Endometriosis, chronic pain, anxiety, and depression: A retrospective study among 12 million women.

BACKGROUND: There is a lack of information regarding the impact of the physical symptoms associated with endometriosis and chronic pain on the mental health and well-being of affected women. Thus, our study aimed to evaluate the relationship between endometriosis, chronic pain, anxiety, and depression. OBJECTIVE: Our study aimed to evaluate the relationship between endometriosis, chronic pain, and mental health disorders among women registered in a large database until 2014. STUDY DESIGN: This was a retrospective population-based study involving 12,904,324 hospitalized women from the Healthcare Cost and Utilization Project (HCUP) database between 2007 and 2014. We calculated the prevalence of chronic pain, endometriosis, anxiety, and depression during the study period. We used multivariate logistic regression to examine the relationship between these variables. RESULTS: An upward pattern was noted in the prevalence of chronic pain, while an opposite trend was seen for endometriosis during the study period. After adjusting for sociodemographic characteristics and comorbidities, including depression, the highest odds ratio of experiencing anxiety appeared in the group with both chronic pain and endometriosis (OR = 2.719, 95 % CI 2.481-2.979). LIMITATIONS: HCUP is a cross-sectional administrative database that does not link patients' records over the years. Thus, we could not establish any temporal association between endometriosis, chronic pain, anxiety, and depression. CONCLUSION: Potential associations were identified between endometriosis, with and without chronic pain, anxiety, and depression. We recommended that clinicians provide proper medical management of endometriosis-related pain through symptom management and adequate counseling for those suffering from anxiety and depression.

Longitudinal associations between paternal mental health and child behavior and cognition in middle childhood.

Introduction: Paternal mental health has been associated with adverse consequences on offspring psychosocial development, and family environmental factors may partly explain those associations. To clarify this, we need comprehensive prospective studies, particularly in middle-childhood when the child enters school and is expected to make use of behavioral and cognitive skills as part of their interactions and learning. Method: Using data from a sub-sample of the prospective 3D birth cohort study comprised of mother-father-child triads, and a follow-up of the parents and the children at 6-8 years of age (n = 61; 36 boys, 25 girls), we examined whether paternal anxious and depressive symptoms measured during the pregnancy period (i.e., prenatally) or concurrently when the child was assessed at 6-8 years old were associated with children's cognition/behavior. Results: In contrast to our hypotheses, we found that greater prenatal paternal depressive symptoms predicted fewer child behavioral difficulties; and that greater concurrent childhood paternal depression or anxiety symptoms were associated with higher child full-scale IQ, controlling for the equivalent maternal mental health assessment and parental education. Father parenting perception did not mediate these associations, nor were they moderated by maternal mental health at the concurrent assessment, or paternal ratings of marital relationship quality. Discussion: These findings suggest that higher symptoms of paternal mental health symptoms are associated with fewer child behavioral difficulties and higher cognitive performance in middle childhood. Potential clinical implications and future research directions are discussed.

Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents.

Importance: Depressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines. Objective: To examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts. Design, Setting, and Participants: This cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023. Main Outcomes and Measures: Self-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories. Results: A total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period. Conclusions and Relevance: In this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth.

Long-term consequences of neonatal encephalopathy in the hypothermia era: protocol for a follow-up cohort study at 9 years of age.

INTRODUCTION: Therapeutic hypothermia (TH) became the standard of care treatment for neonates with moderate and severe neonatal encephalopathy (NE) in most industrialized countries about 10 years ago. Although TH is effective in reducing mortality and the incidence of severe developmental disabilities, the recent literature converges in reporting frequent cognitive and behavioural difficulties at school entry in children with NE-TH. Although these challenges are deemed minor compared with cerebral palsy and intellectual disability, their impacts on a child's self-determination and family's well-being are quite significant. Therefore, the nature and extent of these difficulties need to be comprehensively described so that appropriate care can be offered. METHODS AND ANALYSIS: The current study will be the largest follow-up study of neonates with NE treated with TH to characterize their developmental outcomes and associated brain structural profiles at 9 years of age. Specifically, we will compare executive function, attention, social cognition, behaviour, anxiety, self-esteem, peer problems, brain volume, cortical features, white matter microstructure and myelination between children with NE-TH and matched peers without NE. Associations of perinatal risk factors and structural brain integrity with cognitive, behavioural and psycho-emotional deficits will be evaluated to inform about the potential aggravating and protective factors associated with function. ETHICS AND DISSEMINATION: This study is supported by the Canadian Institute of Health Research (202203PJT-480065-CHI-CFAC-168509), and received approval from the Pediatric Ethical Review Board of the McGill University Health Center (MP-37-2023-9320). The study findings will be disseminated in scientific journals and conferences and presented to parental associations and healthcare providers to inform best practices. TRIAL REGISTRATION NUMBER: NCT05756296.

