Dissertations / Theses on the topic 'Depression in adolescence Adolescent psychopathology Anxiety in adolescence'

This study examined symptoms of anxiety and depression in 99 children and adolescents following a residential fire. Children and their parents completed self-administered questionnaires regarding the fire and their current functioning. The most commonly experienced symptoms were worry/ oversensitivity, anhedonia, negative mood, and fear of failure and criticism. There were no significant ethnic differences across symptomology. Exposure was directly related to parental report of child internalizing behaviors, whereas loss was unrelated to symptoms. Level of support (general and fire related) and active coping were directly associated with positive child adjustment. The impact of negative life events was related to poorer functioning. Overall, a child's environment and coping strategy appear to be the best predictors of adjustment following a residential fire.

Objective: Internalizing problems are commonly diagnosed during adolescence, and are associated with distress, impairment, and negative mental health outcomes in adulthood. Thus, there is a critical need to characterize adolescents who are at the highest risk for escalating to clinical levels of internalizing problems while extending current literature and incorporating both biological and environmental predictors. This study aimed to characterized risk profiles for fourteen-year-old adolescents who developed clinical levels of internalizing (High Internalizing [HI]) problems by age nineteen, using brain, genetic, personality, cognitive, life history, psychopathology, and demographic measures. The study also examined whether there were functional and structural brain differences in three groups of adolescents on select regions of interest (ROIs) on the Faces Task, Stop Signal Task, and Modified Incentive Delay Task. Method: Participants were 91 adolescents who met clinical criteria for at least one Anxiety and/or Depressive Disorder by age 19 and 1,244 controls who varied in symptom level but did not reach clinically-diagnostic criteria. Ten-fold cross-validated logistic regression using elastic net regularization was used to identify risk profiles associated with high levels of internalizing symptomatology. To examine group differences in regions of interest on three fMRI tasks and in gray matter volume, ANCOVAs were conducted. The three groups were: 1) adolescents who never met HI criteria (Controls), 2) those who met HI criteria in middle adolescence (Middle Onset), and 3) those who met HI criteria in late adolescence (Late Onset). Results: Logistic regression identified 13 variables from personality, psychopathology, life events, and functional brain variables to predict High Internalizing symptoms (mean AUC 0.78, p<.0001). ANCOVAs showed there were several ROIs that demonstrated main effects of Time, and one main effect of Group during response inhibition in the left inferior frontal gyrus, triangular part (pars triangularis), with participants in the Middle Onset group showing increased activation levels compared with the Control group. There were no other significant main effects of Group or Time x Group interactions. Conclusions: These findings give insight into personality, psychopathological, and brain-related factors that are associated with high levels of internalizing symptoms, highlighting the importance of including biological variables in conjunction with psychosocial variables when examining risk factors for internalizing problems. Results also suggest an association between activation in frontal cortex and parietal lobe regions during response inhibition and higher internalizing symptoms in late adolescence. Between-group activation and volumetric ROI comparisons generally yielded main effects of time, confirming prior evidence that activation levels and GMV continue to change over the course of adolescence.

Background. There are inconclusive findings regarding whether danger and loss events differentially predict the onset of anxiety and depression. Method. A community sample of adolescents and young adults (n=2304, age 14–24 years at baseline) was prospectively followed up in up to four assessments over 10 years. Incident anxiety and depressive disorders were assessed at each wave using the DSM-IV/M-CIDI. Life events (including danger, loss and respectively mixed events) were assessed at baseline using the Munich Event List (MEL). Logistic regressions were used to reveal associations between event types at baseline and incident disorders at follow-up. Results. Loss events merely predicted incident ‘pure’ depression [odds ratio (OR) 2.4 per standard deviation, 95% confidence interval (CI) 1.5–3.9, p<0.001] whereas danger events predicted incident ‘pure’ anxiety (OR 2.3, 95% CI 1.1–4.6, p=0.023) and ‘pure’ depression (OR 2.5, 95% CI 1.7–3.5, p<0.001). Mixed events predicted incident ‘pure’ anxiety (OR 2.9, 95% CI 1.5–5.7, p=0.002), ‘pure’ depression (OR 2.4, 95% CI 1.6–3.4, p<0.001) and their co-morbidity (OR 3.6, 95% CI 1.8–7.0, p<0.001). Conclusions. Our results provide further evidence for differential effects of danger, loss and respectively mixed events on incident anxiety, depression and their co-morbidity. Since most loss events referred to death/separation from significant others, particularly interpersonal loss appears to be highly specific in predicting depression.

Thesis (Ph. D.)--West Virginia University, 2000.
Title from document title page. Document formatted into pages; contains ix, 138 p. Vita. Includes abstract. Includes bibliographical references (p. 104-117).

This study examined the possible mediating role of the emotional, behavioral, and cognitive components of self-regulation as they relate to adolescent intrinsic religiosity and the internalizing problems of teen depression and anxiety. The sample included 459 adolescent respondents from one wave of the Flourishing Families Project, an ongoing longitudinal study. Through the use of Structural Equation Modeling, results showed that cognitive self-regulation partially mediated the relationship between intrinsic religiosity and adolescent depression. Additionally, emotional self-regulation, but not behavioral self-regulation was found to be negatively linked with both depression and anxiety. These findings provide clinicians with greater direction when working with depressed or anxious teens who also have a religious/spiritual framework.

