Separation-related Problems and Their Interaction with Physical Disease.

The condition of separation-related problems (SRPs) is common in companion dogs and clinicians should be comfortable diagnosing it. There are numerous diagnoses related to physical disease that have clinical signs similar to SRP, that exacerbate SRP, or may cause regression in treatment of SRP. Common examples include conditions affecting the following systems: musculoskeletal, neurologic, gastrointestinal, and dermatologic. Therefore, it is important for clinicians to rule out causes of physical disease and address them accordingly. The signalment of the patient, medications they are receiving, and other behavioral comorbidities should also be considered.

A LONGITUDINAL STUDY OF CHILDHOOD SEPARATION ANXIETY DISORDER AND ITS IMPLICATIONS FOR ADOLESCENT PSYCHOPATHOLOGY.

A prevalent psychiatric disorder called Child Separation Anxiety Disorder (SAD) is characterized by extreme discomfort when a child gets separated from their primary carers. While SAD's quick consequences on kids are well-researched, its long-term implications for teenage psychopathology have received less attention. This longitudinal study aims to ascertain the connection between child SAD and future psychopathological consequences in adolescents. 500 adolescents were chosen as part of the adolescent depression project, and at the age of 17, we retrospectively evaluated past and present mental disorders. At ages 25 and 32, they conducted diagnostic evaluations of these people during adolescence while they continued to monitor them. Based on childhood/adolescent assessments, the participants were split into different groups: SAD (n=34), other forms of Anxiety (n=76), a control group with combined psychiatric conditions (n=205), and mentally sound control group (n=185). Statistics were evaluated by hierarchical multiple logistic regression after various illnesses and pertinent demographic variables were considered. It implies that SAD has a high risk (80.2%) of being a significant risk indicator for the emergence of mental illnesses in young adults. This study highlights the importance of early SAD management and therapy and the possible advantages of treating SAD in lowering the likelihood of developing other mental health problems in adolescence. It also emphasizes the value of continuous studies to comprehend these connections and enhance the effects on SAD sufferers' psychological well-being.

Relationship of behavioral inhibition to separation anxiety in a sample (N = 377) of adult individuals with mood and anxiety disorders.

BACKGROUND: Behavioral Inhibition (BI) is an early temperamental trait characterized by shyness, withdrawal, avoidance, uneasiness, and fear of unfamiliar situations, people, objects, and events. The DSM-5 refers to behavioral inhibition as a temperamental factor related to neurodevelopmental conditions in childhood, including attention deficit hyperactivity disorder, selective mutism, and specific phobias; and to its influence on adult anxiety disorders including social anxiety disorder, agoraphobia, and generalized anxiety disorder, but, interestingly, not separation anxiety disorder (SAD). However, there are phenomenological overlaps between BI and SAD. We aimed to explore whether there is a correlation between BI as an early temperamental trait and childhood or adult separation anxiety disorder. METHODS: The study was conducted in 377 consecutive adults (mean age 40.2±12.4 years) outpatients with anxiety and mood disorders as the principal diagnosis, grouped on the presence/absence of a DSM-5 diagnosis of childhood or adult separation anxiety disorder. Separation anxiety was assessed by the Structured Clinical Interview for Separation Anxiety (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA27). Behavioral inhibition was assessed by the Retrospective Self-Report of Inhibition (RSRI). RESULTS: The four comparison groups included: 1) 168 patients without childhood or adult SAD, 2) 81 with adult SAD, 3) 97 with both adult SAD and childhood SAD, and 4) 31 with childhood SAD only. The group with both adult and childhood SAD had the highest scores on RSRI total and sub-scale scores. Both groups with adult SAD had significantly higher RSRI scores than the group with only childhood SAD or without SAD. Significant bivariate correlations were found between ASA-27 scores and RSRI scores. Correlations between RSRI scores and measures of anxiety and depressive symptoms were significantly weaker than those on the ASA-27. Regression analyses showed a significant predictive value of RSRI scores on ASA-27 total score, but not of age of onset of SAD. CONCLUSIONS: BI has an onset in the very first years of life and may represent a potential developmental endophenotype for later anxiety disorders. Our findings indicate that BI and separation anxiety are connected in individuals with affective and anxiety disorders. This may have important clinical and therapeutic implications for preventive interventions.

