The relationship between resilience and levels of anxiety,depression, and obsessive–compulsive symptoms in adolescents

Objective: Mental health problems affect approximately 20% of adolescents. Traditionally, the principal focus has been on vulnerability and risk factors and less on protective factors. The study, therefore, explores the relation between frequent psychiatric symptoms and resilience factors among older adolescents. Method: The Resilience Scale for Adolescents (READ) was completed by 307 Norwegian high school students (M = 16.4 years) along with the Depression Anxiety Stress Scales, and the Obsessive–Compulsive Inventory‐Revised. Results: Higher resilience scores predicted lower scores on levels of depression, anxiety, stress and obsessive–compulsive symptoms after controlling for age and gender. Conclusion: This study provides further evidence that it may be fruitful for clinicians and researchers to attend to resilience factors in relation to psychological symptoms among older adolescents. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: ? Resilience is significantly related to psychological symptoms in older adolescents after controlling for age and gender. ? Resilience factors are differently expressed by female and male youths, but overall resilience is equally distributed among the sexes. ? Assessment of resilience factors may provide appropriate targets for interventions among youths.     

Social difficulties in adolescent attention deficit hyperactivity disorder: Social motivation,social anxiety and symptom severity as contributing factors

Background

Many interventions have been developed to address the social difficulties commonly experienced by adolescents with attention-deficit/hyperactivity disorder (ADHD), yet they are largely ineffective.

Objective

This study examined social impairment among adolescents with and without ADHD, determining whether gender, social anxiety, age, and ADHD symptom type (inattention and hyperactivity/impulsivity) and severity are associated with social impairment.

Method

Parents and primary caregivers of adolescents (aged 13–17) with (n = 76) and without ADHD (n = 36) completed the Strengths and Weaknesses of ADHD and Normal Behavior, Social Responsiveness Scale 2nd Edition, and Spence Children's Anxiety Scale.

Results

Adolescents with ADHD scored significantly higher than TD adolescents across social impairment domains. ADHD symptoms were associated with severity of impairment in all domains excluding Social Motivation. Hyperactivity/impulsivity and social anxiety predicted social impairment, whereas gender did not.

Conclusion

Adolescents with ADHD are more likely to experience social impairment than TD adolescents, and interventions targeting symptom reduction and social anxiety may improve these social impairments.

     

Association of the tumor necrosis factor ‐308 A/G promoter polymorphism with Tourette syndrome

Several lines of evidence suggest that certain subtypes of obsessive‐compulsive and tic disorders might be paediatric manifestations of post‐streptococcal autoimmunity caused by cross‐reactive autoantibodies. As tumor necrosis factor (TNF) is known to play a seminal role in coordinating the humoral immune response, TNF gene polymorphisms have been proposed as genetic risk factors both in obsessive‐compulsive disorder (OCD) and Tourette syndrome (TS). The aim of this study was to investigate two TNF promoter polymorphisms (‐238 A/G: rs361525 and ‐308 A/G: rs1800629) on the genetic susceptibility to OCD and TS in a child psychiatric sample (102 patients with OCD and 117 patients with TS). In the case–control set‐up, the genotype and allele frequencies were compared to a control group from the general population (n = 405). As a control child psychiatric sample, 194 children with attention‐deficit hyperactivity disorder were also genotyped. Our results revealed that the TNF ‐308 G‐allele was more frequent in children with TS compared to controls (90.2% vs 84.8%, P = 0.037). For confirmation of this genetic association, a family‐based analysis, the transmission disequilibrium test was used, which showed preferential transmission of the G‐allele to patients with TS (nominal P‐value 0.011). Moreover, this allele was also transmitted more frequently to children with tic symptoms (nominal P‐value 0.039). No association was found between OCD or obsessive‐compulsive symptoms and the studied TNF polymorphisms. Based on these findings, the TNF ‐308 G‐allele can be associated with Tourette syndrome, highlighting the potential pathophysiological role of TNF dysregulation.     