Predictors of treatment attrition of cognitive health interventions in first episode psychosis.

AIM: Dropping out of psychological interventions is estimated to occur in up to a third of individuals with psychosis. Given the high degree of attrition in this population, identifying predictors of attrition is important to develop strategies to retain individuals in treatment. We observed a particularly high degree of attrition (48%) in a recent randomized controlled study assessing cognitive health interventions for first-episode psychosis participants with comorbid social anxiety. Due to the importance of developing interventions for social anxiety in first episode psychosis, the aim of the present study was to identify putative predictors of attrition through a secondary analysis of data. METHODS: Participants (n = 96) with first episode psychosis and comorbid social anxiety were randomized to receive cognitive behavioural therapy for social anxiety or cognitive remediation. Differences between completers and non-completers (<50% intervention completed) were compared using t-tests or chi-square analyses; statistically significant variables were entered into a multivariate logistic regression model. RESULTS: Non-completers tended to be younger, had fewer years of education and had lower levels of social anxiety compared to completers. Lower baseline social anxiety and younger age were statistically significant predictors of non-completion in the logistic regression model. CONCLUSIONS: Age and social anxiety were predictors of attrition in cognitive health interventions in first episode psychosis populations with comorbid social anxiety. In the ongoing development of social anxiety interventions for this population, future studies should investigate specific engagement strategies, intervention formats and outcome monitoring to improve participant retention in treatment.

The effect of maternal hypertension and maternal mental illness on adverse neonatal outcomes: A mediation and moderation analysis in a U.S. cohort of 9 million pregnancies.

BACKGROUND: While hypertensive disorders of pregnancy (HDP) coexist with maternal anxiety and depression, it is unclear how these conditions affect neonatal outcomes. We evaluated the prevalence as well as associations and potential mechanisms between HDP, maternal anxiety and depression, preterm birth (PTB), and small for gestational age (SGA). METHODS: We conducted a retrospective population-based study using the Healthcare Cost and Utilization Project (HCUP) database from 2004 to 2014. Preterm birth (<37 weeks), SGA (<10th percentile for gestational age and sex), HDP, and mental disorders (anxiety and depression) were extracted using the International Classification of Diseases, Ninth Revision (ICD-9). Mediation and moderation models were constructed separately to evaluate potential mechanisms between maternal anxiety and depression, HDP, and adverse neonatal outcomes. Multivariate logistic regressions were used to determine their associations. RESULTS: Of 9,097,355 pregnant women, the prevalence of HDP was 6.9 %, anxiety 0.91 %, depression 0.36 %, preterm birth 7.2 %, and SGA 2.1 %. Anxiety increased the probability of having HDP (OR = 1.242, 95 % CI 1.235-1.250), and HDP mediated the association between anxiety and preterm birth (mediation effect = 0.048, p-value<0.001). Depression significantly moderated the effect of HDP on preterm birth (moderation effect = -0.126, p-value = 0.027). HDP also mediated the association between anxiety and SGA (mediation effect = 0.042, p-value<0.001), but depression did not moderate the association between HDP and SGA (p-value = 0.29). CONCLUSION: Our study suggests that women with anxiety are more likely to have HDP, and HDP mediates the associations between anxiety and adverse neonatal outcomes. Depression moderates associations between HDP and preterm birth but not between HDP and SGA.

Manualized group cognitive behavioral therapy for social anxiety in first-episode psychosis: a randomized controlled trial.