Separation-related behavior of dogs shows association with their reactions to everyday situations that may elicit frustration or fear.

Separation related disorder in dogs is a multi-faceted phenomenon. Dogs can react to the absence of their owner due to different inner states such as fear, panic or frustration. We hypothesized that dogs that are prone to frustration or fearfulness in other contexts would show a different behavioral response to separation from the owner. We investigated the association between inner states in different contexts and separation behaviors by combining a questionnaire with a separation test. Fear-related questionnaire components were rather associated with whining and the absence of barking. Dogs that received higher scores in the demanding component of the questionnaire, which might be in association of the frustration threshold of the dog, barked more and were more likely to scratch the door. Finally, dogs that were more prone to phobic reactions whined somewhat more and tried to escape. We provide empirical support for the assumption that separation-related behavioral responses of dogs might be triggered by different emotions.

Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R).

Background: Developmental Trauma Disorder (DTD) has extensive comorbidity with internalizing and externalizing disorders distinct from posttraumatic stress disorder (PTSD). Objective: To replicate findings of DTD comorbidity and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD. Method: DTD was assessed by structured interview, and probable DSM-IV psychiatric disorders were identified with KSADS-PL screening modules, in a multi-site sample of 271 children (ages 8-18 years old; 47% female) in outpatient or residential mental health treatment for multiple (M = 3.5 [SD = 2.4]) psychiatric diagnoses other than PTSD or DTD. Results: DTD (N = 74, 27%) and PTSD (N = 107, 39%) were highly comorbid and shared several DSM-IV internalizing and externalizing disorder comorbidities. Children with DTD with or without PTSD had more comorbid diagnoses (M = 5.7 and 5.2 [SD = 2.4 and 1.7], respectively) than children with PTSD but not DTD (M = 3.8[SD = 2.1]) or neither PTSD nor DTD (M = 2.1[SD = 1.9]), F[3,267] = 55.49, p < .001. Further, on a multivariate basis controlling for demographics and including all potential comorbid disorders, DTD was associated with separation anxiety disorder, depression, and oppositional defiant disorder after controlling for PTSD, while PTSD was associated only with separation anxiety disorder after controlling for DTD. Both DTD and PTSD were associated with suicidality. Conclusions: DTD is associated with psychiatric comorbidity beyond that of PTSD, and DTD warrants assessment for treatment planning with children in intensive psychiatric services.

Antecedentes: El Trastorno por Trauma del Desarrollo (TTD) tiene una amplia comorbilidad con trastornos internalizantes y externalizantes distintos del trastorno de estrés postraumático (TEPT).Objetivo: Replicar los hallazgos de la comorbilidad del TTD y determinar si esta comorbilidad es distinta y se extiende más allá de las comorbilidades del TEPT.Método: Se evaluó el TTD mediante una entrevista estructurada, y se identificaron probables trastornos psiquiátricos del DSM-IV con módulos de detección KSADS-PL, en una muestra multicéntrica de 271 niños (de 8 a 18 años de edad; 47% mujeres) en tratamiento en salud mental ambulatorio o residencial por múltiples (M = 3,5 [SD = 2,4]) diagnósticos psiquiátricos distintos del TEPT o el TTD.Resultados: El TTD (N=74, 27%) y el TEPT (N=107, 39%) fueron altamente comórbidos y compartían varias comorbilidades de trastornos internalizantes y externalizantes del DSM-IV. Los niños con TTD con o sin TEPT tenían más diagnósticos comórbidos (M = 5,7 y 5,2 [SD = 2,4 y 1,7], respectivamente) que los niños con TEPT pero sin TTD (M = 3,8 [SD = 2,1]) o sin TEPT ni TTD (M = 2,1 [SD = 1,9]), F[3,267] = 55,49, p < .001. Además, en una base multivariante que controlaba los datos demográficos e incluía todos los posibles trastornos comórbidos, el TTD se asoció con el trastorno de ansiedad por separación, la depresión y el trastorno oposicionista desafiante después de controlar el TEPT, mientras que el TEPT se asoció sólo con el trastorno de ansiedad por separación después de controlar el TTD. Tanto el TTD como el TEPT se asociaron con suicidalidad.Conclusiones: El DTD se asocia con comorbilidad psiquiátrica más allá del TEPT, y el DTD justifica una evaluación para la planificación del tratamiento con niños en servicios psiquiátricos intensivos.

