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This study aimed: (1) to identify heterogeneous trajectories of anxiety symptoms in early adolescence; (2) to analyze the relationships between risk factors and identified trajectories; (3) to study the association between anxiety symptom trajectories and depression symptom course. Anxiety and depressive symptoms of 825 participants (44.40% boys; mean initial age = 13.01, SD = 0.56) was assessed every 6 months over an 18-month period. Trajectory identification relied on latent-variable approach. As a result, 2-4 trajectories were identified for social phobia (SP), generalized anxiety (GA) and panic symptoms, revealing at least a low-symptom course and a trajectory of elevated symptoms (at-risk trajectory). Being girl and sibling cohabitation were related to at-risk trajectories, and a course of low effortful control and heightened negative affectivity. Finally, SP and GA symptoms were related to heightened depressive symptom courses. Relevant implications towards tailored prevention and intervention are highlighted to promote a healthy development across adolescence.

Background: The long-term trajectory of depressive symptoms has a heterogeneous pattern. Identifying factors associated with different trajectories and outcomes may have important theoretical and clinical implications. This study explored patterns of depressive symptom trajectory from adolescence to adulthood, and their relationship with subsequent psychiatric disorders., Method: A sample of 816 participants (58.8% girls; M = 16.58 years old at baseline, SD = 1.21) from a large community sample were interviewed four times during adolescence and adulthood. Depressive symptoms were also assessed. Symptom trajectory identification was based on latent class mixed modeling. Logistic regression was used for predicting emotional and drug use disorder over age 30., Results: Three trajectories of depressive symptoms were identified: "decreasing symptom" (decreasing trajectory of symptoms; 15.1% of participants), "increasing symptom" (initially decreasing pattern of symptoms and then increasing; 6.1% of participants), and "normative symptom" (consistently low symptom levels; 78.8% of participants). Predictors of the increasing symptom trajectory were high level of loneliness and state anxiety, presence of an emotional disorder, and low involvement in physical exercise at baseline. This trajectory membership predicted the development of anxiety disorders over age 30. Predictors of the decreasing symptom class were being female and high level of worry at baseline., Conclusions: Long-term trajectories of depressive symptoms are heterogeneous, with each trajectory having different predictors and are associated with different outcomes during adulthood., (© 2020 The Authors. Depression and Anxiety published by Wiley Periodicals LLC.)

Background and Objectives: Negative cognitive emotion regulation (ER) strategies are particularly important within the framework of anxiety problems amongst youths and how they cope with stressful events. The aim of this study was to examine the associations between both negative and positive ER style and cardiac regulation under stressful conditions., Design: Eighty-nine adolescents (M = 13.31 years, SD = 0.68, 44.94% girls) were exposed to a socially relevant stress induction protocol., Methods: Participants' emotion regulation strategies were assessed and their cardiac function was recorded., Results: A negative ER style predicted heart rate (HR) entropy at the stressful stage after controlling for anxiety scores. In addition, heart rate variability reactivity and recovery and HR entropy recovery were larger ( p  < .05) in the low negative ER style group ( n  = 16) than in the high negative ER style group ( n  = 23)., Conclusions: Results suggest that individuals with a highly negative ER style have diminished autonomic flexibility.

The risk of suffering anxiety disorders is associated with sustained subthreshold symptoms of anxiety. This study evaluated the stability of anxiety scores (high, moderate or low) across a six-month period in early adolescents (N = 95). The associations between sustained anxiety, vagally-mediated heart rate variability (vmHRV), sympathetic activity, and heart rate fractal dynamics in everyday life conditions were analyzed. The anxiety scores from 71.50% of participants remained at the same level. The linear correlations between anxiety and cardiac measures were weak but a group-based approach revealed that the fractal dimension (FD) from stable-low anxiety participants was higher than the FD from participants with stable-moderate anxiety scores but not higher than the FD from the stable-high anxiety group. The short-term correlations' exponent a1 from the stable-high anxiety group was higher than the a1 from the stable-moderate anxiety group but not higher than the exponent from the stable-low anxiety group. No differences were found in the vmHRV nor sympathetic activity. The lack of a direct association between the complexity of the heart rate and the level of sustained anxiety suggests a nonlinear pattern of associations that would be in accordance with the optimum variability principle.