BACKGROUND: Social anxiety (SA), a prevalent comorbid condition in psychotic disorders with a negative impact on functioning, requires adequate intervention relatively early. Using a randomized controlled trial, we tested the efficacy of a group cognitive-behavioral therapy intervention for SA (CBT-SA) that we developed for youth who experienced the first episode of psychosis (FEP). For our primary outcome, we hypothesized that compared to the active control of group cognitive remediation (CR), the CBT-SA group would show a reduction in SA that would be maintained at 3- and 6-month follow-ups. For secondary outcomes, it was hypothesized that the CBT-SA group would show a reduction of positive and negative symptoms and improvements in recovery and functioning. METHOD: Ninety-six patients with an FEP and SA, recruited from five different FEP programs in the Montreal area, were randomized to 13 weekly group sessions of either CBT-SA or CR intervention. RESULTS: Linear mixed models revealed that multiple measures of SA significantly reduced over time, but with no significant group differences. Positive and negative symptoms, as well as functioning improved over time, with negative symptoms and functioning exhibiting a greater reduction in the CBT-SA group. CONCLUSIONS: While SA decreased over time with both interventions, a positive effect of the CBT-SA intervention on measures of negative symptoms, functioning, and self-reported recovery at follow-up suggests that our intervention had a positive effect that extended beyond symptoms specific to SA.ClinicalTrials.gov identifier: NCT02294409.

Prenatal paternal anxiety symptoms predict child DHEA levels and internalizing symptoms during adrenarche.

Introduction: This study examined (1) whether measures of paternal anxious and depressive symptoms collected prenatally and during a follow-up assessment when the child was in middle childhood, predict child neuroendocrine outcomes, and (2) whether neuroendocrine outcomes are intermediate factors between paternal mental health and child cognitive/behavioral outcomes. Middle childhood coincides with increased autonomy as the child transitions into grade school, and with adrenarche, as the maturing adrenal gland increases secretion of dehydroepiandrosterone (DHEA) and its sulfated metabolite (DHEA-S), hormones that are implicated in corticolimbic development which regulate emotions and cognition. Methods: Participants were recruited from a subsample of a large prospective birth cohort study (3D study). We conducted a follow-up study when children were 6-8 years old (N = 61 families, 36 boys, 25 girls). Parental symptoms of anxiety, stress and depression were assessed via validated self-report questionnaires: prenatally using an in-house anxiety questionnaire, the Perceived Stress Scale (PSS) and the Center for Epidemiologic Studies Depression (CES-D), and at the follow up, using the Beck Anxiety and Beck Depression Inventories. Children provided salivary hormone samples, and their pituitary gland volume was measured from structural Magnetic Resonance Imaging (MRI) scans. Child behaviors were measured using the Strengths and Difficulties Questionnaire and cognitive outcomes using the WISC-V. Multiple regression analyses were used to test whether paternal mental health symptoms assessed prenatally and during childhood are associated with child neuroendocrine outcomes, adjusting for maternal mental health and child sex. Indirect-effect models assessed whether neuroendocrine factors are important intermediates that link paternal mental health and cognitive/behavioral outcomes. Results: (1) Fathers' prenatal anxiety symptoms predicted lower DHEA levels in the children, but not pituitary volume. (2) Higher prenatal paternal anxiety symptoms predicted higher child internalizing symptoms via an indirect pathway of lower child DHEA. No associations were detected between paternal anxiety symptoms measured in childhood, and neuroendocrine outcomes. No child sex differences were detected on any measure. Conclusion: These results highlight the often-overlooked role of paternal factors during pregnancy on child development, suggesting that paternal prenatal anxiety symptoms are associated with child neuroendocrine function and in turn internalizing symptoms that manifest at least up to middle childhood.

Rethinking how health care professionals cope with stress: A process model for COVID-19 and beyond.

ISSUE: Prior to the COVID-19 pandemic, there was evidence of challenges surrounding the psychological well-being of health care professionals (HCPs). HCPs already frayed psychological ability to cope risks being further compromised by COVID-19-related stresses. CRITICAL THEORETICAL ANALYSIS: Most research on stress, psychological distress, and coping among HCPs is done in a piecemeal manner without a theoretical model connecting these different but related phenomena. This critical advancement article aims to apply and extend Wheaton and Montazer's model of stressors, stress, and distress to the literature on HCPs, generally, and COVID-19, specifically, to summarize past and guide future research on HCPs' mental health, resilience, and coping. Our model describes how different sources of support buffer the effect of stressors on stress and how coping strategies moderate the effect of stress on psychological distress. ADVANCE: We extended the model by (a) distinguishing context from the support in HCPs' environment; (b) distinguishing adaptive from maladaptive coping strategies and their relationships with antecedents and outcomes; (c) describing the adverse impacts that psychological distress has on patients, HCPs, and health services; and (d) describing how such outcomes can become stressors, in turn, further contributing to HCPs' stress in a vicious cycle. PRACTICE IMPLICATIONS: Our model provides a broader perspective of HCPs' work-related mental health and helps guide the creation, implementation, and evaluation of different sources of support and promote adaptive coping strategies. This model helps HCPs, researchers, and health services managers better understand and respond to the well-being crisis HCPs are facing, especially during the pandemic.