Separation Anxiety and Measures of Suicide Risk Among Patients With Mood and Anxiety Disorders.

BACKGROUND: Separation anxiety disorder may be important when considering risk of suicide. The aim of this study was to examine the association between both childhood and adult separation anxiety (disorder) and measures of suicide risk in a large cohort of outpatients with anxiety and mood disorders. METHODS: The sample included 509 consecutive adult psychiatric outpatients with DSM-IV mood disorders or anxiety disorders as a principal diagnosis recruited at the Department of Psychiatry, University of Pisa, Italy, between 2015 and 2018. Suicide risk was evaluated by the Hamilton Depression Rating Scale (HDRS) item 3. Patients were classified in 2 groups: those with a score ≥ 1 and those with a score of 0 on HDRS item 3. Suicide risk was also evaluated by specific items within the Mood Spectrum, Self-Report (MOODS-SR), a questionnaire evaluating lifetime suicidal symptoms. Separation anxiety (disorder) was assessed based on the Structured Interview for Separation Anxiety Symptoms in Adulthood/Childhood (SCI-SAS-A/C), the Separation Anxiety Symptom Inventory (SASI), and the Adult Separation Anxiety Scale (ASA-27). RESULTS: Of the 509 patients, 97 had an HDRS item 3 score ≥ 1, and 412 had a score of 0. Adult separation anxiety disorder was more frequent among individuals who had suicidal thoughts (53.6%) than those who did not (39.6%) (P = .01). Dimensional separation anxiety symptoms on all scales were elevated in patients with suicidality when compared to patients without (SASI: P = .02; SCI-SAS-C: P < .001; SCI-SAS-A: P < .001; ASA-27: P = .002). Logistic regression found that adult separation anxiety disorder (odds ratio [OR] = 1.86, 95% CI = 1.16-2.97), major depression (OR = 7.13, 95% CI = 3.18-15.97), bipolar I disorder (8.15, 95% CI = 3.34-19.90), and bipolar II disorder (OR = 8.16, 95% CI = 3.50-19.05) predicted suicidal thoughts. Linear regression found that depression (P = .001) and ASA-27 separation anxiety (P = .001) significantly predicted lifetime suicide risk. Mediation analysis found that separation anxiety significantly mediated the association between depression and suicide risk. CONCLUSIONS: This study indicates a substantial role of separation anxiety in predicting suicidal thoughts, both as state-related symptoms (evaluated by HDRS item 3) and as longitudinal dimensional symptoms (as evaluated by MOODS-SR). Greater understanding of the influence of separation anxiety in patients with affective disorders may encourage personalized interventions for reducing suicide risk.

Impact of preweaning stress on long-term neurobehavioral outcomes in Sprague-Dawley rats: Differential effects of barren cage rearing, pup isolation, and the combination.

