School-based prevention of depression and anxiety symptoms in early adolescence: A pilot of a parent intervention component.

Previous studies suggest that school-based cognitive-behavioral interventions can reduce and prevent depressive symptoms in youth. This pilot study investigated the effectiveness of a cognitive-behavioral depression prevention program, the Penn Resiliency Program for Children and Adolescents (the PRP-CA), when combined with a parent intervention component. Forty-four middle school students and their parents were randomly assigned to the enhanced PRP (the PRP-CA plus parent program) or control conditions. Students completed measures of depression and anxiety symptoms at baseline and 2 weeks, 6 months, and 1 year after the intervention ended. The combined version of the PRP significantly reduced symptoms of depression and anxiety during the follow-up period. Children assigned to the intervention condition were less likely than controls to report clinical levels of anxiety symptoms. Findings suggest that school-based cognitive-behavioral interventions that include parents may prevent depression and anxiety symptoms in early adolescence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Non-neoplastic stenosis of the aqueduct presenting in adolescence and adult life

Twenty-six cases of non-neoplastic stenosis of the aqueduct are reviewed. This condition may take a very chronic course and may not be revealed until decompensation of hydrocephalus takes place. Poor athletic record in the school or intellectual impairment in early life, commonly overlooked, can presage the more obvious symptoms. A prolonged follow-up of these cases is essential to exclude a slowly growing neoplasm near the aqueduct. Our management and the outcome of these cases is discussed.     

Gender differences in the development and adult outcome of co-occurring depression and delinquency in adolescence.

Using a dual trajectory modeling approach, we examined co-occurring trajectories of depression and delinquency from age 11 to age 18 and their relation to adult outcome six years later in a community sample of 1423 (674 boys) adolescents. We also examined the effects of childhood externalizing, internalizing, and social problems on trajectory membership for depression and delinquency. The results showed that although more girls than boys were likely to follow high-level, co-occurring trajectories on depression and delinquency, the adult outcome of adolescents following high-level trajectories on both domains was poorer for boys than for girls. However, the combination of decreasing depression symptoms and increasing delinquency symptoms across adolescence was related with poorer adult outcomes for girls compared to boys. Finally, whereas boys' high-level co-occurring trajectory of depression and delinquency was predicted by childhood aggression, girls' equivalent trajectory was predicted by childhood depression and delinquency. The findings support the “gender paradox” effect (Loeber & Keenan, 1994) stating that in disorders with an unequal gender ratio, members of the gender with the lower prevalence rate tend to be more seriously affected in terms of comorbidity and poor outcome. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Longitudinal evidence that psychopathy scores in early adolescence predict adult psychopathy.

This study examined the relation between psychopathy assessed at age 13 by using the mother-reported Childhood Psychopathy Scale (D. R. Lynam, 1997) and psychopathy assessed at age 24 by using the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine this relation; approximately 9% of the sample met criteria for a possible PCL:SV diagnosis. Despite the long time lag, different sources, and different methods, psychopathy from early adolescence into young adulthood was moderately stable (r=.31). The relation was present for the PCL:SV total and facet scores, was not moderated by initial risk status or initial psychopathy level, and held even after controlling for other age 13 variables. Diagnostic stability was somewhat lower. Both specificity and negative predictive power were good, and sensitivity was adequate, but positive predictive power was poor. This constitutes the first demonstration of the relative stability of psychopathy from adolescence into adulthood and provides evidence for the incremental utility of the adolescent psychopathy construct. Implications and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consequences of depression during adolescence: marital status and marital functioning in early adulthood

In previous studies, depression has been associated with both marital status and marital distress. Unfortunately, given the cross-sectional design of most of this research, the temporal nature of these associations is unclear. The authors examined the marital functioning of young adults as a function of whether they received psychiatric diagnoses of major depressive disorder or nonaffective psychiatric disorder during adolescence. Depression during adolescence was found to predict higher rates of marriage among younger women and subsequent marital dissatisfaction. This pattern of results appears to be specific to depression: The presence during adolescence of a nonaffective psychiatric disorder was unrelated to subsequent marital functioning. These findings highlight the potentially adverse consequences of depression in adolescence and underscore the importance of prevention and early treatment efforts.     

Prevention and early intervention for anxiety disorders: A controlled trial.

