Examination of the overlap between DSM-111-R overanxious disorder and DSM-IV generalized anxiety disorder in childhood

Since DSM-III-R criteria for Overanxious Disorder (OAD) was subsumed under Generalized Anxiety Disorder (GAD) in DSM-IV, three studies have investigated the overlap between the diagnoses. Although two studies have identified children meeting both OAD and GAD criteria (OAD/GAD group), a third study has identified children who met criteria for OAD, but not GAD (OAD group). Based on finding these two groups of children, we examined whether children in the OAD group (n= 30) could be differentiated from children in the OAD/GAD group (n=81) based on self and parent report of anxious symptoms and level of functional impairment. Conditional probability rates were also calculated for each of the DSM anxious symptoms to determine their overall clinicalutility. Findings revealed that the OAD group of children experienced fewer anxious symptoms than children in the OAD/GAD group, though both groups showed some amount of impairment. The implications for research and practice are discussed

DOES NEGATIVE SELF-IMAGERY PLAY A CAUSAL ROLE IN SOCIAL PHOBIA AMONG ADOLESCENTS?

The current study was designed to examine whether negative self-imagery is a significant factor in the development of social phobia among adolescents. Although some adult models of social phobia posit that negative self-imagery serves to increase anxiety and decrease performance within social contexts, few studies have directly examined this relationship and no study has examined self-imagery among socially-phobic adolescents. For the current study, negative self-imagery was manipulated among a group of non-anxious adolescents (IMAG) during two social tasks. Levels of anxiety, specific thoughts, expected and self-rated performance, and observer-rated performance and social skill were compared to both socially-phobic and control adolescents. Results revealed few differences in terms of observer-rated performance and specific social skill between the IMAG and control groups of adolescents, although the socially-phobic group was consistently rated to exhibit poorer performances and decreased social skill. The IMAG group reported marginally significant increases in their anxiety levels during both social tasks. Interestingly, these adolescents reported similar (increased) rates of anxiety during an additional social interaction task where they were instructed to use positive self-imagery. The IMAG group also reported decreases in performance compared to the control group. This finding appears to be explained primarily based on the adolescents' belief that they were unable to hide their anxiety rather than a decrease in social skill (such as reported by socially-phobic youth). Further, the IMAG group reported an overall fewer number of cognitions than both groups during the social interaction task, potentially indicating a significant decrease in cognitive resources based on the use of self-imagery. Overall findings from this investigation do not support the hypothesis that negative self-imagery plays a causal role in the development of social phobia among adolescents. Rather, results indicate that excessive self-focused attention within social contexts, together with normal developmental increases in self-consciousness during the adolescent years may pose a specific risk for development of the syndrome. These findings provide a developmental understanding of the factors involved in the onset of social phobia, as well as those symptoms that may be germane to the maintenance of the disorder over time

Editorial: How does sleep help regulate negative emotion?

In this volume, 15 scientific reports give a snapshot of some of the most exciting current research on how sleep helps regulate negative emotion. Articles illustrate state-of-the-art research paradigms from the cognitive, affective, and behavioral neurosciences, sleep medicine, biological psychiatry, and dream research

Long-Duration Space Exploration and Emotional Health: Recommendations for Conceptualizing and Evaluating Risk.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Spaceflight to Mars will by far exceed the duration of any previous mission. Although behavioral health risks are routinely highlighted among the most serious threats to crew safety, understanding of specific emotional responses most likely to occur and interfere with mission success has lagged in comparison to other risk domains. Even within the domain of behavioral health, emotional constructs remain to be ‘unpacked’ to the same extent as other factors such as attention and fatigue. The current paper provides a review of previous studies that have examined emotional responses in isolated, confined, extreme environments (ICE) toward informing a needed research agenda. We include research conducted during space flight, long-duration space simulation analogs, and polar environments and utilize a widely-accepted and studied model of emotion and emotion regulation by Gross [6] to conceptualize specific findings. Lastly, we propose four specific directions for future research: (1) use of a guiding theoretical framework for evaluating emotion responses in ICE environments; (2) leveraging multi-method approaches to improve the reliability of subjective reports of emotional health; (3) a priori selection of precise emotional constructs to guide measure selection; and (4) focusing on positive in addition to negative emotion in order to provide a more complete understanding of individual risk and resilience