Two developmental stressors were compared in preweaning rats exposed to either one stressor or both. Stressors were barren cage rearing or maternal separation (pup isolation). 40 gravid Sprague-Dawley CD/IGS rats were randomly assigned to two cage conditions: standard (Std) cage or barren cage (Bar), 20 litters/condition throughout gestation and lactation. After delivery, litters were randomly culled to 4 males and 4 females. The second stressor was maternal separation: Two male/female pairs per litter were isolated from their dam 4 h/day (Iso) and two pairs were not (Norm). Hence, there were 4 conditions: Std-Norm, Std-Iso, Bar-Norm, and Bar-Iso. One pair/litter/stress condition received the following: elevated zero-maze (EZM), open-field, swim channel, Cincinnati water maze, conditioned fear, and open-field with methamphetamine challenge. The second pair/litter/condition received the light-dark test, swim channel, Morris water maze, forced swim, and EZM with diazepam challenge. Barren rearing reduced EZM time-in-open, whereas isolation rearing reduced open-field activity in males and increased it in females. Effects on straight channel swimming were minor. In the Cincinnati water maze test of egocentric learning, isolation rearing increased errors whereas barren cage housing reduced errors in combination with normal rearing. Barren cage with maternal separation (pup isolation) increased Cincinnati water maze escape latency but not errors. Barren cage housing reduced hyperactivity in response to methamphetamine. Isolation rearing increased time in open in the EZM after diazepam challenge. Trends were seen in the Morris water maze. These suggested that barren cage and isolation rearing in combination reduced latency on acquisition on days 1 and 2 in males, whereas females had increased latency on days 2 and 3. Combined exposure to two developmental stressors did not induce additive or synergistic effects, however the data show that these stressors had long-term effects with some evidence that the combination of both caused effects when either stressor alone did not, but synergism was not observed.

AMBMP activates WNT pathway and alleviates stress-induced behaviors in maternal separation and chronic stress models.

Depressive disorders are both prevalent and debilitating, and a proportion of patients have treatment resistance to classic antidepressants. Recent evidence has implicated the intracellular WNT signaling pathway as having a key role in the pathogenesis of major depressive disorder. In the present study, we investigated the role of ß-catenin and transcription factor-4 (TCF4) in the depression-like and anxiety-like behaviors exhibited by mice exposed to maternal separation, or chronic mild stress. Both rodent models of childhood and adulthood stress showed depression and anxiety-like behaviors. During the last three weeks of medication, we applied AMBMP (2-Amino-4-[3,4- (methylenedioxy)benzylamino]-6-(3-methoxyphenyl)pyrimidine) to the maternal separation and chronic stress model for the first time. The drug alleviated the depression-like index in saccharin preference test (SPT) and forced swim test (FST), and anxiety-like index in open field test (OFT) and elevated-plus maze (EPM), and reversed the disruption of ß-catenin and TCF4 in stressed mice by upregulating the WNT pathway specifically. Therefore, the WNT pathway may be involved in the mediation of patient recovery and could be a target for novel antidepressants.

Internet-delivered cognitive behavior therapy with minimal therapist support for anxious children and adolescents: predictors of response.

BACKGROUND: In general, Internet-delivered cognitive behavior therapy (iCBT) produces significant reductions in child and adolescent anxiety, but a proportion of participants continue to show clinical levels of anxiety after treatment. It is important to identify demographic, clinical, and family factors that predict who is most likely to benefit from iCBT in order to better tailor treatment to individual needs. METHODS: Participants were 175 young people (7-18 years) with an anxiety disorder, and at least one of their parents, who completed an iCBT intervention with minimal therapist support. Multilevel modeling (MLM) examined predictors of response to iCBT as measured by the slope for changes in the primary outcome measures of child- and parent-reported anxiety scores, from pretreatment, to 12-weeks, 6-month, and 12-month follow-ups, controlling for pretreatment total clinician severity ratings of all anxiety diagnoses. RESULTS: Child age, gender, father age, parental education, parental mental health, parenting style, and family adaptability and cohesion did not significantly predict changes in anxiety in the multivariate analyses. For child-reported anxiety, greater reductions were predicted by a separation anxiety disorder diagnosis (SEP) and elevated depression, with lower reductions predicted by poor couple relationship quality. For parent-reported child anxiety, greater reductions were predicted by higher pretreatment total CSRs, SEP, and lower family income, with lower reductions for children of older mothers. Irrespective of these predictors of change, children in general showed reductions in anxiety to within the normal range. CONCLUSIONS: Overall, children responded well to iCBT irrespective of the demographic, clinical, and family factors examined here. Poor couple relationship quality and older mother age were risk factors for less positive response to iCBT in terms of reductions in anxiety symptoms although still to within the normal range.

