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Title: Using gastrointestinal distress reports to predict youth anxiety risk: Implications for mental health literacy and community care
Abstract
This study investigates the generalizability and predictive validity of associations between gastrointestinal (GI) symptoms and youth anxiety to establish their utility in community mental health decision‐making. We analyzed data from youth ages 3 to 21 years in volunteer cohorts collected in Los Angeles (N = 327) and New York City (N = 102), as well as the Healthy Brain Network cohort (N = 1957). Youth GI distress was measured through items taken from the parent‐reported Child Behavior Checklist (CBCL). We examined generalizability of GI–anxiety associations across cohorts and anxiety reporters, then evaluated the performance of these models in predicting youth anxiety in holdout data. Consistent with previous work, higher levels of gastrointestinal distress were associated with more parent‐reported youth anxiety behaviors in all three cohorts. Models trained on data from the Healthy Brain Network cohort predicted parent‐reported and child‐reported anxiety behaviors, as well as clinician‐evaluated anxiety diagnoses, at above chance levels in holdout data. Models which included GI symptoms often, but not always, outperformed models based on age and sex alone in predicting youth anxiety. Based on the generalizability and predictive validity of GI–anxiety associations investigated here, GI symptoms may be an effective tool for child‐facing professionals for identifying children at risk for anxiety (Preprint:https://psyarxiv.com/zgavu/).
Novick, Danielle R.; Meyer, Christian T.; Wagner, Nicholas J.; Rubin, Kenneth H.; Danko, Christina M.; Dougherty, Lea R.; Druskin, Lindsay R.; Smith, Kelly A.; Chronis‐Tuscano, Andrea(
, Journal of Child Psychology and Psychiatry)
Background
Given the robust evidence base for the efficacy of evidence‐based treatments targeting youth anxiety, researchers have advanced beyond efficacy outcome analysis to identifymechanismsof change and treatment directionality. Grounded in developmental transactional models, interventions for young children at risk for anxiety by virtue of behaviorally inhibited temperament often target parenting and child factors implicated in the early emergence and maintenance of anxiety. In particular, overcontrolling parenting moderates risk for anxiety among highly inhibited children, just as child inhibition has been shown to elicit overcontrolling parenting. Although longitudinal research has elucidated the temporal unfolding of factors that interact to place inhibited children at risk for anxiety, reciprocal transactions between these child and parent factors in the context of early interventions remain unknown.
Method
This study addresses these gaps by examining mechanisms of change and treatment directionality (i.e., parent‐to‐child vs. child‐to‐parent influences) within a randomized controlled trial comparing two interventions for inhibited preschoolers (N = 151): the multicomponent Turtle Program (‘Turtle’) and the parent‐only Cool Little Kids program (‘CLK’). Reciprocal relations between parent‐reported child anxiety, observed parenting, and parent‐reported accommodation of child anxiety were examined across four timepoints: pre‐, mid‐, and post‐treatment, and one‐year follow‐up (NCT02308826).
Results
Hypotheses were tested via latent curve models with structured residuals (LCM‐SR) and latent change score (LCS) models. LCM‐SR results were consistent with the child‐to‐parent influences found in previous research on cognitive behavioral therapy (CBT) for older anxious youth, but only emerged in Turtle. LCS analyses revealed bidirectional effects ofchangesin parent accommodation and child anxiety during and after intervention, but only in Turtle.
Conclusion
Our findings coincide with developmental transactional models, suggesting that the development of child anxiety may result from child‐to‐parent influences rather than the reverse, and highlight the importance of targeting parentandchild factors simultaneously in early interventions for young, inhibited children.
