Child and Adolescent Social Work Journal, 25(6), December 2008, pp.469-481.
Publisher:
Springer
This exploratory study examines cognitive risk factors, anxiety sensitivity, and positive and negative affect, as related to the development of anxiety and depression. In a mailed survey in a region of the US, adolescents completed the Child Anxiety Sensitivity Index and the Positive and Negative Affectivity Scale. Previous research utilized the broad and unified variable of anxiety sensitivity as a predictor of anxiety. This study separates and examines the four specific factors of anxiety sensitivity: mental incapacitation concerns, social concerns, disease concerns, and unsteady concerns, and relates it to specific anxiety disorders and depression. Results indicate good convergent validity and improved divergent validity when utilizing the four factors of anxiety sensitivity as compared to using it as one construct. Results also suggest: (1) OCD and GAD share numerous similarities and (2) the importance of the role of negative affectivity in anxiety and depression. Being aware of the components of anxiety sensitivity and how they relate to specific anxiety disorders can help a social worker when rendering a diagnosis.
This exploratory study examines cognitive risk factors, anxiety sensitivity, and positive and negative affect, as related to the development of anxiety and depression. In a mailed survey in a region of the US, adolescents completed the Child Anxiety Sensitivity Index and the Positive and Negative Affectivity Scale. Previous research utilized the broad and unified variable of anxiety sensitivity as a predictor of anxiety. This study separates and examines the four specific factors of anxiety sensitivity: mental incapacitation concerns, social concerns, disease concerns, and unsteady concerns, and relates it to specific anxiety disorders and depression. Results indicate good convergent validity and improved divergent validity when utilizing the four factors of anxiety sensitivity as compared to using it as one construct. Results also suggest: (1) OCD and GAD share numerous similarities and (2) the importance of the role of negative affectivity in anxiety and depression. Being aware of the components of anxiety sensitivity and how they relate to specific anxiety disorders can help a social worker when rendering a diagnosis.
Subject terms:
obsessive compulsive disorders, risk, young people, anxiety, depression;
This book, and accompanying CD, aims to provide cognitive behavioural therapists with a comprehensive set of work sheets which they can photocopy and use with adult clients. As well as covering the basic techniques of CBT, it also contains worksheets specific to presenting problems, including: depression, panic, anxiety, obsessive compulsive disorder, health anxiety, social anxiety, post traumatic stress disorder, low self esteem, and sleep. Worksheets are considered essential tools in CBT. They record events and patterns, provide new information, and suggest new ways of thinking and acting. When and how to use a worksheet is determined by a number of factors: the formulation, the stage in therapy, the current focus of treatment, the reading and writing ability of the client and the wishes of the client. The use of worksheets in CBT is part of the ongoing learning process for both therapists and clients. The wide range of worksheets included in this resource cover all the key elements of recording and evaluating during therapy.
This book, and accompanying CD, aims to provide cognitive behavioural therapists with a comprehensive set of work sheets which they can photocopy and use with adult clients. As well as covering the basic techniques of CBT, it also contains worksheets specific to presenting problems, including: depression, panic, anxiety, obsessive compulsive disorder, health anxiety, social anxiety, post traumatic stress disorder, low self esteem, and sleep. Worksheets are considered essential tools in CBT. They record events and patterns, provide new information, and suggest new ways of thinking and acting. When and how to use a worksheet is determined by a number of factors: the formulation, the stage in therapy, the current focus of treatment, the reading and writing ability of the client and the wishes of the client. The use of worksheets in CBT is part of the ongoing learning process for both therapists and clients. The wide range of worksheets included in this resource cover all the key elements of recording and evaluating during therapy.
The author shares her life-long journey and battle with obsessive compulsive disorder and depression. She describes how religious belief, meditation, psychotherapy and medication have all played key roles in keeping her afloat and how they are essential tools in her survival kit.
The author shares her life-long journey and battle with obsessive compulsive disorder and depression. She describes how religious belief, meditation, psychotherapy and medication have all played key roles in keeping her afloat and how they are essential tools in her survival kit.