The role of the classroom learning environment in students' mathematics anxiety: A scoping review.

BACKGROUND: Math anxiety is a common experience that interferes with learning and achievement in mathematics. Considering that mathematics learning mostly takes place within the classroom, it is critical to examine how math anxiety develops in this context. AIMS: The purpose of the current scoping review was to identify classroom-learning environment factors associated with math anxiety in elementary and high school students. SAMPLE(S): Out of an initial sample of 3011 studies, 28 were eligible for inclusion. METHODS: Data on author(s), publication year, and study location; sample demographics; classroom variables; intervention details (if applicable); measures; and key results were extracted from articles. RESULTS: Numerous protective and vulnerability factors were identified. CONCLUSIONS: Directions for future research and methodological implications were explored.

The role of maternal child maltreatment history and unsupportive emotion socialization in the intergenerational transmission of emotion regulation difficulties.

BACKGROUND: Maternal mental health problems and poor parenting are thought to account for the intergenerational transmission of poor outcomes to offspring of mothers who have experienced child maltreatment. OBJECTIVE: Given that emotion regulation (ER) difficulties have been linked to adult psychopathology and maladaptive parenting, the goal of the present study was to examine the mechanisms through which a maternal history of child maltreatment, and subsequent difficulties with ER, might contribute to unsupportive emotion socialization and the intergenerational transmission of ER difficulties. PARTICIPANTS AND SETTING: Mothers and their young adult children (aged 18-25) were recruited from across Canada to participate in an online study (N = 185 dyads). METHODS: Mothers responded to questionnaires assessing their child maltreatment histories and ER difficulties. Young adults retrospectively reported on their mothers' emotion socialization behaviours in adolescence as well as their own difficulties with ER. RESULTS: A moderated mediation analysis revealed that mothers who endorsed more types of child maltreatment were described as using more unsupportive contingencies, but only in the context of high levels of maternal ER difficulties. The indirect effect of maternal child maltreatment on young adults' ER difficulties was only significant for mothers with high levels of ER difficulties. More specifically, maternal difficulties with impulse control and emotional clarity contributed to more unsupportive contingencies. CONCLUSIONS: Mothers who have experienced multiple forms of child maltreatment may be more likely to struggle with ER and engage in unsupportive emotion socialization behaviours, which may increase the risk of emotional difficulties in their children. Survivors of child maltreatment should have access to interventions that promote ER skills to improve their own well-being and to prevent the transmission of ER difficulties to future generations.

Maternal anxiety, depression and vascular function during pregnancy.

OBJECTIVE: We aim to clarify whether type and timing of mental health symptoms in early pregnancy distinctly contribute to maternal-fetal vascular function, independent from the psychotropic medications given to treat these conditions. METHODS: Data from a prospective cohort study (n = 1678) were used to test whether self-reported fears about giving birth and depressive symptoms prior to 16 weeks of gestation were associated with vascular outcomes predictive of hypertensive disorders of pregnancy (HDP) i.e., systolic and diastolic blood pressure (BP); uterine artery pulsatility index (UAPI); umbilical artery resistance index (UmbARI); and urine protein creatinine ratio. Multiple linear regressions models and mediation models were used to test for associations between predictors and outcomes, controlling for previously identified risk factors for vascular dysfunction such as maternal age and history of infertility. RESULTS: Fears about giving birth in early pregnancy were inversely associated with UmbARI (ß = -0.33, p = 0.03, df = 51) mid- to late-pregnancy (≥20 weeks). Depressive symptoms in early pregnancy were also inversely associated with maternal systolic BP (ß = -0.13, p = 0.01, df = 387) and diastolic BP (ß = -0.10, p = 0.04, df = 387) during the first trimester. CONCLUSIONS: While fears about giving birth in early pregnancy were associated with lower vascular resistance in the fetal-placental unit, early depressive symptoms were associated with lower maternal vascular tone. At the very least, our results support the notion that early maternal psychological distress is unlikely to account for the development of HDP later during pregnancy and provide preliminary evidence to support distinct roles of pregnancy-related anxiety and depressive symptoms in maternal-fetal vascular function.

