Matthew Owens

Anxiety and depression in academic performance: An exploration of the mediating factors of worry and working memory

Anxiety and depression are linked to lower academic performance. It is proposed that academic performance is reduced in young people with high levels of anxiety or depression as a function of increased test-specific worry that impinges on working memory central executive processes. Participants were typically developing children (12 to 13-years-old) from two UK schools. The study investigated the relationship between negative affect, worry, working memory, and academic performance using self-report questionnaires, school administered academic test data, and a battery of computerized working memory tasks. Higher levels of anxiety and depression were associated with lower academic performance. There was support for a mediation hypothesis, where worry and central executive processes mediated the link between negative affect and academic performance. Further studies should test these hypotheses in larger longitudinal samples. Implications for school psychology practice and interventions in schools are discussed.

Processing efficiency theory in children: Working memory as a mediator between trait anxiety and academic performance

Abstract Working memory skills are positively associated with academic performance. In contrast, high levels of trait anxiety are linked with educational underachievement. Based on Eysenck and Calvos (1992) processing efficiency theory (PET), the present study investigated whether associations between anxiety and educational achievement were mediated via poor working memory performance. Fifty children aged 11–12 years completed verbal (backwards digit span; tapping the phonological store/central executive) and spatial (Corsi blocks; tapping the visuospatial sketchpad/central executive) working memory tasks. Trait anxiety was measured using the State–Trait Anxiety Inventory for Children. Academic performance was assessed using school administered tests of reasoning (Cognitive Abilities Test) and attainment (Standard Assessment Tests). The results showed that the association between trait anxiety and academic performance was significantly mediated by verbal working memory for three of the six academic performance measures (math, quantitative and non-verbal reasoning). Spatial working memory did not significantly mediate the relationship between trait anxiety and academic performance. On average verbal working memory accounted for 51% of the association between trait anxiety and academic performance, while spatial working memory only accounted for 9%. The findings indicate that PET is a useful framework to assess the impact of childrens anxiety on educational achievement.

Elevated morning cortisol is a stratified population-level biomarker for major depression in boys only with high depressive symptoms

Significance Clinical depression is a severe and common illness, characterized primarily by persistent low mood and lack of pleasure in usually enjoyable activities, that results in significant impairment in everyday living. It also involves alterations in cognitive and hormonal functions. There is substantial variation between depressed individuals in terms of the causes and therapeutic response, making it difficult to identify those most likely to benefit from intervention and treatment. We derived subtypes of adolescents in the population based on different levels of the hormone cortisol and subclinical depressive symptoms. A group (17%) with both high levels of cortisol and depressive symptoms of both sexes had more depressed thinking. Boys in this group were at high risk for clinical depression. Major depressive disorder (MD) is a debilitating public mental health problem with severe societal and personal costs attached. Around one in six people will suffer from this complex disorder at some point in their lives, which has shown considerable etiological and clinical heterogeneity. Overall there remain no validated biomarkers in the youth population at large that can aid the detection of at-risk groups for depression in general and for boys and young men in particular. Using repeated measurements of two well-known correlates of MD (self-reported current depressive symptoms and early-morning cortisol), we undertook a population-based investigation to ascertain subtypes of adolescents that represent separate longitudinal phenotypes. Subsequently, we tested for differential risks for MD and other mental illnesses and cognitive differences between subtypes. Through the use of latent class analysis, we revealed a high-risk subtype (17% of the sample) demarcated by both high depressive symptoms and elevated cortisol levels. Membership of this class of individuals was associated with increased levels of impaired autobiographical memory recall in both sexes and the greatest likelihood of experiencing MD in boys only. These previously unidentified findings demonstrate at the population level a class of adolescents with a common physiological biomarker specifically for MD in boys and for a mnemonic vulnerability in both sexes. We suggest that the biobehavioral combination of high depressive symptoms and elevated morning cortisol is particularly hazardous for adolescent boys.

When does anxiety help or hinder cognitive test performance? The role of working memory capacity

Cognitive interference theories (e.g. attentional control theory, processing efficiency theory) suggest that high levels of trait anxiety predict adverse effects on the performance of cognitive tasks, particularly those that make high demands on cognitive resources. We tested an interaction hypothesis to determine whether a combination of high anxiety and low working memory capacity (WMC) would predict variance in demanding cognitive test scores. Ninety six adolescents (12- to 14-years-old) participated in the study, which measured self-report levels of trait anxiety, working memory, and cognitive test performance. As hypothesized, we found that the anxiety-WMC interaction explained a significant amount of variance in cognitive test performance (ΔR(2) .07, p < .01). Trait anxiety was unrelated to cognitive test performance for those adolescents with average WMC scores (β = .13, p > .10). In contrast, trait anxiety was negatively related to test performance in adolescents with low WMC (β = -.35, p < .05) and positively related to test performance in those with high WMC (β = .49, p < .01). The results of this study suggest that WMC moderates the relationship between anxiety and cognitive test performance and may be a determinant factor in explaining some discrepancies found in the literature. Further research is needed to fully understand the mechanisms involved.