The Queensland Early Intervention and Prevention of Anxiety Project evaluated the effectiveness of a cognitive-behavioral and family-based group intervention for preventing the onset and development of anxiety problems in children. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After recruitment and diagnostic interviews, 128 children were selected and assigned to a 10-week school-based child- and parent-focused psychosocial intervention or to a monitoring group. Both groups showed improvements immediately postintervention. At 6 months follow-up, the improvement maintained in the intervention group only, reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. Overall, the results showed that anxiety problems and disorders identified using child and teacher reports can be successfully targeted through an early intervention school-based program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors and pathways from infancy to symptoms of anxiety and depression in early adolescence.

Data from a prospective 11-year longitudinal survey were used to identify early predictors and pathways to symptoms of anxiety and depression at 12–13 years of age, and to examine whether there were unique predictors of anxious versus depressive symptoms. Structural equation modeling was used to explore longitudinal relations between contextual (maternal distress, family adversities, and social support) and temperamental (shyness and emotionality) risk factors in their prediction of informant-consistent symptoms of anxiety and depression. The results show that early risk factors can explain 38% of the variance in boys’ covarying symptoms of anxiety and depression in early adolescence, and 25% of variance in girls’ covarying symptoms. Two main pathways were identified. One pathway was through temperament, as nearly all risk factors were partly mediated through child emotionality in midchildhood. Another pathway was through early contextual risk factors, with all direct and indirect contextual impact from before 5 years of age. Family adversity uniquely predicted depressive symptoms. These findings underscore the persisting impact of contextual predictors in families with children less than 5 years of age. The importance of early interventions to prevent adolescent internalizing problems is stressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecology of depression in late childhood and early adolescence: A profile of daily states and activities.

This study investigated daily states and time use patterns associated with depression. Four hundred eighty-three 5th to 9th graders reported on their experience when signalled by pagers at random times. Depressed youth reported more negative affect and social emotions, lower psychological investment, lower energy, and greater variability in affect. These differences were weaker for 5th and 6th graders, suggesting that self-reported feeling states are a poor indicator of depression prior to adolescence. No differences were found in the daily activities of depressed youths nor in the amount of time spent alone, but depressed youths experienced other people as less friendly and more often reported wanting to be alone, especially when with their families. They also spent less time in public places and more time in their bedrooms. Finally, depressed boys, but not girls, spent much less time with friends, particularly of the same sex, suggesting that social isolation is more strongly associated with depression for boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood.

This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening and early intervention for COPD

Chronic obstructive pulmonary disease is on the increase. Therapeutic improvement is limited by the irreversible nature of lung tissue loss. Basic lung function tests can detect early loss of function, which may facilitate smoking cessation and other interventions likely to delay disease progression. The advent of inexpensive portable spirometers promises to permit such testing in the primary care physician's office.     

Automatic prejudice in childhood and early adolescence.

Four cross-sectional studies are presented that investigated the automatic activation of prejudice in children and adolescents (aged 9 years to 15 years). Therefore, 4 different versions of the affective priming task were used, with pictures of ingroup and outgroup members being presented as prejudice-related prime stimuli. In all 4 studies, a pattern occurred that suggests a linear developmental increase of automatic prejudice with significant effects of outgroup negativity appearing only around the ages of 12 to 13 years. Results of younger children, on the contrary, did not indicate any effect of automatic prejudice activation. In contrast, prejudice effects in an Implicit Association Test (IAT) showed high levels of prejudice independent of age (Study 3). Results of Study 4 suggest that these age differences are due to age-related differences in spontaneous categorization processes. Introducing a forced-categorization into the affective priming procedure produced a pattern of results equivalent to that obtained with the IAT. These results suggest that although children are assumed to acquire prejudice at much younger ages, automatization of such attitudes might be related to developmental processes in early adolescence. We discuss possible theoretical implications of these results for a developmental theory of prejudice representation and automatization during childhood and adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strain-specific cognitive deficits in adult mice exposed to early life stress.