Action Boundary Proximity Effects on Perceptual-Motor Judgments

INTRODUCTION: Designed as a more ecological measure of reaction times, the Perception-Action Coupling Task (PACT) has shown good reliability and within-subject stability. However, a lengthy testing period was required. Perceptual-motor judgments are known to be affected by proximity of the stimulus to the action boundary. The current study sought to determine the effects of action boundary proximity on PACT performance, and whether redundant levels of stimuli, eliciting similar responses, can be eliminated to shorten the PACT.METHODS: There were 9 men and 7 women who completed 4 testing sessions, consisting of 3 familiarization cycles and 6 testing cycles of the PACT. For the PACT, subjects made judgments on whether a series of balls presented on a tablet afford "posting" (can fit) through a series of apertures. There were 8 ratios of ball to aperture size (B-AR) presented, ranging from 0.2 to 1.8, with each ratio appearing 12 times (12 trials) per cycle. Reaction times and judgment accuracy were calculated, and averaged across all B-ARs. Ratios and individual trials within each B-AR were systematically eliminated. Variables were re-averaged, and intraclass correlation coefficients (ICC) and coefficients of variation (CVTE) were calculated in an iterative manner.RESULTS: With elimination of the 0.2 and 1.8 B-ARs, the PACT showed good reliability (ICC = 0.81-0.99) and consistent within-subject stability (CVTE = 2.2-14.7%). Reliability (ICC = 0.81-0.97) and stability (CVTE = 2.6-15.6%) were unaffected with elimination of up to 8 trials from each B-AR.DISCUSSION: The shortened PACT resulted in an almost 50% reduction in total familiarization/testing time required, significantly increasing usability.Johnson CD, LaGoy AD, Pepping G-J, Eagle SR, Beethe AZ, Bower JL, Alfano CA, Simpson RJ, Connaboy C. Action boundary proximity effects on perceptual-motor judgments. Aerosp Med Hum Perform. 2019; 90(12):1000-1008

The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

The authors acknowledge the efforts of Patricia Rao, Ph.D., Project Coordinator, Richard Gross, M.D., and Stephen Kwass, M.D., psychiatrists.Discrepancies between informants’ reports of children’s behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between parent-child reporting discrepancies on measures of child social phobia symptoms, administered before and after treatment for social phobia. Participants included a clinic sample of 81 children (7–16 years old [M=11.75, SD=2.57]; 39 girls, 42 boys) and their parents receiving treatment as part of a multisite controlled trial. Pretreatment parent-child reporting discrepancies predicted parent-child discrepancies at posttreatment, and these relations were not better accounted for by the severity of the child’s pretreatment primary diagnosis. Further, treatment responder status moderated this relation: Significant relations were identified for treatment non-responders and not for treatment responders. Overall, findings suggest that informant discrepancies can be reliably employed to measure individual differences over the course of controlled treatment trials. These data provide additional empirical support for recent work suggesting that informant discrepancies can meaningfully inform understanding of treatment response as well as variability in treatment outcomes.This research was supported in part by NIMH grant R01MH53703 to the third author. Lilly Corporation supplied the fluoxetine and matching placebo capsules. Clinical trial registration information- URL: http://www.clinicaltrials.gov; Unique identifier: NCT00043537

Interaction of sleep and emotion across the menstrual cycle

Menstruating individuals experience an increased risk for sleep and affective disorders, attributed in part to monthly oscillations in sex hormones. Emotional functioning and sleep continuity worsens during the perimenstrual phase of the menstrual cycle. This study examined the interactive effects of sleep, menstrual phase, and emotion in healthy women. Participants (N = 51, 43% Caucasian) aged 18–35 (m = 24 years) completed actigraphy and daily sleep/emotion diaries over two menstrual cycles (m days = 51.29). Diary and actigraphic total wake time at night (TWT) and daily ratings of positive and negative affect were compared across four phases of the menstrual cycle: perimenstrual, mid-follicular, periovulatory, and mid-luteal. Relationships between phase, sleep, and emotion were estimated using multistep hierarchical linear modelling. Mean menstrual cycle length was 28.61 ± 2.69 days. Perimenstrual phase positively predicted anger (p < 0.001) but no other emotions. Additionally, the perimenstrual phase predicted higher rates of TWT, such that diary TWT was 8–16 min longer during the perimenstrual (m = 67.54, SE = 3.37) compared to other phases (p < 0.001). Actigraphic TWT was also increased by 4–7 min (m = 61.54, SE = 3.37) in the perimenstrual phase (p < 0.001). Positive emotions were 0.05–0.10 points lower (p = 0.006–0.02) when TWT was greater in the perimenstrual phase. Greater rates of anger and sleep disruption were seen during the perimenstrual phase compared with other phases. When poor sleep occurred during the perimenstrual phase individuals reported reduced positive emotions. Reducing perimenstrual sleep disruptions may be an important intervention target for those at risk for affective disorders

