Elucidating the Roles of Maternal Overcontrol and Warmth in the Development of Childhood Anxiety and Depression: A Moderated Mediation Framework.

Studies have linked childhood anxiety and depression with parenting characterized by high control and low warmth. However, few studies have examined how control and warmth may work together to influence internalizing symptoms in children. Therefore, the goal of this study was to examine the moderating effect of warmth on the relationship between overcontrol and anxiety and depressive symptoms, as well as whether negative thoughts serve as a mediator of these pathways. A total of 182 fourth and fifth grade children completed measures of maternal parenting behavior, negative thoughts, and anxiety and depressive symptoms. Results showed an interaction between overcontrol and warmth for depressive but not anxiety symptoms. Furthermore, low warmth increased the strength of the mediating relationship between overcontrol and depression via thoughts of personal failure. Findings may signal a need for early interventions to address parenting behaviors, such as controlling behaviors, in parents of children at risk for internalizing difficulties.

Youth Temperament Moderates Associations Between Parental Involvement and Pediatric Type 1 Diabetes Treatment Outcome.

OBJECTIVE: Both youth self-regulation and quality of parental involvement have been associated with blood glucose levels (HbA1c) of youth with type 1 diabetes mellitus (T1DM). However, it is unclear whether and how youth and parental factors interact in their relation to youth HbA1c. The differential susceptibility hypothesis proposes that youth with high negative affectivity (NA) and low effortful control (EC) may be more susceptible to the deleterious impact of lower quality parenting behaviors but also reap greater benefit from higher quality parenting behaviors. This study investigated whether youth temperament would moderate the link between diabetes-specific parental assistance (e.g., checking blood sugar) or support (e.g., encouraging, praising) and HbA1c among youth with T1DM. METHODS: Primary caregivers of youth with T1DM (N = 101; M age = 12.02, SD = 2.43) completed surveys on diabetes-specific parental involvement and youth temperament. Medical information (i.e., HbA1c) was obtained from chart review. RESULTS: Multiple regression analyses indicated that youth NA and EC significantly interacted with parental assistance, but not support. Specifically, higher parental assistance was associated with higher HbA1c among youth with high NA or high EC. High assistance was only linked to lower HbA1c for youth with low NA. CONCLUSIONS: Results suggest that optimal levels of parental involvement related to better T1DM outcomes depend on youth's NA or EC. Consistent with the goodness-of-fit framework, when parenting approaches match youth's temperament, youth with T1DM may be better able to maintain lower HbA1c. Family interventions for pediatric T1DM management may take into consideration youth temperament.

Discrimination and depressive symptoms among Black and Asian American college students: Shared and group-specific processes of self-concept.

OBJECTIVES: Black and Asian American emerging adults are at higher risk of experiencing racial/ethnic discrimination and related distress. Racial/ethnic discrimination may increase vulnerability for depressive symptoms by diminishing individuals' positive self-concept. While low global self-esteem has been noted as a crucial process linking discrimination and depressive symptoms, it is unclear if it plays a unique role beyond other relevant aspects of one's self-concept: racial/ethnic private regard and centrality. Moreover, although different racial/ethnic groups are known to experience discrimination in distinctive ways, little is known about how relative processes of self-esteem and racial/ethnic identity may differ across these groups. We investigated the generalizability and specificity of discrimination to distress linkages across Asian and Black Americans. METHOD: Undergraduate Black (N = 109) and Asian American (N = 90) students self-reported racial/ethnic discrimination, depressive symptoms, and self-concept. RESULTS: Global self-esteem indirectly linked the association between discrimination and depressive symptoms among Black Americans beyond the effects of racial/ethnic identity. Only among Black Americans, discrimination was associated with lower private regard. CONCLUSIONS: Finding highlight group-specific processes underlying Black and Asian Americans' experiences of discrimination and depressive symptoms. Findings also demonstrate shared processes of discrimination-depressive symptoms linkage across groups and underscore the need to address the pervasive issues of racism and discrimination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Mediated Moderation Model of Depressive Symptoms, Alcohol Use, and Consequences: The Protective Role of Executive Function.

