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Is anxiety sensitivity a predictor of PTSD in children and adolescents

OBJECTIVE Anxiety sensitivity (AS) is the fear of the physical symptoms of anxiety and related symptoms. Longitudinal studies support AS as a vulnerability factor for development of anxiety disorders. This study aimed to investigate AS as a vulnerability factor in the development of childhood posttraumatic stress disorder (PTSD) following traumatic experiences. METHODS The study included 81 children 8-15 years of age who experienced the 1999 earthquake in Bolu, Turkey. The earthquake survivors were compared to a randomized group of age- and sex-matched controls 5 years after the earthquake. Both the subject and control groups were administered the Childhood Anxiety Sensitivity Index (CASI), State and Trait Anxiety Inventory for Children (STAI-C), and Child Depression Inventory (CDI), while the PTSD symptoms of the subjects were assessed using the Child Posttraumatic Stress Reaction Index (CPTS-RI). RESULTS Subjects and controls did not differ significantly in CASI, STAI-C, or CDI scores. Multiple regression analysis showed that both trait anxiety and CASI scores predicted CPTS-RI scores of the subjects; the prediction by CASI scores was over and above the effect of trait anxiety. CONCLUSION The results of this study support the hypothesis that AS may be a constitutional factor, which might increase the risk of PTSD following traumatic experiences.

Internet addiction is related to attention deficit but not hyperactivity in a sample of high school students.

Abstract Objective. To assess the effects of attention-deficit/hyperactivity disorder (ADHD) symptom dimensions on Internet addiction (IA) after controlling for Internet usage features among high school students. Methods. This study consisted of 640 students (331 females and 309 males) ranging from 14 to 19 years of age. The Internet Addiction Scale, the Conners-Wells’ Adolescent Self-Report Scale-Short Form, and a personal information form were completed by the participants. Statistical analyses were conducted for both sexes and the total sample. Results. According to the logistic regression analysis, attention deficit and playing online games were significant predictors of IA in both sexes. Other predictors of IA included behavioral problems for females, total weekly Internet usage time, and lifelong total Internet use for males. Hyperactivity and other Internet usage features did not predict IA. Conclusion. These results suggest that attention deficit and playing online games are important determinants of IA in this age group.

Hiccups Associated with Aripiprazole in an Adolescent with Bipolar Disorder

Aripiprazole is one of the atypical antipsychotic medications with a mechanism of action involving mixture of agonist, partial agonist, and antagonist activity at dopamine and serotonin receptors (Deb et al. 2014). It was first approved for the treatment of schizophrenia; later it was found effective for bipolar disorder, major depressive disorder, and irritability associated with autism spectrum disorders (Nelson et al. 2010; de Bartolomeis and Perugi 2012; Deb et al. 2014). Initially, aripiprazole had been regarded as a relatively safe agent with little extrapyramidal adverse effects, minimal weight gain, and a favorable metabolic profile. However, by contrast, there are slowly increasing published data regarding the adverse effects of the drug. Hiccup is a repeated involuntary, spasmodic, and temporary contraction of the diaphragm accompanied by a sudden closure of the glottis, producing the characteristic inspiratory sound and discomfort. The exact etiology of hiccup remains unclear in most cases. Many causes have been attributed to the etiology of hiccups, including drugs. A few reports were available regarding aripiprazole-induced hiccup in the adult literature (Ray et al. 2009; Yeh 2011; Silverman et al. 2014). Herein, we present an adolescent with newly diagnosed bipolar disorder who displayed acute hiccup during aripiprazole therapy.

The Relationship Between Parental Affective Temperament Traits and Disruptive Behavior Disorders Symptoms in Children With ADHD

Objective: This study investigated the relationship between parental affective temperaments and the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with ADHD. Method: The sample consisted of 542 treatment-naive children with ADHD and their biological parents. Children were assessed via both parent- and teacher-rated behavioral disorder scales. Parental affective temperament and ADHD symptoms were measured by self-report inventories. The relationships between psychiatric variables were evaluated using structural equation modeling. Results: According to parent-rated behavioral disorder scales, paternal cyclothymic and maternal irritable temperaments were associated with ODD scores, and maternal depressive temperament was associated with CD scores. In terms of teacher-rated behavioral disorder scales, maternal anxious temperament was associated with ODD scores, and paternal cyclothymic and maternal depressive temperaments were associated with CD scores. Conclusion: These results suggest that certain parental affective temperaments are related to an increase in symptoms of disruptive behavioral disorders in children with ADHD.

Association of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder

This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive–proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive–proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive–proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive–proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.

Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder.

