Social Support Seeking And Early Adolescent Depression And Anxiety Symptoms: The Moderating Role Of Rumination

This study examined how social support seeking and rumination interacted to predict depression and anxiety symptoms 6 months later in early adolescents (N = 118; 11-14 years at baseline). We expected social support seeking would be more helpful for adolescents engaging in low rather than high levels of rumination. Adolescents self-reported on all measures at baseline, and on depression and anxiety symptoms 6 months later. Social support seeking predicted fewer symptoms of depression and anxiety at low rumination levels but was not associated with benefits as rumination increased. For depression symptoms, social support seeking predicted more symptoms at high rumination levels. Results were stronger for emotion-focused than problem-focused support seeking and for depression compared with anxiety symptoms. These findings suggest that cognitive risk factors like rumination may explain some inconsistencies in previous social support literature, and highlight the importance of a nuanced approach to studying social support seeking

Evaluating the Feasibility of a Collaborative Care Clinical Pathway for the Treatment of Adolescent Depression and Anxiety in Rural Pediatric Primary Care

Evaluating the Feasibility of a Collaborative Care Clinical Pathway for the Treatment of Adolescent Depression and Anxiety in Rural Pediatric Primary Care Kayla Watson Background: Due to a national shortage of Child and Adolescent Psychiatrists (CAP), Primary Care Providers (PCP) are often required to manage patients with mental health disorders despite a lack of focused training and lower self-efficacy or confidence in the management of these disorders. Referral to CAPs for management following the diagnosis of adolescent depression and anxiety is a common practice. The integration of mental health services within the primary care setting can overcome many of these barriers and have been shown to improve patient outcomes. This model involves PCPs prescribing psychotherapeutic drugs while the patient receives evidence-based psychotherapies provided by community Behavioral Health Clinicians (BHC). Purpose: The purpose of this quality improvement (QI) project is to incorporate evidenced-based practice recommendations and select components from integrated care models (ICM) to design a collaborative care, decision making pathway for PCPs to utilize in the management of adolescent depression and anxiety and to evaluate the feasibility of the intervention within the primary care practice setting. Methods: A literature review and synthesis was completed to gather current recommendations and determine the most effective components of ICMs. A collaborative clinical decision-making pathway was designed and presented to the project participants in the form of a PCP packet containing a medication guide, a treatment algorithm, a BHC provider directory, and a list of built in EMR visit and patient handout templates for clinical use. A focus group was held with project participants following a 12- week implementation period to determine the feasibility of the project. Focus group data were evaluated by coding responses and identifying common themes relating to feasibility. Future directions of the project were also discussed. Pre-implementation and post self-efficacy mean scores on a modified version of the Mental Illness Management (MIM) questionnaire were calculated as a secondary outcome measure. Results: The clinical decision-making pathway was determined to be feasible within the intended practice setting based on the feasibility areas of emphasis: acceptability and demand. Mean scores of the MIM questionnaire showed a positive trend for each of the survey items suggesting the intended effect on care delivery. Discussion: This QI initiative met each project aim through successful implementation and by an increase in provided collaborative care, an increase in the level of integration within the practice setting, a positive trend in PCP self-efficacy following implementation, and a decrease in the time from diagnosis- to- treatment of adolescent depression and anxiety. Following the determination of intervention feasibility, further testing within the organization is recommended and warranted

Race/Ethnicity as a Moderator in Child and Adolescent Depression and Anxiety Trials

The inclusion of racial/ethnic minorities in treatment outcomes trials for children and adolescents with depression and anxiety is essential, particularly given the assumption, required by the NIH, that racial diversity is important to the generalizability of clinical trial outcomes. A search for randomized clinical trials on the treatment of child and adolescent depression and anxiety was conducted using the Medline and Psychinfo databases. These were then reviewed to determine whether race or ethnicity were 1) factored into recruitment strategies; 2) represented in the trial sample; and 3) included in moderator analyses to determine the extent to which they may influence trial outcomes. 37 original and 13 follow-up trials were identified (total N = 3330). None identified strategies for targeted recruitment of racial/ethnic minorities. Six did not report race. All minority groups except for Native Americans are underrepresented as compared to 2000 US Census figures; however, only one study reported Native Americans as participants. Overall, 67% of the sample was Caucasian, 26% minority, and 6% unreported. There was no trend in minority representation by year. Most studies reviewed do report the ethnic breakdown of their sample population, although methods vary. Six studies, three original and three follow-up, explored the ethnicity as a moderator. Without an increased presence of minorities in clinical trials, it is unclear that the results of these studies can reliably generalize to a diverse population. The importance of studies in minority samples becomes apparent, as does the need for a greater emphasis on recruitment

Clinical Applications of Aerobic Exercise with Adolescents Experiencing Depression and Anxiety

