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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We conducted a longitudinal study of young children with clinical, subclinical, or nonclinical levels of separation anxiety to evaluate the diagnostic stability and concomitant parent and family variables of separation anxiety disorder (SAD). Youngsters were assessed at age 3 years (n = 60) and 3.5 years later (n = 44). Data were collected from children, parents, teachers, and clinicians. Results revealed that most diagnoses of SAD were not stable during this developmental period, as many children drifted toward subclinical or nonclinical status. In addition, children with clinical SAD, compared to those with subclinical SAD or no symptoms of SAD, had a disproportionately higher number of comorbid diagnoses and experienced significantly greater somatic concerns, anxiety, and general internalizing behavior. In addition, their parents experienced greater depression, obsessive-compulsive behavior, phobic anxiety, and general distress. The results preliminarily support prior findings that most children experience a dissipation of SAD symptoms in young childhood but that some children continue to experience stable, significant distress. The results are consistent with prior research on older children that SAD remits for many but not all youth and suggest that parent and family variables may have much to do with cases of poor remission in this population.
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PMID:Separation anxiety disorder in young children: a longitudinal and family analysis. 1471 Apr 68

Studies have reported that childhood asthma is associated with internalizing disorders, but most of these studies have used global measures of depressive and anxiety symptoms. The Diagnostic Interview Schedule for Children was administered to a group of 1891 youth ages 4 to 17 and their caregivers in Puerto Rico to determine DSM-IV symptoms and diagnoses. Asthma diagnosis and having had an asthma attack were assessed by parental report. A diagnosis of asthma was associated with having any depressive disorder and one symptom of separation anxiety. An asthma attack was associated with any depressive disorder and any anxiety disorder and, more specifically, with separation anxiety disorder, major depressive disorder, and symptoms of depression, separation anxiety, and generalized anxiety. Possible explanations for the findings are discussed.
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PMID:Comorbidity of asthma and anxiety and depression in Puerto Rican children. 1501 21

To begin to resolve conflicts among current competing taxonomies of child and adolescent psychopathology, the authors developed an interview covering the symptoms of anxiety, depression, inattention, and disruptive behavior used in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), the International Statistical Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1992), and several implicit taxonomies. This interview will be used in the future to compare the internal and external validity of alternative taxonomies. To provide an informative framework for future hypothesis-testing studies, the authors used principal factor analysis to induce new testable hypotheses regarding the structure of this item pool in a representative sample of 1,358 children and adolescents ranging in age from 4 to 17 years. The resulting hypotheses differed from the DSM-IV, particularly in suggesting that some anxiety symptoms are part of the same syndrome as depression, whereas separation anxiety, fears, and compulsions constitute a separate anxiety dimension.
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PMID:The structure of child and adolescent psychopathology: generating new hypotheses. 1531 83

School truancy is not a diagnostic entity. It is rather a conglomeration of symptoms with various causal factors. With a prevalence of about 5% of all children attending school, three typical groups of anxious school truants can be differentiated: children with separation anxiety, with simple and social phobia as well as anxious and/or depressive symptoms. Anxious truants show depressive symptoms and separation anxiety significantly above chance, while school truancy is closely associated with social disorders, depression and oppositional behaviour and mostly occurs in boys. Psychosocial risk factors such as contact problems with peers, familial and school problems often play an important part. The increased comorbidity as well as various associated stress factors demand multiple behaviour and psychological diagnostics. Sophisticated therapeutic measures should regard this and focus on cognitive behaviour therapy as well as educative and supportive interventions.
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PMID:[School truancy. A heterogeneous disturbing picture]. 1537 77

Psychological factors play an important role in the aetiopathogenesis of temporomandibular disorders (TMD), as demonstrated by an increase in stress, anxiety, depression and somatization in TMD patients. The aim of this work was to investigate the presence of mood and panic-agoraphobic symptoms in different groups of TMD patients by means of a spectrum approach to psychopathology. A total of 131 subjects were included in this study and TMD signs and symptoms were investigated by means of a standardized clinical examination. Two self-report questionnaires were used to evaluate mood (MOODS-SR) and panic-agoraphobic (PAS-SR) spectrum. anova and Bonferroni's post hoc test for multiple comparisons were used to compare mean scores of all TMD groups for MOODS-SR, PAS-SR and all their domains. Results revealed a significantly higher prevalence of both mood (P < 0.001) and panic-agoraphobic (P < 0.01) symptoms in myofascial pain patients than in all other diagnostic groups (TMD-free, disc displacement and joint disorders). With regard to mood spectrum, strong differences emerged for all domains evaluating depressive symptoms. As for the panic-agoraphobic spectrum, myofascial pain patients differed from the other groups for the presence of stress sensitivity, panic, separation anxiety, hypochondriac and agoraphobic symptoms. It was concluded that myofascial pain patients differed from those with disc displacement, joint disorders and no TMD in relation to some psychopathological symptoms, while the last three groups presented very similar profiles.
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PMID:Mood and anxiety psychopathology and temporomandibular disorder: a spectrum approach. 1538 31

Paranoia is a complex phenomenon that is likely to arise from a number of factors. In a recent cognitive model of persecutory delusions, three key factors are highlighted: anomalous experiences, emotion, and reasoning. In the first of two linked studies, we report a questionnaire survey of nonclinical paranoia designed to assess the theoretical model. A nonclinical population (N = 327) completed measures of paranoia, anomalous experiences (hallucinatory predisposition, perceptual anomalies), emotion (depression, anxiety, self-focus, stress, interpersonal sensitivity), and reasoning (need for closure). Paranoia was best explained by separation anxiety, depression, fragile inner self, hallucinatory experiences, discomfort with ambiguity, stress, self-focus, perceptual anomalies, and anxiety. The findings are consistent with the central predictions within the model of paranoia.
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PMID:The psychology of persecutory ideation I: a questionnaire survey. 1587 Jun 13

