Catastrophizing, rumination, and reappraisal prospectively predict adolescent PTSD symptom onset following a terrorist attack: Jenness et al.

Disruptions in emotion regulation are a transdiagnostic risk factor for psychopathology. However, scant research has examined whether emotion regulation strategies are related to the onset of posttraumatic stress disorder (PTSD) symptoms among youths exposed to trauma. We investigated whether pretrauma emotion regulation strategies prospectively predicted PTSD symptom onset after the 2013 Boston Marathon terrorist attack among adolescents and whether these associations were moderated by the degree of exposure to media coverage of the attack

Maltreatment Exposure, Brain Structure and Fear Conditioning in Children and Adolescents

Alterations in learning processes and the neural circuitry that supports fear conditioning and extinction represent mechanisms through which trauma exposure might influence risk for psychopathology. Few studies examine how trauma or neural structure relates to fear conditioning in children. Children (n=94) aged 6–18 years, 40.4% (n=38) with exposure to maltreatment (physical abuse, sexual abuse, or domestic violence), completed a fear conditioning paradigm utilizing blue and yellow bells as conditioned stimuli (CS+/CS−) and an aversive alarm noise as the unconditioned stimulus. Skin conductance responses (SCR) and self-reported fear were acquired. Magnetic resonance imaging data were acquired from 60 children. Children without maltreatment exposure exhibited strong differential conditioning to the CS+ vs CS−, based on SCR and self-reported fear. In contrast, maltreated children exhibited blunted SCR to the CS+ and failed to exhibit differential SCR to the CS+ vs CS− during early conditioning. Amygdala and hippocampal volume were reduced among children with maltreatment exposure and were negatively associated with SCR to the CS+ during early conditioning in the total sample, although these associations were negative only among non-maltreated children and were positive among maltreated children. The association of maltreatment with externalizing psychopathology was mediated by this perturbed pattern of fear conditioning. Child maltreatment is associated with failure to discriminate between threat and safety cues during fear conditioning in children. Poor threat–safety discrimination might reflect either enhanced fear generalization or a deficit in associative learning, which may in turn represent a central mechanism underlying the development of maltreatment-related externalizing psychopathology in children

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (>= 65 years; estimated glomerular filtration rate <= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off <= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men

The Roles of Respiratory Sinus Arrhythmia Reactivity and Intimate Partner Violence in Childhood as Predictors of Adolescent Risky Behavior

Thesis (Master's)--University of Washington, 2013Adolescence is a time of experimentation, associated with heightened engagement in risky behaviors such as alcohol and drug use and unsafe sexual behavior. Recent literature suggests that individual differences in physiological stress reactivity and exposure to intimate partner violence (IPV) in childhood may predict problem behavior in adolescence (Silk et al. 2003; Evans et al. 2008). This study aims to examine whether respiratory sinus arrhythmia reactivity (RSAR) in middle childhood predicts risky behaviors in adolescence, and to determine whether the presence of intimate partner violence in childhood moderates this relation. Forty-three mother and child dyads were recruited as part of a longitudinal study of children at risk for behavior problems. Children's RSAR was assessed during an interpersonal stressor task when they were 9 years old on average. At this time point, mothers were assessed for the experience of intimate partner violence. When these children reached age 16, they completed questionnaires about their risky behaviors. Results indicated that RSA augmentation to interpersonal stress in childhood predicted adolescent risky behaviors. Intimate partner violence was not significantly related to a composite measure of adolescent risky behaviors, but did significantly strengthen the relation between childhood RSA augmentation to interpersonal stress and problems from alcohol use during adolescence. These results suggest that RSA augmentation to interpersonal stress may be an individual differences factor that sets some children at risk for problems with alcohol use in adolescence. The presence of intimate partner violence in their homes compounds this risk. Future research should investigate interventions that target emotion regulation skills in children exposed to IPV to prevent these children from exhibiting risky behavior in adolescence

