Anxiety Symptom Questionnaire Research Articles

Assessing Changes in Symptoms of Depression and Anxiety During Four Weeks of Cannabis Abstinence Among Adolescents.

Background: Cannabis use is prevalent among adolescents, and many report using in attempts to alleviate negative mood and anxiety. Abstinence from substances such as alcohol and tobacco has been reported to improve symptoms of anxiety and depression. Few studies have examined the effect of cannabis abstinence on symptoms of anxiety and depression.Objective: To test the effect of 4 weeks of continuous cannabis abstinence on depressive and anxious symptoms.Methods: Healthy, non-treatment seeking adolescents who used cannabis at least weekly (n = 179) were randomized to either 4 weeks of cannabis abstinence achieved through a contingency management paradigm (CB-Abst) or cannabis use monitoring without an abstinence requirement (CB-Mon). Abstinence was assessed by self-report verified with quantitative assay of urine for cannabinoids. Anxiety and depressive symptoms were assessed weekly with the Mood and Anxiety Symptom Questionnaire (MASQ).Results: Symptoms of depression and anxiety decreased throughout the study for all participants (MASQ-AA: stnd beta = −0.08, p = 0.01, MASQ-GDA: stnd beta = −0.11, p = 0.003, MASQ-GDD: stnd beta = −0.08, p = 0.02) and did not differ significantly between randomization groups (p's > 0.46). Exploratory analyses revealed a trend that abstinence may be associated with greater improvement in symptoms of anxiety and depression among those using cannabis to cope with negative affect and those with potentially hazardous levels of cannabis use.Conclusions: Among adolescents who use cannabis at least weekly, 4 weeks of cannabis abstinence was not associated with a significant change in anxiety or depressive symptoms compared to continued use. For recreational cannabis users who may be concerned about reducing their use for fear of increased symptoms of anxiety and depression, findings suggest that significant symptom worsening may not occur within the first 4 weeks of abstinence. Further studies are needed in clinical populations where anxiety and depression symptoms are measured more frequently and for a longer period of abstinence. Future studies are also needed to determine whether there are subgroups of adolescents who are uniquely impacted by sustained cannabis abstinence.

Associations between beta-blocker use and psychological distress in bereaved adults with cardiovascular conditions.

The death of a close other is a major life stressor that disrupts mental and physical health. Beta-blocker medications are indicated treatments for cardiovascular conditions that may also mitigate psychological distress in the context of stressors by reducing adrenergic activity. We sought to examine observational links between beta-blocker medication use and psychological distress during bereavement. Using publicly available data from the Midlife in the United States Refresher study, we examined associations between beta-blocker use and general distress, depressive symptoms, and anxiety symptoms (as measured by the Mood and Anxiety Symptom Questionnaire) among bereaved adults with cardiovascular conditions (n=161) using t-tests and regression models. Beta-blocker users reported lower levels of anxiety-related general distress (b=-2.49, SE=0.88, p=0.005) and depression-related general distress than non-users (b=-2.39, SE=1.14, p=0.039) in multivariate linear regression models adjusting for demographic characteristics, mental health treatments, time since loss and comorbid health conditions. These observed links between beta-blockers and lower psychological distress in bereavement warrant further investigation in prospective and randomized studies, as beta-blockers could be a scalable intervention for mitigating distress following loss.

Efficacy of attention bias modification training for depressed adults: a randomized clinical trial.