Differentiating Between Comorbidity and Symptom Overlap in ADHD and Early Onset Bipolar Disorder

Reported rates of comorbidity between early onset bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) have a wide range, perhaps due to developmental issues and differences in interpretation of overlapping symptoms. We compared questionnaire-based and neuropsychological measures of inattention and impulsivity/hyperactivity, in children/adolescents with ADHD combined subtype (ADHD-C; n26), concurrent ADHD-C and BD (n15), BD (n25) with Controls (n69). Sub-analyses were performed on BD with and without inattention symptoms. The two ADHD-C groups displayed neuropsychological impairments that were not found in the BD group in spite of subjective and questionnaire-rated inattention. The findings caution against over-diagnosis of ADHD in BD.     

The occurrence of panic and obsessive compulsive symptoms in women with postpartum dysphoria: a prospective study

Summary Objective: This study investigated the prevalence of panic and obsessive compulsive symptoms in a sample of postpartum women who endorsed high levels of dysphoria on a self-report depression measure. Method: A community-based sample of 788 postpartum women with self-reported depressive symptomatology completed an interview assessing major depression, panic disorder, and obsessive compulsive disorder. Results: An estimated 11% of the sample reported difficulties with panic attacks, 8% reported difficulties with obsessions, and 9% reported difficulties with compulsions. The most common panic symptoms included heart palpitations, sweating, trembling, and parasthesis. The most common content areas of obsessive compulsive symptoms were concerns about imminent disaster, compulsive cleaning behavior, and compulsive checking behavior, which were often related to fears concerning the newborn child. Comorbid depression and panic disorder was diagnosed in 1% of this sample, and comorbid depression and obsessive compulsive disorder was diagnosed in 2.4% of this sample. Conclusion: Postpartum panic and obsessive compulsive symptoms are common experiences that should be considered in treatment planning for women reporting dysphoria after they give birth.     

Validation of the Serbian version of the Metacognitions Questionnaire‐30 in nonclinical and clinical samples

The Metacognitions Questionnaire (MCQ‐30) is a brief multidimensional measure used for assessment of metacognitive beliefs in psychopathology. The aim of this study was to assess the psychometric properties of MCQ‐30 in Serbian nonclinical (n = 246) and clinical (n = 171; anxiety and depressive disorders) samples. The reliability of the questionnaire and its subscales was satisfactory. An exploratory factor analysis yielded a five‐factor solution in both groups, whereas a confirmatory factor analysis showed a somewhat weaker fit of the model. The MCQ‐30 showed positive associations with measures of anxiety, pathological worry, depressive, and obsessive–compulsive symptoms in both samples, demonstrating adequate convergent validity. The instrument was sensitive to differences in metacognitive beliefs between nonclinical and clinical samples. MCQ‐30 subscales showed incremental contributions in predicting pathological worry after controlling for the variance in obsessive–compulsive symptoms and vice versa. Our results suggest that the MCQ‐30 is a reliable and valid instrument for assessing metacognitive beliefs in both nonclinical and clinical samples. Moreover, the findings support the use of the MCQ‐30 in Serbian population and extend support for the metacognitive model.     

Common obesity risk alleles in childhood attention‐deficit/hyperactivity disorder

Children with attention‐deficit/hyperactivity disorder (ADHD) have a higher rate of obesity than children without ADHD. Obesity risk alleles may overlap with those relevant for ADHD. We examined whether risk alleles for an increased body mass index (BMI) are associated with ADHD and related quantitative traits (inattention and hyperactivity/impulsivity). We screened 32 obesity risk alleles of single nucleotide polymorphisms (SNPs) in a genome‐wide association study (GWAS) for ADHD based on 495 patients and 1,300 population‐based controls and performed in silico analyses of the SNPs in an ADHD meta‐analysis comprising 2,064 trios, 896 independent cases, and 2,455 controls. In the German sample rs206936 in the NUDT3 gene (nudix; nucleoside diphosphate linked moiety X‐type motif 3) was associated with ADHD risk (OR: 1.39; P = 3.4 × 10^?4; P_corr = 0.01). In the meta‐analysis data we found rs6497416 in the intronic region of the GPRC5B gene (G protein‐coupled receptor, family C, group 5, member B; P = 7.2 × 10^?4; P_corr = 0.02) as a risk allele for ADHD. GPRC5B belongs to the metabotropic glutamate receptor family, which has been implicated in the etiology of ADHD. In the German sample rs206936 (NUDT3) and rs10938397 in the glucosamine‐6‐phosphate deaminase 2 gene (GNPDA2) were associated with inattention, whereas markers in the mitogen‐activated protein kinase 5 gene (MAP2K5) and in the cell adhesion molecule 2 gene (CADM2) were associated with hyperactivity. In the meta‐analysis data, MAP2K5 was associated with inattention, GPRC5B with hyperactivity/impulsivity and inattention and CADM2 with hyperactivity/impulsivity. Our results justify further research on the elucidation of the common genetic background of ADHD and obesity. © 2013 Wiley Periodicals, Inc.     

