Alexandra H. Bettis

A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors†‡

Deficits in neurocognitive functioning are an important area of late effects in survivors of pediatric brain tumors, but a quantitative analysis of the magnitude of these deficits has yet to be conducted.

Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review.

In this meta-analytic and narrative review, we examine several overarching issues related to the study of coping, emotion regulation, and internalizing and externalizing symptoms of psychopathology in childhood and adolescence, including the conceptualization and measurement of these constructs. We report a quantitative meta-analysis of 212 studies (N = 80,850 participants) that measured the associations between coping and emotion regulation with symptoms of internalizing and externalizing psychopathology. Within the meta-analysis we address the association of broad domains of coping and emotion regulation (e.g., total coping, emotion regulation), intermediate factors of coping and emotion regulation (e.g., primary control coping, secondary control coping), and specific coping and emotion regulation strategies (e.g., emotional expression, cognitive reappraisal) with internalizing and externalizing symptoms. For cross-sectional studies, which made up the majority of studies included, we examine 3 potential moderators: age, measure quality, and single versus multiple informants. Finally, we separately consider findings from longitudinal studies as these provide stronger tests of the effects. After accounting for publication bias, findings indicate that the broad domain of emotion regulation and adaptive coping and the factors of primary control coping and secondary control coping are related to lower levels of symptoms of psychopathology. Further, the domain of maladaptive coping, the factor of disengagement coping, and the strategies of emotional suppression, avoidance, and denial are related to higher levels of symptoms of psychopathology. Finally, we offer a critique of the current state of the field and outline an agenda for future research.

Efficacy and moderators of a family group cognitive-behavioral preventive intervention for children of parents with depression.

OBJECTIVE Building on an earlier study (Compas, Forehand, Thigpen, et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported. METHOD Assessed a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2, 6, 12, 18 and 24 months after baseline. RESULTS Significant effects favoring the FGCB intervention over a written information comparison condition were found on measures of childrens symptoms of depression, mixed anxiety/depression, internalizing problems, and externalizing problems, with multiple effects maintained at 18 and 24 months, and on incidence of child episodes of major depressive disorder over the 24 months. Effects were stronger for child self-reports than for parent reports. Minimal evidence was found for child age, child gender, parental education, parental depressive symptoms, or presence of a current parental depressive episode at baseline as moderators of the FGCB intervention. CONCLUSIONS The findings provide support for sustained and robust effects of this preventive intervention.

Testing Specificity: Associations of Stress and Coping with Symptoms of Anxiety and Depression in Youth

Research has documented the co-occurrence of symptoms of anxiety and depression across the lifespan, suggesting that these symptoms share common correlates and etiology. The present study aimed to examine potential specific and/or transdiagnostic correlates of symptoms of anxiety and depression in at-risk youth. The present study examined youth stress associated with parental depression and youth coping as potential correlates of symptoms of anxiety and depression in a sample of children of depressed parents. One hundred eighty parents with a history of depression and their children ages 9–15 completed measures assessing youths’ stress associated with parental depression (RSQ), symptoms of anxiety and depression (YSR and CBCL), and coping (RSQ). The results support the hypothesis that secondary control coping is a transdiagnostic correlate of symptoms of anxiety and depression in youth. Youth stress related to parental depression and primary control coping were specific correlates of youth depressive symptoms and not anxiety symptoms. Disengagement coping was not a significant correlate of symptoms of anxiety or depression in youth. Results suggest that there are both transdiagnostic and specific correlates of symptoms of anxiety and depression in youth. The current study provides evidence to suggest specific types of stress and strategies to cope with this stress demonstrate specificity to symptoms of anxiety and depression in high-risk offspring of depressed parents. These findings highlight the importance of understanding the relationship between stress, coping, and symptoms to inform prevention and treatment research.

The Role of Parent Depressive Symptoms in Positive and Negative Parenting in a Preventive Intervention

This study examined the role of parent depressive symptoms as a mediator of change in behaviorally observed positive and negative parenting in a preventive intervention program. The purpose of the program was to prevent child problem behaviors in families with a parent who has current or a history of major depressive disorder. One hundred eighty parents and one of their 9- to 15-year-old children served as participants and were randomly assigned to a family group cognitive-behavioral (FGCB) intervention or a written information (WI) comparison condition. At two months after baseline, parents in the FGCB condition had fewer depressive symptoms than those in the WI condition, and these symptoms served as a mediator for changes in negative, but not positive, parenting at 6 months after baseline. The findings indicate that parent depressive symptoms are important to consider in family interventions with a parent who has current or a history of depression.