This study examined the efficacy of attention bias modification training (ABMT) for the treatment of depression. In this randomized clinical trial, 145 adults (77% female, 62% white) with at least moderate depression severity [i.e. self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ⩾13] and a negative attention bias were randomized to active ABMT, sham ABMT, or assessments only. The training consisted of two in-clinic and three (brief) at-home ABMT sessions per week for 4 weeks (2224 training trials total). The pre-registered primary outcome was change in QIDS-SR. Secondary outcomes were the 17-item Hamilton Depression Rating Scale (HRSD) and anhedonic depression and anxious arousal from the Mood and Anxiety Symptom Questionnaire (MASQ). Primary and secondary outcomes were administered at baseline and four weekly assessments during ABMT. Intent-to-treat analyses indicated that, relative to assessment-only, active ABMT significantly reduced QIDS-SR and HRSD scores by an additional 0.62 ± 0.23 (p = 0.008, d = -0.57) and 0.74 ± 0.31 (p = 0.021, d = -0.49) points per week. Similar results were observed for active v. sham ABMT: a greater symptom reduction of 0.44 ± 0.24 QIDS-SR (p = 0.067, d = -0.41) and 0.69 ± 0.32 HRSD (p = 0.033, d = -0.42) points per week. Sham ABMT did not significantly differ from the assessment-only condition. No significant differences were observed for the MASQ scales. Depressed individuals with at least modest negative attentional bias benefitted from active ABMT.

Allostatic load and mental health: a latent class analysis of physiological dysregulation

This study explored the associations between specific profiles of biological dysregulation and mental health outcomes in a national, community sample of healthy adults in the United States. A latent class analysis of data from the Midlife Development in the United States study (n = 1,757) was conducted to determine classes of biological dysregulation. Multinomial logistic regressions of class membership were employed to determine associations with measures related to depression, including whether or not individuals had sought treatment, Center for Epidemiological Studies Depression Scale, and both the generalized distress and anhedonia subscales of the Mood and Anxiety Symptoms Questionnaire. Four classes of dysregulation emerged: baseline/low dysregulation, metabolic and inflammatory dysregulation, parasympathetic dysregulation, and SAM pathway dysregulation. Individuals who met the criteria for depression measures were more likely to be in the metabolic and immune dysregulation and parasympathetic dysregulation groups as compared to the baseline group. The results suggest that mental health outcomes, such as depression, are differentially associated with specific profiles of biological dysregulation. A more nuanced approach to profiles of dysregulation could better inform treatment decisions. Lay summary Higher levels of allostatic load, which represents the cumulative wear and tear of exposure to stress, are associated with increased rates of depression and anhedonia. Specifically, parasympathetic dysregulation and immunometabolic dysregulation are associated with negative mental health outcomes

Psychometric analysis of the adult separation anxiety symptom questionnaire: Item functioning and invariance across gender and time.

The Adult Separation Anxiety Symptom Questionnaire (ASA-27) is the most widely used self-report assessment of adult separation anxiety (ASA). Despite its widespread use, relatively little is known about its psychometric properties, specifically whether it is unidimensional, its degree of precision (or information) across latent levels of ASA, the functioning of individual items in general and of DSM-derived versus non-DSM-derived items in particular, and whether the measure is invariant across gender and time. We addressed these issues in a sample of 509 adult women and 407 adult men from the local community participating in a longitudinal study of temperament and psychopathology in children. Two items from the ASA-27 were removed so that the measure met the item response theory (IRT) assumption of unidimensionality. Findings from a graded response model for categorical items suggested that the ASA-27 assesses ASA most reliably at moderate to high levels and that the DSM-derived items were more closely related to latent ASA than the non-DSM-derived items. Invariance tests employing single-factor confirmatory factor analysis models suggested that the measure is partially invariant across gender and time at the unique factor level, with fewer than 7% of parameters freed in both cases; this implies that the means and variances of the latent factors and differences in the observed responses are attributable to true differences in ASA. Future work should replicate these findings in a sample that includes individuals with a wider range of ASA severity and may consider removing additional items that provide little or redundant information. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