Contribution of ADHD characteristics to the academic treatment outcome of children with learning difficulties

This study analyzed how different characteristics of attention deficits are connected to academic treatment outcomes among children with learning difficulties belonging to either a neurocognitively oriented treatment group or a homework support treatment group. The academic treatment outcome of children showing attention deficit hyperactivity disorder (ADHD) symptoms was compared to the outcome of children with no ADHD symptoms. The connection of inattention, hyperactivity, and change in inattention and hyperactivity to academic treatment outcome was analyzed comparing children with no ADHD symptoms and children with ADHD symptoms. Children with ADHD symptoms improved equally well as children with no symptoms. Improvement of attention was associated with improvement in reading and writing, and initial hyperactivity was associated with improvement in mathematics. The findings suggest that hyperactivity and inattention are differentially associated with treatment outcome among children with ADHD symptoms. Based on the findings it seems that consideration of the dimensions (inattention and hyperactiv‐ity‐impulsivity) suggested by the Diagnostic and Statistical Manual of Mental Disorders (4th ed., American Psychiatric Association, 1994) can give relevant information for treatment planning.     

The relationship between core symptoms of ADHD and the Cognitive Reflection Test in a non-clinical sample

Introduction. Attention Deficit and Hyperactivity Disorder (ADHD) symptoms are frequently linked to executive function deficits. There is reason to believe that these deficits may give rise to problems with complex reasoning and problem solving.

Methods. Eighty-six men (N?=?45) and women (N?=?41) completed a self-report measure to assess ADHD symptoms, along with a complex reasoning task; the Cognitive Reflection Test (CRT). IQ was also tested due to its covariance with reasoning ability.

Results. Analysis suggested that all three symptoms of ADHD (inattention, hyperactivity, and impulsivity) are negatively related to performance on the CRT, however, only inattention significantly contributed to a model that predicted CRT performance.

Conclusions. Of the three core symptoms of ADHD, inattention is the most important for reasoning ability. Results are discussed with reference to an executive function model of ADHD, with particular emphasis on the role of working memory in inattention.     

Microduplication of 15q13.3 and Xq21.31 in a family with tourette syndrome and comorbidities

Tourette syndrome (TS) is a childhood onset neurodevelopmental disorder. Although it is widely accepted that genetic factors play a significant role in TS pathogenesis the etiology of this disorder is largely unknown. Identification of rare copy number variations (CNVs) as susceptibility factors in several neuropsychiatric disorders such as attention deficit‐hyperactivity disorder (ADHD), autism and schizophrenia, suggests involvement of these rare structural changes also in TS etiology. In a male patient with TS, ADHD, and OCD (obsessive compulsive disorder) we identified two microduplications (at 15q13.3 and Xq21.31) inherited from a mother with subclinical ADHD. The 15q duplication included the CHRNA7 gene; while two genes, PABPC5 and PCDH11X, were within the Xq duplication. The Xq21.31 duplication was present in three brothers with TS including the proband, but not in an unaffected brother, whereas the 15q duplication was present only in the proband and his mother. The structural variations observed in this family may contribute to the observed symptoms, but further studies are necessary to investigate the possible involvement of the described variations in the TS etiology. © 2013 Wiley Periodicals, Inc.     