Zhou, Zexi; Chen, Ya-Yun; Yang, Beiming; Qu, Yang; Lee, Tae-Ho(
, The Journal of Neuroscience)
Despite a recent surge in research examining parent–child neural similarity using fMRI, there remains a need for further investigation into how such similarity may play a role in children's emotional adjustment. Moreover, no prior studies explored the potential contextual factors that may moderate the link between parent–child neural similarity and children's developmental outcomes. In this study, 32 parent–youth dyads (parents:Mage= 43.53 years, 72% female; children:Mage= 11.69 years, 41% female) watched an emotion-evoking animated film while being scanned using fMRI. We first quantified how similarly emotion network interacts with other brain regions in responding to the emotion-evoking film between parents and their children. We then examined how such parent–child neural similarity is associated with children's emotional adjustment, with attention to the moderating role of family cohesion. Results revealed that higher parent–child similarity in functional connectivity pattern during movie viewing was associated with better emotional adjustment, including less negative affect, lower anxiety, and greater ego resilience in youth. Moreover, such associations were significant only among families with higher cohesion, but not among families with lower cohesion. The findings advance our understanding of the neural mechanisms underlying how children thrive by being in sync and attuned with their parents, and provide novel empirical evidence that the effects of parent–child concordance at the neural level on children's development are contextually dependent.
SIGNIFICANCE STATEMENTWhat neural processes underlie the attunement between children and their parents that helps children thrive? Using a naturalistic movie-watching fMRI paradigm, we find that greater parent–child similarity in how emotion network interacts with other brain regions during movie viewing is associated with youth's better emotional adjustment including less negative affect, lower anxiety, and greater ego resilience. Interestingly, these associations are only significant among families with higher cohesion, but not among those with lower cohesion. Our findings provide novel evidence that parent–child shared neural processes to emotional situations can confer benefits to children, and underscore the importance of considering specific family contexts in which parent–child neural similarity may be beneficial or detrimental to children's development, highlighting a crucial direction for future research.
associations
between income and youth mental and behavioral health by delineating economic risks derived from
family, neighborhood, and school contexts within a nationally representative sample of high school students
(N = 13,179, average age 16). Attending schools with more affluent schoolmates was associated with heightened
likelihoods of intoxication, drug use, and property crime, but youth at poorer schools reported greater
depressive and anxiety symptoms, engagement in violence, and for male adolescents, more frequent violence
and intoxication. Neighborhood and family income were far less predictive. Results suggest that adolescent
health risks derive from both ends of the economic spectrum, and may be largely driven by school contexts.
Schacter, Hannah_L; Juvonen, Jaana(
, The Journal of Early Adolescence)
Although high-quality friendships are presumed to protect peer-victimized adolescents from distress, evidence supporting this claim is mixed. This study investigated whether the protective function of high-quality best friendships for victimized youth varies depending on adolescents’ perceptions of their best friend’s victimization. Among a sample of 1,667 eighth graders, we tested the effects of self-perceived victimization, best friend emotional support, and best friend victimization on depressive symptoms and social anxiety across eighth grade. Perceptions of higher emotional support buffered links between boys’ victimization and depressive symptoms. Perceived emotional support buffered links between girls’ victimization and internalizing symptoms if they viewed their best friend as nonvictimized, but it amplified such associations if they viewed their friend as victimized. These results suggest that although perceptions of best friend emotional support benefit peer-victimized youth, highly intimate friendships between victimized adolescent girls may promote maladaptive coping and increased distress.
Veile, Amanda; Faria, Amy_A; Rivera, Sydney; Tuller, Sydney_M; Kramer, Karen_L(
, American Journal of Human Biology)
AbstractObjectives
Cesarean delivery is linked to breastfeeding complications and child morbidity. These outcomes may disproportionately affect Latin American indigenous populations that are experiencing rising cesarean delivery rates, but often inhabit environments that exacerbate postnatal morbidity risks. We therefore assess relationships between birth mode, infant feeding practices, and childhood infectious morbidity in a modernizing Yucatec Maya community, where prolonged breastfeeding is the norm. We predicted that under these conditions, cesarean delivery would increase risk of childhood infectious morbidity, but prolonged breastfeeding postcesarean would mitigate morbidity risk.