Early life stress is a prominent risk factor for the development of adult psychopathology. Numerous studies have shown that early life stress leads to persistent changes in behavioral and endocrine responses to stress. However, despite recent findings of gene expression changes and structural abnormalities in neurons of the forebrain neocortex, little is known about specific cognitive deficits that can result from early life stress. Here we examined five cognitive functions in two inbred strains of mice, the stress-resilient strain C57Bl/6 and the stress-susceptible strain Balb/c, which were exposed to an infant maternal separation paradigm and raised to adulthood. Between postnatal ages P60 to P90, mice underwent a series of tests examining five cognitive functions: Recognition memory, spatial working memory, associative learning, shifts of attentional sets, and reversal learning. None of these functions were impaired in IMS C57Bl/6 mice. In contrast, IMS Balb/c mice exhibited deficits in spatial working memory and extradimensional shifts of attention, that is, functions governed primarily by the medial prefrontal cortex. Thus, like recently discovered changes in frontocortical gene expression, the emergence of specific cognitive deficits associated with the medial prefrontal cortex is also strain-specific. These findings illustrate that early life stress can indeed affect specific cognitive functions in adulthood, and they support the hypothesis that the genetic background and environmental factors are critical determinants in the development of adult cognitive deficits in subjects with a history of early life stress. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Significant individuals in adolescence: adolescent and adult perspectives

The pentadentate H3bhci [1,3,5-trideoxy-1, 3-bis((2-hydroxybenzyl)amino)-cis-inositol] and its bifunctionalized analogue H3bhci-glu-H [1,3,5-trideoxy-1, 3-bis((2-hydroxybenzyl)amino)-5-glutaramido-cis-inositol] were synthesized, and their coordination chemistry was investigated with inactive rhenium, with no carrier added Re-188 and with carrier added Re-186. The neutral Re(V) complexes [ReO(bhci)] and [ReO(bhci-glu-H)] are formed in good yields starting from [ReOCl3(P(C6H5)3)2] or in quantitative yield directly from [186/188ReO4]- in aqueous solution by reduction with Sn(II) or Sn(0). The X-ray structures of [ReO(bhci)] and [ReO(bhci-glu-H)] were elucidated revealing pentadentate "side on" coordination of the ligands to the "Re=O" core. The basic cyclohexane frame adopts a chair form in the case of [ReO(bhci)] and a twisted boat form in the case of [ReO(bhci-glu-H)]. [ReO(bhci)] crystallizes in the monoclinic space group C2/c with a = 27.425(3), b = 14.185(1), c = 19.047(2) A, and beta = 103.64(2) degrees and [ReO(bhci-glu-H)] in the monoclinic space group P21/c with a = 13.056(3), b = 10.180(1), c = 22.378(5) A, and beta = 98.205(9) degrees. Both 188Re complexes are stable in human serum for at least 3 days without decomposition. After injection into mice, [ReO(bhci-glu)]- is readily excreted through the intestines, while [ReO(bhci)] is excreted by intestines, liver, and the kidneys. TLC investigations of the urine showed exclusively the complexes [ReO(bhci-glu-H)] and [ReO(bhci)], respectively, and no decomposition products. For derivatization of antibodies, the carboxylic group of [ReO(bhci-glu-H)] was activated with N-hydroxysuccinimide, which required unusually vigorous reaction conditions (heating). The anti colon cancer antibody mAb-35 [IgG and F(ab')2 fragment] was labeled with [186/188ReO(bhci-glu)] to a specific activity of up to 1.5 mCi/mg (55 MBq/mg) with full retention of immunoreactivity. Labeling yields followed pseudo-first-order kinetics in antibody concentration with the ratio of rates between aminolysis and hydrolysis being about 2. Biodistributions of 186Re-labeled intact mAb-35 as well as of its F(ab')2 fragment in tumor-bearing nude mice revealed good uptake by the tumor with only low accumulation of radioactivity in normal tissue.     

The co-occurrence of depression and substance abuse in late adolescence

This article examines the role of adolescent social relationships in fostering the occurrence and co-occurrence of depression and substance abuse, using two waves of data from a community sample of adolescents (N = 900). Multinomial logistic response models were estimated to identify the extent to which risk and protective features of youths' family and peer relations were differentially linked with depressive symptoms, substance abuse, and their co-occurrence. Taking a within-person, configurational approach to adolescent adaptation, contrasts involved four subgroups of adolescents: those high on both depressed mood and substance abuse, those who experience neither problem, those evidencing high levels of depressive symptoms only, and those high on substance abuse only. Risk for depressive symptoms was differentiated by its association with conflict and lack of support in the friendship domain. Substance abuse was associated with negative peer pressure, but these youth were otherwise little different from youths with no problems. Whereas co-occurrence of depression and substance use was associated with more difficulties in both the family and peer environments, the most distinctive risk was that of low family support. Discussion centers on the developmental antecedents of co-occurring problems and family relations during adolescence.     