Aims. To prospectively examine whether negative life events (NLE) and low perceived coping efficacy (CE) increase the risk for the onset of various forms of psychopathology and low CE mediates the associations between NLE and incident mental disorders. Methods. A representative community sample of adolescents and young adults (N = 3017, aged 14–24 at baseline) was prospectively followed up in up to three assessment waves over 10 years. Anxiety, depressive and substance use disorders were assessed at each wave using the DSM-IV/M-CIDI. NLE and CE were assessed at baseline with the Munich Event List and the Scale for Self-Control and Coping Skills. Associations (odds ratios, OR) of NLE and CE at baseline with incident mental disorders at follow-up were estimated using logistic regressions adjusted for sex and age. Results. NLE at baseline predicted the onset of any disorder, any anxiety disorder, panic disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.02–1.09 per one NLE more). When adjusting for any other lifetime disorder prior to baseline, merely the associations of NLE with any anxiety disorder, any depression, major depressive episodes, dysthymia and any substance use disorder remained significant (OR 1.02–1.07). Low CE at baseline predicted the onset of any disorder, any anxiety disorder, agoraphobia, generalised anxiety disorder, any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs at follow-up (OR 1.16–1.72 per standard deviation). When adjusting for any other lifetime disorder prior to baseline, only the associations of low CE with any depression, major depressive episodes, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence and abuse/dependence of illicit drugs remained significant (OR 1.15–1.64). Low CE explained 9.46, 13.39, 12.65 and 17.31% of the associations between NLE and any disorder, any depression, major depressive episodes and dysthymia, respectively. When adjusting for any other lifetime disorder prior to baseline, the reductions in associations for any depression (9.77%) and major depressive episodes (9.40%) remained significant, while the reduction in association for dysthymia was attenuated to non-significance ( p-value > 0.05). Conclusions. Our findings suggest that NLE and low perceived CE elevate the risk for various incident mental disorders and that low CE partially mediates the association between NLE and incident depression. Subjects with NLE might thus profit from targeted early interventions strengthening CE to prevent the onset of depression.

Adolescent depression is a major public health problem, which is associated with educational problems, long-term psychiatric illness and suicide. One major source of stress during adolescence is peer rejection. In this thesis, I investigate the nature of the relationship between peer rejection and adolescent depression. In a review of longitudinal and experimental studies, I describe a bi-directional relationship between peer rejection and depressive symptoms. I then outline how genetic, cognitive and neural vulnerability may modify the effects of peer rejection on adolescent depression. Finally, I introduce five empirical chapters which test these hypotheses using different methodological approaches. The first study is a molecular genetic analysis of a sample of adolescents with and without a diagnosis of mood disorder. I report an interaction between diagnostic group, environmental stress (though not peer rejection specifically) and 5HTTLPR genotype on symptoms of anxiety, which supports the role of genetic factors in modifying the relationship between environmental stress and adolescent mood disorder. The second study is a behavioural study of negative attention biases in a typically developing sample of adolescents. I report a negative attention bias in adolescents with low (versus high) self-esteem. Although the data do not support a causal role for attention biases in adolescent depression, such biased cognitions could also moderate responses to peer rejection, maintaining affective symptoms. A final set of three fMRI datasets investigates how neural circuitry may influence depressed adolescents’ responses to peer rejection at three distinct stages: i) expectation of peer feedback, ii) the receipt of peer rejection, iii) emotion regulation of peer rejection. Data show distinct behavioural and neural differences between depressed patients and healthy controls during expectation and reappraisal of peer rejection, although heightened emotional reactivity immediately following the receipt of peer rejection did not differentiate behavioural or neural responses in adolescents with and without depression.

Differences in self-reported depression, anxiety, self-esteem, and coping were evaluated in two groups of pediatric oncology patients: newly diagnosed (less than six months post-diagnosis) (n=5) and patients on cancer treatment for seven months or longer (n=5). Participants (6 males, 4 females, ages 7-17 years) completed the Children's Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAIC), and the Culture-Free Self-Esteem Inventory (CFSEI-2); nine of the ten participants discussed in a semi-structured interview their personal experiences and feelings about having cancer. Although the newly diagnosed group had a higher mean score on the CDI than the 7 months or greater group, the difference was not significant (p = .054). The newly diagnosed group also had higher mean state and trait anxiety scores on the STAIC, indicating higher anxiety levels, and a slightly lower CFSEI-2 mean score, indicating slightly lower self-esteem than the 7 months or greater group, but differences were not at a statistically significant level (p>.05).