Intersession Reliability and Within-Session Stability of a Novel Perception-Action Coupling Task

BACKGROUND: The perception-action coupling task (PACT) was designed as a more ecologically valid measure of alertness/reaction times compared to currently used measures by aerospace researchers. The purpose of this study was to assess the reliability, within-subject variability, and systematic bias associated with the PACT. METHODS: There were 16 subjects (men/women = 9/7; age = 27.8 +/- 3.6 yr) who completed 4 identical testing sessions. The PACT requires subjects to make judgements on whether a virtual ball could fit into an aperture. For each session, subjects completed nine cycles of the PACT, with each cycle lasting 5 min. Judgement accuracy and reaction time parameters were calculated for each cycle. Systematic bias was assessed with repeated-measures ANOVA, reliability with intraclass correlation coefficients (ICC), and within-subject variability with coefficients of variation (CVTE). RESULTS: Initiation time (Mean = 0.1065 s) showed the largest systematic bias, requiring the elimination of three cycles to reduce bias, with all other variables requiring, at the most, one. All variables showed acceptable reliability (ICC > 0.70) and within-subject variability (CVTE <20%) with only one cycle after elimination of the first three cycles. CONCLUSIONS: With a three-cycle familiarization period, the PACT was found to be reliable and stable

Associations among Adolescent Sleep Problems, Emotion Regulation, and Affective Disorders: Findings from a Nationally Representative Sample.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Sleep problems in youth reliably forecast the development of anxiety and mood disorders, presumably due to increased emotional difficulties. However, precise emotional mechanisms have yet to be delineated. The current study investigated how sleep problems in adolescence are associated with different emotion regulation strategies, and how sleep and psychiatric risk may be indirectly associated via poor emotion regulation. This study utilized data from the National Comorbidity Survey-Adolescent Supplement, a nationally representative sample from the United States (N = 10,148; age range 13–18 years). A diagnostic interview determined if adolescents qualified for a mood or anxiety disorder within the past year. Participants provided reports of their sleep, emotion regulation, and current life stress. Adolescents who reported greater sleep problems were more likely to qualify for a mood or anxiety disorder and generally reported poorer emotion regulation strategy use, even when accounting for demographic characteristics and current stress. Specifically, adolescents with greater sleep problems reported less problem solving, and greater avoidance, suppression, rumination, and acceptance. Sleep problems were indirectly associated with anxiety disorders through greater suppression and rumination, and indirectly associated with mood disorders through greater rumination and lower problem solving. Although cross-sectional, this study extends current research by suggesting that certain emotion regulation strategies may be more difficult for youth struggling with sleep problems, and provides initial evidence that poor emotion regulation may be one factor contributing to sleep-based psychiatric risk. These findings can inform more efficacious intervention efforts

Which objective sleep elements predict children’s perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy

Objectives: Objective sleep elements that underlie child ratings of sleep quality are largely unknown. Child-based sleep recommendations, therefore, typically focus on duration. An expert panel recently provided specific recommendations regarding objective sleep parameters that correspond with higher quality sleep, but child-based studies from which to draw conclusions were notably limited. The present study used actigraphy and polysomnography to explore sleep continuity and architectural variables that correspond with higher ratings of sleep quality in a sample of school-aged children.  Methods: Fifty-two healthy, prepubertal children (aged 7–11 years) completed one night of unattended ambulatory polysomnography at home with concurrent actigraphy and provided sleep quality ratings the following morning. Associations between sleep variables and subjective ratings were examined using polynomial regression models to examine potential linear and nonlinear relationships.  Results: In contrast to findings among adults, total sleep time, sleep onset latency, and sleep efficiency values were unrelated to child ratings of sleep quality. Wake after sleep onset (WASO) showed a curvilinear (reversed j-shaped) relationship such that perceptions of sleep quality were high when WASO values were less than approximately 30 minutes. For sleep architecture, N1% showed a significant quadratic association with sleep quality such that N1% between 2% and 6% corresponded with high sleep quality ratings.  Conclusions: Our findings support expert recommendations regarding WASO values that predict high quality sleep in children, but also await replication. There is need for additional research aimed at understanding objective sleep elements and other influences of children's perceptions of sleep quality using linear and nonlinear models