Despite continued growth and improvements in traditional treatments for adolescent depression and anxiety, the rates at which adolescents are experiencing depression and anxiety continue to increase. Current research indicates that physical activity has a positive correlation with mental health. While staying true to the ethics and values that guide clinical social work practice, how can clinicians use aerobic exercise to treat adolescent depression and/or anxiety? This Systematic Literature Review SLR collected and synthesized findings from similar studies in order to identify specific aerobic exercises that have been successful in treating adolescent depression, common strategies for implementation and tools and strategies used to evaluate the effectiveness of treatment. Aerobic exercise interventions that have been successful in treating adolescent depression involve high levels of support, three 45 minute sessions of preferred exercise intensity per week for 10 weeks. The outcome is a delayed response to treatment and a lasting decrease in symptoms in comparison to traditional treatments, with clients retaining remission one year after the conclusion of the intervention. The findings of this research indicate that aerobic exercise can be successfully and ethically implemented as a treatment for adolescent depression, due to a lack of research on the use of aerobic exercise in treating adolescent anxiety. Clinical social workers and other mental health professionals are invited to consider a number of variables when utilizing aerobic exercise, including supervision, consultation and their own clinical judgment

Cohesive Neighborhoods Where Social Expectations Are Shared May Have Positive Impact On Adolescent Mental Health

Adolescent mental health problems are associated with poor health and well-being in adulthood. This study uses data from a birth cohort of children born in large U.S. cities (N=2,264) to examine whether neighborhood collective efficacy (social cohesion and control) is associated with improvements in adolescent mental health. We find that children who grow up in high collective efficacy neighborhoods experience fewer depressive and anxiety symptoms during adolescence than similar children from low collective efficacy neighborhoods. The magnitude of this neighborhood effect is comparable to the effects of depression prevention programs. Findings do not vary by family or neighborhood income, indicating that neighborhood collective efficacy supports adolescent mental health across diverse populations and urban settings. We recommend greater emphasis on neighborhood environments in individual mental health risk assessments and greater investment in community-based initiatives that strengthen neighborhood social cohesion and control

EXPLORING THE RELATIONSHIPS AMONG AUTHORITATIVE PARENTING, RELIGIOSITY, AND ADOLSCENT INTERNALIZING BEHAVIORS

The public health issue of adolescent depression and anxiety in association with religiosity and family dynamics has not been established. This research explored the associations among authoritative parenting, religiosity (i.e. organizational, personal, and family), parent-child connectedness, and internalizing behaviors among adolescents. Data are from 325 adolescents ages 13 to 18 and caregiver dyads participating in the Flourishing Families Project, Wave V. A path model demonstrated that authoritative parenting encouraged connectedness between caregivers and adolescents. Parent-adolescent connectedness was associated with personal and organizational religious incongruencies. Implications for research and practice are discussed

Effects of physical activity in child and adolescent depression and anxiety: role of inflammatory cytokines and stress-related peptide hormones

Depression and anxiety are the most common mental illnesses affecting children and adolescents, significantly harming their well-being. Research has shown that regular physical activity can promote cognitive, emotional, fundamental movement skills, and motor coordination, as a preventative measure for depression while reducing the suicide rate. However, little is known about the potential role of physical activity in adolescent depression and anxiety. The studies reviewed in this paper suggest that exercise can be an effective adjunctive treatment to improve depressive and anxiety symptoms in adolescents, although research on its neurobiological effects remains limited

Aetiology of Shame and its Association with Adolescent Depression and Anxiety: Results from a Prospective Twin and Sibling Study

Background Shame is considered a maladaptive self-conscious emotion that commonly co-occurs alongside depression and anxiety. Little is known, however, about the aetiology of shame and its associations with depression and anxiety. We estimated, for the first time, genetic and environmental influences on shame and on its associations with depression and anxiety in adolescence. Methods The sample was twin and sibling pairs from the Genesis 1219 Study (Time 1, N = 2,685; males 42.8%, Mage = 14.95, SD = 1.67, age range: 12–21; Time 2, N = 1618; males 39.7%, Mage = 16.97, SD = 1.64, age range: 14–23). Participants completed validated questionnaires to measure shame (at Time 1), depression and anxiety (at Times 1 and 2). Results Shame was moderately to strongly associated with concurrent depression and anxiety. Prospectively, shame was significantly associated with an increase in depression, but not anxiety. Genetic analyses revealed that shame was moderately heritable with substantial nonshared environmental influence. The associations between shame and concurrent depression and anxiety were primarily accounted for by overlapping genetic influences. Prospectively, the association between shame and later depression was primarily accounted for by genetic and nonshared environmental influences shared with earlier depression. The unique association between shame and later depression was mostly explained by common nonshared environmental influences. Conclusions The findings offer novel evidence regarding aetiology of shame—although moderately heritable, shame in adolescents may also result from nonshared environmental factors. Genetic and nonshared environmental influences contribute to the co-occurrence of shame with depression and anxiety

Mental Illness Awareness in the State of New Hampshire

New Hampshire is a small state with 1.36 million people reported in 2019. In New Hampshire, 4% of adults live with serious mental health conditions, such as schizophrenia, bipolar disorder, and major depression (Resources to Recover, 2020). The National Alliance of Mental Illness (NAMI) has a chapter in New Hampshire to help support, promote, and educate on the topic of mental illness. I would like to partner my effort with NAMI NH and also with the STAMP OUT STIGMA Campaign through the Association for Behavioral Health and Wellness (ABHW) to bring greater awareness of serious mental illness (SMI) and any mental illness (AMI) to New Hampshire