BACKGROUND: Heavy episodic drinking (HED) and negative drinking consequences represent prevalent and serious health concerns for college students. Depressive symptoms may elevate students' risk for engaging in HED and experiencing negative consequences, but levels of risk may vary by executive function (EF) capabilities. Growing evidence suggests that EF deficits are associated with comorbid depressive symptoms and alcohol misuse. Nevertheless, little is known about unique and shared risks that depressive symptoms and EF may interactively pose for HED and negative drinking consequences. Methods: To address these gaps, the study assessed depressive symptoms, multiple domains of EF via multimethod approach, HED, and negative drinking consequences in a sample of 446 undergraduate students. Mediated moderation models were conducted to examine associations between depressive symptoms and alcohol use behaviors and modulating roles of EF. Results: Depressive symptoms, poor planning, and self-reported executive dysfunction were significantly associated with HED and negative drinking consequences. HED mediated the effect of depressive symptoms and executive dysfunction on negative consequences. A significant interaction indicated that better EF (i.e. low or average self-reported executive dysfunction) may buffer the risk depressive symptoms present for negative drinking consequences. Conclusions: The current findings suggest that among college students, risk and resilience factors for HED and negative drinking consequences may vary. Effective EF capabilities may be especially helpful for reducing students' risk for more serious drinking consequences.

The role of anticipated regret and health beliefs in HPV vaccination intentions among young adults.

Although cognitions have predicted young adults' human papillomavirus (HPV) vaccine decision-making, emotion-based theories of healthcare decision-making suggest that anticipatory emotions may be more predictive. This study examined whether anticipated regret was associated with young adults' intentions to receive the HPV vaccine above and beyond the effects of commonly studied cognitions. Unvaccinated undergraduates (N = 233) completed a survey assessing Health Belief Model (HBM) variables (i.e., perceived severity of HPV-related diseases, perceived risk of developing these diseases, and perceived benefits of HPV vaccination), anticipatory emotions (i.e., anticipated regret if one were unvaccinated and later developed genital warts or HPV-related cancer), and HPV vaccine intentions. Anticipated regret was associated with HPV vaccine intentions above and beyond the effects of HBM variables among men. Among women, neither anticipated regret nor HBM variables showed consistent associations with HPV vaccine intentions. Findings suggest that anticipatory emotions should be considered when designing interventions to increase HPV vaccination among college men.

Differential Contributions of Parental Warmth and Mindfulness to Child Executive Function and Pediatric Type 1 Diabetes Management.

OBJECTIVE: Positive parenting (e.g., parental warmth, mindful parenting) has been posited to promote effective pediatric type 1 diabetes mellitus (T1DM) management. This promotive effect may partly be conferred by fostering child self-regulatory development, such as executive function (EF). However, no research has examined whether better child EF serves as a mechanism underlying associations between positive parenting and child blood glucose levels (HbA1c). Moreover, it is unclear whether mindful parenting offers a unique benefit beyond that of parental warmth-a key pillar of effective parental involvement in T1DM management. METHODS: Primary caregivers of children with T1DM (N = 101; Mage = 12.02) reported on parenting behaviors and child EF. Children's medical information was obtained through chart review. Path analysis was used to examine direct and indirect relations in the cross-sectional data. RESULTS: The path analysis indicated that only parental warmth, not mindful parenting, was significantly associated with lower HbA1c. Both parental warmth and mindful parenting were significantly related to better child EF, but child EF did not mediate the associations between parenting and HbA1c. CONCLUSION: Parental warmth may constitute a key parenting behavior promoting effective pediatric T1DM management. Enhancing parental warmth may be an important target of interventions aiming to improve HbA1c. Although child EF was unrelated to HbA1c in this sample, given positive associations between parental warmth and mindfulness and child EF, longitudinal research is warranted to examine whether these positive parenting behaviors may confer long-term benefits for T1DM self-management through improved EF.

Stressful life events and the tripartite model: relations to anxiety and depression in adolescent females.

Although the tripartite model reliably distinguishes anxiety and depression in adolescents, it remains unclear how negative affectivity (NA) and positive affectivity (PA) influence developmental pathways to internalizing problems. Based on models which propose that affectivity shapes how youth react to stress, the present study attempted to investigate the relative roles of NA, PA, and stressful life events in characterizing and differentiating adolescent anxiety and depression. A sample of adolescent females (N=63), including a sub-sample of adolescent mothers, completed measures of NA, PA, negative life event (NLE) occurrence, anxiety, and depression. Findings supported the tripartite model as a "temperamental reactivity to stress" approach. Anxious and depressive symptoms were predicted by a combination of high NA and high NLE occurrence. However, a combination of low PA and high NLE occurrence was uniquely linked to greater depressive symptoms. Implications of these findings for early identification and prevention programs are discussed.

Children's anxious reactions to an invasive medical procedure: The role of medical and non-medical fears.

