Anxiety and Depression in Children of Depressed Parents: Dynamics of Change in a Preventive Intervention

The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and depression in a sample of children of depressed parents. Parents with a history of depression (N = 180) and their children (N = 242; 50% female; M_age = 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Youth in the FGCB intervention reported significantly greater declines in symptoms of both anxiety and depression at 6, 12, and 18 months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g., anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6 months in the FGCB intervention only. Changes in anxiety symptoms from 0 to 6 months predicted different patterns of subsequent changes in depressive symptoms from 6 to 12 months for the two conditions, such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth. Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting that both initial symptom levels and initial magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.     

Psychological Adjustment to Cancer: Control Beliefs and Coping in Adult Cancer Patients

Appraisals of control, the use of problem- andemotion-focused coping strategies, and symptoms ofanxiety/depression were assessed in a sample of 83 adultcancer patients (mean age of 41.6 years) on average 10 weeks after their diagnosis.Anxiety/depression symptoms were related to patients'ratings of their use of problem-focused coping, but notto perceived control or emotion-focused coping in simplecorrelations. In hierarchical multiple-regression analyses,problem-focused coping was associated with lowersymptoms of anxiety/depression and emotion-focusedcoping with higher symptoms. The interaction ofproblem-focused coping and perceived control was a significantpredictor of lower symptoms of anxiety/depression. Thispattern was found for patients' but not external judges'ratings of patients' coping intentions. The interaction of coping and control did notpredict anxiety/depression symptoms 4 months later,after controlling for initial anxiety/depressionsymptoms. Implications for adaptive coping with cancerare highlighted.     

Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: a systematic review and meta-analysis

Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.     

A Prospective Study of Coping, Perceived Control, and Psychological Adaptation to Breast Cancer

Coping, perceived control, and symptoms ofanxiety/depression were assessed in 70 women with breastcancer near their diagnosis and at 3- and 6-monthfollow-ups. Multiple regression equations wereconstructed to investigate the effects of coping, perceivedcontrol, and their interaction on anxiety/depressionsymptoms. Problemfocused engagement coping was relatedto lower anxiety/depression symptoms neardiagnosis;emotion-focused disengagementcopingwas related tomoreanxiety/depression symptoms at 6 months, controllingfor initial anxiety/depression; and problemfocusedengagement was marginally related to loweranxiety/depression symptoms at 6 months controlling for initialanxiety/depression. There were no main effects forperceived control. The interaction of problem-focusedengagement coping and perceived control was asignificant predictor of lower anxiety/depression symptomsonly near the time of diagnosis. Thus, thegoodness-of-fit effect, in which problemfocused copinginteracts with perceived control to predict lower levels of anxiety/depression, was replicatedcross-sectionally, but not prospectively.     

Coping and responses to stress in Navajo adolescents: Psychometric properties of the Responses to Stress Questionnaire

This study tested the factor structure of coping and stress responses in Navajo adolescents and examined the reliability and validity of the Responses to Stress Questionnaire (RSQ; Connor‐Smith, Compas, Wadsworth, Thomsen, & Saltzman, 2000) with this population. Confirmatory factor analyses revealed that a correlated five‐factor model of stress responses using the five factors of the RSQ fit the data well for this group of adolescents. The factor structure of the RSQ did not differ by gender. Internal consistency of the RSQ scales and factors was acceptable, and convergent and discriminant validity were moderate to high. Primary and secondary control engagement coping responses were associated with fewer depressive symptoms in the sample, whereas disengagement coping and involuntary engagement responses were associated with more depressive symptoms. The promising implications for stress and coping research with American Indian adolescents are emphasized. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 391–411, 2004.