Subthreshold-depression and subthreshold-anxiety are associated with an increased burden of disease and suicide risk. These results highlight the importance of early identification of adolescent subthreshold-depression and anxiety to minimize suicide. Incorporating these subthreshold disorders into a diagnosis could provide a bridge between categorical and dimensional diagnostic models.
Witthöft, M., and Kraaij, V. (2016of the relationships between specific strategies and symptoms of psychopathology was consistent across countries. Although there were cross-cultural differences in the use of cognitive strategies, the consistent relationship between strategies and psychopathology across countries supports the idea of a trans-cultural approach to treating psychopathology.
BackgroundAccording to literature data, psychopathology is associated with both quality of life (QoL) and suicidal risk in adolescents, but the literature does not fully support a direct association between psychopathology and suicidal thoughts and behaviors. The aim of this study was to investigate the possible mediational role of QoL in the relationship between psychopathology and level of suicidal risk in a clinical sample of adolescents.MethodThe authors examined a clinical population of 134 adolescents, aged 13–18 years. Suicidal risk—having any current suicidal ideations and/or previous suicide attempt—was assessed by the Mini International Neuropsychiatric Interview. QoL was evaluated by the adolescent self-rated versions of “Das Intervertar zur Erfassung der Lebensqualität Kindern und Jugendlichen” (ILK: Measure of Quality of Life for Children and Adolescents) and psychopathology was measured by adolescent self-rated versions of the Strengths and Difficulties Questionnaire (SDQ). A mediational model, in which QoL mediated the relationship between psychopathology and suicidal risk controlling for gender and age, was tested by means of regression analyses.ResultsGender and age were both associated with suicidal risk. Self-reported QoL significantly mediated the relationships between emotional problems (=1.846; 95% BCa CI: 0.731–2.577), as well as peer problems (=0.883; 95% BCa CI: 0.055–1.561) and suicidal risk: more emotional and peer problems were associated with lower QoL, which in turn was related to higher level of suicidal risk.ConclusionBased on this study, which aims to make further steps in suicidal prevention, our findings suggest that clinicians should routinely screen the QoL of their patients, especially in adolescents with emotional and peer problems. Furthermore, it is important to focus intervention and treatment efforts on improving the QoL of adolescents with emotional and peer problems.
Our results draw the attention to the importance of taking into account age, gender, and both self- and parent reports when measuring QoL of children with ADHD and both dimensional and categorical approaches should be used.
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders, severely affecting the emotional well-being of children as well as of adults. It has been suggested that individuals who experience symptoms of ADHD develop maladaptive schemata of failure, impaired self-discipline, social isolation, and shame. These schemata may then contribute to impaired emotional well-being by increasing unhelpful responses to stressful life events. However, to date, no empirical research has tested this theoretical proposition. In a sample of 204 nonclinical adults, we conducted a serial multiple mediator analysis, which supported the proposed model. More severe ADHD symptoms were associated with higher levels of perceived stress both directly and indirectly through stronger maladaptive schemata, which, in turn, were related to lower levels of emotional well-being. Results suggest that identifying and modifying maladaptive schemata may be an important addition to psychotherapy for adult ADHD patients.
IntroductionStress de ned in terms of perceptions of uncontrollability and unpredictability has been one of the central issues in behavioural medicine, partly because of its negative impact on physical and mental health [1]. Though recent studies have underlined the e ects of stress on brain functioning, stress-related changes in cognitive processes of emotion regulation have been under-investigated [2].Emotion regulation has been de ned as the physiological, motivational, behavioural, and cognitive processes responsible for monitoring, evaluating, and modifying emotional reactions in order to accomplish one's goals [3], and has been considered to be important for understanding the onset, maintenance, and treatment of anxiety disorders (see [4] for review).Cognitive regulation of emotion refers to conscious cognitive methods of emotion regulation including attentional and evaluative processes [5,6]. A possible way to characterize cognitive strategies of emotion regulation is in terms of the involvement of the executive functions [7,8]. Executive cognitive emotion regulation, e.g. reappraisal, implies the use of higher cognitive processes such as mental set-shifting, evaluation, planning, working memory, and information updating and monitoring, whereas non-executive cognitive strategies, such as rumination, are associated with deficits in executive functions, e.g. attentional in exibility or inhibitory de cits [8]. For example, reappraisal was shown to be associated with enhanced a ective exibility [9], interference resolution [10], and working memory capacity [11], while rumination was associated with decreased cognitive exibility [12] and internal shifting impairments in working memory [13].Converging results have revealed that negative emotional states are strongly related to the excessive use of non-executive cognitive emotion regulation strategies, particularly rumination, catastrophizing, and self-blame.Low use of executive strategies, such as positive reappraisal, has also been found to be connected to psychopathology [e.g. 14-17], as well as to negative emotional states such as irritability and anger [18].Executive functions depend on the structural and functional integrity of the prefrontal cortex (PFC) [19], which guides emotions and behaviour through projections to subcortical regions like the hypothalamus and the amygdala [20]. Under safe conditions, the amygdala, which has been suggested to serve as a rapid detector of potential threats, is under tonic inhibitory control by the PFC.Under stressful conditions, critical areas of the PFC become hypoactive, resulting in a hyperactivation of the amygdala, which leads to the evocation of adaptive fear responses, but might also lead to chronic threat perception and sustained fear in unpredictable conditions (see [21] for review). Recent research in animal modelsdemonstrates that exposure to stress is regulation has yet to be investigated. The present study explores the possible role of cognitive emotion regulation strategies in mediating the well-establishe...
Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.
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