Leaving care and mental health: outcomes for children in out-of-home care during the transition to adulthood

There were 59,500 Children in out-of-home care in England in 2008. Research into this population points to poor health and quality of life outcomes over the transition to adult independence. This undesirable outcome applies to mental health, education and employment. This lack of wellbeing for the individual is a burden for health and social care services, suggesting limitations in the current policy approaches regarding the transitional pathway from care to adult independence. Although the precise reasons for these poor outcomes are unclear long term outcomes from national birth cohorts suggest that mental health could be a key predictor for subsequent psychosocial adjustment.Researching the wellbeing of children in out-of-home care has proven difficult due to the range and complexity of the factors leading to being placed in care and the different methods used internationally for recording information. This paper delineates the estimated prevalence of mental health problems for adolescents in the care system, organisational factors, influencing service provision, and pathways through the transition from adolescence to independent young adult life. The extent to which being taken into care as a child moderates adult wellbeing outcomes remains unknown. Whether the care system enhances, reduces or has a null effect on wellbeing and specifically mental health cannot be determined from the current literature. Nonetheless a substantial proportion of young people display resilience and experience successful quality of life outcomes including mental capital. A current and retrospective study of young people transitioning to adult life is proposed to identify factors that have promoted successful outcomes and which would be used to inform policy developments and future longitudinal studies.

Exercise and depressive symptoms in adolescents: a longitudinal cohort study

IMPORTANCE Physical activity (PA) may have a positive effect on depressed mood. However, whether it can act as a protective factor against developing depressive symptoms in adolescence is largely unknown. OBJECTIVE To investigate the association between objectively measured PA and depressive symptoms during 3 years of adolescence. DESIGN, SETTING, AND PARTICIPANTS We performed a longitudinal study between November 1, 2005, and January 31, 2010, of a community-based sample from Cambridgeshire and Suffolk, United Kingdom, that included 736 participants (mean [SD] age, 14.5 years [6 months]). The follow-up period was approximately 3 years after baseline (the ROOTS study). Linear regression models were fitted using physical activity energy expenditure (PAEE) and moderate and vigorous physical activity (MVPA) as the predictors and depressive symptoms as the outcome variable. Binomial logistic regression models were also fitted using PAEE and MVPA as the predictors and clinical depression as the outcome measure. EXPOSURES Exercise. MAIN OUTCOMES AND MEASURES Individually calibrated heart rate and movement sensing were used to measure PA at baseline only. Physical activity summary measures included total PAEE and time spent in MVPA. These measures were divided into weekend and weekday activity. All participants also completed the Mood and Feelings Questionnaire, a self-report measure of current depressive symptoms, and took part in a Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version interview at baseline and 3 years later. RESULTS Depressive symptoms at 3-year follow-up were not significantly predicted by any of the 4 PA measures at baseline: weekend MVPA (unstandardized β = 0.02; 95% CI, -0.15 to 0.20; P = .79), weekday MVPA (β = 0.00; 95% CI, -0.17 to 0.17; P = .99), weekend PAEE (β = 0.03; 95% CI, -0.14 to 0.20; P = .75), and weekday PAEE (β = -0.03; 95% CI, -0.20 to 0.14; P = .71). This was also true for major depressive disorder diagnoses at follow-up: weekend MVPA (odds ratio [OR], 1.37; 95% CI, 0.76-2.48; P = .30), weekday MVPA (OR, 1.33; 95% CI, 0.74-2.37; P = .34), weekend PAEE (OR, 1.19; 95% CI, 0.67-2.10; P = .56), and weekday PAEE (OR, 0.92; 95% CI, 0.52-1.63; P = .78). CONCLUSIONS AND RELEVANCE No longitudinal association between objectively measured PA and the development of depressive symptoms was observed in this large population-based sample. These results do not support the hypothesis that PA protects against developing depressive symptoms in adolescence.

5-HTTLPR and Early Childhood Adversities Moderate Cognitive and Emotional Processing in Adolescence

Background Polymorphisms in the promoter region of the serotonin transporter gene (5-HTTLPR) and exposure to early childhood adversities (CA) are independently associated with individual differences in cognitive and emotional processing. Whether these two factors interact to influence cognitive and emotional processing is not known. Methodology and Principal Findings We used a sample of 238 adolescents from a community study characterised by the presence of the short allele of 5-HTTLPR (LL, LS, SS) and the presence or absence of exposure to CA before 6 years of age. We measured cognitive and emotional processing using a set of neuropsychological tasks selected predominantly from the CANTAB® battery. We found that adolescents homozygous for the short allele (SS) of 5-HTTLPR and exposed to CA were worse at classifying negative and neutral stimuli and made more errors in response to ambiguous negative feedback. In addition, cognitive and emotional processing deficits were associated with diagnoses of anxiety and/or depressions. Conclusion and Significance Cognitive and emotional processing deficits may act as a transdiagnostic intermediate marker for anxiety and depressive disorders in genetically susceptible individuals exposed to CA.