1099 Sleep Restriction Leads To Greater Next-day Anxiety: The Moderating Role Of Anxiety And Depression

Abstract Introduction Evidence from both experimental and daily-diary studies suggests that a single night of sleep restriction leads to higher levels of anxiety the following day. Depressive symptoms also increase the next day in healthy populations, although sleep restriction has demonstrated short-term antidepressant properties in depressed populations. Relatively little research has examined symptoms of anxiety and depression separately on days following naturally-occurring sleep restriction and whether any change from the previous day might be moderated by baseline levels of anxiety or depression. Methods Undergraduates completed electronic daily diaries twice per day for 14 days (N = 96). Upon waking, participants answered questions assessing their sleep, and every evening, before going to bed, completed the Mood and Anxiety Symptom Questionnaire - Short Form to assess daily levels of general distress, anxious arousal, and anhedonic depression. The State-Trait Anxiety Inventory - State and the Center for Epidemiologic Studies Depression Scale provided baseline measures of anxiety and depression, respectively. A night of sleep restriction was operationally defined as one for which participants reported obtaining 4 hours of sleep or less. Results Multilevel modeling revealed that anxious arousal was higher following sleep restriction (β =.92, z=2.40, p=.017). This was moderated by baseline anxiety (β =.09, z=2.89, p=.004) and baseline depression (β =.09, z=3.39, p=.001) so that anxious arousal was even higher the next day for individuals reporting a high number of anxious and depressive symptoms. These effects remained significant after controlling for lagged anxious arousal, gender, baseline anxiety and depression, substance use, and napping. Conversely, no significant results were found when next-day general distress or anhedonic depression were examined. Conclusion Our results suggest that naturally-occurring sleep restriction is accompanied by increases in anxiety, but not depressive symptoms, the following day. This effect is heightened in individuals with higher baseline levels of anxiety and depression. Support N/A

Human milk cortisol and immune factors over the first three postnatal months: Relations to maternal psychosocial distress.

Many biologically active factors are present in human milk including proteins, lipids, immune factors, and hormones. The milk composition varies over time and shows large inter-individual variability. This study examined variations of human milk immune factors and cortisol concentrations in the first three months post-partum, and their potential associations with maternal psychosocial distress. Seventy-seven healthy mothers with full term pregnancies were enrolled, of which 51 mothers collected morning milk samples at 2, 6 and 12 weeks post-delivery. Maternal psychosocial distress was assessed at 6 weeks post-delivery using questionnaires for stress, anxiety, and depressive symptoms. Immune factors were determined using multiplex immunoassays and included innate immunity factors (IL1β, IL6, IL12, IFNγ, TNFα), acquired immunity factors (IL2, IL4, IL10, IL13, IL17), chemokines (IL8, Groα, MCP1, MIP1β), growth factors (IL5, IL7, GCSF, GMCSF, TGFβ2) and immunoglobulins (IgA, total IgG, IgM). Cortisol was quantified using liquid chromatography-tandem mass spectrometry. A linear mixed effects model was fit to test whether stress, anxiety, and depressive symptoms individually predicted human milk cortisol concentrations after accounting for covariates. Repeated measurement analyses were used to compare women with high (n = 13) versus low psychosocial distress (n = 13) for immune factors and cortisol concentrations. Virtually all immune factors and cortisol, with the exception of the granulocyte-macrophage colony-stimulating factor (GMCSF), were detected in the human milk samples. The concentrations of the immune factors decreased during the first 3 months, while cortisol concentrations increased over time. No correlation was observed between any of the immune factors and cortisol. No consistent relationship between postnatal psychosocial distress and concentrations of immune factors was found, whereas higher psychosocial distress was predictive of higher cortisol concentrations in human milk. In the current study we found no evidence for an association between natural variations in maternal distress and immune factor concentrations in milk. It is uncertain if this lack of association would also be observed in studies with larger populations, with less uniform demographic characteristics, or with women with higher (clinical) levels of anxiety, stress and/or depressive symptoms. In contrast, maternal psychosocial distress was positively related to higher milk cortisol concentrations at week 2 post-delivery. Further investigation on maternal psychosocial distress in relation to human milk composition is warranted.

Antiepileptic drugs are not independently associated with cognitive dysfunction.