This study investigated the relationship of medical and non-medical fears to children's anxiety, pain, and distress during an invasive medical procedure, the voiding cystourethrogram. Parents of 34 children completed the Fear Survey Schedule-II prior to their child's procedure. Child distress behaviors during the procedure were audiotaped and coded using the Child-Adult Medical Procedure Interaction Scale-Revised. Ratings of child procedural anxiety and pain were obtained from children, parents, and examining technologists within minutes following the procedure. Associations were observed between medical fears, procedural anxiety (parent and staff reports), and coded distress behaviors. Findings may inform preparation efforts to reduce anxiety around invasive medical procedures.

Psychosocial factors contributing to inflammatory bowel disease activity and health-related quality of life.

OBJECTIVE: This study aimed to examine the contributions of coping and social constraint to disease activity and health-related quality of life (HRQOL) and to examine group differences in disease activity and HRQOL between patients with high versus low anxiety or depression symptoms in adults with inflammatory bowel disease (IBD). METHODS: This study was a retrospective analysis in which disease activity was measured with either the Harvey-Bradshaw Index or the Simple Clinical Colitis Activity Index. HRQOL was measured with the Short Inflammatory Bowel Disease Questionnaire. Coping was measured with a modified COPE questionnaire. Anxiety and depression symptoms were measured with the Hospital Anxiety and Depression Scale. Social constraint was measured with the Social Constraint Questionnaire. Correlational and regression analyses were performed to assess the relationships between social constraint, coping, anxiety symptoms, depression symptoms, and HRQOL and disease activity. RESULTS: Data from 80 adults with IBD were reviewed. Social constraint, disengagement coping, anxiety symptoms, and depression symptoms were inversely correlated with HRQOL. Disengagement coping was positively correlated with disease activity. Regression analyses showed that smokers had significantly worse HRQOL than nonsmokers and that greater use of engagement coping was associated with significantly diminished HRQOL. Regression analyses also showed that patients diagnosed between 17 and 40 years of age were significantly less likely to have active disease than patients diagnosed before 16 years of age and that greater use of disengagement coping was associated with increased odds of having active disease. CONCLUSIONS: Medical providers should be aware that coexisting social constraint and symptoms of anxiety and depression are common in patients with IBD. Screening for these factors, as well as patients' coping styles, should be strongly considered, and patients should be referred to mental health providers as appropriate.

Is parental anxiety and coping associated with girls' distress during a VCUG? Preliminary findings.

PURPOSE: We investigated the relationship between parental anxiety/coping strategies and girls' distress during VCUGs. METHODS: Parents of 32 girls (age 4-10, mean 5.8 years) completed a trait anxiety measure and a measure of parental reactions to children's distress. Post procedure, children, parents and radiology staff rated the level of anxiety, fear, pain and discomfort. RESULTS: Trends indicated that parents who reported increased anxiety rated their children as experiencing increased distress (r = 0.27, p = 0.071), similarly for medical staff ratings (r = 0.28, p = 0.061). Parents with lower trait anxiety scores reported using more emotion- and problem-focused coping strategies (r = -0.37 and r = -0.40, p < 0.05, respectively). These were related to children experiencing less procedural distress (r = -0.30, p = 0.054; r = -0.33, p = 0.037, respectively) and parents rated as less anxious by staff (r = -0.40, p = 0.014; r = -0.31, p = 0.047, respectively). CONCLUSIONS: There was a trend toward parental anxiety being related to their child's distress during VCUG. Parental coping strategies resulted in less distress among children and parents. Teaching coping techniques might obviate the need for sedation and help children deal with future stressors.

The effects of anticholinergic drugs on attention span and short-term memory skills in children.

AIMS: Studies have shown cognitive problems in adults treated with anticholinergics. It is unclear if children are also susceptible to anticholinergic adverse effects. This study evaluates the effects of long-acting oxybutynin and tolterodine on short-term memory and attention in children with urgency and urge incontinence. METHODS: Children with urgency or urge incontinence were recruited to take part in a prospective, randomized double-blinded placebo controlled trial using long-acting oxybutynin or tolterodine. Patients underwent a baseline test of their memory/recall ability and attention span using a standardized developmental/neuropsychological assessment tool. They were then randomized to either medication or placebo with retesting in 2 weeks, at which time they were crossed. They were retested after the second 2 weeks. RESULTS: Fourteen children (9 boys and 5 girls), ranging in age from 5 to 11 (M = 7.7) participated in the study. Attention and memory scores increased over time in all children, however, the analyses showed no significant negative effects of anticholinergic medications on attention or memory. Indeed, though not statistically significant, trends were for improvement in test scores in both areas. CONCLUSIONS: Our results in a double blinded cross-over trial suggest that long-acting oxybutynin and tolterodine do not have a deleterious effect on children's attention and memory. Other cognitive functions may be affected.