Medical schools are charged with the challenge of teaching effective communication skills, a core competency for residents and medical students. Especially challenging is the task of developing effective methods for training residents and students to communicate with children with mental health issues. The authors describe a pilot program at Mercer University School of Medicine that used pediatric standardized patients (SPs), ages 9-19, to aid in training residents and medical students in complex interviewing skills addressing mental health issues. New curriculum components for four pediatric problems, anorexia nervosa, depression, separation anxiety, and attention deficit hyperactivity disorder (ADHD), were designed and implemented by the authors in 2002-04. The training sessions were evaluated by the participating SPs as well as the residents and medical students in training. The components of the training were a lecture and subsequent practice using pediatric SPs and adults acting as their mothers. Evaluation included the qualitative analysis of SPs' reactions to participation in the training as described during a posttraining-session focus-group, as well as questionnaire responses by residents and medical students. The children role-playing the scenario of a difficult-to-manage situation and their adult "parent" actors voiced strongly positive reactions to participating in training residents and medical students. The reactions of physicians in training were also positive. The authors thus conclude that child and adolescent actors can be effectively used as SPs to train residents and students in complex interviewing skills, even in cases involving children with challenging mental health issues.
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PMID:Using children as simulated patients in communication training for residents and medical students: a pilot program. 1630 84

Maternal separation in non-human primates has been proposed as a model of early adversity. The symptoms of separation anxiety were studied in vervet monkeys, during the weaning period, when psychotropic medications were administered. The control group received a normal diet and treatment groups received citalopram, reboxetine or lamotrigine in their food daily. Treatment was given for 7 weeks starting 1 month prior to weaning. Behavior was recorded twice weekly for 8 weeks, and was rated for anxiety and depression. Cerebrospinal fluid was collected at the beginning and end of the trial and analyzed for monoamines and metabolites using High Performance Liquid Chromatography. Citalopram pretreatment prevented the reduction of affiliation behavior and reduced stereotypies after weaning, and both citalopram and reboxetine abolished the increase in activity seen in control monkeys after weaning, but no statistically significant differences were found between groups. Citalopram pretreatment also significantly increased noradrenaline and 5-hydroxyindolacetic acid (5-HIAA) levels and reboxetine significantly decreased dopamine levels over time. The 5-HIAA levels of reboxetine and lamotrigine treated monkeys were significantly lower than that of the control group at the end of the trial. Although limited by a small sample size, this study demonstrates the possibility of investigating the psychopharmacology of early adversity in a non-human primate model.
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PMID:Psychopharmacology of maternal separation anxiety in vervet monkeys. 1685 Feb 60

Selective serotonin reuptake inhibitors (SSRIs) have been used increasingly since the early 1990s to treat anxiety disorders and depression in children and adolescents. Several recent reports, however, cast doubt on their efficacy and especially raise questions about their role in serious adverse effects (increase in suicidal ideation and suicide attempts as well as reactions involving irritability, hostility, self-harm and self-destructive actions). The efficacy of SSRIs (fluoxetine, sertraline, fluvoxamine, paroxetine) in the treatment of obsessive-compulsive disorders in this population is clear today, although their effects are globally relatively modest. SSRIs remain notably less effective than clomipramine for this indication, although a variety of factors (age, family history, and psychiatric comorbidity) are also likely to influence response to treatment. Only several placebo-controlled studies suggest that the SSRIs (fluoxetine, sertraline and fluvoxamine) may have some utility in the treatment of anxiety disorders (generalized anxiety, separation anxiety, social phobias) in children and teens. The additional benefits from SSRIs for this indication nonetheless require confirmation. Imipramine and related tricyclic antidepressants are ineffective in the treatment of depressive disorders in children and adolescents. Among the SSRIs, only fluoxetine has proven its efficacy for this indication, although its effect here too appears relatively modest. The efficacy of sertraline and paroxetine cannot be considered more than probable, requiring confirmation, and that of citalopram has not been demonstrated. Moreover, because of the risk of suicidal behavior observed in some studies, SSRIs are inadvisable for the treatment of depressive disorders in this population. Overall, although the currently available data show SSRIs to be moderately effective and useful in treating anxiety disorders and depression in children and adolescents, future studies must focus on more precise identification of their indications, especially relative to psychotherapeutic strategies, which are still considered to be the first-line treatment in these disorders. From a legal point of view, only sertraline has been authorized in France for the treatment of obsessive-compulsive disorders in this population.
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PMID:[Efficacy of selective serotonin reuptake inhibitor treatment in children and adolescents]. 1696 24

The current study examines the implications of responsibility and obligation on separation-individuation processes and the appearance of various symptoms of psychological distress in adolescent children of multiple sclerosis (MS) parents. We examined 56 children, between the ages of 10 and 18 years, each with a parent with MS. The results were compared to a control group of 156 children whose parents were healthy. Children's emotions were examined by means of two questionnaires: Youth Self Report (YSR), and Separation Individuation Test of Adolescence (SITA). It was found that children with a MS-affected parent displayed higher levels of depression and anxiety than children from the control group. Furthermore, children in the study group reported a greater degree of separation anxiety, compared to the control group. We conclude with clinical recommendations for developing therapeutic interventions for adolescents to MS-affected parents, as well as for their ill and healthy parents.
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PMID:Separation-individuation processes of adolescent children of parents with multiple sclerosis. 1729 16


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