Showing papers by "Michelle Rozenman published in 2022"

2.11 Content Specificity of Anxiety Symptoms to Performance-Based Interpretation Bias Domains in Youth

Abstract: ObjectivesThis study explores whether performance-based interpretation bias is associated with pediatric anxiety symptoms, including whether this relationship is content-specific to generalized, social, and/or panic/somatic domains. We also explore if age moderates this relationship.MethodsData are drawn from the first wave of a longitudinal study of 152 youths (55% male) aged 9 to 14 years (mean = 11.28; SD = 1.37). Performance-based interpretation bias was measured with the Word Sentence Association Paradigm (WSAP) (Beard and Amir, 2008) for youth (Rozenman et al, 2014; Rozenman et al, 2017); the task provides the percent of threat interpretations endorsed and a reaction time index for endorsing vs rejecting threat. Anxiety was measured with child and parent versions of the Screen for Child Anxiety Related Emotional Disorders (SCARED; Birmaher et al, 1997), which provides a total score as well as subscales for generalized, social, and panic/somatic symptoms.ResultsInterpretation bias demonstrated small, positive, and significant correlations with youth-reported anxiety symptoms (percent threat interpretations endorsed: r = .19, p = .022; threat reaction time index: r = .18, p = .024), but not with parent-reported anxiety symptoms (all p > .05). Age did not moderate the relationship between interpretation bias and anxiety. Partial correlations provided evidence for content specificity between interpretation bias and youth-reported generalized (r = .18; p = .029) and social anxiety (r = .21; p = .019), but bias for panic/somatic symptoms was associated with youth-reported generalized anxiety (r = .19; p = .018) and not panic/somatic symptoms (p < .05). We did not find content specificity between interpretation bias and parent-reported symptoms.ConclusionsConsistent with prior work, performance-based interpretation bias was associated with child-reported anxiety symptoms, with content-specific links between generalized and social domains. However, age did not moderate the links between bias and anxiety. The poster will also include information about links between threat bias and the presence of an anxiety diagnosis. Findings add to the growing literature that supports interpretation bias as a feature of youth anxiety. Future longitudinal analyses may better decipher these relationships.AD, NEURODEV, COG ObjectivesThis study explores whether performance-based interpretation bias is associated with pediatric anxiety symptoms, including whether this relationship is content-specific to generalized, social, and/or panic/somatic domains. We also explore if age moderates this relationship. This study explores whether performance-based interpretation bias is associated with pediatric anxiety symptoms, including whether this relationship is content-specific to generalized, social, and/or panic/somatic domains. We also explore if age moderates this relationship. MethodsData are drawn from the first wave of a longitudinal study of 152 youths (55% male) aged 9 to 14 years (mean = 11.28; SD = 1.37). Performance-based interpretation bias was measured with the Word Sentence Association Paradigm (WSAP) (Beard and Amir, 2008) for youth (Rozenman et al, 2014; Rozenman et al, 2017); the task provides the percent of threat interpretations endorsed and a reaction time index for endorsing vs rejecting threat. Anxiety was measured with child and parent versions of the Screen for Child Anxiety Related Emotional Disorders (SCARED; Birmaher et al, 1997), which provides a total score as well as subscales for generalized, social, and panic/somatic symptoms. Data are drawn from the first wave of a longitudinal study of 152 youths (55% male) aged 9 to 14 years (mean = 11.28; SD = 1.37). Performance-based interpretation bias was measured with the Word Sentence Association Paradigm (WSAP) (Beard and Amir, 2008) for youth (Rozenman et al, 2014; Rozenman et al, 2017); the task provides the percent of threat interpretations endorsed and a reaction time index for endorsing vs rejecting threat. Anxiety was measured with child and parent versions of the Screen for Child Anxiety Related Emotional Disorders (SCARED; Birmaher et al, 1997), which provides a total score as well as subscales for generalized, social, and panic/somatic symptoms. ResultsInterpretation bias demonstrated small, positive, and significant correlations with youth-reported anxiety symptoms (percent threat interpretations endorsed: r = .19, p = .022; threat reaction time index: r = .18, p = .024), but not with parent-reported anxiety symptoms (all p > .05). Age did not moderate the relationship between interpretation bias and anxiety. Partial correlations provided evidence for content specificity between interpretation bias and youth-reported generalized (r = .18; p = .029) and social anxiety (r = .21; p = .019), but bias for panic/somatic symptoms was associated with youth-reported generalized anxiety (r = .19; p = .018) and not panic/somatic symptoms (p < .05). We did not find content specificity between interpretation bias and parent-reported symptoms. Interpretation bias demonstrated small, positive, and significant correlations with youth-reported anxiety symptoms (percent threat interpretations endorsed: r = .19, p = .022; threat reaction time index: r = .18, p = .024), but not with parent-reported anxiety symptoms (all p > .05). Age did not moderate the relationship between interpretation bias and anxiety. Partial correlations provided evidence for content specificity between interpretation bias and youth-reported generalized (r = .18; p = .029) and social anxiety (r = .21; p = .019), but bias for panic/somatic symptoms was associated with youth-reported generalized anxiety (r = .19; p = .018) and not panic/somatic symptoms (p < .05). We did not find content specificity between interpretation bias and parent-reported symptoms. ConclusionsConsistent with prior work, performance-based interpretation bias was associated with child-reported anxiety symptoms, with content-specific links between generalized and social domains. However, age did not moderate the links between bias and anxiety. The poster will also include information about links between threat bias and the presence of an anxiety diagnosis. Findings add to the growing literature that supports interpretation bias as a feature of youth anxiety. Future longitudinal analyses may better decipher these relationships.AD, NEURODEV, COG Consistent with prior work, performance-based interpretation bias was associated with child-reported anxiety symptoms, with content-specific links between generalized and social domains. However, age did not moderate the links between bias and anxiety. The poster will also include information about links between threat bias and the presence of an anxiety diagnosis. Findings add to the growing literature that supports interpretation bias as a feature of youth anxiety. Future longitudinal analyses may better decipher these relationships.