Nurses' and Physicians' Distress, Burnout, and Coping Strategies During COVID-19: Stress and Impact on Perceived Performance and Intentions to Quit.

INTRODUCTION: Health care providers (HCPs) have experienced more stress and burnout during COVID-19 than before. We compared sources and levels of stress, distress, and approaches to coping between nurses and physicians, and examined whether coping strategies helped mitigate the negative impact of stress and intentions to quit. METHODS: Using a cross-sectional study design, burnout was measured with the Maslach Burnout Inventory. Psychological distress was measured using the Depression, Anxiety, and Stress Scale. A self-reported survey was used to evaluate stressors, impact on perceived performance, and intentions to quit. The data were analyzed using t-tests and linear regression models. RESULTS: Responses of 119 HCPs were analyzed. Findings suggest that (1) compared to physicians, nurses experienced a higher level of distress and burnout, and used more maladaptive coping strategies. (2) Both nurses and physicians experienced more distress and burnout during COVID-19 than before. (3) Adaptive coping strategies moderated the negative impact of stress on work performance (4) Adaptive coping strategies moderated the negative effect of stress on burnout, which in turn reduced intentions to quit. Stress negatively impacted work performance and burnout only for those with low, but not high, levels of adaptive coping strategies. DISCUSSION: The current findings of HCPs' challenges, risks, and protective factors provide valuable information (1) on COVID-19's impact on HCPs, (2) to guide the distribution of institutional supportive efforts and recommend adaptive coping strategies, and (3) to inform medical education, such as resilience training, focusing on adaptive coping approaches.

Evaluations of Healthcare Providers' Perceived Support From Personal, Hospital, and System Resources: Implications for Well-Being and Management in Healthcare in Montreal, Quebec, During COVID-19.

Increased stressful experiences are pervasive among healthcare providers (HCPs) during the COVID-19 pandemic. Identifying resources that help mitigate stress is critical to maintaining HCPs' well-being. However, to our knowledge, no instrument has systematically examined how different levels of resources help HCPs cope with stress during COVID-19. This cross-sectional study involved 119 HCPs (64 nurses and 55 physicians) and evaluated the perceived availability, utilization, and helpfulness of a list of personal, hospital, and healthcare system resources. Participants also reported on their level of burnout, psychological distress, and intentions to quit. Results revealed that HCPs perceived the most useful personal resource to be family support; the most useful hospital resources were a safe environment, personal protective equipment, and support from colleagues; the most useful system resources were job protection, and clear communication and information about COVID. Moreover, HCPs who perceived having more available hospital resources also reported lower levels of psychological distress symptoms, burnout, and intentions to quit. Finally, although training and counseling services were perceived as useful to reduce stress, training was not perceived as widely available, and counseling services, though reported as being available, were underutilized. This instrument helps identify resources that support HCPs, providing implications for healthcare management.

Cannabis use, depression and suicidal ideation in adolescence: direction of associations in a population based cohort.

BACKGROUND: To clarify the direction of the association between frequency of cannabis use, depressive symptoms and suicidal ideation from 15 to 20 years using cross-lagged analyses. METHOD: We included 1606 adolescents from the province of Québec followed since 1997 with information on frequency of cannabis use (none/monthly/weekly), depression (defined as being in the top 10% symptoms) and serious suicidal ideation at ages 15, 17 and 20 years. RESULTS: The prevalence of weekly cannabis use increased from 7.0% at age 15 years to 15.6% by age 20 years. Adolescents who reported using cannabis weekly at one age were 11 to 15 times more likely to continue using cannabis over time. In longitudinal cross-lagged analyses, weekly cannabis use at age 15 was associated with greater odds (OR=2.19, 95% CI=1.04-4.58) of suicidal ideation two years later. However, other substance use (alcohol, tobacco, other drugs) fully explained this association. Further, depression predicted subsequent weekly cannabis use, even after adjusting for comorbid other substance use (eg, for depression at 15 years predicting cannabis use at 17 years: OR=2.30, 95% CI=1.19-4.43). LIMITATIONS: Quantity of cannabis consumed was not measured. CONCLUSION: Findings suggest that depressive symptoms in adolescence may represent a risk factor for weekly cannabis consumption, which once initiated is likely to remain chronic. Weekly cannabis use increased risk for suicidal ideation, but not independently from other substance use including alcohol, tobacco and other drugs.

Emotion regulation interacts with gambling motives to predict problem gambling among emerging adults.