Background. Previous research suggests that individuals experiencing DSM-IV panic attacks (PA) are at increased risk for various forms of psychopathology, including anxiety, depressive and substance use disorders. However, little is known regarding whether the sole occurrence of fearful spells (FS-only; distressing spells of anxiety with less than four panic symptoms and/or lacking crescendo in symptom onset) similarly elevates the risk for subsequent psychopathology and could therefore be promising to identify high-risk groups for targeted preventive interventions. Thus, the current dissertation thesis aims to examine (a) whether FS-only predict incident mental disorders in addition to full-blown PA and whether their associations with subsequent psychopathology differ from those obtained for PA, (b) whether FS-only, PA, and panic disorder (PD) share similar etiologies, (c) which characteristics of initial FS/PA and other risk factors predict a progression to more severe panic pathology and other mental disorders, and (d) whether help-seeking/potential treatment in individuals with panic alters the risk for subsequent psychopathology. Methods. A representative community sample of adolescents and young adults (N=3021, aged 14-24 at baseline) was prospectively followed up in up to three assessment waves over a time period of up to 10 years. FS-only, PA, PD, and other mental disorders were assessed at each assessment wave using the DSM-IV-M-CIDI. Additional modules/questionnaires were used to assess characteristics of initial FS/PA (T1/T2), potential risk factors, and help-seeking/potential treatment. Logistic regressions were applied to test associations (Odds Ratios, OR) of FS-only and PA at baseline with incident mental disorders at follow-up as well as respective interactive effects with help-seeking at baseline. Associations (Hazard Ratios, HR) of putative risk factors with the onset of panic pathology (FS-only, PA, and PD) or the onset of subsequent anxiety/depressive vs. substance use disorders in those with panic pathology (aggregated data across assessment waves) were estimated with Cox regressions. Multinomial logistic regressions were used to test associations of initial FS/PA characteristics (aggregated from T1 and T2) with PA and PD (lifetime incidences aggregated across assessment waves). Results. FS-only at baseline predicted incident anxiety and depressive disorders at follow-up (OR 1.59-4.36), while PA at baseline predicted incident anxiety, depressive, and substance use disorders at follow-up (OR 2.08-8.75; reference group: No FS/PA). Merely any anxiety disorder (OR=3.26) and alcohol abuse/dependence (OR=2.26) were significantly more strongly associated with PA than with FS-only. Female sex, parental anxiety disorders, parental depressive disorders, behavioral inhibition, harm avoidance, lower coping efficacy, and parental rejection predicted FS-only, PA, and PD (HR 1.2-3.0), whereas the associations with other risk factors partially differed for FS-only, PA, and PD and tended to be more pronounced for PA and PD than for FS-only. Alcohol consumption, use of drugs/medication, and physical illness as perceived reasons for the initial FS/PA were associated with the occurrence of full-blown PA (without PD, OR 2.46-5.44), while feelings of anxiety/depression and having always been anxious/nervous as perceived reasons for the initial FS/PA, appraising the initial FS/PA as terrible and long-term irritating/burdensome, subsequent feelings of depression, avoidance of situations/places, and consumption of medication, alcohol, or drugs were associated with the development of PD (OR 2.64-4.15). A longer duration until “feeling okay again” was associated with both PA and PD (OR 1.29-1.63 per category). Moreover, partially different risk constellations in subjects with panic pathology (FS/PA/PD) predicted the onset of subsequent anxiety/depressive vs. substance use disorders. Panic pathology (FS/PA) and help-seeking/potential treatment at baseline interacted on predicting incident PD (OR=0.09) and depression (OR=0.22) at follow-up in a way that panic pathology only predicted these disorders in individuals not seeking help at baseline. Conclusions. Findings suggest that individuals with FS-only are at similar risk of developing subsequent psychopathology compared to individuals with full-blown PA. Specific initial FS/PA characteristics and additional risk factors may be used to identify sub-groups of individuals with panic pathology, which are at particular risk of progressing to more severe panic pathology or other mental disorders and might therefore profit from supplemental outcome-related preventive interventions in addition to panic-specific treatment. Future research may replicate the current findings and test the efficacy of targeted preventive interventions in panickers at elevated risk for PD and other forms of psychopathology
Theoretischer Hintergrund. Auf Grundlage früherer Forschungsbefunde ist anzunehmen, dass Personen mit DSM-IV-Panikattacken (PA) ein erhöhtes Risiko für zahlreiche psychische Störungen, einschließlich Angst-, depressiver und Substanzstörungen, aufweisen. Unklar ist jedoch, ob das alleinige Auftreten von Fearful Spells (FS-only, Angstanfälle mit weniger als vier Paniksymptomen und/oder fehlendem Crescendo in der Symptomentwicklung) das Risiko für Psychopathologie in ähnlicher Weise erhöht und hilfreich sein könnte, um Hochrisikogruppen für Präventivinterventionen zu identifizieren. Innerhalb der vorliegenden Dissertation wird daher untersucht, (a) ob FS-only zusätzlich zu PA inzidente psychische Störungen vorhersagen und ob sich Unterschiede in den Assoziationen von FS-only vs. PA mit nachfolgender Psychopathologie ergeben, (b) ob FS-only, PA und Panikstörung (PS) ähnliche Ätiologien teilen, (c) welche Merkmale initialer FS/PA und welche anderen Risikofaktoren die Entwicklung schwerer Panikpathologie und weiterer psychischer Störungen vorhersagen und (d) ob Hilfesuchverhalten/potenzielle Behandlung bei Personen mit Panik das Risiko für nachfolgende Psychopathologie verändert. Methodik. Eine repräsentative Bevölkerungsstichprobe Jugendlicher und junger Erwachsener (N=3021, 14-24 Jahre zur Baseline-Erhebung) wurde in bis zu drei Erhebungswellen über einen Zeitraum von bis zu 10 Jahren untersucht. FS-only, PA, PS und andere psychische Störungen wurden zu jeder Erhebungswelle mithilfe des DSM-IV-M-CIDI erfasst. Merkmale initialer FS/PA (T1/T2), mögliche Risikofaktoren sowie Hilfesuchverhalten/potenzielle Behandlung wurden mit weiteren Modulen und Fragebögen erhoben. Mithilfe logistischer Regressionen wurden Assoziationen (Odds Ratios, OR) von FS-only und PA zu Baseline mit inzidenten psychischen Störungen zum Follow-Up sowie diesbezügliche Interaktionen mit Hilfesuchverhalten zu Baseline getestet. Zusammenhänge zwischen möglichen Risikofaktoren und dem Auftreten von Panikpathologie (FS-only, PA und PS) bzw. nachfolgender Angst-/depressiver und Substanzstörungen bei Personen mit Panikpathologie (Verwendung von über die Erhebungswellen hinweg aggregierter Daten) wurden mithilfe von Cox-Regressionen geschätzt. Multinomiale logistische Regressionen wurden genutzt, um Assoziationen von Merkmalen initialer FS/PA (aggregiert über T1 und T2) mit PA und PS (über die Erhebungswellen hinweg aggregierte Lebenszeitinzidenzen) zu erfassen. Ergebnisse. FS-only zu Baseline sagten inzidente Angst- und depressive Störungen zum Follow-Up vorher (OR 1.59-4.36), wohingegen PA zu Baseline inzidente Angst-, depressive und Substanzstörungen zum Follow-Up vorhersagten (OR 2.08-8.75; Referenzkategorie: Keine FS/PA). Lediglich irgendeine Angststörung (OR=3.26) und Alkoholmissbrauch/-abhängigkeit (OR=2.26) waren signifikant stärker mit PA als mit FS-only assoziiert. Weibliches Geschlecht, elterliche Angst- und depressive Störungen, Verhaltenshemmung, Schadensvermeidung, geringere Coping-Erwartung und elterliche Zurückweisung sagten FS-only, PA und PS vorher (HR 1.2-3.0), während sich teils unterschiedliche Assoziationen anderer Risikofaktoren mit FS-only, PA und PS ergaben, die tendenziell stärker für PA und PS als für FS-only waren. Alkoholkonsum, Drogen-/Medikamentengebrauch und körperliche Erkrankungen als wahrgenommene Gründe für die initiale FS/PA waren mit dem Auftreten vollständiger PA assoziiert (ohne PS; OR 2.46-5.44), während Gefühle von Angst/Depression und die Einschätzung schon immer ängstlich/nervös gewesen zu sein als wahrgenommene Gründe für die initiale FS/PA, die Bewertung der initialen FS/PA als schrecklich und langfristig verunsichernd/belastend, nachfolgende Gefühle von Niedergeschlagenheit, Vermeidung von Situationen/Orten und Konsum von Medikamenten, Alkohol oder Drogen mit der Entwicklung von PS assoziiert waren (OR 2.64-4.15). Eine längere Dauer bis sich die betroffene Person wieder vollständig in Ordnung fühlte war sowohl mit PA als auch mit PS assoziiert (OR 1.29-1.63 pro Kategorie). Weiterhin sagten teils unterschiedliche Risikokonstellationen bei Personen mit Panikpathologie (FS/PA/PS) die nachfolgende Entstehung von Angst-/depressiven und Substanzstörungen vorher. Panikpathologie (FS/PA) und Hilfesuchverhalten/potenzielle Behandlung zu Baseline interagierten bei der Vorhersage von inzidenter PS (OR=0.09) und Depression (OR=0.22) zum Follow-Up; d.h. das Vorhandensein von Panikpathologie sagte diese Störungen nur bei Personen ohne, nicht aber bei Personen mit Hilfesuchverhalten zu Baseline vorher. Schlussfolgerungen. Die vorliegenden Ergebnisse implizieren, dass Personen mit FS-only im Vergleich zu Personen mit vollständigen PA ein ähnliches Risiko für die Entwicklung nachfolgender Psychopathologie aufweisen. Spezifische Merkmale initialer FS/PA und zusätzliche Risikofaktoren könnten zur Identifikation von Sub-Gruppen von Personen mit Panik genutzt werden, die sich durch ein besonderes Risiko für schwergradige Panikpathologie und andere psychische Störungen auszeichnen und demzufolge von Outcome-bezogenen Präventionen (ergänzend zu Panik-spezifischer Intervention) profitieren könnten. Zukünftige Studien sollten die vorliegenden Befunde replizieren und die Effektivität gezielter Präventivinterventionen bei Personen mit erhöhtem Risiko für PS und andere psychische Störungen testen