To test the hypothesis that individual antiepileptic drugs (AEDs) are not associated with cognitive impairment beyond other clinically relevant factors, we performed a cross-sectional study of patients admitted to an inpatient video-EEG monitoring unit. We prospectively enrolled patients admitted to an inpatient specialist epilepsy program between 2009 and 2016. Assessments included objective cognitive function, quality of life subscales for subjective cognitive function, and questionnaires for anxiety and depressive symptoms. Bayesian model averaging identified predictors of cognitive function. Bayesian model selection approach investigated effect of individual AEDs on cognition. Conventional frequentist analyses were also performed. A total of 331 patients met inclusion criteria. Mean age was 39.3 years and 61.9% of patients were women. A total of 45.0% of patients were prescribed AED polypharmacy, 25.1% AED monotherapy, and 29.9% no AED. Age, seizure frequency, and a diagnosis of concomitant epilepsy and psychogenic nonepileptic seizure were predictors of objective cognitive function. Depression, anxiety, and seizure frequency were predictors of subjective cognitive function. Individual AEDs were not independently associated with impaired cognitive function beyond other clinically relevant variables. This study found that no AED was independently associated with cognitive dysfunction. Significant determinants of objective and subjective cognitive dysfunction included seizure frequency and depression, respectively. These findings suggest that optimizing therapy to prevent seizures is not likely to occur at the expense of cognitive function.

Anxiety Symptoms Questionnaire (ASQ): development and validation

BackgroundThe Anxiety Symptoms Questionnaire (ASQ) is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting....

Distress and anhedonia as predictors of depression treatment outcome: A secondary analysis of a randomized clinical trial

Two core features of depression include depressed mood (heightened distress) and anhedonia (reduced pleasure). Despite their centrality to depression, studies have not examined their contribution to treatment outcomes in a randomized clinical trial providing mainstream treatments like antidepressant medications (ADM) and cognitive therapy (CT). We used baseline distress and anhedonia derived from a factor analysis of the Mood and Anxiety Symptom Questionnaire to predict remission and recovery in 433 individuals with recurrent/chronic major depressive disorder. Patients were provided with only ADM or both ADM and CT. Overall, higher baseline distress and anhedonia predicted longer times to remission within one year and recovery within three years. When controlling for treatment condition, distress improved prediction of outcomes over and above anhedonia, while anhedonia did not improve prediction of outcomes over and above distress. Interactions with treatment condition demonstrated that individuals with higher distress and anhedonia benefited from receiving CT in addition to ADM, whereas there was no added benefit of CT for individuals with lower distress and anhedonia. Assessing distress and anhedonia prior to treatment may help select patients who will benefit most from CT in addition to ADM. For the treatments and outcome measures tested, utilizing distress to guide treatment planning may yield the greatest benefit. Trial registrationclinicaltrials.gov Identifier: NCT00057577.

Perceived Stress and Sleep Quality in Midlife and Later: Controlling for Genetic and Environmental Influences

ABSTRACT Objective/Background Stress is a strong predictor for poor sleep quality. However, little is known about the mechanism of this association or the respective contribution of genetic and environmental factors. This study aims to investigate general distress as a mediator and cognitive/emotional control as a moderator in the stress–sleep relationship and estimate the influence of gene and environment in this mechanism using a national representative sample. Participants 1,255 middle-aged and elderly Americans and a subset of 296 twins. Methods The Pittsburgh Sleep Quality Index, the Perceived Stress Scale, the Mood and Anxiety Symptom Questionnaire and the Self-Control Scale assessed sleep quality, perceived stress, general distress, and emotional/cognitive control. Structural equation modeling was used to test the mediating and moderating effect. ACE models on MZ and DZ twins were used to separate the contribution of genetic and environmental factors. Finally, a co-twin design was nested in the SEM to control for the genetic and familial confounds in the stress–sleep relationship. Results General distress mediated the relationship between stress and sleep while emotional/cognitive control buffered the impact of stress on general distress. 7.69% of the variance in sleep quality was explained by genetic and familial factors and 8.26% was explained by individual-specific factors. Emotional/cognitive control only moderated the individual-specific association between stress and sleep. Conclusions Gene/family factors and individual factors explained an equivalent proportion of the stress–sleep relationship. The genetic and familial association between stress and sleep is more robust, whereas the individual-specific association can be buffered by regulation strategies.