How does a CBT-based transdiagnostic program for separation anxiety symptoms work in children?: effects of Super Skills for Life / ¿Es eficaz un programa transdiagnóstico basado en TCC para los síntomas de ansiedad por separación infantil? Resultados del programa Super Skills

Super Skills for Life (SSL) is a transdiagnostic program of Anglo-Saxon origin based on cognitive behavioural therapy, aimed at treating emotional problems in children. It has been translated and implemented in the Spanish population, achieving significant reductions in anxious and depressive symptoms. The objective of the current study was to examine the short- and long-term efficacy of SSL in schoolchildren with separation anxiety. The program was attended by 86 Spanish-speaking children aged 8-12 years, who were evaluated before receiving the intervention, immediately after and 12 months later. Results indicated statistically significant improvements both in the main problem, separation anxiety and other comorbid symp-toms or problems (depression, behaviour problems, problems with peers, interference of anxiety in daily life, etc.). Overall, the results show that the program was more effective in the long-term than in the short-term. The findings of the study suggest that SSL can be useful for treating emotional problems in children with separation anxiety. Clinical implications of these findings are discussed

Super Skills for Life (SSL) es un programa transdiagnóstico de origen anglosajón basado en la terapia cognitiva conductual, dirigido a tratar problemas emocionales infantiles. Se ha traducido e implementado en población española, logrando reducciones significativas en síntomas de ansiedad y depresión. El objetivo del presente estudio fue examinar la eficacia a corto y largo plazo de SSL en escolares con ansiedad por separación. Participaron 86 niños hispanohablantes de 8 a 12 años, que fueron evaluados antes de recibir la intervención, inmediatamente después y 12 meses después. Los resultados indicaron mejoras estadísticamente significativas tanto en el problema principal, la ansiedad por separación, como en otros síntomas o problemas comórbidos (depresión, problemas de comportamiento, problemas con los compañeros, interferencia de ansiedad en la vida diaria, etc.). En general, los resultados muestran que el programa fue más efectivo a largo plazo que a corto plazo. Los hallazgos del estudio sugieren que SSL puede ser útil para tratar problemas emocionales en niños con ansiedad por separación. Se discuten las implicaciones prácticas de estos hallazgos

Hypothalamus-pituitary-adrenal axis imbalance and inflammation contribute to sex differences in separation- and restraint-induced depression.

Whether social contact contributes to the underlying mechanisms of depression and the observed sex differences is unclear. In this study, we subjected young male and female mice to separation- and restraint-induced stress for 4 weeks and assessed behaviors, neurotransmitter levels, hormones, and inflammatory cytokines. Results showed that, compared with controls, male mice exposed to stress displayed significant decreases in body weight and sucrose preference after 1 week. In the fourth week, they exhibited a higher degree of anxiety (open field test) and depressive-like behavior (forced swim test). Moreover, the males showed significant decreases in monoamine neurotransmitters, including norepinephrine and dopamine in striatum, and an increase in pro-inflammatory cytokines, such as tumor necrosis factor α and interleukin 1ß in serum. In contrast, females showed persistent loss of weight during stress and displayed significant decreases in sucrose preference after stress. Importantly, the females but not males showed activation of the hypothalamus-pituitary-adrenal (HPA) axis, with significantly higher levels adrenocorticotropic hormone. Additionally, mRNA level of c-fos and AVP showed there was significant interaction between stress and sex. Finally, we conclude that an imbalance of the HPA axis and inflammation might be important contributors to sex differences in separation/restraint-induced depressive behavior and that changes might be mediated by c-fos and AVP.

A neurobiological framework of separation anxiety and related phenotypes.

In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.

Internal structure and measurement invariance of the Dominic Interactive among Indigenous children in Quebec.