Alcohol-related expectations have been defined as the anticipated consequences from consuming alcohol (Brown, Goldman, Inn, & Anderson, 1980). Previous research has been conducted to examine the role of alcohol expectations in the co-occurrence of alcohol problems with anxiety and depressive symptoms. In the current study, the relationship between alcohol problems, anxiety and depressive traits, and alcohol expectancies were examined within a male juvenile correction sample. Specifically, statistical analyses were conducted to test the degree to which alcohol expectancies combined with anxiety/depression traits improve the prediction of alcohol-related problems beyond that of anxiety/depression traits alone. Archival data were collected from 205 incarcerated male adolescents who completed both the Alcohol Expectancy Questionnaire -- Adolescent Form (AEQ-A) and the Minnesota Multiphasic Personality Inventory--Adolescent (MMPI-A). Two research hypotheses were tested using correlation and regression analyses. The results demonstrated that depressive traits significantly predicted an increase in alcohol-related problems, and the addition of expectancies related to global positive changes and increased social behavior produced a significant gain in the prediction of alcohol problems. Furthermore, anxiety traits significantly predicted an increase in alcohol-related problems, and the inclusion of tension reduction expectancies yielded a significant gain in prediction. The results suggest that alcohol-related problems may be exacerbated by the presence of reinforcement-based expectancies in male juvenile offenders who are concurrently experiencing elevated levels of anxiety and depressive traits. These findings have implications for prevention and treatment programs that utilize cognitive-behavioral and expectancy challenge techniques to affect change in problematic alcohol consumption behaviors.
"December 2006."

by Cola S.L. Lo.
Includes questionarires in Chinese.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1994.
Includes bibliographical references (leaves 62-79).
ABSTRACT --- p.ii
ACKNOWLEDGEMENTS --- p.iv
TABLE OF CONTENTS --- p.v
LIST OF TABLES --- p.vi
LIST OF APPENDICES --- p.vii
Chapter CHAPTER I - --- LITERATURE REVIEW AND RATIONALE
The relation between self-report anxiety and depression --- p.1
Mood Dimensions: Negative and Positive Affectivity Model --- p.5
Personality Dimensions: Neuroticism and Extraversion --- p.11
Structural convergence of Affective and Personality Dimensions --- p.13
Rationale and hypotheses of the present study --- p.16
Chapter CHAPTER II - --- METHOD
Subjects --- p.19
Instruments --- p.19
Procedure --- p.25
Chapter CHAPTER III - --- RESULTS
Instrument reliabilities --- p.26
"Mean and standard deviation of the symptoms, emotionality and personality measures" --- p.28
"Correlations of the symptoms, emotionality and personality measures" --- p.30
Canonical Correlation Analyses --- p.35
Hierarchical Regression Analyses --- p.41
Chapter CHAPTER IV - --- DISCUSSION --- p.51
REFERENCES --- p.62
APPENDICES --- p.80