5-HTTLPR-environment interplay and its effects on neural reactivity in adolescents.

It is not known how 5-HTTLPR genotype × childhood adversity (CA) interactions that are associated with an increased risk for affective disorders in population studies operate at the neural systems level. We hypothesized that healthy adolescents at increased genetic and environmental risk for developing mood disorders (depression and anxiety) would demonstrate increased amygdala reactivity to emotional stimuli compared to those with only one such risk factor or those with none. Participants (n = 67) were classified into one of 4 groups dependent on being homozygous for the long or short alleles within the serotonin-transporter-linked polymorphic region (5-HTTLPR) of the SLC6A4 gene and exposure to CA in the first 11 years of life (present or absent). A functional magnetic resonance imaging investigation was undertaken which involved viewing emotionally-salient face stimuli. In addition, we assessed the role of other variables hypothesized to influence amygdala reactivity, namely recent negative life-events (RNLE) assessed at ages 14 and 17, current anxiety symptoms and psychiatric history. We replicated prior findings demonstrating moderation by gene variants in 5-HTTLPR, but found no support for an effect of CA on amygdala reactivity. We also found a significant effect of RNLE aged 17 with amygdala reactivity demonstrating additive, but not interactive effects with 5-HTTLPR. A whole-brain analysis found a 5-HTTLPR × CA interaction in the lingual gyrus whereby CA appears to differentially modify neural reactivity depending on genotype. These results demonstrate that two different forms of environmental adversities interplay with 5-HTTLPR and thereby differentially impact amygdala and cortical reactivity.

Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents

Background Early life stress (ELS) consists of child family adversities (CFA: negative experiences that happened within the family environment) and/or peer bullying. ELS plays an important role in the development of adolescent depressive symptoms and clinical disorders. Identifying factors that may reduce depressive symptoms in adolescents with ELS may have important public mental health implications. Methods We used structural equation modelling and examined the impact of adolescent friendships and/or family support at age 14 on depressive symptoms at age 17 in adolescents exposed to ELS before age 11. To this end, we used structural equation modelling in a community sample of 771 adolescents (322 boys and 477 girls) from a 3 year longitudinal study. Significant paths in the model were followed-up to test whether social support mediated or moderated the association between ELS and depressive symptoms at age 17. Results We found that adolescent social support in adolescence is negatively associated with subsequent depressive symptoms in boys and girls exposed to ELS. Specifically, we found evidence for two mediational pathways: In the first pathway family support mediated the link between CFA and depressive symptoms at age 17. Specifically, CFA was negatively associated with adolescent family support at age 14, which in turn was negatively associated with depressive symptoms at age 17. In the second pathway we found that adolescent friendships mediated the path between peer bullying and depressive symptoms. Specifically, relational bullying was negatively associated with adolescent friendships at age 14, which in turn were negatively associated with depressive symptoms at age 17. In contrast, we did not find a moderating effect of friendships and family support on the association between CFA and depressive symptoms. Conclusions Friendships and/or family support in adolescence mediate the relationship between ELS and late adolescent depressive symptoms in boys and girls. Therefore, enhancing affiliate relationships and positive family environments may benefit the mental health of vulnerable youth that have experienced CFA and/or primary school bullying.

General distress, hopelessness—suicidal ideation and worrying in adolescence: Concurrent and predictive validity of a symptom-level bifactor model for clinical diagnoses

Background Clinical disorders often share common symptoms and aetiological factors. Bifactor models acknowledge the role of an underlying general distress component and more specific sub-domains of psychopathology which specify the unique components of disorders over and above a general factor. Methods A bifactor model jointly calibrated data on subjective distress from The Mood and Feelings Questionnaire and the Revised Childrens Manifest Anxiety Scale. The bifactor model encompassed a general distress factor, and specific factors for (a) hopelessness—suicidal ideation, (b) generalised worrying and (c) restlessness—fatigue at age 14 which were related to lifetime clinical diagnoses established by interviews at ages 14 (concurrent validity) and current diagnoses at 17 years (predictive validity) in a British population sample of 1159 adolescents. Results Diagnostic interviews confirmed the validity of a symptom-level bifactor model. The underlying general distress factor was a powerful but non-specific predictor of affective, anxiety and behaviour disorders. The specific factors for hopelessness—suicidal ideation and generalised worrying contributed to predictive specificity. Hopelessness—suicidal ideation predicted concurrent and future affective disorder; generalised worrying predicted concurrent and future anxiety, specifically concurrent generalised anxiety disorders. Generalised worrying was negatively associated with behaviour disorders. Limitations The analyses of gender differences and the prediction of specific disorders was limited due to a low frequency of disorders other than depression. Conclusions The bifactor model was able to differentiate concurrent and predict future clinical diagnoses. This can inform the development of targeted as well as non-specific interventions for prevention and treatment of different disorders.