Genetic meta‐analysis of obsessive–compulsive disorder and self‐report compulsive symptoms

We investigated whether obsessive–compulsive (OC) symptoms from a population‐based sample could be analyzed to detect genetic variants influencing obsessive–compulsive disorder (OCD). We performed a genome‐wide association studies (GWAS) on the obsession (rumination and impulsions) and compulsion (checking, washing, and ordering/precision) subscales of an abbreviated version of the Padua Inventory (N = 8,267 with genome‐wide genotyping and phenotyping). The compulsion subscale showed a substantial and significant positive genetic correlation with an OCD case–control GWAS (r _G = 0.61, p = .017) previously published by the Psychiatric Genomics Consortium (PGC‐OCD). The obsession subscale and the total Padua score showed no significant genetic correlations (r _G = ?0.02 and r _G = 0.42, respectively). A meta‐analysis of the compulsive symptoms GWAS with the PGC‐OCD revealed no genome‐wide significant Single‐Nucleotide Polymorphisms (SNPs combined N = 17,992, indicating that the power is still low for individual SNP effects). A gene‐based association analysis, however, yielded two novel genes (WDR7 and ADCK1). The top 250 genes in the gene‐based test also showed a significant increase in enrichment for psychiatric and brain‐expressed genes. S‐Predixcan testing showed that for genes expressed in hippocampus, amygdala, and caudate nucleus significance increased in the meta‐analysis with compulsive symptoms compared to the original PGC‐OCD GWAS. Thus, the inclusion of dimensional symptom data in genome‐wide association on clinical case–control GWAS of OCD may be useful to find genes for OCD if the data are based on quantitative indices of compulsive behavior. SNP‐level power increases were limited, but aggregate, gene‐level analyses showed increased enrichment for brain‐expressed genes related to psychiatric disorders, and increased association with gene expression in brain tissues with known emotional, reward processing, memory, and fear‐formation functions.     

Differences in clinical intrusive thoughts between obsessive–compulsive disorder,generalized anxiety disorder,and hypochondria

Differences and similarities between intrusive thoughts typical of obsessive–compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non‐clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive–compulsive disorder (n  = 35; 60% women, mean age 38.57), generalized anxiety disorder (n  = 36; 61.1% women, mean age 41.50), and hypochondriasis (n  = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire—Transdiagnostic Version (Romero‐Sanchiz, Nogueira‐Arjona, Godoy‐Ávila, Gavino‐Lázaro, & Freeston, 2017 ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive–compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed.     

Effect of Maternal Anxiety on Parenting Stress of Fathers of Children With ADHD

BackgroundHyperactivity, inattention, and impulsivity of children with attention deficit hyperactivity disorder (ADHD) increase parenting stress and familial conflict. Among parent-related factors, maternal mental health has been studied in-depth, but studies on paternal factors in this context are scarce. This cross-sectional study was conducted of children with ADHD and their parents in South Korea. We investigated the relationships between ADHD symptom severity of children and the mental health of their mothers and fathers.MethodsThe study included 70 children with ADHD and their 140 married heterosexual parents (70 fathers and 70 mothers). Children completed the Child Depression Inventory and State-Anxiety Inventory for children, and their parents completed the Korean ADHD rating scale-IV, Adult ADHD self-report scale, State-Anxiety Inventory, Patient Health Questionnaire-9, and Parental Stress Scale.ResultsThere was a significant positive correlation between children’s ADHD symptoms and maternal anxiety symptom severity, whereby more severe ADHD symptoms were associated with more severe maternal anxiety symptoms. There was also a significant positive correlation between maternal anxiety symptom severity and paternal parenting stress severity, whereby more severe maternal anxiety was associated with more severe paternal parenting stress. A mediation model showed that paternal parenting stress severity was not directly related to children’s ADHD symptoms, but the severity of maternal anxiety mediated this relationship.ConclusionThe present study found the importance of mental health in mothers of children with ADHD and the interrelatedness of mental health within families. Future assessments and treatment of children with ADHD should include both the children and their parents.     

