Matching Items (5)

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Identifying mediators of youth anxiety and depression intervention outcomes: a meta-analytic path analysis

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

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.

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Created

Date Created
  • 2015

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A longitudinal examination of anxiety across childhood and adolescence

Description

Data from the NICHD Study of Early Child Care and Youth Development (SECCYD) was used to study the role of child individual, parental, and environmental predictors of anxiety across childhood

Data from the NICHD Study of Early Child Care and Youth Development (SECCYD) was used to study the role of child individual, parental, and environmental predictors of anxiety across childhood and adolescence. Longitudinal growth modeling was used to examine the influence of behavioral inhibition, parental control, parental anxiety and stressful life events on the developmental progression of anxiety from 4 to 15 years of age. Based on these data, it appears that there are significant developmental differences between the role of child individual, parental and environmental risk factors. These results highlight the importance of considering developmental factors when assessing and targeting risk for anxiety.

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Agent

Created

Date Created
  • 2012

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In search of culturally grounded profiles of parental over-control: implications for anxiety in Hispanic/Latino children

Description

Parental over-control (excessively restrictive and regulatory parenting behaviors) has been consistently identified as a robust risk factor in the development and maintenance of child anxiety problems. However, current understanding of

Parental over-control (excessively restrictive and regulatory parenting behaviors) has been consistently identified as a robust risk factor in the development and maintenance of child anxiety problems. However, current understanding of the parental over-control to child anxiety relation is limited by a lack of specificity. The broad ‘parental over-control’ construct represents a heterogeneous category of related but distinct parenting behaviors each of which may exert a unique effect on child anxious emotion. Still, research to date has generally failed to consider this possibility. Moreover, culturally cognizant theory and emerging empirical evidence suggest cross-ethnic (Caucasian vs. Hispanic/Latino) differences in the utilization of various parenting strategies as well as the effects of parenting behaviors on child outcomes. But, only a handful of studies have considered the potential differences in the functioning of parental over-control behaviors within a Hispanic/Latino cultural framework. Using a sample of 98 pre-adolescent children at-risk for anxiety problems, the present study sought to further explicate the association between parental over-control and child anxiety symptoms in the context of ethnic and cultural diversity. Results suggest that parents’ use of overprotection and (lack of) autonomy granting might be particularly relevant to child anxiety, compared to parental intrusiveness and behavioral control. Findings also indicate that some youth may be more vulnerable to parental over-control and suggest that cultural values may play a role in the relation between over-controlling parenting and child anxiety symptoms. Knowledge about cross-cultural variations in the relation among parental over-control behaviors and the development of anxiety symptoms is important because it can improve the cultural robustness of child anxiety theory and has potential to inform culturally sensitive child anxiety prevention and intervention efforts.

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Created

Date Created
  • 2016

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Relations between family/friendship satisfaction and anxiety in a sample of children with phobic and anxiety disorders: exploring variability across age and ethnicity

Description

Although anxiety may be developmentally appropriate, it can become problematic in some youth. From an ecological perspective, social systems, like family and friendships, are theorized to influence developmental trajectories toward

Although anxiety may be developmentally appropriate, it can become problematic in some youth. From an ecological perspective, social systems, like family and friendships, are theorized to influence developmental trajectories toward (mal)adjustment, but empirical evidence is scant with regard to the relative impact of subjective satisfaction with family and friendship on anxiety problem development. This thesis study used a subsample of approximately 50% Hispanic/Latino clinic-referred youth (n = 71, ages 6-16 years). Overall, results suggest that the effect of friendship satisfaction on anxiety varied as a function of age but not ethnicity, such that there was a significant negative relationship between child-reported friendship satisfaction and anxiety levels for older children (approx. 9 years and older) but not for younger children. The effect of family satisfaction on anxiety also varied as a function of age, such that older children showed a positive relation between child reported family satisfaction and parent reported anxiety. Furthermore, a positive relation between family satisfaction and anxiety was found only for the H/L children. Post hoc analyses regarding cultural underpinnings of this finding and implications for future research are discussed, as are the results regarding differences between parent and child reports of anxiety.

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Created

Date Created
  • 2013

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Learning of anxiety sensitivity and anxiety symptoms in youth

Description

Anxiety sensitivity (AS; the fear of anxiety-related bodily sensations) has been earmarked as a significant risk factor in the development and maintenance of pathological anxiety in adults and children. Given

Anxiety sensitivity (AS; the fear of anxiety-related bodily sensations) has been earmarked as a significant risk factor in the development and maintenance of pathological anxiety in adults and children. Given the potential implications of heightened AS, recent research has focused on investigating the etiology and developmental course of elevated AS; however, most of this work has been conducted with adults and is retrospective in nature. Data from college students show that early anxiety-related learning experiences may be a primary source of heightened AS levels, but it remains unclear whether AS in children is linked to their learning experiences (i.e., parental reinforcement, modeling, punishment, and/or transmission of information about anxiety-related behaviors). Based on AS theory and its iterations, an emerging theoretical model was developed to aid further exploration of the putative causes and consequences of heightened AS levels. Using a sample of 70 clinic-referred youth (ages 6 to 16 years old; 51.4% Hispanic/Latino), the present study sought to further explicate the role of learning in the development of AS and anxiety symptoms. Results suggest that childhood learning experiences may be an important precursor to heightened AS levels and, subsequently, increased experiences of anxiety symptoms. Findings also indicate that some youth may be more vulnerable to anxiety-related learning experiences and suggest that culture may play a role in the relations among learning, AS, and anxiety symptoms.

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Agent

Created

Date Created
  • 2012