Parental divorce during early adolescence in Caucasian families: The role of family process variables in predicting the long-term consequences for early adult psychosocial adjustment.

The relationship between parental divorce occurring during adolescence and young adult psychosocial adjustment was examined, as was the role of family process variables in clarifying this relationship. Participants were young Caucasian adults from divorced (n?=?119) and married (n?=?123) families. Assessments were conducted during adolescence and 6 years later during early adulthood. Young adults from married families reported more secure romantic attachments than those from divorced families; however, differences were not evident in other domains of psychosocial adjustment after demographic variables were controlled. Three family process variables (parent–adolescent relationship, interparental conflict, and maternal depressive symptoms) were examined as potential mediators and moderators of the association between parental divorce and young adult adjustment. No evidence supporting mediation or moderation was found; however, the parent–adolescent and parent–young adult relationships, particularly when the identified parent was the father, emerged as significant predictors of young adult psychosocial adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivation and cheating during early adolescence.

The relations of motivational variables to self-reported cheating behaviors and beliefs in science were examined in a sample of early adolescents. It was hypothesized that cheating and beliefs in the acceptability of cheating would be more likely when students perceived an emphasis on performance and extrinsic incentives rather than on mastery and improvement. Results indicated that students who reported cheating in science perceived their classrooms as being extrinsically focused and perceived their schools as being focused on performance and ability. Students who believed in the acceptability of cheating also reported personal extrinsic goals and a perceived emphasis on extrinsic factors in class. Students who reported cheating also worried about school. The reported use of deep cognitive strategies was related negatively and the use of self-handicapping strategies was related positively to cheating beliefs and behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing binge drinking during early adolescence: One- and two- year follow-up of a school-based preventive intervention.

Examined the effectiveness of a school-based prevention program on reducing binge drinking in a sample of minority, inner-city, middle-school students. Rates of binge drinking were compared among 1,713 youths who received the program beginning in the 7th grade 9n?=?1,713) and acontrol group (n?=?1,328) that did not. The prevention program had protective effects in terms of binge drinking at the 1-year (8th grade) and 2-year (9th grade) follow-up assessments. The proportion of binge drinkers was over 50% lower in the intervention group relative to the control group at the follow-up assessments. There were also several significant program effects on proximal drinking variables, including drinking knowledge, pro-drinking attitudes, and peer drinking norms. These findings indicate that a school-based drug abuse prevention approach previously found to be effective among White youth significantly reduced binge drinking among urban minority youth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing for life: The critical transition of adolescence.

Discusses recent events that have drastically changed the experience of adolescence (e.g., confusion about adult roles and difficulty in foreseeing the future, erosion of family and social support networks) and describes the activities of the Carnegie Council on Adolescent Development to help redress these problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low self-esteem prospectively predicts depression in adolescence and young adulthood.

Low self-esteem and depression are strongly correlated in cross-sectional studies, yet little is known about their prospective effects on each other. The vulnerability model hypothesizes that low self-esteem serves as a risk factor for depression, whereas the scar model hypothesizes that low self-esteem is an outcome, not a cause, of depression. To test these models, the authors used 2 large longitudinal data sets, each with 4 repeated assessments between the ages of 15 and 21 years and 18 and 21 years, respectively. Cross-lagged regression analyses indicated that low self-esteem predicted subsequent levels of depression, but depression did not predict subsequent levels of self-esteem. These findings held for both men and women and after controlling for content overlap between the self-esteem and depression scales. Thus, the results supported the vulnerability model, but not the scar model, of self-esteem and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nurses in early intervention

The number of children from ages birth to 3 in need of early intervention services has increased over the past decades. A family-centered approach to early intervention services is essential. The family-centered approach emerged from early intervention philosophy developed by professionals in response to the needs of children and families. The historical perspective of early intervention and family-centered care, the role of nurses in early intervention and suggested focus of future research are outlined.