Background and objectives. Spurred by the longstanding interest in the intimate relationship between anxiety and depression, different conceptual models of negative affectivity have been proposed to account for their common and unique features. The two-factor model (Tellegen, 1985; Watson, Clark & Tellegen, 1988) proposes that Negative Affect (NA) represents a nonspecific factor common to both depression and anxiety, whereas low Positive Affect (PA) is a specific factor to depressed mood. The tripartite model (Clark & Watson, 1991b) divides symptoms into three groups: Negative Affect (general distress) symptoms that are largely non-specific; low Positive Affect (anhedonia) symptoms that are specific to depression; and Physiological Hyperarousal (PH) symptoms that are unique to anxiety. The structural model of negative affectivity (Zinbarg et al., 1994; Zinbarg & Barlow, 1996; Brown et al., 1998) postulates NA and PA as higher order factors under which PH, DSM-IV anxiety and depression are subsumed as lower order factors in a hierarchical arrangement. For the cognitive approach, Beck's cognitive content-specificity hypothesis (Beck, 1976) emphasizes the important role of specific cognitions in differentiating anxiety and depression. The objectives of the present study were: (1) To examine the relationship between anxiety and depression in an adolescent sample of Hong Kong; (2) To examine the phenotypic structure of anxiety and depression in the Hong Kong adolescent sample; and (3) To assess the validity and applicability of the western negative affectivity models and cognitive model for differentiating anxiety and depression in the Hong Kong adolescent sample.
Conclusions. Overall, the present study provides good support for the affective models of negative affectivity and the cognitive model developed in the west which constitutes a good basis for elucidating the relationship between anxiety and depression in the Chinese adolescents of Hong Kong. Although cross-cultural differences in anxiety and depressive symptoms are not directly addressed in this study, the results tend to suggest that Chinese adolescents do not uniformly over or under-report depressive or anxiety symptoms as compare to their Western reference groups. The results generally support the view that there is a large degree of universality or commonality of emotional constructs and affect structures between adolescents in the East and West. (Abstract shortened by UMI.)
Results. Good construct and concurrent validity were established for all the scales applied. Both the two-factor model and the tripartite model showed good fit to our data which also supported the various predictions by the models. Moreover, the results provided good evidence for the hierarchical model in which NA and PA were interpreted as higher orders, whereas Physiological Hyperarousal (PH), DSM-IV anxiety disorders, and depression were specific lower order factors. Consistent with the content-specificity hypothesis, anxious and depressive cognitions were found to specifically predict anxiety and depressive symptoms respectively.
Kwok, Wai Yee Alice.
"April 2007."
Source: Dissertation Abstracts International, Volume: 69-01, Section: B, page: 0221.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2007.
Includes bibliographical references (p. 155-179).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

Thesis (Ph. D.)--Florida State University, 2003.
Advisor: Jeanette Taylor, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (Apr. 9, 2004). Includes bibliographical references.

The prevalence of dieting is alarmingly high amongst adolescents in South Africa. Dieting behaviour, influenced by the promotion of the thin ideal, poses one of the main risks for eating disorders, which have serious physical, psychological and social consequences, including death. Treatment of eating disorders is a costly, difficult and long-term process, therefore preventative measures have been advocated. One of the shortcomings of existing school-based primary intervention programmes has been the failure to bring about significant changes in body image, a key defining feature of eating disorders. This study evaluates the effectiveness of a modified version of Rosen's body image programme with adolescents, with the view to exploring the idea of adding a body image component to existing preventative programmes. The modified version of Rosen's programme proved to be effective in improving the body image of mid-adolescents.
Educational Studies
M. Ed. (Psychology of Education, with specialisation in Guidance and Counselling)

Stress in adolescence is a putative risk factor for developing mental illnesses such as schizophrenia and mood disorders. Symptoms for these illnesses first emerge in late adolescence and early adulthood, with both incidence and severity being sexually dimorphic. Animal models can shed light on the neurobiological underpinnings of these disorders by allowing one to explore the relationship between a risk factor such as stress, and development of symptoms. In the current work the role of adolescent stress is explored in the development of biomarkers that are associated with adolescent-onset illnesses using Long Evans rats. Repeated exposure to predator odour was combined with social isolation during adolescence to create a novel stressor model. The specific objectives of this study were to determine (i) if repeated predator odour exposure altered measures related to sensorimotor gating (measured as prepulse inhibition, PPI), startle, and emotionality, and (ii) whether social support affected the outcome of predator odour stress. Predator odour elicited immediate avoidance, which did not habituate with repeated exposures, suggesting a strong behavioural stress response. In contrast to past work, few significant long-term effects were observed in animals exposed to predator odour compared with ones exposed to a non-threatening odour. Unexpectedly, animals exposed to a no odour (control) condition displayed altered PPI, startle response, anxiety-related behaviour, and memory, compared to rats exposed to a non-threatening, control odour or a predator odour. Moreover, the no odour animals showed altered expression of dopamine D2R receptor protein in the medial prefrontal cortex. The outcomes for this group were remarkably similar to those seen in animals raised in social isolation, suggesting an underlying similarity in the neurobiological mechanisms associated with these experiences that likely can be traced to being raised in environments lacking adequate social and physical complexity. Sex differences were noted in PPI, startle response, tests of anxiety- and depression-like behaviour, memory, and levels of dopamine D2R receptors, although the sex of the animal did not interact with stressor treatment to affect these measures. In conclusion, results of the current work provide further evidence for the importance of the social and physical environment to normal development during adolescence, as well as the importance of being male versus female.