How to Be Yourself in a World That's Different is an accessible guide to Asperger's Syndrome (AS) written for young readers who have been diagnosed with AS and other autism spectrum conditions. The book features a clear explanation of the condition, including symptoms that are common to people on the autism spectrum, such as a hypersensitivity to touch and difficulties with balance and coordination. The characteristics and symptoms of other syndromes that often coincide with AS are also discussed, for example AD/HD, learning disorders, and tics, as well as the temporary states of mental dysfunction that people with AS tend to be predisposed to, including depression, anxiety, obsessive and compulsive behaviours, and catatonia. This informative and encouraging text highlights the positive aspects of autism spectrum conditions, such as diligence, fairness, and a knack for unique ideas, but it also acknowledges the daily challenges faced by young people with AS and, crucially, offers strategies for dealing with these. Using case examples, Yoshida explores the difficulties of disclosing a diagnosis, takes readers through the stages of practicing key social skills, and offers advice on seeking support.
How to Be Yourself in a World That's Different is an accessible guide to Asperger's Syndrome (AS) written for young readers who have been diagnosed with AS and other autism spectrum conditions. The book features a clear explanation of the condition, including symptoms that are common to people on the autism spectrum, such as a hypersensitivity to touch and difficulties with balance and coordination. The characteristics and symptoms of other syndromes that often coincide with AS are also discussed, for example AD/HD, learning disorders, and tics, as well as the temporary states of mental dysfunction that people with AS tend to be predisposed to, including depression, anxiety, obsessive and compulsive behaviours, and catatonia. This informative and encouraging text highlights the positive aspects of autism spectrum conditions, such as diligence, fairness, and a knack for unique ideas, but it also acknowledges the daily challenges faced by young people with AS and, crucially, offers strategies for dealing with these. Using case examples, Yoshida explores the difficulties of disclosing a diagnosis, takes readers through the stages of practicing key social skills, and offers advice on seeking support.
Child Abuse and Neglect, 30(3), March 2006, pp.257-269.
Publisher:
Elsevier
The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p < .02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.
The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p < .02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.
Subject terms:
interpersonal relationships, mental health problems, obsessive compulsive disorders, self-esteem, anorexia nervosa, child sexual abuse, depression;
This information pack provides a general introduction to mental health and mental wellbeing in children, before looking at mental health problems in children and young people with learning disabilities in more detail. Areas covered include identifying mental health problems, such as depression, anxiety, obsessive behaviour and serious mental health problems; how to record concerns; who to talk to; and what to do in a crisis. A list of useful resources that can be used to help children are also included.
(Original abstract)
This information pack provides a general introduction to mental health and mental wellbeing in children, before looking at mental health problems in children and young people with learning disabilities in more detail. Areas covered include identifying mental health problems, such as depression, anxiety, obsessive behaviour and serious mental health problems; how to record concerns; who to talk to; and what to do in a crisis. A list of useful resources that can be used to help children are also included.
(Original abstract)
Subject terms:
learning disabilities, mental health problems, children, young people, depression, anxiety, severe mental health problems, obsessive compulsive disorders, assessment;
Counselling and Psychotherapy Research, 7(4), December 2007, pp.203-210.
Publisher:
Wiley
Postpartum mood disorders (PMDs), the distressing mental and emotional symptoms experienced by women after childbirth, are just now receiving the attention they warrant. Given the serious and sometimes life-threatening nature of PMDs, a qualitative research design was used to examine more closely the nature of symptoms experienced and the effective strategies women used to cope with PMD. The respondents were 252 members of PMD and breast-feeding (La Leche League) support groups throughout the United States. Participants responded anonymously to open-ended questions in an online survey. The data were reviewed by the research team to determine common themes and prevailing issues. Participants reported myriad different symptoms and used a host of various strategies to alleviate problematic thoughts, feelings, and behaviours following childbirth. Postpartum symptoms affected participants' plans to have future children. For some women, symptoms became more intense during subsequent births. Despite the problematic nature of PMD, more than half of the participants reported receiving little or no information from healthcare providers about PMDs. Implications for counsellors and other healthcare providers are discussed in detail.