This study aims to examine the reliability and validity of the French version of the Dominic Interactive screening tool (Valla, 2008) among Indigenous children in Quebec. The Dominic Interactive is a computerized screening tool, which assesses prevalent emotional and behavioral problems in children. Participants in this study were 195 Innu Nation children aged between 8 and 11 years. Statistical analyses were performed on each of the 7 scales of the Dominic Interactive to assess reliability, factor structure, and measurement invariance across boys and girls. Results show satisfactory reliability (ranging from αtet = .83 to .94 and from ω = .84 to .95) for 5 out of the 7 scales scores. Separation Anxiety and Specific Phobias scales failed to show adequate reliability. Confirmatory factor analyses confirm the 1-factor structure for Opposition and Conduct Problems scales (root mean square error of approximation, RMSEA ≤ .05; comparative fit index, CFI ≥ .95). Within an exploratory framework, confirmatory factor analyses also show good fit indices of relaxed models for Inattention/Hyperactivity/Impulsivity, Depression, and Specific phobias, admitting some error correlations. Generalized anxiety had poorer model fits; factor structure is not confirmed for this scale. The Separation anxiety construct appears to be better described by a 2-factor structure than by the postulated 1-factor structure. Measurement invariance between boys and girls was sufficiently supported for most of the scales, except for Specific Phobias. Therefore, results demonstrate promising reliability and validity for scales evaluating behavioral problems and depressive symptoms, but further research is still needed to determine the generalizability of these exploratory results in Indigenous populations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Ambiguous Loss in Transnational Families' Adolescents: An Exploratory Study in Ecuador.

In psychosocial migration literature, the perspective of ambiguous loss has been relevant to articulate personal and relational experiences in the context of transnational families and ongoing separation. Most studies have focused on adult members' experiences of transnational families, but research exploring ambiguous loss in adolescents whose parents have migrated is still lacking. The present study aimed to explore adolescents' lived experiences of parental migration. In a pilot explorative study, 14 adolescents with at least one parent who migrated were interviewed about their lived experiences of transnational parent-child relationships and ongoing parent-child separation. Data analysis identified four themes in participants' accounts: practices of separation creating confusion; current relationship with migrant parents permeated by ambiguity; distrustful representations of migrant parents; and family and social dynamics reactivating the pain of loss. The findings reveal how in the context of parental migration, patterns of separation and ongoing relational processes, compounded by the uncertainty of reunification and an exclusionary social fabric, constitute core elements that shape adolescents' lived experiences of parent-child relationships characterized by ambiguity.

En la bibliografía sobre las consecuencias psicosociales de la migración, la perspectiva de la pérdida ambigua ha sido relevante para expresar las experiencias personales y relacionales en el contexto de las familias transnacionales y la separación constante. La mayoría de los estudios se han centrado en las experiencias de los miembros adultos de las familias transnacionales, pero aun faltan investigaciones que analicen la pérdida ambigua en los adolescentes cuyos padres han emigrado. El presente estudio tiene como finalidad analizar las vivencias de los adolescentes de padres migrantes. En un estudio piloto exploratorio, se entrevistó a 14 adolescentes con al menos un padre que emigró acerca de sus vivencias con respecto a las relaciones transnacionales entre padre e hijo y la separación constante entre padre e hijo. Los análisis de datos identificaron cuatro temas en los informes de los participantes: las prácticas de separación que generan confusión; la relación actual con los padres emigrantes impregnada por la ambigüedad; las representaciones desconfiadas de los padres emigrantes; y la dinámica familiar y social que reactiva el dolor de la pérdida. Los resultados revelan cómo, en el contexto de la migración parental, los patrones de separación y los procesos relacionales constantes, agravados por la incertidumbre de la reunificación y una estructura social exclusivista, constituyen elementos fundamentales que moldean las vivencias de los adolescentes en las relaciones entre padres e hijos caracterizadas por la ambigüedad.

Rejection Sensitivity and Borderline Personality Disorder Features: The Mediating Roles of Attachment Anxiety, Need to Belong, and Self-Criticism.

Rejection hypersensitivity has been considered the core feature of patients with borderline personality disorder (BPD). However, little is known about the possible developmental mechanisms that might explain the association between rejection sensitivity and BPD features. The current study investigated the mediating roles of adult attachment, need to belong, and self-criticism in the association between rejection sensitivity and BPD features in 256 healthy adults. Results indicated that attachment anxiety, need to belong, and self-criticism mediated the association between rejection sensitivity and BPD features. However, attachment anxiety and self-criticism did not moderate the mediated association between rejection sensitivity and BPD features. The findings suggest that individuals with high rejection sensitivity are more likely to be anxiously attached to significant others, which might increase the desire to be accepted by others. To satisfy this elevated need to affiliate with others, these individuals might become more self-critical, which may contribute to high BPD features.