Purpose: To explore sleep-related problems reported by patients with cancer prior to undergoing radiotherapy, and to analyse the effect of cancer severity, history of treatment and psychosomatic symptomatology on these problems., Method: A descriptive cross-sectional study was conducted. One hundred and five patients with cancer were evaluated prior to radiotherapy. The primary endpoint was the sleep problem score measured by a self-rated version of the Oviedo Sleep Questionnaire. Secondary variables were impact of pain on sleep, anxiety and asthenia., Results: Patients reported important levels of insomnia and hypersomnia. Insomnia-related problems were significantly higher in patients with more-severe disease (P < 0.05), and led to higher levels of hypnotic drug intake. Prior chemotherapy was significantly associated with hypersomnia-related problems (P < 0.05). Anxiety was significantly associated with both sleep-related problems., Conclusions: Sleep problems are significant among patients with cancer prior to undergoing radiotherapy, and were found to be associated with progression of cancer, prior treatments and other psychosomatic symptoms (e.g. anxiety). Sleep problems within this context must be explored to provide adequate guidelines to palliate their effects on quality of life., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Nonlinear measures can capture the complex structure of the heart beating, and recordings taken while the individual performs daily activities may help to understand the cardiac system's output in natural conditions. As healthy systems are characterized by having highly complex outputs, we hypothesized that the cardiac output from high anxious adolescents should be less complex than the output from their low anxious counterparts. In this study ECG was recorded for two hours in 50 adolescents while they performed regular school activities. Fractal dimension (FD), scaling exponents and multiscale entropy were calculated on the interbeat intervals time series. Both FD and entropy were significantly lower in the high-anxious group than the low-anxious group. These results suggest different heart-related regulation in adolescents who suffered from high anxious symptomatology., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: In recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia. Methods: Data from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up. Results: Group membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI95 = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI95 = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI95 = 1.16, 2.43). Limitations: Data on anti-inflammatory drugs and psychopharmacological medication were not collected in this study.Conclusions: Elevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID‐19) pandemic has constrained opportunities in social, educational and professional domains, leading to developmental challenges for adolescents initiating their transition to adulthood. Meta‐analysis indicated that there was a small increase in psychological distress during the first year of the COVID‐19 pandemic. However, significant heterogeneity in the psychological response to the COVID‐19 pandemic was noted. Developmental antecedents as well as social processes may account for such heterogeneity. The goal of this study was to characterize trajectories of psychological distress in late adolescence during the COVID‐19 pandemic. Methods: 5014 late adolescents born between 2000 and 2002 from the UK Millennium Cohort Study completed online self‐reported assessments at three occasions during the first year of the COVID‐19 pandemic (May 2020, September/October 2020 and February/March 2021). These surveys assessed psychological distress, loneliness, social support, family conflict, as well as other pandemic stressors. Information on developmental antecedents were obtained when cohort members were 17 years of age. Results: Four distinct trajectories class were identified. Normative class (52.13%) experienced low and decreasing levels of psychological distress, while moderately increasing class (31.84%) experienced a small, but significant increase in distress over time and increasing class (8.75%) exhibited a larger increase in distress after the first wave of the pandemic. Inverted U‐shaped class (7.29%) experienced elevated psychological distress during the first wave of the pandemic, followed by a decrease in distress in subsequent waves of the pandemic. Larger longitudinal increases in loneliness were noted among individuals in the elevated distress trajectory, compared to other trajectories. Pre‐pandemic psychopathology was associated with elevated distress early in the pandemic. Conclusions: The largest trajectory showed low and declining psychological distress, highlighting the resilience of the majority of late adolescents. However, a subgroup of adolescents experienced large increases in psychological distress, identifying a group of individuals more vulnerable to pandemic‐related stress. [ABSTRACT FROM AUTHOR]