Le lien entre la santé mentale et la consommation de cannabis est encore incompris. De plus, les lesbiennes, gays et bisexuel.les (LGB) présentent des taux élevés de consommation de cannabis et de problèmes de santé mentale comparativement aux hétérosexuel.les. Objectifs. Examiner les associations entre le cannabis, la dépression et l’anxiété au cours de l’adolescence, ainsi que l’effet modérateur de l’orientation sexuelle. Méthode. Les liens entre le cannabis, la dépression et l’anxiété à 13, 15 et 17 ans sont examinés longitudinalement à l’aide d’un modèle à effets croisés chez 1548 participant.es. Des analyses multi-groupes sont effectuées pour examiner les modèles selon l’orientation sexuelle. Résultats. Des associations de petite taille qui demeurent significatives lors de l’ajout des variables de contrôle sont trouvées dans l’échantillon complet : la consommation de cannabis prédit positivement les symptômes d’anxiété subséquents et les symptômes de dépression à 15 ans prédisent positivement la consommation de cannabis à 17 ans. Les LGBs présentent un lien positif plus prononcé entre les symptômes de dépression à 15 ans et la consommation de cannabis à 17 ans, ainsi qu’un lien négatif entre les symptômes d’anxiété à 15 ans et la consommation de cannabis à 17 ans. Conclusion. Ces résultats soutiennent que les associations entre le cannabis, la dépression et l’anxiété sont bidirectionnelles, quoique de petite taille, au cours de l’adolescence. Les LGB présentent des liens particulièrement forts qui pourraient suggérer une pratique d’automédication pour les symptômes de dépression entre 15 et 17 ans.
The association between cannabis use and mental health is not yet well understood. Additionally, sexual minorities present higher rates of cannabis use and mental health issues than heterosexuals. Objective. To examine the developmental relationships between cannabis, and depression and anxiety across adolescence in heterosexual and LGB youth. Method. The relationships between cannabis, and depressive and anxiety symptoms at 13, 15, and 17 years were examined using cross-lagged models in 1548 participants. Multigroup analyses were conducted to examine the models according to sexual orientation. Results. Small bidirectional associations were found in the full sample, which remained significant once control variables were included in the model: cannabis use positively predicted later anxiety symptoms, and depressive symptoms at 15 years predicted cannabis at 17 years. LGB participants presented a considerably larger association between depressive symptoms at 15 years and cannabis at 17 years, as well as a negative association between anxiety symptoms at 15 years and cannabis at 17 years. Conclusion. These results suggest that the relationships between cannabis, and depressive and anxiety symptoms are bidirectional across adolescence, albeit small. Sexual minorities present particularly strong associations that may represent self-medication efforts for depressive symptoms between 15 and 17 years.