Exposure to early life adversity alters the future behavioral response to a stressful challenge in BALB/C mice.

Depression is considered as a maladaptive response to stress in adult life. Exposure to stress in early childhood is recognized as a risk factor for being unable to adapt to environmental changes in adult life. Early life stress (ELS) has been modelled in animals to help understand the behavioral outcome of the adversity. Periodic maternal separation (MS) in rodents for the first two weeks of life is one such model. We used MS as a form of ELS in Balb/c mice to study its effect on a stressful challenge encountered in adult life. According to our results, exposure to MS predisposed mice to an altered behavioral response. However, this response was not worsened by exposure to restraint stress (RS) experienced in early adult life. This controversy may be attributed to methodological and biological variations among animals as well as humans.

The characteristics of the comorbidity between social anxiety and separation anxiety disorders in adult patients.

Objective: In the present study, we compared social anxiety disorder (SAD) patients with (n = 31) and without childhood and adulthood separation anxiety disorder (SeAD) (n = 50) with respect to suicidal behavior, avoidant personality disorder (AvPD), other anxiety disorders (ADs), and major depression as well as some sociodemographic variables. Methods: In assessment of patients, we used Structured Clinical Interview for Separation Anxiety Symptoms, childhood and adulthood Separation Anxiety Symptom Inventories, Liebowitz Social Anxiety Scale, The SCID-II Avoidant Personality Disorder Module, Beck Depression Inventory, and Beck Scale for Suicidal Ideation. Results: SAD patients with SeAD had higher comorbidity rates of AvPD, other lifetime ADs and panic disorder, and current major depression than those without SeAD. The current scores of SAD, depression, and suicide ideation and the mean number of AvPD symptoms were significantly higher in comorbid group compared to pure SAD subjects. The SAD and SeAD scores had significant associations with current depression, suicide ideations, and AvPD. The mean number of AvPD criteria and the current severity of depression were significantly associated with the comorbidity between SAD and SeAD. Conclusion: Our findings might indicate that the comorbidity of SeAD with SAD may increase the risk of the severity of AvPD and current depression.

Assessing anxiety symptoms in children: Agreement between parents and children.

Assessment of anxiety disorders in children is a difficult process and requires the use of multiple resources of information. Such resources may come from children, parents, and educators and they also require the use of multiple types of diagnostic tools, like structured and semi-structured clinical interviews, as well as self-report questionnaires. Previous research shows that anxiety symptoms ratings of different informants are to some degree correlated (low to moderate agreement) but nonetheless also often show clear discrepancies. Important variables may affect the degree of child-parent agreement. The present study focused on child's gender and age possible impact. The aim of the present study was to examine the agreement between children's and parents' reports on self-reported questionnaires for anxiety symptoms. 431 children from 4th to 6th grade of elementary school and their parents participated in the study. 190 were boys and 241 were girls. Both children and their parents responded to Spence Children's Anxiety Scale (SCAS) (child's and parent's version correspondingly). Relations between children's and parents' reports concerning anxiety symptoms were examined by calculation Pearson's correlation coefficients. The results showed that there was a medium but statistically important positive correlation between children's and parents' reports on SCAS total score (r=0.50, p<0.01). Concerning SCAS subscales results supported that higher correlations were those reported for Separation Anxiety (r=0.53, p<0.01) and Fear of Physical Injury (r=0.55, p<0.01). Concerning gender differences the present study found that correlation coefficients for girls were higher than for boys in SCAS total score (r=0.57 and r=0.39 correspondingly, p<0.01). Correlations according to age showed that the highest correlation coefficients were found in comparatively older children (r=0.34, r=0.54 και r=0.63, p<0.01 for 4th, 5th and 6th Grade). The latter underlies that in the process of assessing and diagnosing anxiety disorders in children, it is both necessary and important to gather information from multiple sources, especially in cases of younger children.