Methods
Using a longitudinal child health dataset (n = 88 children aged 0‐60 months, 24% cesarean‐delivered, 2290 observations total), we compare gastrointestinal infectious (GI) and respiratory infectious (RI) morbidity rates by birth mode. We model associations between cesarean delivery and breastfeeding duration, formula feeding and child nutritional status, then model GI and RI as a function of birth mode, child age, and feeding practices.
Results
Cesarean delivery was associated with longer breastfeeding durations and higher child weight‐for‐age, but not with formula feeding, GI, or RI. Adolescent motherhood and RI were risk factors for GI; formula feeding and GI were risk factors for RI. Regional housing materials protected against GI; breastfeeding protected against RI and mitigated the effect of formula feeding.
Conclusions
We find no direct link between birth mode and child infectious morbidity. Yucatec Maya mothers practice prolonged breastfeeding, especially postcesarean, and in conjunction with formula feeding. This practice protects against childhood RI, but not GI, perhaps because GI is more susceptible to maternal and household factors.
Bloom, Paul Alexander, Douglas, Ian, VanTieghem, Michelle, Tottenham, Nim, and Callaghan, Bridget. Using gastrointestinal distress reports to predict youth anxiety risk: Implications for mental health literacy and community care. Developmental Psychobiology 63.6 Web. doi:10.1002/dev.22126.
Bloom, Paul Alexander, Douglas, Ian, VanTieghem, Michelle, Tottenham, Nim, & Callaghan, Bridget. Using gastrointestinal distress reports to predict youth anxiety risk: Implications for mental health literacy and community care. Developmental Psychobiology, 63 (6). https://doi.org/10.1002/dev.22126
Bloom, Paul Alexander, Douglas, Ian, VanTieghem, Michelle, Tottenham, Nim, and Callaghan, Bridget.
"Using gastrointestinal distress reports to predict youth anxiety risk: Implications for mental health literacy and community care". Developmental Psychobiology 63 (6). Country unknown/Code not available: Wiley Blackwell (John Wiley & Sons). https://doi.org/10.1002/dev.22126.https://par.nsf.gov/biblio/10367366.
@article{osti_10367366,
place = {Country unknown/Code not available},
title = {Using gastrointestinal distress reports to predict youth anxiety risk: Implications for mental health literacy and community care},
url = {https://par.nsf.gov/biblio/10367366},
DOI = {10.1002/dev.22126},
abstractNote = {Abstract This study investigates the generalizability and predictive validity of associations between gastrointestinal (GI) symptoms and youth anxiety to establish their utility in community mental health decision‐making. We analyzed data from youth ages 3 to 21 years in volunteer cohorts collected in Los Angeles (N = 327) and New York City (N = 102), as well as the Healthy Brain Network cohort (N = 1957). Youth GI distress was measured through items taken from the parent‐reported Child Behavior Checklist (CBCL). We examined generalizability of GI–anxiety associations across cohorts and anxiety reporters, then evaluated the performance of these models in predicting youth anxiety in holdout data. Consistent with previous work, higher levels of gastrointestinal distress were associated with more parent‐reported youth anxiety behaviors in all three cohorts. Models trained on data from the Healthy Brain Network cohort predicted parent‐reported and child‐reported anxiety behaviors, as well as clinician‐evaluated anxiety diagnoses, at above chance levels in holdout data. Models which included GI symptoms often, but not always, outperformed models based on age and sex alone in predicting youth anxiety. Based on the generalizability and predictive validity of GI–anxiety associations investigated here, GI symptoms may be an effective tool for child‐facing professionals for identifying children at risk for anxiety (Preprint:https://psyarxiv.com/zgavu/).},
journal = {Developmental Psychobiology},
volume = {63},
number = {6},
publisher = {Wiley Blackwell (John Wiley & Sons)},
author = {Bloom, Paul Alexander and Douglas, Ian and VanTieghem, Michelle and Tottenham, Nim and Callaghan, Bridget},
}
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