Multidimensional assessment of OCD: integration and revision of the vancouver obsessional‐compulsive inventory and the symmetry ordering and arranging questionnaire

This article reports on the integration and revision of two self‐report measures of obsessive‐compulsive symptoms based on data from an obsessive‐compulsive disorder (OCD) sample (n=228): the Vancouver Obsessional‐Compulsive Inventory (VOCI) and the Symmetry Ordering and Arranging Questionnaire (SOAQ). The revised measure provides scores on five symptom subscales (Contamination, Checking, Hoarding, Symmetry and Ordering, Obsessions). It shows improvement upon current versions in several ways: it has a good model fit, eliminates redundancy, reduces overlap across subscales, is much shorter, and covers those OCD dimensions most frequently identified in factor‐analytic studies. Strengths of the revision compared with other measures are high distinctiveness of subscales, discriminant validity with depression and anxiety, and a more fine‐grained and comprehensive assessment of obsessional contents. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1–19, 2010.     

Brief school‐based interventions to assist adolescents’ sleep‐onset latency: Comparing mindfulness and constructive worry versus controls

Difficulties falling asleep are common among adolescents, especially during times of stress. Adolescents may thus benefit from brief techniques (15 min) that decrease pre‐sleep cognitive‐emotional arousal and sleep‐onset latency. The present study used a 3 (intervention: mindfulness bodyscan mp3, constructive worry, control) by 3 (time: baseline, week 1, week 2) mixed‐model design on a school‐based sample of adolescents (N = 232; M_age = 15.9 ± 0.8 years, range = 14–18 years; 19% male), and a sub‐sample of adolescents with prolonged sleep‐onset latency (i.e. ≥30 min; N = 119; M_age = 16.9 ± 0.9 years; 21% male). It was expected that the 15‐min pre‐recorded breath‐based mindfulness bodyscan, and constructive worry, would decrease sleep‐onset latency and pre‐sleep arousal similarly over time, relative to the control condition. A significant interaction was observed among adolescents with prolonged sleep‐onset latency, who completed ≥3 days for at least 1 week (p = .001), where mindfulness decreased sleep‐onset latency relative to constructive worry and the control. Neither technique changed pre‐sleep worry or cognitive‐emotional arousal, or associated daytime functioning (both the whole sample and sub‐sample). A pre‐recorded mp3 breath‐based mindfulness bodyscan technique is a promising means by which adolescents with prolonged sleep‐onset latency can decrease sleep‐onset latency. This simple tool has potential for scalable dissemination by stakeholders (e.g. teachers), unqualified to treat adolescent sleep difficulties. Future studies are needed to determine whether benefits may extend to academic performance and mental health, if performed for a longer time period with increased compliance.     

Obsessive‐Compulsive Disorder in the DSM‐5

Whereas the specific diagnostic criteria for obsessive‐compulsive disorder (OCD) have changed in only minor ways in the transition from DSM‐IV to DSM‐5, a more substantial change is that OCD is no longer classified as an anxiety disorder. Rather, it is now the flagship diagnosis of a new diagnostic category: the obsessive‐compulsive and related disorders (OCRDs). In this article, we describe the nature of obsessional problems as determined through empirical research before turning to a consideration of how OCD is defined in previous editions of the DSM and in DSM‐5. We then critically consider the DSM criteria, as well as the basis for removing OCD from the anxiety disorders and creating the new OCRD category. Finally, we consider the implications of these changes for clinical practice and research on OCD.     