Comparison of two approaches to prevention of mental health problems in college students: Enhancing coping and executive function skills

ABSTRACT Objective: College students face a significant number of stressors, increasing risk for internalizing and externalizing psychopathology. The current study examines two promising avenues of intervention aimed to reduce stress and prevent psychopathology in this population: a coping skills group and a cognitive training program. Participants: 62 undergraduate students from two universities were recruited from 2013 to 2015. Methods: Students were randomized to a 6-week coping skills group or cognitive training program and completed measures of stress, coping, executive function, and symptoms of anxiety, depression and Attention-Deficit Hyperactivity Disorder (ADHD) at pre- and post-intervention. Results: Participants in both conditions reported significant decreases in social stress, executive function difficulties, and anxiety symptoms post-intervention. Students in the cognitive program improved significantly more on measures of behavior regulation and ADHD symptoms compared to the coping group at post-intervention. Conclusions: Brief stress management interventions targeting coping and executive function may benefit college students at risk for psychopathology.

Anxiety and depression in children of depressed parents: dynamics of change in a preventive intervention

The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and depression in a sample of children of depressed parents. Parents with a history of depression (N = 180) and their children (N = 242; 50% female; Mage = 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Youth in the FGCB intervention reported significantly greater declines in symptoms of both anxiety and depression at 6, 12, and 18 months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g., anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6 months in the FGCB intervention only. Changes in anxiety symptoms from 0 to 6 months predicted different patterns of subsequent changes in depressive symptoms from 6 to 12 months for the two conditions, such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth. Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting that both initial symptom levels and initial magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.

Stress, coping, executive function, and brain activation in adolescent offspring of depressed and nondepressed mothers

ABSTRACT This study examined the associations among chronic stress, activation in the prefrontal cortex (PFC), executive function, and coping with stress in at-risk and a comparison sample of adolescents. Adolescents (N = 16; age 12–15) of mothers with (n = 8) and without (n = 8) a history of depression completed questionnaires, neurocognitive testing, and functional neuroimaging in response to a working memory task (N-back). Children of depressed mothers demonstrated less activation in the anterior PFC (APFC) and both greater and less activation than controls in distinct areas within the dorsal anterior cingulate cortex (dACC) in response to the N-back task. Across both groups, activation of the dorsolateral PFC (DLPFC; Brodmann area [BA9]) and APFC (BA10) was positively correlated with greater exposure to stress and negatively correlated with secondary control coping. Similarly, activation of the dACC (BA32) was negatively correlated with secondary control coping. Regression analyses revealed that DLPFC, dACC, and APFC activation were significant predictors of adolescents’ reports of their use of secondary control coping and accounted for the effects of stress exposure on adolescents’ coping. This study provides evidence that chronic stress may impact coping through its effects on the brain regions responsible for executive functions foundational to adaptive coping skills.

Parental Depressive Symptoms and Parenting: Associations with Children’s Coping in Families of Depressed Parents

SYNOPSIS Objective. This multi-method study examined parental depressive symptoms and levels of harsh/intrusive and warm/responsive parenting as correlates of secondary control coping (acceptance, cognitive reappraisal, distraction) in children of parents with a history of depression. Design. The sample included 165 parents with a history of major depressive disorder and their 9- to 15-year-old children. Parents provided self-reports of their current depressive symptoms; videorecordings of parent–child interactions were coded to determine parenting behaviors; and children reported their use of secondary control coping strategies. Results. Harsh/intrusive parenting related to less, and warm/responsive parenting related to greater, use of secondary control coping strategies in children. Parents’ current depressive symptoms were only conditionally related to children’s use of secondary control coping strategies, such that depressive symptoms moderated the relation between warm/responsive parenting behaviors and child secondary control coping. When parental depressive symptoms were low or average, warm/responsive parenting was positively related to children’s secondary control coping. When parental depressive symptoms were high, warm/responsive parenting was not associated with children’s secondary control coping. Conclusions. The association between positive parenting behaviors and children’s coping is contingent on current levels of parents’ depressive symptoms. Efforts to enhance children’s coping skills should target both parental depressive symptoms and parenting skills.

Laboratory and Self-Report Methods to Assess Reappraisal and Distraction in Youth

Coping and emotion regulation are central features of risk and resilience in childhood and adolescence, but research on these constructs has relied on different methods of assessment. The current study aimed to bridge the gap between questionnaire and experimental methods of measuring secondary control coping strategies, specifically distraction and cognitive reappraisal, and examine associations with symptoms of anxiety and depression in youth. A community sample of 70 youth (ages 9–15) completed a novel experimental coping and emotion regulation paradigm and self-report measures of coping and emotion regulation and symptoms. Findings indicate that use of distraction and reappraisal during the laboratory paradigm was associated with lower levels of negative emotion during the task. Youth emotion ratings while implementing distraction, but not reappraisal, during the laboratory task were associated with youth self-reported use of secondary control coping in response to family stress. Youth symptoms of anxiety and depression were also significantly positively associated with negative emotion ratings during the laboratory task, and both laboratory task and self-reported coping and emotion regulation accounted for significant variance in symptoms in youth. Both questionnaire and laboratory methods to assess coping and emotion regulation in youth are important for understanding these processes as possible mechanisms of risk and resilience and continued integration of these methods is a priority for future research.