Background. Previous research suggests that individuals experiencing DSM-IV panic attacks (PA) are at increased risk for various forms of psychopathology, including anxiety, depressive and substance use disorders. However, little is known regarding whether the sole occurrence of fearful spells (FS-only; distressing spells of anxiety with less than four panic symptoms and/or lacking crescendo in symptom onset) similarly elevates the risk for subsequent psychopathology and could therefore be promising to identify high-risk groups for targeted preventive interventions. Thus, the current dissertation thesis aims to examine (a) whether FS-only predict incident mental disorders in addition to full-blown PA and whether their associations with subsequent psychopathology differ from those obtained for PA, (b) whether FS-only, PA, and panic disorder (PD) share similar etiologies, (c) which characteristics of initial FS/PA and other risk factors predict a progression to more severe panic pathology and other mental disorders, and (d) whether help-seeking/potential treatment in individuals with panic alters the risk for subsequent psychopathology. Methods. A representative community sample of adolescents and young adults (N=3021, aged 14-24 at baseline) was prospectively followed up in up to three assessment waves over a time period of up to 10 years. FS-only, PA, PD, and other mental disorders were assessed at each assessment wave using the DSM-IV-M-CIDI. Additional modules/questionnaires were used to assess characteristics of initial FS/PA (T1/T2), potential risk factors, and help-seeking/potential treatment. Logistic regressions were applied to test associations (Odds Ratios, OR) of FS-only and PA at baseline with incident mental disorders at follow-up as well as respective interactive effects with help-seeking at baseline. Associations (Hazard Ratios, HR) of putative risk factors with the onset of panic pathology (FS-only, PA, and PD) or the onset of subsequent anxiety/depressive vs. substance use disorders in those with panic pathology (aggregated data across assessment waves) were estimated with Cox regressions. Multinomial logistic regressions were used to test associations of initial FS/PA characteristics (aggregated from T1 and T2) with PA and PD (lifetime incidences aggregated across assessment waves). Results. FS-only at baseline predicted incident anxiety and depressive disorders at follow-up (OR 1.59-4.36), while PA at baseline predicted incident anxiety, depressive, and substance use disorders at follow-up (OR 2.08-8.75; reference group: No FS/PA). Merely any anxiety disorder (OR=3.26) and alcohol abuse/dependence (OR=2.26) were significantly more strongly associated with PA than with FS-only. Female sex, parental anxiety disorders, parental depressive disorders, behavioral inhibition, harm avoidance, lower coping efficacy, and parental rejection predicted FS-only, PA, and PD (HR 1.2-3.0), whereas the associations with other risk factors partially differed for FS-only, PA, and PD and tended to be more pronounced for PA and PD than for FS-only. Alcohol consumption, use of drugs/medication, and physical illness as perceived reasons for the initial FS/PA were associated with the occurrence of full-blown PA (without PD, OR 2.46-5.44), while feelings of anxiety/depression and having always been anxious/nervous as perceived reasons for the initial FS/PA, appraising the initial FS/PA as terrible and long-term irritating/burdensome, subsequent feelings of depression, avoidance of situations/places, and consumption of medication, alcohol, or drugs were associated with the development of PD (OR 2.64-4.15). A longer duration until “feeling okay again” was associated with both PA and PD (OR 1.29-1.63 per category). Moreover, partially different risk constellations in subjects with panic pathology (FS/PA/PD) predicted the onset of subsequent anxiety/depressive vs. substance use disorders. Panic pathology (FS/PA) and help-seeking/potential treatment at baseline interacted on predicting incident PD (OR=0.09) and depression (OR=0.22) at follow-up in a way that panic pathology only predicted these disorders in individuals not seeking help at baseline. Conclusions. Findings suggest that individuals with FS-only are at similar risk of developing subsequent psychopathology compared to individuals with full-blown PA. Specific initial FS/PA characteristics and additional risk factors may be used to identify sub-groups of individuals with panic pathology, which are at particular risk of progressing to more severe panic pathology or other mental disorders and might therefore profit from supplemental outcome-related preventive interventions in addition to panic-specific treatment. Future research may replicate the current findings and test the efficacy of targeted preventive interventions in panickers at elevated risk for PD and other forms of psychopathology.:CONTENT 0 Synopsis 10 1 Introduction 13 1.1 Current challenges in clinical psychology 13 1.2 Psychological models of mental disorders 13 1.3 Diagnostic approaches to psychopathology 15 1.4 Methodological issues 16 1.5 Preventive and early treatment interventions 17 2 Panic pathology 18 2.1 Definitions 18 2.2 Epidemiology 19 2.3 Etiology 20 2.4 Physiological, neurobiological, and genetic findings 21 2.5 Unresolved issues 22 3 Aims 24 4 Methods 26 5 Study I: Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: A 10-year prospective-longitudinal community study of adolescents and young adults 27 5.1 Abstract 27 5.2 Introduction 27 5.3 Materials and methods 28 5.4 Results 30 5.5 Discussion 35 6 Study II: Characteristics of initial fearful spells and their associations with DSM-IV panic attacks and panic disorder in adolescents and young adults from the community 37 6.1 Abstract 37 6.2 Introduction 37 6.3 Materials and methods 38 6.4 Results 41 6.5 Discussion 43 7 Study III: Risk factors for fearful spells and panic: A 10-year prospective-longitudinal study among adolescents and young adults 47 7.1 Abstract 47 7.2 Introduction 47 7.3 Materials and methods 49 7.4 Results 52 7.5 Discussion 60 8 Study IV: Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community study 63 8.1 Abstract 63 8.2 Introduction 63 8.3 Materials and methods 64 8.4 Results 66 8.5 Discussion 70 9 General discussion 73 9.1 Summary and discussion of main findings 73 9.2 Preventive interventions among individuals with panic pathology 75 9.3 Research implications 77 10 Conclusions 78 11 References 79 12 Appendix 94 12.1 Acknowledgements 94 12.2 Erklärung zu den Eigenanteilen an einzelnen Publikationen 95 12.3 Eigenständigkeitserklärung 96