BACKGROUND: It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in specific dimensions of emotion regulation coupled with the motivation to escape negative emotions (i.e., coping motives) increases the likelihood of problem gambling severity, while controlling for variables such as gambling frequency, age, and sex. METHODS: A sample of 919 emerging adult gamblers (Mage = 21.16 years-old, SD = 2.90, 48.1% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, gambling motivations, and difficulties in emotion regulation. In total, 15.2% and 8.1% of this sample were at moderate or high risk for gambling disorder. RESULTS: A series of six moderation analyses revealed that the total models accounted for approximately 37-38% of the variance in problem gambling and that coping motives interacted with less difficulties engaging in goal-directed behavior, increased lack of emotional clarity, and increased lack of emotional awareness to create a toxic mixture for problem gambling. CONCLUSIONS: These findings reveal the importance of considering both psychological factors such as emotion regulation and motivational factors in understanding who is at greatest risk for gambling problems.

The Late Positive Potential as a Reliable Neural Marker of Cognitive Reappraisal in Children and Youth: A Brief Review of the Research Literature.

The mental health of young people is a growing public health concern. With socio-emotional difficulties in youth often resulting in psychiatric disorders later in life and most with mental health conditions rather stabilizing in time, it is essential to support healthy socio-emotional development. With a comprehensive definition of mental health, since emotion regulation (ER) plays a critical role in prevention, it becomes imperative to better understand how children effectively manage their emotions from an early age. Determining effective use of ER skills relies on adequate measurements. Typical methods of data collection in children present consistent shortcomings. This review addresses research findings considering the suitability of the late positive potential measured through electroencephalogram as a neural indicator of ER in children and youth. There is growing evidence, as reported in this review, that indicates that the late positive potential may be a reliable neural indicator of children's cognitive reappraisal abilities more specifically. Results generally suggest that the late positive potential amplitudes are sensitive to directed reappraisal in children. However, given the scant research, questions remain regarding developmental trends, methodology, interindividual variability, reappraisal of various stimuli, and how the late positive potential may relate to more traditional measures of ER. Directions for future research are provided, which are expected to address unanswered research questions and fill literature gaps. Taken together, the findings reviewed indicate that the late positive potential is generally sensitive to directed cognitive reappraisal in children and that there is promise of establishing this neural marker as an indicator of ER.

Emotion regulation in emerging adult gamblers and its mediating role with depressive symptomology.

BACKGROUND: It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in emotion regulation explain the association between problem gambling severity and depression. METHODS: A sample of 820 emerging adult gamblers (Mage = 21.14 years-old, SD = 2.90, 50.9% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, levels of anxious/depressive symptomology, and difficulties in emotion regulation. In total, 15.6% and 8.2% of this sample were at moderate or high risk for gambling disorder. RESULTS: Results from a linear regression model revealed that difficulties with impulse control positively contributed to problem gambling scores and engagement in goal-directed behavior positively contributed to problem gambling scores, even after accounting for symptoms of depression. Moreover, results from a mediation model revealed that the association between problem gambling and depression was explained by participants' deficits in non-acceptance, goals, strategies, and clarity. LIMITATIONS: Limitations include the use of self-report and cross-sectional data making it difficult to infer causality. CONCLUSIONS: These findings add to our understanding of the mechanisms that appear to explain for the first time the affective consequences of problem gambling. Enhancing specific dimensions of emotion regulation will allow for tailored interventions among gamblers with depression, ultimately achieving better mental health outcomes.

Attribution bias and social anxiety in schizophrenia.

Studies on attribution biases in schizophrenia have produced mixed results, whereas such biases have been more consistently reported in people with anxiety disorders. Anxiety comorbidities are frequent in schizophrenia, in particular social anxiety disorder, which could influence their patterns of attribution biases. The objective of the present study was thus to determine if individuals with schizophrenia and a comorbid social anxiety disorder (SZ+) show distinct attribution biases as compared with individuals with schizophrenia without social anxiety (SZ-) and healthy controls. Attribution biases were assessed with the Internal, Personal, and Situational Attributions Questionnaire in 41 individual with schizophrenia and 41 healthy controls. Results revealed the lack of the normal externalizing bias in SZ+, whereas SZ- did not significantly differ from healthy controls on this dimension. The personalizing bias was not influenced by social anxiety but was in contrast linked with delusions, with a greater personalizing bias in individuals with current delusions. Future studies on attribution biases in schizophrenia should carefully document symptom presentation, including social anxiety.