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- All Subjects: Depression
Description
Anxiety and depression are among the most prevalent disorders in youth, with prevalence rates ranging from 15% to 25% for anxiety and 5% to 14% for depression. Anxiety and depressive disorders cause significant impairment, fail to spontaneously remit, and have been prospectively linked to problematic substance use and legal problems in adulthood. These disorders often share a high-degree of comorbidity in both clinical and community samples, with anxiety disorders typically preceding the onset of depression. Given the nature and consequences of anxiety and depressive disorders, a plethora of treatment and preventative interventions have been developed and tested with data showing significant pre to post to follow-up reductions in anxiety and depressive symptoms. However, little is known about the mediators by which these interventions achieve their effects. To address this gap in the literature, the present thesis study combined meta-analytic methods and path analysis to evaluate the effects of youth anxiety and depression interventions on outcomes and four theory-driven mediators using data from 55 randomized controlled trials (N = 11,413). The mediators included: (1) information-processing biases, (2) coping strategies, (3) social competence, and (4) physiological hyperarousal. Meta-analytic results showed that treatment and preventative interventions reliably produced moderate effect sizes on outcomes and three of the four mediators (information-processing biases, coping strategies, social competence). Most importantly, findings from the path analysis showed that changes in information-processing biases and coping strategies consistently mediated changes in outcomes for anxiety and depression at both levels of intervention, whereas gains in social competence and reductions in physiological hyperarousal did not emerge as significant mediators. Knowledge of the mediators underlying intervention effects is important because they can refine testable models of treatment and prevention efforts and identify which anxiety and depression components need to be packaged or strengthened to maximize intervention effects. Allocating additional resources to significant mediators has the potential to reduce costs associated with adopting and implementing evidence-based interventions and improve dissemination and sustainability in real-world settings, thus setting the stage to be more readily integrated into clinical and non-clinical settings on a large scale.
ContributorsStoll, Ryan (Author) / Pina, Armando A (Thesis advisor) / MacKinnon, David (Committee member) / Knight, George (Committee member) / Arizona State University (Publisher)
Created2015
Description
The current study utilized data from two longitudinal samples to test mechanisms in the relation between a polygenic risk score indexing serotonin functioning and alcohol use in adolescence. Specifically, this study tested whether individuals with lower levels of serotonin functioning as indexed by a polygenic risk score were vulnerable to poorer self-regulation, and whether poorer self-regulation subsequently predicted the divergent outcomes of depressive symptoms and aggressive/antisocial behaviors. This study then examined whether depressive symptoms and aggressive/antisocial behaviors conferred risk for later alcohol use in adolescence, and whether polygenic risk and effortful control had direct effects on alcohol use that were not mediated through problem behaviors. Finally, the study examined the potential moderating role of gender in these pathways to alcohol use.
Structural equation modeling was used to test hypotheses. Results from an independent genome-wide association study of 5-hydroxyindoleacetic acid in the cerebrospinal fluid were used to create serotonin (5-HT) polygenic risk scores, wherein higher scores reflected lower levels of 5-HT functioning. Data from three time points were drawn from each sample, and all paths were prospective. Findings suggested that 5-HT polygenic risk did not predict self-regulatory constructs. However, 5-HT polygenic risk did predict the divergent outcomes of depression and aggression/antisociality, such that higher levels of 5-HT polygenic risk predicted greater levels of depression and aggression/antisociality. Results most clearly supported adolescents’ aggression/antisociality as a mechanism in the relation between 5-HT polygenic risk and later alcohol use. Deficits in self-regulation also predicted depression and aggression/antisociality, and indirectly predicted alcohol use through aggression/antisociality. These pathways to alcohol use might be the most salient for boys with low levels of socioeconomic status.
Results are novel contributions to the literature. The previously observed association between serotonin functioning and alcohol use might be due, in part, to the fact that individuals with lower levels of serotonin functioning are predisposed towards developing earlier aggression/antisociality. Results did not support the hypothesis that serotonin functioning predisposes individuals to deficits in self-regulatory abilities. Findings extend previous research by suggesting that serotonin functioning and self-regulation might be transdiagnostic risk factors for many types of psychopathology.
Structural equation modeling was used to test hypotheses. Results from an independent genome-wide association study of 5-hydroxyindoleacetic acid in the cerebrospinal fluid were used to create serotonin (5-HT) polygenic risk scores, wherein higher scores reflected lower levels of 5-HT functioning. Data from three time points were drawn from each sample, and all paths were prospective. Findings suggested that 5-HT polygenic risk did not predict self-regulatory constructs. However, 5-HT polygenic risk did predict the divergent outcomes of depression and aggression/antisociality, such that higher levels of 5-HT polygenic risk predicted greater levels of depression and aggression/antisociality. Results most clearly supported adolescents’ aggression/antisociality as a mechanism in the relation between 5-HT polygenic risk and later alcohol use. Deficits in self-regulation also predicted depression and aggression/antisociality, and indirectly predicted alcohol use through aggression/antisociality. These pathways to alcohol use might be the most salient for boys with low levels of socioeconomic status.
Results are novel contributions to the literature. The previously observed association between serotonin functioning and alcohol use might be due, in part, to the fact that individuals with lower levels of serotonin functioning are predisposed towards developing earlier aggression/antisociality. Results did not support the hypothesis that serotonin functioning predisposes individuals to deficits in self-regulatory abilities. Findings extend previous research by suggesting that serotonin functioning and self-regulation might be transdiagnostic risk factors for many types of psychopathology.
ContributorsWang, Frances Lynn (Author) / Chassin, Laurie (Thesis advisor) / Eisenberg, Nancy (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / MacKinnon, David (Committee member) / Arizona State University (Publisher)
Created2017
Description
The nature and correlates of emerging internalizing symptoms in young children are largely unknown. Maternal factors such as psychological symptoms and detached parenting style have been found to be present in children with anxiety and depression. Further, child attentional control in task completion has been associated with difficulty related to internalizing problems. This study tested hypotheses that child anxiety and depression at age five could be predicted by a combination of maternal distress and maternal detached behavior recorded at age three. An additional hypothesis was tested to determine if child attentional control at age four may be a partial mediator of the relation between maternal symptoms and parenting to child internalizing symptoms. Using structural equation modeling, no hypotheses were supported; child internalizing problems were not significantly predicted by maternal distress nor detached parenting. Further, child attentional control was not predicted by maternal distress or detached behavior, nor did attentional control predict internalizing problems. Findings indicate that over a two-year interval, childhood internalizing problems at age five are likely best predicted by early internalizing problems at age three. There was no support that the mother or child factors tested were predictive of child outcomes.
ContributorsSkelley, Shayna (Author) / Crnic, Keith A (Thesis advisor) / Eisenberg, Nancy (Committee member) / MacKinnon, David (Committee member) / Arizona State University (Publisher)
Created2010