Deliberate emotional expressions of socially anxious children and their mothers

The aim of the present study was to investigate whether socially anxious children show deficits in their deliberate facial expression of emotions. To test for potential mother-child transmission effects, the mothers' facial expressions were also assessed. Fifty socially anxious and 25 socially nonanxious children (8-12 years) and their mothers participated in a facial expression posing task. The expressions produced were coded using Ekman and Friesen's (1978) Facial Action Coding System (FACS). In addition, naive raters rated their quality of emotion. FACS analyses indicated that socially anxious children show a reduced general facial activity, have a more restricted facial repertoire and differ qualitatively from controls in their facial expression of emotions. Similarly, the global ratings indicated that the socially anxious children's posed facial expressions are less accurate. For the mothers no differences between groups were found when global ratings were used. However, the FACS data demonstrate that the facial expressions of mothers of socially anxious children are less intense compared to controls. It is possible that the decreased intensity of the mothers' facial expressiveness makes it more difficult for the socially anxious children to learn adequate facial expressions.     

Anxiety and depressive disorders in fathers and mothers of anxious school-refusing children.

OBJECTIVE: To examine anxiety and depressive disorders in the mothers and fathers of children with anxious school refusal and to test for the existence of differences in familial aggregation between children suffering from school refusal related to separation anxiety disorder and those suffering from phobic disorder-based school refusal. METHOD: Using a blind standardized diagnostic evaluation (Schedule for Affective Disorders and Schizophrenia-Lifetime version, modified for the study of anxiety disorders; Diagnostic Interview for Genetic Studies; and Schedule for Affective Disorders and Schizophrenia for School-Age Children), the authors compared parental lifetime psychiatric illness for the 2 groups of anxious school refusers. RESULTS: Relationships between specific anxiety disorders in children and their parents revealed increased prevalence of simple phobia and simple and/or social phobia among the fathers and mothers of phobic school refusers, and increased prevalence of panic disorder and panic disorder and/or agoraphobia among the fathers and mothers of school refusers with separation anxiety disorder. Simple and/or social phobia in the father, simple phobia in the mother, and age of the father were associated with the group of phobic school refusers. CONCLUSIONS: The data show the high prevalence of both anxiety and depressive disorders in fathers and mothers of anxious school refusers. Significant differences were observed in familial aggregation considering the subgroups of anxious school-refusing children.     

Searching for evidence on the validity of generalized anxiety disorder: Psychopathology in children of anxious mothers

The diagnostic validity of generalized anxiety disorder (GAD) is tested by examining the relationship between GAD in mothers and children's overanxious disorder (OAD), separation anxiety (SA), and anxious symptoms in 331 mother-child dyads from a geographically based probability sample. Data on the relationship between mothers' major depressive disorder (MDD) and children's depression are presented for comparison. The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) was used in mothers and the NIMH Diagnostic Interview Schedule for Children (DISC), in children. Children of mother with GAD were not at increased risk for OAD, SA, or anxious symptoms. In contrast, MDD in mothers conferred a risk for OAD in younger children and of MDD in older children. Additionally, older children of depressed mothers exhibited significantly more depressive symptoms. The presence of diffuse anxiety in children of mothers with MDD may represent a non-specific response pattern in psychiatrically vulnerable children. Like GAD in adults, these anxiety symptoms in children may constitute a prodromal manifestation of other disorders and transient responses to life stressors.     

Psychiatric illness through the lifespan

European Archives of Psychiatry and Clinical Neuroscience -     

Psychiatric illness in the New Zealand Maori

This paper compares psychiatric illness in the contemporary Maori with that in the non-Maori New Zealander. The ethnic data available are all from secondary sources. The limitations of this and the problems of achieving a satisfactory definition of "a Maori" are discussed. The data suggest that the Maori have a slightly greater risk of psychiatric hospitalization than the non-Maori. First admission rates for schizophrenia are higher for the Maori, as are the readmission rates. First admission rates for major affective illness are roughly comparable in the two groups, and those for neuroses and neurotic depression are lower in the Maori. Rates of admission for alcohol abuse, alcohol dependence and personality disorders are much higher for the Maori male aged 20-40 years and this group is at greatest risk of psychiatric hospitalization. A larger proportion of Maori are admitted involuntarily, especially under the Criminal Justice Act. The median stay in hospital is not longer for the Maori but their re-admissions are more frequent. The Maori have shown an increase in first psychiatric admission rates since the 1950s, with rapid increases in the early 60s and the 80s. The rates for psychotic disorders have been relatively constant and the most significant changes have been for alcohol abuse, alcohol dependence and personality disorders. The author relates this historical change to socioeconomic and politico-cultural factors, particularly the stress of rapid urbanization.     