Concurrent Validity and Reliability of Two Short Forms of the Mood and Anxiety Symptom Questionnaire in a Student Sample from Northwest Mexico

It is estimated that aproximately 4% of the world’s population is either living with depression, anxiety, or both. The prevalence of these disorders has been consistently increasing. This widespread and increasing prevalence highlights the importance of having well-validated scales to assess symptoms in different languages. The Mood and Anxiety Symptom Questionnaire (MASQ; Clark and Watson Journal of Abnormal Psychology, 100(3), 316–336, 1991) is a commonly used self-report questionnaire that assesses both depression and anxiety symptoms. To investigate the psychometric properties of a Spanish translation of two short forms of the MASQ (the MASQ-SF and Mini-MASQ), each item was translated and back translated by bilingual researchers and checked by two additional senior investigators. The sample included 238 graduate and undergraduate students from Northwestern Mexico. Participants also completed questionnaires assessing self-reported perceived stress, well-being, resilience, and personality traits. We examined internal consistency reliability, factor structure, and convergent, discriminant and concurrent validity of both MASQ short forms. The Mini-MASQ and MASQ-SF showed good internal consistency; moreover, consistent with previous studies, a three-factor structure emerged. We additionally found that MASQ measures were negatively associated with well-being and resilience, and positively related to stress and neuroticism. The study findings suggest that these Spanish versions of the the Mini-MASQ and MASQ-SF are valid and reliable instruments to assess dimensional aspects of depression and anxiety and can be implemented in studies in Northwest Mexico.

The Assessment and Impact of Careless Responding in Routine Outcome Monitoring within Mental Health Care

Careless responding by mental health patients on self-report assessments is rarely investigated in routine care despite the potential for serious consequences such as faulty clinical decisions. We investigated validity indices most appropriate for detecting careless responding in routine outcome monitoring (ROM) in mental health-care. First, we reviewed indices proposed in previous research for their suitability in ROM. Next, we evaluated six selected indices using data of the Brief Symptom Inventory and the Mood and Anxiety Symptom Questionnaire from 3,483 outpatients. Simulations showed that for typical ROM scales the index, Mahalanobis distance, and inter-item standard deviation may be too strongly confounded with the latent trait value to compare careless responding across patients with different symptom severity. Application of two different classification methods to the validity indices did not converge in similar prevalence estimates of careless responding. Finally, results suggest that careless responding does not have a substantial biasing effect on scale-score statistics. We recommend the person-fit index to screen for random careless responding in large ROM data sets. However, additional research should further investigate methods for detecting repetitive responding in typical ROM data and assess whether there are specific circumstances in which simpler validity statistics or direct screening methods perform similarly as the index.

Measuring treatment outcome in patients with anxiety disorders: A comparison of the responsiveness of generic and disorder-specific instruments

BackgroundFor routine outcome monitoring, generic (i.e., broad-based) and disorder-specific instruments are used to monitor patient progress. While disorder-specific instruments may be more sensitive to therapeutic change, generic measures can be applied more broadly and allow for an assessment of therapeutic change, irrespective of a specific anxiety disorder. Our goal was to investigate whether disorder-specific instruments for anxiety disorders are a valuable (or even necessary) addition to generic instruments for an appropriate assessment of treatment outcome in groups of patients. MethodsData were collected from 2002 to 2013 from psychiatric outpatients in treatment for Social Phobia (SP; n = 834), Generalized Anxiety Disorder (GAD; n = 661), Panic Disorder (PD; n = 944), Obsessive-Compulsive Disorder (OCD; n = 460), and Posttraumatic Stress Disorder (PTSD; n = 691). Instruments used were the generic Brief Symptom Inventory (BSI), The Mood and Anxiety Symptoms Questionnaire (MASQ), and several disorder-specific instruments (e.g., Social Interaction Anxiety Scale, Social Phobia Scale, Panic Appraisal Inventory, etc.). Responsiveness (i.e., sensitivity to therapeutic change) was examined through correlational analyses, effect sizes (ES), and analysis of variance for repeated measures. ResultsThe MASQ appeared generally more responsive than the BSI, except for the BSI Anxiety subscale for PD. Disorder-specific measures equaled the MASQ and BSI in responsiveness. When statistically significant differences occurred, the ES was small. Discussion/conclusionsFor most anxiety disorder groups (i.e., SP, PD and OCD), the MASQ or BSI was equally suited as disorder-specific instruments to detect change at group level. Exceptions are GAD and PTSD. These findings suggest limited incremental information value of disorder-specific instruments over the MASQ and BSI for measuring change.

