Editorial:Factualities - establishing empirical truths in child psychology and psychiatry

Empirical science is a fact-finding enterprise. This raises the question when we know enough about a particular topic to draw firm conclusions and can stop searching for additional evidence in order to save efforts for issues that are less well-established. Clarity on when scientific evidence has passed the stage of to-be-tested hypotheses is important, and setting up criteria for such stopping rules is a necessary as well as thought-provoking challenge. Not only over-investigating phenomena is undesirable but the opposite, falsely assuming beliefs to be facts, as well. Two common reasons for such misperceptions are that negative news is more likely to spread around than positive news (negativity instinct), and that individuals tend to look at problems from always the same perspective (single-perspective instinct). Our field is not immune to those instincts: child psychologists and psychiatrists tend to focus on messages suggesting that the burden of children´s mental health problems calls for more intervention and research, rather than on reports that the majority of children are doing quite well. This focus on problems may obscure the reality that the vast majority of children and adolescents never experience severe mental health problems, despite the challenges of growing up in a complex world

A longitudinal perspective on childhood adversities and onset risk of various psychiatric disorders

It is well-known that childhood adversities can have long-term effects on mental health, but a lot remains to be learned about the risk they bring about for a first onset of various psychiatric disorders, and how this risk develops over time. In the present study, which was based on a Dutch longitudinal population survey of adolescents TRAILS (N = 1,584), we investigated whether and how childhood adversities, as assessed with three different measures, affected the risk of developing an incident depressive, anxiety, or disruptive behavior in childhood and adolescence. In addition, we tested gender differences in any of the effects under study. The results indicated that depressive, anxiety and disruptive behavior disorders each had their own, characteristic, pattern of associations with childhood adversities across childhood and adolescence, which was maintained after adjustment for comorbid disorders. For depressive disorders, the overall pattern suggested a high excess risk of incidence during childhood, which decreased during adolescence. Anxiety disorders were characterized by a moderately increased incident risk during childhood, which remained approximately stable over time. Disruptive behavior disorders took an intermediate position. Of the three childhood adversities tested, an overall rating of the stressfulness of the childhood appeared to predict onset of psychiatric disorders best. To conclude, the risk of developing a psychiatric disorder after exposure to adversities early in life depends on the nature of the adversities, the nature of the outcome, and the time that has passed since the adversities without disorder onset

The Role of Group Dynamics in Scientific Inconsistencies: A Case Study of a Research Consortium

Judith Rosmalen and Albertine Oldehinkel describe their experience in the TRAILS research consortium to discuss why research teams might publish contradictory or inconsistent results despite procedures to avoid this; they emphasize the role of internal group dynamics rather than faulty publication practices

Life changes and depressive symptoms: the effects of valence and amount of change

Background Only few studies have focused on the effects of positive life changes on depression, and the ones that did demonstrated inconsistent findings. The aim of the present study was to obtain a better understanding of the influence of positive life changes on depressive symptoms by decomposing life changes into a valence and an amount of change component. Methods Using hierarchical multiple regression, we examined the unique effects of valence (pleasantness/unpleasantness) and amount of change on depressive symptoms in 2230 adolescents (M age: 16.28 years) from the TRAILS study. Results Adjusted for age, gender and pre-event depressive symptoms, the amount of life change was positively associated with depressive symptoms. A small excess of positive life changes predicted fewer symptoms, but experiencing a large excess of positive life changes did not have any additional beneficial effects, rather the opposite. Valence was more strongly associated with cognitive-affective than with neurovegetative-somatic symptoms. Conclusions More positive life changes relative to negative life changes can protect against depressive symptoms, yet only when the amount of change is limited. This study encourages examination of the effects of life changes on specific symptom clusters instead of total numbers of depressive symptoms, which is the current standard

Prevalence, 20-month incidence and outcome of unipolar depressive disorders in a community sample of adolescents