Postpartum mood disorders (PMDs), the distressing mental and emotional symptoms experienced by women after childbirth, are just now receiving the attention they warrant. Given the serious and sometimes life-threatening nature of PMDs, a qualitative research design was used to examine more closely the nature of symptoms experienced and the effective strategies women used to cope with PMD. The respondents were 252 members of PMD and breast-feeding (La Leche League) support groups throughout the United States. Participants responded anonymously to open-ended questions in an online survey. The data were reviewed by the research team to determine common themes and prevailing issues. Participants reported myriad different symptoms and used a host of various strategies to alleviate problematic thoughts, feelings, and behaviours following childbirth. Postpartum symptoms affected participants' plans to have future children. For some women, symptoms became more intense during subsequent births. Despite the problematic nature of PMD, more than half of the participants reported receiving little or no information from healthcare providers about PMDs. Implications for counsellors and other healthcare providers are discussed in detail.
Psychiatric Bulletin, 31(4), April 2007, pp.121-123.
Publisher:
Royal College of Psychiatrists
Cognitive-behavioural therapy (CBT) is well established as an effective intervention for people with unipolar depression, generalised anxiety disorder, panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, bulimia, obsessive-compulsive disorder and schizophrenia. There are two separate strands to developing improved and coherent management of CBT resistance: identification and assessment of patients’ continuing needs and selection of appropriate interventions.
Cognitive-behavioural therapy (CBT) is well established as an effective intervention for people with unipolar depression, generalised anxiety disorder, panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, bulimia, obsessive-compulsive disorder and schizophrenia. There are two separate strands to developing improved and coherent management of CBT resistance: identification and assessment of patients’ continuing needs and selection of appropriate interventions.
European Neuropsychopharmacology, 16(2), February 2006, pp.79-82.
Publisher:
Elsevier
The use of antidepressants for paediatric patients has been linked to increased risk of suicidal behaviours in some studies. This meta-analysis reviews all 22 paediatric, short term placebo-controlled trials of selective serotonin and/or noradrenergic reuptake inhibitors (SSRIs and NSRIs) that have been submitted to the European registration authority by pharmaceutical companies for events related to suicidality (suicide, suicide attempts or suicidal thoughts). No completed suicides were reported, but suicidal signals were detected in at least one study for all but two of the eight products examined, which themselves had each been used in only one study. There was a significant increase in risk in the depression studies. All antidepressants, in particular SSRIs and NSRIs, should therefore be used with caution in the paediatric population.
The use of antidepressants for paediatric patients has been linked to increased risk of suicidal behaviours in some studies. This meta-analysis reviews all 22 paediatric, short term placebo-controlled trials of selective serotonin and/or noradrenergic reuptake inhibitors (SSRIs and NSRIs) that have been submitted to the European registration authority by pharmaceutical companies for events related to suicidality (suicide, suicide attempts or suicidal thoughts). No completed suicides were reported, but suicidal signals were detected in at least one study for all but two of the eight products examined, which themselves had each been used in only one study. There was a significant increase in risk in the depression studies. All antidepressants, in particular SSRIs and NSRIs, should therefore be used with caution in the paediatric population.
Extended abstract:
Author
WOHLFARTH Tamar D.; et al ;
Antidepressants use in children and adolescents and risk of suicide.
Journal citation/publication details
European Neuropsychopharmacology, 16(2), February 2006, pp.79-82.
Summary
Some randomised controlled trials of the use of antidepressants in young patients have indicated an apparent risk with respect to suicide-related events, and this meta-analysis examines data from 22 controlled trials of selective serotonin and/or noradrenergic reuptake inhibitors (SSRIs and NSRIs) used in the treatment of depression or anxiety in paediatric or adolescent patients. While no completed suicides are reported, there was at least one study for each compound that showed an increased risk for events related to suicidality in the active compound group. Caution is called for in the use of antidepressants, in particular SSRIs and NSRIs, in this population.
Context
There have been contradictory findings regarding the risk of suicide following the use of antidepressants by paediatric or adolescent populations. This paper examines the evidence used by the European Agency for the Evaluation of Medicinal Products to formulate its recommendations on the use of antidepressants in these populations.
Methods
What sources were used?
Clinical trials submitted to the European drug registration authorities were examined.
What search terms/strategies were used?