Assessing anxiety symptoms in children: Agreement between parents and children.

Assessment of anxiety disorders in children is a difficult process and requires the use of multiple resources of information. Such resources may come from children, parents, and educators and they also require the use of multiple types of diagnostic tools, like structured and semi-structured clinical interviews, as well as self-report questionnaires. Previous research shows that anxiety symptoms ratings of different informants are to some degree correlated (low to moderate agreement) but nonetheless also often show clear discrepancies. Important variables may affect the degree of child-parent agreement. The present study focused on child's gender and age possible impact. The aim of the present study was to examine the agreement between children's and parents' reports on self-reported questionnaires for anxiety symptoms. 431 children from 4th to 6th grade of elementary school and their parents participated in the study. 190 were boys and 241 were girls. Both children and their parents responded to Spence Children's Anxiety Scale (SCAS) (child's and parent's version correspondingly). Relations between children's and parents' reports concerning anxiety symptoms were examined by calculation Pearson's correlation coefficients. The results showed that there was a medium but statistically important positive correlation between children's and parents' reports on SCAS total score (r=0.50, p<0.01). Concerning SCAS subscales results supported that higher correlations were those reported for Separation Anxiety (r=0.53, p<0.01) and Fear of Physical Injury (r=0.55, p<0.01). Concerning gender differences the present study found that correlation coefficients for girls were higher than for boys in SCAS total score (r=0.57 and r=0.39 correspondingly, p<0.01). Correlations according to age showed that the highest correlation coefficients were found in comparatively older children (r=0.34, r=0.54 και r=0.63, p<0.01 for 4th, 5th and 6th Grade). The latter underlies that in the process of assessing and diagnosing anxiety disorders in children, it is both necessary and important to gather information from multiple sources, especially in cases of younger children.

