and Act with Awareness, Observe and Non-React, and Observe and Describe.ConclusionsThese findings suggest that anxiety is strongly linked to poor immunity across both Māori and non-Māori in New Zealand while networks of mindfulness and distress also demonstrated differences unique for each of these groups. Both similarities and differences between Māori and non-Māori should be considered when developing targeted interventions to improve physical and mental health in New Zealand.
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| 8. |
- Breeze, Catherine, et al.
(författare)
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Unique contributions of anxiety, stress and depression to immunity: A cross-cultural investigation
- 2024
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Ingår i: Journal of Affective Disorders Reports. - 2666-9153. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- While immunity and psychological distress are strongly associated, studies seldom consider how different types of distress relate to immune functioning. The literature tends to emphasis the impact of stress on immunity. The present cross-sectional study estimated the unique contributions of depression, anxiety, and stress on immune function in culturally diverse samples of adults from Italy, New Zealand and India. Participants were Italian (n = 1061), New Zealand (n = 1037), and Indian (n = 384) volunteers. Stepwise multiple linear regression and dominance analysis were used to analyse differences in immunity uniquely explained by anxiety, depression, and stress. While samples from the three countries differed significantly, anxiety consistently explained the greatest proportion of differences in immunity. After accounting for the effect of anxiety, stress and depression explained only negligible variation in immune functioning. This association of anxiety with immune functioning was consistent across three different countries and this unique impact was further confirmed by the results of dominance analysis. These findings suggest a clear link between anxiety and immunity, which advances the prevailing stress-disease model and foster further experimental and longitudinal research into the impact of anxiety on immunity.
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| 9. |
- Bångstad, Amanda, et al.
(författare)
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Perceived causal symptom network of adolescent mental health issues
- 2022
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Ingår i: Journal of Child and Adolescent Mental Health. - 1728-0583. ; 34:1-3, s. 101-114
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent mental health is difficult to capture in categories such as depression or specific anxiety disorders. An alternative is to approach psychiatric symptoms as causal networks, potentially revealing feedback loops that maintain a pathological state. One approach to creating such networks, implemented in the PECAN methodology, is to ask adolescents about their perceptions of the causes to their symptoms. For this purpose, a transdiagnostic item list was created, and adolescents who screened positive for depression (N = 55) completed twice in two weeks a survey quantifying perceptions of causality between their mental health problems. A network that was averaged across all participants was reliable and revealed three strong feedback loops: a first loop running through stress, insomnia, fatigue, procrastination, and back to stress; a second loop between stress and overthinking; and a third loop between stress and procrastination. Although all adolescents in the study screened positive for depression, symptoms of depression were not particularly central to the network. Instead, the most central symptoms were procrastination and overthinking. The average test-retest reliability for individual networks was low, limiting clinical application. In conclusion, PECAN was found to be reliable and useful when creating a group-level network of adolescent mental health problems. While informative at a group level, the method should be improved before it can be used to inform treatment at the individual level.
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| 10. |
- Cardeña, Etzel, et al.
(författare)
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A Network Analysis to Identify Associations between PTSD and Dissociation among Teenagers
- 2022
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Ingår i: Journal of Trauma & Dissociation. - : Informa UK Limited. - 1529-9732 .- 1529-9740. ; 23:4, s. 432-450
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Tidskriftsartikel (refereegranskat)abstract
- We conducted a network analysis of measures of dissociation and posttraumatic symptoms (PTS) with a varied sample of adolescents (N = 312), some of them previously exposed to war scenarios. The global measure of dissociation (A-DES) was uniquely linked to the arousal PTS symptom cluster (CRIES-13), in particular sleep problems, but not to the reexperiencing and avoidance clusters. Three of four (i.e., depersonalization/derealization, amnesia, mental partition/compartmentalization) dissociation clusters were uniquely linked to PTS severity, but not absorption. The results with the pooled groups were generally representative of both groups. The DP/DR relation to PTS was based on data from both samples, whereas the link between amnesia and partition/parts might have been driven by the normative group, although the refugee sample had significantly higher scores in those variables. The results replicate some previous findings with adult samples and suggest new paths for research and theory.
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