Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents

Developmental Epidemiology Program, Duke University Medical Center, Durham, NC 27710, USA.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 02/2008; 49(1):34-42. DOI: 10.1111/j.1469-7610.2007.01822.x
Source: PubMed


Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on risk factor-disorder associations. This study tests the specificity of putative psychosocial risk factors while addressing these criticisms.
Eight waves of data from the Great Smoky Mountains Study (N = 1,420) were used, covering children in the community age 9-16 years old. Youth and one parent were interviewed up to seven times using the Child and Adolescent Psychiatric Assessment, providing a total of 6,674 pairs of interviews. A wide range of putative neighborhood, school, peer, family, and child risk factors, and common and comorbid youth disorders were assessed.
The majority of putative risk factors were specific to one disorder or one disorder domain. A unique or 'signature set' of putative risk factors was identified for each disorder. Several putative risk factors were associated with a disorder in preadolescent males, preadolescent females, adolescent males, or adolescent females only.
Our findings support the need to define risk factors and disorders narrowly, to control comorbidity and other risk factors, and to consider developmental patterns of specificity by sex.

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    • "Some aspects of parenting (e.g., negative affect, intrusiveness) are relatively ubiquitous risk factors for maladaptive child outcomes. However, harsh parenting, typically defined as high levels of control, coercion, punitive behaviors, and/or punishment by parents, has been identified as a risk factor specific to the development of anxiety problems (Shanahan et al., 2008), multiplying risk by a factor of 2–4, depending on the diagnosis. Greater harsh parenting appears to be particularly detrimental for fearful children (Degnan et al., 2010a; Leve et al., 2005). "
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    ABSTRACT: Temperamentally fearful children are at increased risk for the development of anxiety problems relative to less-fearful children. This risk is even greater when early environments include high levels of harsh parenting behaviors. However, the mechanisms by which harsh parenting may impact fearful children's risk for anxiety problems are largely unknown. Recent neuroscience work has suggested that punishment is associated with exaggerated error-related negativity (ERN), an event-related potential linked to performance monitoring, even after the threat of punishment is removed. In the current study, we examined the possibility that harsh parenting interacts with fearfulness, impacting anxiety risk via neural processes of performance monitoring. We found that greater fearfulness and harsher parenting at 2 years of age predicted greater fearfulness and greater ERN amplitudes at age 4. Supporting the role of cognitive processes in this association, greater fearfulness and harsher parenting also predicted less efficient neural processing during preschool. This study provides initial evidence that performance monitoring may be a candidate process by which early parenting interacts with fearfulness to predict risk for anxiety problems.
    07/2014; 9. DOI:10.1016/j.dcn.2014.03.001
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    • "GAD symptoms in children and adolescents have also been associated with harsh parental discipline and parenting characterized by strict rules and high expectations (Shanahan et al. 2008) as well as parental overprotection (Beesdo et al. 2010, Nordahl et al. 2010). The combination of overprotection of the child and harsh discipline may impede children's development of autonomy and convey that they are incapable of handling challenging situations without parental intervention. "
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    ABSTRACT: Generalized anxiety disorder (GAD) is associated with substantial personal and societal cost yet is the least successfully treated of the anxiety disorders. In this review, research on clinical features, boundary issues, and naturalistic course, as well as risk factors and maintaining mechanisms (cognitive, biological, neural, interpersonal, and developmental), are presented. A synthesis of these data points to a central role of emotional hyperreactivity, sensitivity to contrasting emotions, and dysfunctional attempts to cope with strong emotional shifts via worry. Consistent with the Contrast Avoidance model, evidence shows that worry evokes and sustains negative affect, thereby precluding sharp increases in negative emotion. We also review current treatment paradigms and suggest how the Contrast Avoidance model may help to target key fears and avoidance tendencies that serve to maintain pathology in GAD.
    Annual Review of Clinical Psychology 03/2013; 9(1):275-97. DOI:10.1146/annurev-clinpsy-050212-185544 · 12.67 Impact Factor
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    • "Consistent with strain theories, many factors contribute to psychological distress in youth, as measured by symptoms of depression, anxiety, and anger (e.g., Cuevas et al. 2010; Kessler et al. 2002; Shanahan et al. 2008). The finding that the experience of victimization is related to psychological distress may be explained by the possibility that many youths who are victimized may then make negative self-attributions that could contribute to a sense of negative self-worth and feelings of depression and loneliness (Lopez and DuBois 2005; Graham and Juvonen 1998). "
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    ABSTRACT: Peer victimization is a well-known national and international problem, contributing to a range of emotional, social, and behavioral consequences. Using structural equation modeling, the authors tested a theoretical model suggesting that psychological distress and student engagement mediate the association between the experience of victimization and concurrent academic achievement. Participants were 469 (46.4 % male, 53.6 % female) 6th to 8th grade students, from randomly selected classrooms in 11 middle schools in a southeastern school district. Structural equation models of the hypothesized effects demonstrated adequate fit to the data, with both symptoms of psychological distress and engagement mediating the relationship between victimization and academic achievement. In general, the results suggest that victimization predicts diminished academic achievement by way of psychological distress and poorer engagement in classroom and academic tasks. However, the direct relationship between victimization and measures of achievement lacked significance across many correlational and path analyses conducted. These findings have implications for researchers and practitioners in understanding how psychological distress and student engagement are associated with the academic performance of students who experience peer victimization.
    Journal of Youth and Adolescence 02/2013; 43(1). DOI:10.1007/s10964-013-9918-4 · 2.72 Impact Factor
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