Theoretischer Hintergrund. Auf Grundlage früherer Forschungsbefunde ist anzunehmen, dass Personen mit DSM-IV-Panikattacken (PA) ein erhöhtes Risiko für zahlreiche psychische Störungen, einschließlich Angst-, depressiver und Substanzstörungen, aufweisen. Unklar ist jedoch, ob das alleinige Auftreten von Fearful Spells (FS-only, Angstanfälle mit weniger als vier Paniksymptomen und/oder fehlendem Crescendo in der Symptomentwicklung) das Risiko für Psychopathologie in ähnlicher Weise erhöht und hilfreich sein könnte, um Hochrisikogruppen für Präventivinterventionen zu identifizieren. Innerhalb der vorliegenden Dissertation wird daher untersucht, (a) ob FS-only zusätzlich zu PA inzidente psychische Störungen vorhersagen und ob sich Unterschiede in den Assoziationen von FS-only vs. PA mit nachfolgender Psychopathologie ergeben, (b) ob FS-only, PA und Panikstörung (PS) ähnliche Ätiologien teilen, (c) welche Merkmale initialer FS/PA und welche anderen Risikofaktoren die Entwicklung schwerer Panikpathologie und weiterer psychischer Störungen vorhersagen und (d) ob Hilfesuchverhalten/potenzielle Behandlung bei Personen mit Panik das Risiko für nachfolgende Psychopathologie verändert. Methodik. Eine repräsentative Bevölkerungsstichprobe Jugendlicher und junger Erwachsener (N=3021, 14-24 Jahre zur Baseline-Erhebung) wurde in bis zu drei Erhebungswellen über einen Zeitraum von bis zu 10 Jahren untersucht. FS-only, PA, PS und andere psychische Störungen wurden zu jeder Erhebungswelle mithilfe des DSM-IV-M-CIDI erfasst. Merkmale initialer FS/PA (T1/T2), mögliche Risikofaktoren sowie Hilfesuchverhalten/potenzielle Behandlung wurden mit weiteren Modulen und Fragebögen erhoben. Mithilfe logistischer Regressionen wurden Assoziationen (Odds Ratios, OR) von FS-only und PA zu Baseline mit inzidenten psychischen Störungen zum Follow-Up sowie diesbezügliche Interaktionen mit Hilfesuchverhalten zu Baseline getestet. Zusammenhänge zwischen möglichen Risikofaktoren und dem Auftreten von Panikpathologie (FS-only, PA und PS) bzw. nachfolgender Angst-/depressiver und Substanzstörungen bei Personen mit Panikpathologie (Verwendung von über die Erhebungswellen hinweg aggregierter Daten) wurden mithilfe von Cox-Regressionen geschätzt. Multinomiale logistische Regressionen wurden genutzt, um Assoziationen von Merkmalen initialer FS/PA (aggregiert über T1 und T2) mit PA und PS (über die Erhebungswellen hinweg aggregierte Lebenszeitinzidenzen) zu erfassen. Ergebnisse. FS-only zu Baseline sagten inzidente Angst- und depressive Störungen zum Follow-Up vorher (OR 1.59-4.36), wohingegen PA zu Baseline inzidente Angst-, depressive und Substanzstörungen zum Follow-Up vorhersagten (OR 2.08-8.75; Referenzkategorie: Keine FS/PA). Lediglich irgendeine Angststörung (OR=3.26) und Alkoholmissbrauch/-abhängigkeit (OR=2.26) waren signifikant stärker mit PA als mit FS-only assoziiert. Weibliches Geschlecht, elterliche Angst- und depressive Störungen, Verhaltenshemmung, Schadensvermeidung, geringere Coping-Erwartung und elterliche Zurückweisung sagten FS-only, PA und PS vorher (HR 1.2-3.0), während sich teils unterschiedliche Assoziationen anderer Risikofaktoren mit FS-only, PA und PS ergaben, die tendenziell stärker für PA und PS als für FS-only waren. Alkoholkonsum, Drogen-/Medikamentengebrauch und körperliche Erkrankungen als wahrgenommene Gründe für die initiale FS/PA waren mit dem Auftreten vollständiger PA assoziiert (ohne PS; OR 2.46-5.44), während Gefühle von Angst/Depression und die Einschätzung schon immer ängstlich/nervös gewesen zu sein als wahrgenommene Gründe für die initiale FS/PA, die Bewertung der initialen FS/PA als schrecklich und langfristig verunsichernd/belastend, nachfolgende Gefühle von Niedergeschlagenheit, Vermeidung von Situationen/Orten und Konsum von Medikamenten, Alkohol oder Drogen mit der Entwicklung von PS assoziiert waren (OR 2.64-4.15). Eine längere Dauer bis sich die betroffene Person wieder vollständig in Ordnung fühlte war sowohl mit PA als auch mit PS assoziiert (OR 1.29-1.63 pro Kategorie). Weiterhin sagten teils unterschiedliche Risikokonstellationen bei Personen mit Panikpathologie (FS/PA/PS) die nachfolgende Entstehung von Angst-/depressiven und Substanzstörungen vorher. Panikpathologie (FS/PA) und Hilfesuchverhalten/potenzielle Behandlung zu Baseline interagierten bei der Vorhersage von inzidenter PS (OR=0.09) und Depression (OR=0.22) zum Follow-Up; d.h. das Vorhandensein von Panikpathologie sagte diese Störungen nur bei Personen ohne, nicht aber bei Personen mit Hilfesuchverhalten zu Baseline vorher. Schlussfolgerungen. Die vorliegenden Ergebnisse implizieren, dass Personen mit FS-only im Vergleich zu Personen mit vollständigen PA ein ähnliches Risiko für die Entwicklung nachfolgender Psychopathologie aufweisen. Spezifische Merkmale initialer FS/PA und zusätzliche Risikofaktoren könnten zur Identifikation von Sub-Gruppen von Personen mit Panik genutzt werden, die sich durch ein besonderes Risiko für schwergradige Panikpathologie und andere psychische Störungen auszeichnen und demzufolge von Outcome-bezogenen Präventionen (ergänzend zu Panik-spezifischer Intervention) profitieren könnten. Zukünftige Studien sollten die vorliegenden Befunde replizieren und die Effektivität gezielter Präventivinterventionen bei Personen mit erhöhtem Risiko für PS und andere psychische Störungen testen.:CONTENT 0 Synopsis 10 1 Introduction 13 1.1 Current challenges in clinical psychology 13 1.2 Psychological models of mental disorders 13 1.3 Diagnostic approaches to psychopathology 15 1.4 Methodological issues 16 1.5 Preventive and early treatment interventions 17 2 Panic pathology 18 2.1 Definitions 18 2.2 Epidemiology 19 2.3 Etiology 20 2.4 Physiological, neurobiological, and genetic findings 21 2.5 Unresolved issues 22 3 Aims 24 4 Methods 26 5 Study I: Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: A 10-year prospective-longitudinal community study of adolescents and young adults 27 5.1 Abstract 27 5.2 Introduction 27 5.3 Materials and methods 28 5.4 Results 30 5.5 Discussion 35 6 Study II: Characteristics of initial fearful spells and their associations with DSM-IV panic attacks and panic disorder in adolescents and young adults from the community 37 6.1 Abstract 37 6.2 Introduction 37 6.3 Materials and methods 38 6.4 Results 41 6.5 Discussion 43 7 Study III: Risk factors for fearful spells and panic: A 10-year prospective-longitudinal study among adolescents and young adults 47 7.1 Abstract 47 7.2 Introduction 47 7.3 Materials and methods 49 7.4 Results 52 7.5 Discussion 60 8 Study IV: Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community study 63 8.1 Abstract 63 8.2 Introduction 63 8.3 Materials and methods 64 8.4 Results 66 8.5 Discussion 70 9 General discussion 73 9.1 Summary and discussion of main findings 73 9.2 Preventive interventions among individuals with panic pathology 75 9.3 Research implications 77 10 Conclusions 78 11 References 79 12 Appendix 94 12.1 Acknowledgements 94 12.2 Erklärung zu den Eigenanteilen an einzelnen Publikationen 95 12.3 Eigenständigkeitserklärung 96

Divorce has become so prevalent in our present day society, that it is regarded as one of the most sressful and complex mental health crises facing children today. As parents are often under tremendous stress during the time of divorce, they may be incapable of provding the support and guidance children need. The purpose of this study is to present a group counselling intervention programme to assist children of divorce and to create a supportive group atmosphere in which children can share divorce-related feelings, clarify common misconceptions and reduce feelings of isolation. Findings of this study indicate that the acquisition of problem-solving communication and anger control skills help to reduce feelings of depression and anxiety, improve the self-concept and ultimately promote post-divorce adjustment.
Psychology of Education
M. Ed. (Guidance and Counselling)