Abstract Objective: This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Methods: Fifty outpatients, aged 8–18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Results: Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Childrens Somatization Inventory (CSI) scores of subjects. Conclusions: This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.

Relationships Among Depression, Anxiety, Anxiety Sensitivity, and Perceived Social Support in Adolescents with Conversion Disorder

Introduction Only a limited number of studies have examined the association of conversion disorder (CD) with depression and anxiety in adolescents. Furthermore, no data regarding the association of CD with anxiety sensitivity and perceived social support are available. This study aimed to assess the relationships among psychological characteristics and conversion symptoms in adolescents. Methods We assessed 50 outpatients, aged 8–18 years, who had been diagnosed with CD and members of a control group using the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI), and Multidimensional Scale of Perceived Social Support (MSPSS). Symptoms of CD were assessed using the Somatoform Dissociation Questionnaire (SDQ) and Childrens Somatization Inventory (CSI). Results Compared with controls, adolescents with CD scored higher on the CDI, SCARED, CASI total, CASI physical and cognitive subscales, and MSPSS total and MSPSS family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the SDQ scores and that CDI and CASI total scores predicted the CSI scores of subjects. Conclusion This study suggest that adolescents with CD had poor psychosocial well-being, and depression and global AS and AS cognitive concerns may play a role in the development of conversion symptoms.

Association of Anxiety, Anxiety Sensitivity and Depressive Symptoms with Aggression and Disruptive Behavioral Disorders in Children with ADHD

Introduction Numerous factors including anxiety, anxiety sensitivity (AS), and depression were reported to be relevant to the aggression both for disruptive behavioral disorders (DBD) in children and for attention-deficit/hyperactivity disorder (ADHD), but the pathways through which they act are insufficiently understood. Objectives To investigate the role of anxiety, AS, and depression in the relationship between aggression and DBD symptoms in ADHD children. Methods The sample consisted of 342 treatment naive children with ADHD aged 9-17 years. ADHD severity and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Severity of anxiety, AS, depression, and reactive and proactive agression of children were evaluated by self-report inventories. The association between DBD and other psychiatric variables was evaluated with two separate structural equation models. Results Relationships of psychiatric variables and DBD symptoms were presented in Figures 1 and 2. Discussion: These results may suggest the presence of a vicious circle between anxiety, reactive aggression and DBD in ADHD children. However, global AS seems to have a protective effect on the development of DBD, probably due to its role in aversive conditioning. Download : Download full-size image Download : Download full-size image Figure . Structural model for the perdictores of parent-rated disruptice behavioural disorders symptoms in children with ADHD

The Role of Parental Temperament Traits in Disruptive Behavioral Disorders of Children with ADHD

Introduction No study up to now investigated the role of parental temperament traits in disruptive behavioral disorders (DBD) of children with attention-deficit/hyperactivity disorder (ADHD). Objectives To determine the relationships between parent temperament characteristics and child DBD symptoms in children with ADHD. Methods The sample consisted of 542 treatment naive children with ADHD aged 6-17 years. All children had to be living with both biological mothers and fathers. The severity of ADHD and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Temperamental dimensions of mothers and fathers were measured by TEMPS-A. The association between parental ADHD and DBD was evaluated with two separate structural equation models. Results Relationships of parent ADHD and DBD symptoms were presented in Figures 1 and 2. Discussion This study showed a significant relationship between maternal depressive and paternal cyclothymic affective temperament and conduct disorder, and between maternal anxious and irritable, and paternal cyclothymic affective temperament and oppositional defiant disorder in children with ADHD. This study highlights that children with more severe behavioural symptoms are more likely to have a parent with certain temperament traits. Download : Download full-size image Download : Download full-size image

Impact of Parental ADHD Dimensions On Disruptive Behavioral Disorders Symptomatology in Children with ADHD

Introduction Little is known about the effect of parental attention-deficit/hyperactivity disorder (ADHD) dimensions on the development of disruptive behavioral disorders (DBD) in children with ADHD. Objectives To study the association of parental ADHD on the DBD symptoms in children with ADHD. Methods The sample consisted of 542 treatment naive children with ADHD aged 6-17 years. All children had to be living with both biological mothers and fathers. The severity of ADHD and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Current ADHD severity of mothers and fathers were evaluated by a self-report inventory. The association between parental ADHD and DBD was evaluated with two separate structural equation models. Results Relationships of parent ADHD and DBD symptoms were presented in Figures 1 and 2. Discussion These results suggest maternal hyperactivity may be a vulnerability factor for the development of conduct disorder and oppositional defiant disorder in children with ADHD. Download full-size image Download full-size image