Interpersonal Violence Exposure, Social Cognition, and Aggression in Adolescence

Thesis (Ph.D.)--University of Washington, 2018Adolescents who are victims of interpersonal violence are at markedly elevated risk of perpetrating violence not only in childhood and adolescence, but also in adulthood. This is concerning, given that almost a third of American youth have been exposed to at least one form of violence by the time they reach adolescence. Although deficits in empathic ability have long been proposed as a determinant of aggressive behavior, scant research has examined the social cognitive processes underlying empathy (e.g. moral reasoning) as potential mechanisms in the cycle of violence. To that end this study aimed to examine the impact of interpersonal violence exposure on the development of social cognitive processes involved in empathy, and their neural bases. Specifically, I examined the role of disruptions in processes that underlie empathy including emotion perception, cognitive and affective theory of mind, and experience-sharing, as a mechanism linking interpersonal violence exposure and aggressive behavior. This conceptual model was tested by acquiring self-report, behavioral, and functional MRI data in a community-based sample of 70 14-19 year old adolescents with a high concentration of exposure to interpersonal violence. Interpersonal violence exposure was associated with slower processing of faces expressing negative emotions and delayed identification of others’ emotions across a variety of contexts, as well as difficulty discriminating unintentional from intentional behavior. These disruptions in social cognition, in turn, were associated with aggressive behavior, but did not significantly explain the indirect effect of interpersonal violence on aggression. These findings build on existing research on the cycle of violence by identifying a specific pattern of atypical social cognitive processes influenced by childhood experiences of interpersonal violence. Findings not only enhance knowledge of how adverse environments alter development in ways that might increase risk for aggression, but also indicate possible targets for preventive interventions aimed at reducing aggressive behavior in adolescents who are victims of violence

Cardiovascular reactivity as a mechanism linking child trauma to adolescent psychopathology

Alterations in physiological reactivity to stress are argued to be central mechanisms linking adverse childhood environmental experiences to internalizing and externalizing psychopathology. Childhood trauma exposure may influence physiological reactivity to stress in distinct ways from other forms of childhood adversity. This study applied a novel theoretical model to investigate the impact of childhood trauma on cardiovascular stress reactivity - the biopsychosocial model of challenge and threat. This model suggests that inefficient cardiovascular responses to stress - a threat as opposed to challenge profile - are characterized by blunted cardiac output (CO) reactivity and increased vascular resistance. We examined whether childhood trauma exposure predicted an indicator of the threat profile of cardiovascular reactivity and whether such a pattern was associated with adolescent psychopathology in a population representative sample of 488 adolescents (M = 16.17 years old, 49.2% boys) in the TRacking Adolescents' Individual Lives Survey (TRAILS). Exposure to trauma was associated with both internalizing and externalizing symptoms and a pattern of cardiovascular reactivity consistent with the threat profile, including blunted CO reactivity during a social stress task. Blunted CO reactivity, in turn, was positively associated with externalizing, but not internalizing symptoms and mediated the link between trauma and externalizing psychopathology. None of these associations varied by gender. The biopsychosocial model of challenge and threat provides a novel theoretical framework for understanding disruptions in physiological reactivity to stress following childhood trauma exposure, revealing a potential pathway linking such exposure with externalizing problems in adolescents. (C) 2016 Elsevier B.V. All rights reserved

Childhood Maltreatment Exposure and Disruptions in Emotion Regulation: A Transdiagnostic Pathway to Adolescent Internalizing and Externalizing Psychopathology

Child maltreatment is a robust risk factor for internalizing and externalizing psychopathology in children and adolescents. We examined the role of disruptions in emotion regulation processes as a developmental mechanism linking child maltreatment to the onset of multiple forms of psychopathology in adolescents. Specifically, we examined whether child maltreatment was associated with emotional reactivity and maladaptive cognitive and behavioral responses to distress, including rumination and impulsive behaviors, in two separate samples. We additionally investigated whether each of these components of emotion regulation were associated with internalizing and externalizing psychopathology and mediated the association between child maltreatment and psychopathology. Study 1 included a sample of 167 adolescents recruited based on exposure to physical, sexual, or emotional abuse. Study 2 included a sample of 439 adolescents in a community-based cohort study followed prospectively for 5 years. In both samples, child maltreatment was associated with higher levels of internalizing psychopathology, elevated emotional reactivity, and greater habitual engagement in rumination and impulsive responses to distress. In Study 2, emotional reactivity and maladaptive responses to distress mediated the association between child maltreatment and both internalizing and externalizing psychopathology. These findings provide converging evidence for the role of emotion regulation deficits as a transdiagnostic developmental pathway linking child maltreatment with multiple forms of psychopathology