DISC1 in adult ADHD patients: An association study in two European samples

The DISC1 gene was named after its discovery in a Scottish pedigree with schizophrenia (SCZ) patients. However, subsequent studies have shown association of DISC1 variants with a range of different neurocognitive phenotypes and psychiatric disorders, including bipolar disorder (BPD), and major depression. Attention‐deficit/hyperactivity disorder (ADHD) shares some symptoms with BPD and ADHD patients often suffer from comorbid affective disorders. We wanted to examine the role of DISC1 in ADHD, and with comorbid symptoms of mood disorders. Eleven single nucleotide polymorphisms (SNPs) previously implicated in SCZ and BPD, and a DISC1 duplication involving exon 1, were genotyped in 561 adult ADHD cases and 713 controls of Norwegian ancestry. The intronic SNP rs1538979 was associated with ADHD in the Norwegian sample [odds ratio (OR): 1.33, 95% confidence interval (CI) 1.03–1.73, P = 0.03] and replicated in a Spanish adult ADHD sample of 694 cases and 735 controls, using the tagging SNP rs11122330 (meta‐analysis: P = 0.008, OR 1.25, 95% CI 1.06–1.47). In the Norwegian ADHD sample we also observed an association between the Phe607‐variant of rs6675281 and a positive score on the Mood Disorder Questionnaire (MDQ; OR = 1.44, 95% CI 1.08–1.93, P = 0.01). To our knowledge, this is the first study to show an association between DISC1 variants and ADHD. Our study suggests that further studies are warranted to resolve if DISC1 variation is involved in several common neurodevelopmental disorders including ADHD. © 2013 Wiley Periodicals, Inc.     

卫校学生考试焦虑状况及相关因素

目的:了解毕节市卫校参加护士资格考试学生的考试焦虑状况和心理健康水平,探讨考试焦虑的程度、主要原因及表现形式,为卫校学生心理问题的干预提供依据。方法:采用问卷法对毕节市卫生学校参加2014年护士资格考试的4个班级204名学生的考试焦虑状况和影响因素进行了调查,分析卫校学生考试焦虑的状况、原因及其与心理健康水平的关系。结果:47.5%的卫校考生有考试焦虑问题;焦虑的原因"担心考糟了他人对自己的评价"占30.4%,"担心对个人的自我形象增加威胁"占24.0%;考试焦虑主要表现"思维阻抑"占60.8%;卫校学生心理问题检出率为60.29%,总均分为(2.10±0.51),中度及以上心理问题检出率为3.92%。方差分析显示,心理健康状况得分及强迫症状、偏执、人际关系紧张与敏感、抑郁、焦虑、学习压力、心理不平衡维度得分在不同程度焦虑中的差异均有统计学意义(F=6.310,P0.001;F=7.919,P0.001;F=3.231,P0.05;F=6.615,P0.001;F=3.417,P0.05;F=5.725,P0.01;F=7.467,P0.001;F=4.273,P0.001)。结论:毕节市卫校考生考试焦虑的主要原因以"担心考糟了他人对自己的评价"为主,考试焦虑主要表现为思维阻抑,学习压力感是卫校学生最突出的心理问题。随着焦虑程度的增加,考生的心理健康状况下降,尤其在强迫症状和学习压力方面。     

Inferential confusion,obsessive beliefs and obsessive–compulsive symptoms: a multidimensional investigation of cognitive domains

Generally, research into the relationship between cognitive domains and obsessive–compulsive symptoms involves the use of scales that are highly intercorrelated with each other. The current study investigates the relationship between cognitive constructs and obsessive–compulsive symptoms using the item set of the Obsessive Beliefs Questionnaire and the Inferential Confusion Questionnaire. In order to create constructs that would not be excessively correlated with each other, factor scores were used to investigate the relationship between cognitive domains and obsessive–compulsive symptoms. Factor analysis followed by oblique rotation resulted in four moderately correlated cognitive constructs (importance/control of thoughts, inferential confusion/threat estimation, perfectionism/certainty and responsibility for preventing harm). With the exception of responsibility for preventing harm, the cognitive constructs under investigation were quite strongly related to obsessive–compulsive symptoms. In particular, hierarchical regression revealed the construct inferential confusion/threat estimation to be a global and strong predictor of obsessive–compulsive symptoms, followed by the constructs of perfectionism/certainty and the construct importance/control. Responsibility for preventing harm acted to be a negative predictor of obsessive–compulsive symptoms. It is concluded that the construct of inferential confusion acts as a more powerful predictor of obsessive–compulsive symptoms than any specific obsessive belief Copyright © 2008 John Wiley & Sons, Ltd.