Developmental differences in the linkages between anxiety control beliefs and posttraumatic stress in youth.

BACKGROUND: Anxiety control beliefs have emerged as a trans-diagnostic risk factor for anxiety disorders and a potential mechanism of change in cognitive and behavioral therapies. The purpose of this study was to examine the association between anxiety control beliefs and anxiety disorder symptoms following exposure to hurricanes in youth and test a developmental hypothesis about those associations. METHODS: A large school-based sample of (N = 1048) children and adolescents with a history of exposure to natural disaster were assessed with the short form of the Anxiety Control Questionnaire for Children (ACQ-C), symptom measures (PTSD and generalized anxiety disorder symptoms) and level of disaster exposure. Developmental differences in the association between ACQ-C scores and symptoms were tested, as well as the ACQ-C's ability to assess symptoms beyond level of exposure. RESULTS: ACQ-C scores were associated with symptoms beyond level of exposure, but age moderated the strength of the association. Modeling the interaction suggested that the ACQ-C short had incremental validity beyond hurricane exposure in youth over 12 years. CONCLUSIONS: Findings extend previous work to a novel population of youth and add to the developmental understanding of the role of anxiety control beliefs in anxiety regulation. Age differences in the linkages between anxiety control and symptoms is consistent with a developmental model where low perceived control exhibited by younger children may be less indicative of problems with anxiety but may instead be related to normal cognitive development.

Fitting anxious emotion-focused intervention into the ecology of schools: results from a test anxiety program evaluation.

Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.

Is T.V. traumatic for all youths? The role of preexisting posttraumatic-stress symptoms in the link between disaster coverage and stress.

In youths, watching T.V. coverage of a disaster is associated with traumatic-stress symptoms. However, the role of predisaster symptoms in this link has not been addressed. In this study, urban-school youths who had experienced both Hurricanes Katrina and Gustav (N = 141; grades 4-8) were assessed 12 months and 6 months before Gustav and then 1 month after Gustav. The amount of T.V. viewing was associated with post-Gustav stress symptoms, controlling for pre-Gustav symptoms. However, pre-Gustav stress symptoms interacted with T.V. viewing in predicting post-Gustav symptoms such that for youths with higher preexisting symptoms, there was a stronger association between T.V. viewing and level of post-Gustav symptoms. The results advance the literature on the role of media coverage in stress reactions by showing that preexisting symptoms can be an important component of identifying which children are likely to be most negatively affected by TV coverage.

Anxiety, hostile attributions, and differences in heart rate response to ambiguous situational vignettes in adolescents.

Theoretically, subjective levels of anxiety and hostile attributions of intent may affect physiological responding to ambiguous social situations. This study examined youths' (n = 80 aged 11-17 years; 51% female; 37.5% African American) physiological responding (i.e., heart rate [HR]) to a series of animated vignettes depicting ambiguous social situations. Anxiety, aggression, hostile attributional bias (HAB), and their interactions were tested as predictors of differential physiological responding to the vignettes. Results indicated that there was differential physiological responding to the vignettes such that, as predicted, participants' hearts rates showed a pattern of deceleration followed by acceleration, similar to a threat response. There was support for elevated anxiety as a significant predictor of responses, but only among those participants with higher levels of HABs such that HRs remained elevated with very little deceleration across time. These results suggest a pattern of physiological hyperarousal and blunted reactivity for those with high anxiety and HABs indicating that that youths' interpretation of a situation may interact with subjective levels of anxiety to predict heart rate responses. (PsycINFO Database Record

Family and peer social support and their links to psychological distress among hurricane-exposed minority youth.

Experiencing a disaster such as a hurricane places youth at a heightened risk for psychological distress such as symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Social support may contribute to resilience following disasters, but the interrelations of different types of support, level of exposure, and different symptoms among youth is not well understood. This study examined associations among family and peer social support, level of hurricane exposure, and their links to psychological distress using both a large single-time assessment sample (N = 1,098) as well as a longitudinal sample followed over a 6-month period (n = 192). Higher levels of hurricane exposure were related to lower levels of social support from family and peers. Higher levels of family and peer social support demonstrated both concurrent and longitudinal associations with lower levels of psychological distress, with associations varying by social support source and psychological distress outcome. Findings also suggested that the protective effects of high peer social support may be diminished by high hurricane exposure. The results of this study further our understanding of the role of social support in hurricane-exposed youths' emotional functioning and point to the potential importance of efforts to bolster social support following disasters.

Memories of traumatic events in childhood fade after experiencing similar less stressful events: results from two natural experiments.

The long-term stability of youth reports of traumatic events is largely unknown. Translational animal research suggests that there may be an alteration of memories for traumatic events via memory reconsolidation processes, whereas clinical research suggests memory alteration may occur through augmentation by negative emotions. In this report, 2 natural experiments test reconsolidation model and augmentation model predictions about the course of traumatic memories in youth. Data are from 2 prospective studies that assessed reports of an initial traumatic event (Hurricane Katrina) and tested recall both pre and post a similar event (Hurricane Gustav). In the 1st (Sample 1; n = 94, initial Grade 9 followed to 11), youth were assessed at 4 time points: Times 1-3 were 13, 20, and 26 months post-Katrina and then Time 4 was 5 months post-Hurricane Gustav. In the 2nd (Sample 2; n = 141, Grades 4 through 8), youth were assessed at 12 months pre-Gustav (Time 1; 24 months post-Katrina) and then again at 1 month (Time 2) and 8 months (Time 3) post-Gustav. Those with relatively high Gustav exposure showed more stability in their reports of Katrina exposure events, whereas in those with low Gustav exposure, reports of Katrina events decreased. Time spans between recall, age, gender, symptoms of posttraumatic stress disorder, or cognitive/learning ability did not explain changes in the reports. The study provides the 1st long-term data on the consistency of youth reports of disaster-related experiences and provides initial evidence for the ecological validity of memory reconsolidation theory applied to traumatic events in youth.

Identity Distress among Youth Exposed to Natural Disasters: Associations with Level of Exposure, Posttraumatic Stress, and Internalizing Problems.

Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent PTSD symptoms may negatively impact identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. The purpose of this study was to examine these relationships in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. Finally, PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and add to the extant knowledge about identity distress by providing data on the linkages between disaster exposure, posttraumatic stress and internalizing problems in adolescents.