Psychiatric illness in homicide victims.

The authors studied the demographic characteristics and history of psychiatric treatment of 214 homicide victims and 67 suicide victims. Thirty-two (15%) of the homicide victims and 12 (18%) of the suicide victims had a record of psychiatric care; these rates were higher than the treatment rate of the general population. The authors suggest that there may be a connection between the occurrence of homicide and the increased frequency of psychiatric disorders among victims of this crime.     

Psychiatric illness and non-cancer hysterectomy

Forty-nine randomly selected women who received hysterectomy for reasons other than cancer were studied preoperatively with systematic interviews and record reviews, and were diagnosed using the explicit criteria of Feighner, et al. Fifty-seven percent were found to be psychiatrically ill, with 27% suffering from hysteria (Briquet's Syndrome), and 18% from primary depression. Recently some investigators have attributed a "post-hysterectomy syndrome" characterized by multiple psychologic and somatic symptoms to the surgery itself. However, a high pre-operative prevalence of psychiatric illness, particularly hysteria, must be considered when evaluating symptoms in a post-hysterectomy population.     

Psychiatric illness in physicians: A review

The occurrence of psychiatric illness in physicians is primarily determined by their personality abnormalities and life adjustments prior to medical school. The specific features of psychiatric illness in physicians, such as high rates of addiction and suicide, are the result of a failure to recognize and treat emotional illness in this group. The evidence that psychiatrists have not been particularly successful in treating this particular group is discussed and examined. The facts that the group at risk is identifiable, that a screening procedure is already available (i.e., medical school admission), and that secondary and tertiary prevention have failed suggest that primary prevention should be employed. The literature on primary prevention of psychiatric illness in physicians is described, and the feasibility of a preventive approach is discussed from the point of view of its principles and the difficulties of practical application. It is suggested that the application of primary prevention to emotional illness in physicians might potentially benefit the individual doctor and the profession, and also test the hypothesis of the effectiveness of preventive psychiatry.     

School-based interventions for anxious children

OBJECTIVE: To compare the effectiveness of three school-based interventions for anxious children: group cognitive-behavioral therapy (CBT) for children, group CBT for children plus parent training group, and no-treatment control. METHOD: Students (7-11 years old) in three elementary schools (N = 453) were screened using the Multidimensional Anxiety Scale for Children and teacher nomination. Subsequently, 101 identified children and their parents completed the Anxiety Disorders Interview Schedule for DSM-IV, Child Version. Children with features or DSM-IV diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia (n = 61) were randomized by school to one of three conditions. Active treatments were nine weekly sessions of either group CBT or group CBT plus concurrent parent training. RESULTS: Clinician-report, child-report, and parent-report measures of child anxiety demonstrated significant benefits of CBT treatments over the no-treatment control group. Effect size was 0.58 for change in composite clinician severity rating, the primary outcome measure, favoring collapsed CBT conditions compared with control. In addition, several instruments showed significantly greater improvement in child anxiety for group CBT plus parent training over group CBT alone. CONCLUSIONS: Both active CBT treatments were more effective than the no-treatment control condition in decreasing child anxiety symptoms and associated impairment. When parent training was combined with child group CBT, there were some additional benefits for the children.     

Indicators of flourishing in anxious preschool-aged children

Anxiety disorders in the preschool-age population can cause behavioral, social and community concerns. Identifying factors related to flourishing may limit long-term consequences related to the experience of anxiety. The first goal of this study was to examine a national data-set from the 2011/2012 National Survey of Children's Health to determine the frequency of caregivers reporting that their preschool-aged child (between 2 and 5 years) experienced anxiety. The second aim was to detect predictors related to caregiver perceptions of flourishing in children who were described as anxious. Flourishing was a composite measure that included curiosity about learning, resilience, attachment with a caregiver, experiencing contentment and overall positive health status. Findings indicated that 262 children were experiencing moderate to severe anxiety. A regression analyses was used to examine factors that could be related to well-being in children who were anxious. Results indicated that positive behavior and peer relationships were significant predictors of flourishing.