Malleability of rumination: An exploratory model of CBT-based plasticity and long-term reduced risk for depressive relapse among youth from a pilot randomized clinical trial.

Clinical trials registrationNCT01905267, https://clinicaltrials.gov/ct2/show/NCT01905267

Effects of parental monitoring on alcohol use in the US and Sweden : A brief report

Objective Adolescent alcohol use predicts a myriad of negative mental and physical health outcomes including fatality (Midanik, 2004). Research in parental influence on alcohol consumption finds parental monitoring (PM), or knowing where/whom your child is with, is associated with lower levels of alcohol use in adolescents (e.g., Arria et al., 2008). As PM interventions have had only limited success (Koutakis, Stattin, & Kerr, 2008), investigating moderating factors of PM is of importance. Country may serve as one such moderator (Calafat, Garcia, Juan, Becoña, & Fernández-Hermida, 2014). Thus, the purpose of the present report is to assess the relationship between PM and alcohol use in the US and Sweden. Method High school seniors from the US (n = 1181, 42.3% Male) and Sweden (n = 2171, 44.1% Male) completed assessments of total drinks consumed in a typical week, problematic alcohol use, and perceived PM. Results Generalized linear mixed modeling (GLM, Cohen, Cohen, West, & Aiken, 2013; Hilbe, 2011) was used to examine whether country moderated the relationship between PM and alcohol use. Results revealed main effects of country and PM and a significant interaction between country and PM in predicting total drinks per week and PM in predicting problematic alcohol use (p < 0.001). Conclusions While PM is related to lower quantity of alcohol consumed and problematic alcohol use, greater PM appears to be more strongly related to fewer drinks per week and less problematic alcohol use in the US, as compared to Sweden

Screening Parents During Child Evaluations: Exploring Parent and Child Psychopathology in the Same Clinic

Objective: Children of depressed and/or anxious parents are at increased risk for developing psychiatric disorders. Little research has focused on screening parents bringing their children for psychiatric evaluation, and few studies have included fathers or Hispanic children. This study had the following aims: 1) to identify current symptom rates in parents bringing their children for evaluation; and 2) to determine whether parental symptoms were associated with children\u27s symptoms, diagnoses, and functioning. Method: The sample included 801 mothers, 182 fathers, and 848 children (aged 6 through 17 years). The majority (55.66%) were Hispanic, who attended a child and adolescent psychiatric evaluation service. Parent and child symptoms were assessed via parental reports. Children\u27s diagnoses and functioning were determined by clinicians. Multiple regression analyses were used to determine whether severity of parental symptoms was associated with clinical child variables adjusting for child and parent demographic variables. Results: In all, 18.80% of mothers and 18.42% of fathers reported elevated internalizing symptoms. Maternal symptoms were significantly associated with problems in children\u27s functioning and children\u27s anxiety, depression, and oppositional/conduct diagnoses; but not attention-deficit/hyperactivity disorder. Adjusting for parental and child demographics had a reduction on the effect of maternal symptoms on child depression. Paternal symptoms and functioning were positively associated with children\u27s diagnoses, but the associations were smaller and not significant. Both parents\u27 symptoms were significantly associated with children\u27s internalizing and externalizing symptoms. However, these significant effects were not moderated by marital status or child ethnicity. Conclusions: This study highlights the importance of screening parents when their children receive a psychiatric evaluation. The findings support the development of mental health services that address psychiatric needs of the entire family within one clinical setting