3520 Neural connectivity mechanisms linking off-time pubertal development and depression risk in adolescence

OBJECTIVES/SPECIFIC AIMS: Earlier pubertal timing has been associated with risk for depression, particularly in girls (e.g., Keenan etal., 2014). Evidence suggests pubertal timing in girls also relates to alterations in the microstructural properties of brain white matter tracts in late adolescence (Chahal etal., 2018), and structural connectivity of cingulate and frontal regions (Chahal etal., in prep), though differences in pubertal development in both boys and girls have not been examined in the context of brain functional connectivity (FC). Individual differences in the course of puberty may have enduring effects on functional coupling among brain regions that may contribute to the risk for psychopathology. To address this question, we explored the relation between pubertal timing and tempo with depression symptoms (age 16). Then, we examined whether brain network FC (age 16) associates with pubertal indices and predicts concurrent and later depressive symptoms (age 18). METHODS/STUDY POPULATION: Sixty-eight adolescents (37 females) completed the Mini-Mood and Anxiety Symptom Questionnaire (MASQ; Clark &amp; Watson, 1995) at ages 14-18. Gompertz growth curve modelling of pubertal development (age 10-15; Waves 1-6) was used to estimate pubertal timing and tempo per individual, separately for males and females (e.g., Chahal etal., 2018). Resting-state MRI data (age 16) were parcellated into 264 cortical and subcortical regions to create region-to-region FC matrices based on correlations of time-series. Individual matrices were fed to the GraphVar program (Kruschwitz etal., 2015) to assess the interaction of pubertal timing and pubertal tempo with functional network connectivity using Network-based statistic (NBS; Zalesky etal., 2010). Subnetworks showing alterations in relation to pubertal timing and tempo were then examined in association with concurrent (age 16) symptoms and used to predict future depressive symptoms (age 18). RESULTS/ANTICIPATED RESULTS: In all youth, earlier pubertal timing was associated with higher depressive symptoms at age 16 (p&lt;.018). This association was stronger in girls with slower pubertal tempo (p&lt;.039). Interregional connectivity analyses revealed that the interaction of earlier pubertal timing and slower tempo was associated with lower FC between the left cingulate gyrus and right precuneus (p&lt;.0001), regions implicated in emotion processing (i.e., Affective Processing Network) and self-referential thinking (i.e., Default Mode Network). FC of the three other emotion- and self-referential processing network regions (i.g., left insula, superior parietal lobule, and precuneus) was lower in youth with greater age 16 depressive symptoms (p&lt;.0001). Finally, lower FC of of the left and right inferior parietal lobule predicted greater depressive symptoms at age 18 (p&lt;.0001). In summary, FC of overlapping affective and default mode network areas was related to earlier pubertal timing and higher concurrent and future depressive symptoms. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings demonstrate individual differences in pubertal maturation are associated with depressive symptoms and differences in brain connectivity in mid-adolescence. Early pubertal development was associated with greater depression symptoms and lower FC of brain regions involved in emotion regulation and self-referential processing. Further, FC between these regions predicted higher depression symptoms two years later. These neurobiological mechanisms may, in part, underlie the link between off-time pubertal development and the risk for depression. These findings also have important implications for precision psychiatry, as we show that a risk-factor of depression (early pubertal timing) may manifest in developing neurobiology in region-specific ways. Previous network models of depression (e.g., Li etal., 2018) implicated affective network connectivity in sustained negative mood and the default mode/ self-referential network in rumination. Other networks implicated in these past models include the reward network, which may be involved in anhedonia and loss of pleasure. Our study only found associations between affective and self-referential regional connectivity, pubertal maturation, and depression, suggesting that pubertal risk factors may relate more closely with emotion-regulation and self-referential processing deficits.

Is replacing time spent in 1 type of physical activity with another associated with health in children?

Altering the proportion of total physical activity time accumulated while participating in different types of physical activity may influence health. Our objective was to use observational data to estimate whether replacing time from 1 type of physical activity with another is associated with physical and mental health indicators among children. Participants were 385 children aged 10-13 years. They wore a Global Positioning System watch and accelerometer and completed an activity log for 7 days. Data from these instruments was used to estimate time spent in outdoor active play, organized sport, curriculum-based physical activity at school, and active transportation. A cardiometabolic risk factor score was created from body fat, resting heart rate, and resting blood pressure measures. An internalizing symptoms score was created using anxiety and depression symptom questionnaire items. Isotemporal substitution models estimated if health indicators changed when time in 1 type of physical activity was replaced with equivalent time from another. The results indicated that time spent in all types of physical activity combined was associated with the cardiometabolic risk factor and internalizing symptom scores. Replacing active transportation with outdoor active play was associated with an increase in the internalizing symptoms score but a decrease in the cardiometabolic risk factor score. The internalizing symptoms score decreased when active transportation was replaced by equivalent time in organized sport. Other time substitutions were not significant. In conclusion, the total time spent participating in physical activity and not a specific type of physical activity was the most consistent correlate of the health indicators.

Metacognition strengthens the association between neurocognition and attenuated psychosis syndrome: Preliminary evidence from a pilot study among treatment-seeking versus healthy adolescents