Background. This article presents prospective longitudinal findings on prevalence, incidence, patterns of change and stability of depressive disorders in a community sample of 1228 adolescents. Methods. Data were collected at baseline and follow-up (20 months later) in a representative population sample of 1228 adolescents, aged 14–17 at baseline. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI). Results. The overall cumulative lifetime incidence of any depressive condition was 20·0% (major depressive disorder (MDD), 12·2%; dysthymia, 3·5%; subthreshold MDD, 6·3%), of which about one-third were incident depressions in the period between baseline and follow-up. Depressive disorders rarely started before the age of 13. Females were about twice as likely as males to develop a depressive disorder. Overall, the 20-month outcome of baseline depression was unfavourable. Dysthymia had the poorest outcome of all, with a complete remission rate of only 33% versus 43% for MDD and 54% for subthreshold MDD. Dysthymia also had the highest number of depressive episodes, and most psychosocial impairment and suicidal behavioural during follow-up. Treatment rates were low (8–23%). Subthreshold MDD associated with considerable impairment had an almost identical course and outcome as threshold MDD. Conclusions. DSM-IV MDD and dysthymia are rare before the age of 13, but frequent during adolescence, with an estimated lifetime cumulative incidence of 14%. Only a minority of these disorders in adolescence is treated, and more than half of them persist or remit only partly

Comparison of Two Ecological Momentary Intervention Modules for Treatment of Depression on Momentary Positive and Negative Affect

Background: Ecological Momentary Assessment (EMA), comprising repeated self-assessments in daily life, have shown promise as an intervention strategy for depression. Whether the content of such assessments influences affect has hardly received attention. The current study consists of two EMA intervention (EMI) modules, enabling us to compare the impact of EMI content on the course of momentary affect during the intervention. Methods: The intervention, implemented as add-on to regular depression treatment, consists of intensive self-monitoring (5x/day, 28 days) and weekly personalized feedback. Patients with depressive complaints (N = 110; M-age = 32.9, SD = 12.2; 44.5% male) were randomly assigned to one of two treatment modules focusing on activities and positive affect ("Do") or on thoughts and negative affect ("Think"). Results: Linear mixed models showed no significant (p > .18) differences between the two modules on both positive and negative affect over time. Across modules positive affect showed an initial decreasing trend, leveling off towards the end of the intervention period. Negative affect did not change significantly over time (p > .06). Limitations: Both modules assessed positive and negative affect, enabling a direct comparison but potentially decreasing the impact of their differential focus. Conclusions: In our sample, the focus of the EMI was not associated with differential effects on momentary affect. This implies that a focus on thoughts and negative affect compared to positive affect and activities may not lead to added adverse effects on mood, which is an often-voiced concern when using EMA in both research and clinical practice

Bullying and Victimization in Elementary Schools: A Comparison of Bullies, Victims, Bully/Victims, and Uninvolved Preadolescents

Research on bullying and victimization largely rests on univariate analyses and on reports from a single informant. Researchers may thus know too little about the simultaneous effects of various independent and dependent variables, and their research may be biased by shared method variance. The database for this Dutch study was large (N = 1,065) and rich enough to allow multivariate analysis and multisource information. In addition, the effect of familial vulnerability for internalizing and externalizing disorders was studied. Gender, aggressiveness, isolation, and dislikability were most strongly related to bullying and victimization. Among the many findings that deviated from or enhanced the univariate knowledge base were that not only victims and bully/victims but bullies as well were disliked and that parenting was unrelated to bullying and victimization once other factors were controlled.

Personalized lifestyle advice alters affective reactivity to negative events in anhedonic young adults

BACKGROUND: Anhedonia is a common symptom of several disorders, but cost-effective treatments that focus on anhedonia specifically have been lacking. Therefore, personalized lifestyle advice has recently been investigated as a suitable means of enhancing pleasure and positive affect (PA) in young adults with anhedonia. This intervention provided individuals with a personalized lifestyle advice which was based on observed individual patterns of lifestyle behaviors and experienced pleasure in daily life. The present study extends this previous work by examining a potential mechanism of treatment success, affective reactivity. METHODS: We explored changes in affective reactivity to events in daily life from pre- to post-intervention in a subclinical sample of young adults with anhedonia (N = 69). Using the Experience Sampling Method (ESM), participants answered questions on their activities, their pleasure levels, PA and negative affect (NA) before and after the intervention. RESULTS: Multilevel analysis revealed that participants did not experience an altered affective reactivity to positive events after the intervention. The affective reactivity to negative events depended on the level of improvement in mean-PA after the lifestyle advice intervention. LIMITATIONS: The present study used a subclinical sample with the majority of participants being female which limited the generalizability of the findings. CONCLUSION: This study suggests that an altered affective reactivity to negative events is an underlying mechanism of the effectiveness of a personalized lifestyle advice