The study reports were searched for descriptions of adverse events that could indicate suicide or events related to suicidality. These were ‘suic*' OR ‘self-‘ OR ‘harm' OR ‘injur' or ‘injurious' OR ‘intentional' OR ‘non-accidental' OR ‘hostility' OR ‘emotional' OR ‘lability'.
What criteria were used to decide on which studies to include?
Studies of short term (up to 12 weeks) randomised double-blind, placebo-controlled clinical trials of SSRIs and NSRIs in the treatment of depression or anxiety disorders in children and/or adolescents were selected. Diagnoses were based on DSM-III or DSM-IV criteria (i.e. from the third or fourth editions of the Diagnostic and Statistical Manual of Mental Disorders).
Who decided on their relevance and quality?
All submitted studies were included.
How many studies were included and where were they from?
Twenty two studies conducted between 1984 and 2002 were examined.
How were the study findings combined?
The rates of events related to suicidality in the active and placebo arms of each study were extracted. The existence of a signal for suicidality was defined as any rate observed in the treatment group that was higher than that seen in the placebo group. Where possible relative risks were calculated. A random effects meta-analysis was then conducted.
Findings of the review
The studies involved eight different pharmaceutical products and included over 4,000 patients. Fifteen trials included patients with major depressive disorders, four covered patients with obsessive-compulsive disorders, two with generalised anxiety disorder, and one with social anxiety disorder.
No completed suicides were reported in any of the studies. However, suicidal signals were detected in at least one study for all but two products examined, which themselves had each been used in only one study. These signals were not associated with the duration of the studies or age range of patients. The combined odds ratio for events relating to suicidality in all of the depression studies was 1.67, and was statistically significant. The odds ratio in anxiety disorders was weaker and did not reach statistical significance, but the risk for suicidality in patients treated for anxiety cannot be ruled out given the rarity of the event.
Authors' conclusions
The evidence from other sources for the association of SSRIs and suicidality in paediatric patients is contradictory and inconclusive, but this review gives ‘grounds for concerns regarding the use of antidepressants in the paediatric population due to the increased risk of suicidality and related behaviours'. The signal is weak but the fact that it is found consistently in studies of all products indicates that it might not be a chance finding.
Implications for policy or practice
Analysis of the balance between benefit and risk as presented in this paper has led the European registration authority to issue a warning for all SSRIs in paediatric patients. In the absence of contradictory evidence, other antidepressants should also be used with caution in this population.
Research on Social Work Practice, 13(5), September 2003, pp.588-607.
Publisher:
Sage
This American study examined the effects of a collaborative intervention targeting 107 juvenile detainees with co-occurring mental health and substance abuse problems. Changes in mental health problems, substance use, and delinquency between pretest and 3-and 6-month follow-up were assessed. Three distinct clusters of detained youth characterised by varying levels of self-reported symptoms and behaviours across these three problem domains were included in a series of repeated measures analyses. Significant time effects were found for anxiety and depression and for the frequency of substance use and delinquency between pretest and 3- and 6-month follow-up. Significant time by cluster interactions were found for mental health problems of obsessive-compulsive behavior and interpersonal sensitivity and for property and drug-related offending. Concludes that cross-system collaboration among mental health, substance abuse, and juvenile justice systems is a promising approach for treating delinquent youth with co-occurring problem behaviors.
This American study examined the effects of a collaborative intervention targeting 107 juvenile detainees with co-occurring mental health and substance abuse problems. Changes in mental health problems, substance use, and delinquency between pretest and 3-and 6-month follow-up were assessed. Three distinct clusters of detained youth characterised by varying levels of self-reported symptoms and behaviours across these three problem domains were included in a series of repeated measures analyses. Significant time effects were found for anxiety and depression and for the frequency of substance use and delinquency between pretest and 3- and 6-month follow-up. Significant time by cluster interactions were found for mental health problems of obsessive-compulsive behavior and interpersonal sensitivity and for property and drug-related offending. Concludes that cross-system collaboration among mental health, substance abuse, and juvenile justice systems is a promising approach for treating delinquent youth with co-occurring problem behaviors.
Subject terms:
intervention, mental health problems, obsessive compulsive disorders, substance misuse, young offenders, young people, anti-social behaviour, anxiety, depression;