Brief Behavioral Therapy for Anxiety and Depression in Pediatric Primary Care: Breadth of Intervention Impact.

Abstract: To report on broad-based outcomes of the Brief Behavioral Therapy (BBT) trial for pediatric anxiety and depression. Secondary data analyses expand on previous reports by assessing diagnostic remission and independent functioning, impact on targeted psychopathology, and spillover effects on non-targeted outcomes.Youth (N = 185; 8-16.9 years; 58% female; 78% White; 21% Hispanic) with anxiety and/or depression were eligible for this multi-site trial. Enrolled youth were randomly assigned to receive 8 to 12 sessions of BBT in primary care or assisted referral to outpatient care (ARC). Assessments were conducted 16 and 32 weeks post randomization.BBT was superior to ARC on remission of all targeted diagnoses (week 16: 56.8% vs 28.2%, p < .001; week 32: 62.5% vs 38.9%, p = .004), clinician-rated independent functioning (week 16: 75.0% vs 45.7%, p < .001; week 32: 81.2% vs 55.7%, p < .001), and on measures of anxiety, depression, suicide items, total comorbid behavioral and emotional problems, and hyperactivity (d = 0.21-0.49). Moderation analyses revealed superior outcomes for Hispanic youth in BBT vs ARC for diagnostic remission, anxiety, emotional problems, and parent-child conflict. Youth depression at baseline moderated effects on peer problems and parent-child conflict, with effects favoring BBT. Significant main and moderated effects of BBT on change in non-targeted outcomes were largely mediated by change in anxiety (24.2%-49.3% of total effects mediated).BBT has positive effects on youth, mediated by the strong impact of the intervention on anxiety. Analyses continue to support positive outcomes for Hispanic youth, suggesting that BBT is a broadly effective transdiagnostic treatment option for diverse populations.Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; https://clinicaltrials.gov; NCT01147614.

thinkSMART®: A pilot study of a transdiagnostic cognitive-behavioral treatment for adolescents with executive functioning weaknesses

Abstract: Executive functions are a broad term used to describe the cognitive functions necessary to help individuals complete tasks and achieve goals. Executive functioning weaknesses are a hallmark feature of psychopathology, particularly in youth. These weaknesses are associated with chronic impairment across academic, social and family domains and do not typically improve into adulthood. Despite these negative outcomes, few behavioral interventions have been successfully developed to target executive functioning outside of ADHD, particularly in adolescents with various types of psychopathology. The thinkSMART® program was created to target the broad heterogeneity of adolescents with executive function weakness. We discuss the rationale for the development of the program, as well as outline the primary skill areas addressed. We also present an open-trial pilot study using the program in adolescents ages 12–17 who identify as having executive functioning weaknesses. Preliminary findings highlight the acceptability and feasibility of the program, as well as the initial efficacy in improving adolescents’ day-to-day executive functioning. We discuss the limitations and benefits of providing broad skills and compensatory strategies to improve adolescent executive functioning.

Compounding Effects of Domain-General Cognitive Weaknesses and Word Reading Difficulties on Anxiety Symptoms in Youth.

Abstract: This study examined whether domain-general cognitive weaknesses in processing speed (PS) or executive functioning (EF) moderate the relation between word reading scores and anxiety such that lower word reading scores in combination with lower cognitive scores are associated with higher anxiety symptoms. The sample included 755 youth aged 8-16 who were recruited as part of the Colorado Learning Disabilities Research Center twins study. Lower scores on PS (R2 = .007, p = .014), EF (R2 = .009, p = .006), and word reading (R2 = .006-.008, p = .010-.032) were associated with higher anxiety scores. In addition, the word reading × cognitive interactions were significant such that lower scores on PS (R2 = .010, p = .005) or EF (R2 = .013, p = .010) combined with lower word reading were associated with higher-than-expected anxiety symptoms. Results suggest that weaknesses in PS, EF, and word reading are modestly associated with higher anxiety symptoms, and these anxiety symptoms may be compounded in youth with both PS or EF weaknesses and word reading difficulties. These findings can guide assessment approaches for identifying youth with word reading challenges who may be at increased risk for anxiety.