BackgroundIn a pilot study, we assessed the potential value of deficits at the metacognitive versus the neurocognitive level of functioning for identifying adolescents with attenuated psychotic syndrome (APS). MethodTwenty-two treatment-seeking adolescents with APS, 42 treatment-seeking comparisons, and 34 age-matched healthy comparisons were evaluated using the Prodromal Questionnaire, the Structured Interview for Prodromal Syndromes, and the Mood and Anxiety Symptom Questionnaire. Neurocognitive and metacognitive functioning were assessed in two non-social (verbal memory and executive functioning) and two social (facial emotion perception and theory of mind) cognitive domains. In addition to the standard neurocognitive administration of the tasks, subjects were asked to rate their confidence level on each answer and to choose whether they wanted it “counted” toward their overall task performance score on the task. Choices were rewarded. ResultsAs hypothesized, APS among treatment-seeking adolescents was more strongly associated with impaired neurocognition than with impaired metacognition. Likewise, as hypothesized, impaired metacognition was shown to significantly improve the APS prediction beyond the contribution of impaired neurocognition alone, even after controlling for general intellectual ability, negative symptoms, social functioning, and depression. ConclusionsThese results suggest that metacognitive monitoring and control play a strengthening role in the association between neurocognition and APS. One possible explanation is that metacognition serves as an indicator of insight into the condition, accounting for differences in insight not explained by neurocognition alone. However, further research with larger samples that include non-treatment seeking individuals, established measures of insight, and follow-up data is required to assess this possibility.

Comparative Study on the Effectiveness of a Unified Protocol for the Transdiagnostic Treatment and Emotion Regulation Intervention in Anxious Arousal

Background: The extremely high prevalence, chronicity, and high comorbidity with other mental disorders suggest that anxiety disorder imposes many expenses on individuals, families, and society, and has negative impacts on quality of life, social, and individual aspects. Methods: This quasi-experimental study utilized a pretest-posttest design with a follow-up period of three months. 30 eligible patients were selected by random sampling and assigned to two experimental (10 persons receiving unified protocol for the transdiagnostic treatment and 10 persons receiving emotion regulation intervention) and control (10 persons receiving no intervention) groups. The instrument for measuring variables was the Mood and Anxiety Symptoms Questionnaire (MASQ-D30). The data were analyzed using descriptive and inferential statistics (repeated measurements and Bonferroni post hoc test). Results: The results showed that the interventions had significant effects on anxious arousal and they were able to show therapeutic effects in the post-test stage maintained until the follow-up stage. The therapeutic effects of the interventions were slightly different, although statistically insignificant. Conclusions: The most important implication of the research is the effectiveness of the interventions. Thus, care therapists are suggested considering the relative limitations of specific treatments, avoiding the multiple treatment guidelines, and paying attention to the privilege of these approaches such as the applicability for a wide range of disorders and ability to easy learning. Thus, they would find these treatments effective in this area.

Impact of a 3-Day High-Altitude Trek on Xue Mountain (3886 m), Taiwan, on the Emotional States of Children: A Prospective Observational Study.

Changes in emotions associated with mountain treks have rarely been reported. This study examined emotional state changes in sixth-grade elementary school students before and after a 3-day high-altitude mountain trek from the trailhead (2140 m) to Xue Mountain (3886 m) in Taiwan. In June 2011, 201 students participated in the trek. The round-trip distance was 21.8 km. The age, gender, blood group, and family configuration of the participants were documented before the trek. A 36-item short-form survey instrument, including the Mood and Anxiety Symptom Questionnaire and the Positive and Negative Affect Scale for Children, was used to evaluate the participants' emotional states (happiness, anticipation, sadness, and anger). The participants answered the questionnaires 1 month before and 1 week after the trek. A Likert scale was used to evaluate individual items (range 1-4; from strongly disagree to strongly agree). We calculated scores for each index before and after the trek. The incidence and presentation of acute mountain sickness (AMS) among the participants was also studied and published previously. In total, 187 (112 boys and 75 girls) participants (mean age 11.9 ± 0.4 years) completed the trek and the survey. The sadness and anger scores (negative emotions) were significantly lower after than before the trek (39.5 vs. 36.6; p < 0.01). The happiness and anticipation scores (positive emotions) before and after the trek did not differ significantly (49.9 vs. 48.9; p = 0.11). No participant used AMS prophylaxis, while 78 participants met the AMS criteria. Negative emotions decreased more in those with AMS than without AMS (-4.6 vs. -1.8; p = 0.04), and the use of medications or acetazolamide did not alter the emotions. A 3-day high-altitude mountain trek can reduce children's negative emotions. Negative emotions decreased more in those with AMS, whereas medications or acetazolamide did not alter their emotions.