Objectives 1) To study the relationship between resilience resources (both social and individual) and emotional symptomatology (depression and anxiety symptoms), taking into account the potential indirect effects through perceived stress; 2) to investigate whether this network of relationships varies in different age groups. Method: A sample of 718 Brazilians completed self-reports on perceived stress, depressive and anxious symptomatology, social support and individual resilience. The sample comprised two age groups: a sample of adults aged 60 or older (n = 361; 38.78% men; Mage = 67.32 years, SDage = 5.76, range = 60-86), and a sample of younger adults (n = 357; 29.41% men; Mage = 41.37 years, SDage = 7.23, range = 18-59). Multigroup multiple indicator, multiple cause (MIMIC) modelling was used to test for the direct and indirect effects of resilience resources on emotional symptom development, considering the age groups. Results: The relationship between individual resilience resources and depressive or anxiety symptomatology was found to take place exclusively through stressfulness appraisal. On the other hand, social resilience resources showed a direct and indirect effect on emotional symptoms. This pattern of relationships was found to be invariant across age groups. Conclusion: Our findings suggest that both individual and social resilience resources are negatively related to both depressive and anxiety symptoms in adults regardless of age, thus opening the way to future research analysing how interventions may build resilience resources to minimise the influence of stressful and traumatic events across the lifespan. [ABSTRACT FROM AUTHOR]

Growing evidence supports the hypothesis that temperamental traits are not static throughout adolescence. The known links between both reactive and regulatory temperament and anxiety symptoms should be investigated bearing this hypothesis in mind. This study collected self-reported data on behavioral inhibition system (BIS) sensitivity, attentional control (AC), and anxiety symptomatology, from 296 adolescents (64.2% girls; M = 12.96 years at the first assessment, SD = 0.47) every six months, four times over eighteen months. The relationships between temperament factors (AC and BIS sensitivity), considered longitudinally (by means of their trajectories) and anxiety symptoms were investigated using Multigroup Latent Growth Modeling (MLGM), as well as the mediating effect of sex on trajectories and anxiety. BIS sensitivity decreased over time and showed differential patterns across sexes. AC remained relatively stable and we found no sex influence on its trajectory. On the other hand, we observed that the BIS sensitivity trajectory was a significant predictor of anxiety symptomatology at age 15. In conclusion, temperamental changes between the ages of 13 and 15 seem to play a relevant role in explaining subsequent anxiety symptomatology, under the mediating influence of sex. [ABSTRACT FROM AUTHOR]

Breast cancer constitutes a challenge for survival and wellbeing. Emotional distress may persist many years after cancer being cured. This study aimed to analyse how emotional symptomatology was present in breast cancer survivors. Additionally, it aimed to study the role of sleep difficulty and worry on symptom maintenance. A sample of 206 women (M= 56.07 years, SD= 11.56) was selected to form four groups: healthy controls, breast cancer patients, short-term and long-term survivors. Emotional distress, worry and sleep problems were assessed. Long-term survivors showed significantly higher levels of anxiety (p< .05). Anxiety was predicted by worry for all groups but with higher variance in long-term survivors (R2 adj= .47). Insomnia and age predicted depression in this group (R2 adj= .40). To conclude, long-term emotional distress was observed even after the threat of cancer passed. Our findings confirm the need to extend supportive care to meet survivors' needs. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders frequently have an onset during adolescence, which when left untreated could lead to a chronic course and outcome. This study aimed to examine the way in which a cognitive behaviour therapy-based programme (Super Skills for Life - adolescent version; SSL-A) could change the course of anxiety symptoms through adolescent's behavioural performance and cardiac function.Method: Sixty-one adolescents at risk of developing an anxiety disorder (45.30% boys; M = 13.76 years, SD = 0.32) were randomly assigned to either an intervention (IG), placebo (PG), or a waitlist group (WG). Adolescents in the IG participated in SSL-A over an 8-week period. Adolescents in the PG participated in an 8-session school-work programme. Adolescents in the WG did not receive any intervention. Anxiety symptoms were assessed every six months, twice before the intervention, as well as at the post-intervention and six months after the intervention. Participants in the IG additionally underwent a stressful task to assess behavioural performance and cardiac adjustment.Results: Adolescents in the IG significantly reported lower levels of social phobia and generalised anxiety symptoms at the follow-up assessment compared to the adolescents in the PG and the WG. They also showed a significant improvement in vocal quality and lower discomfort during a stressful task at post-intervention, and showed attenuated cardiac recovery indexes, in terms of sample entropy.Limitations: The study has a small sample size.Conclusion: SSL-A changed the natural course of anxiety symptoms, as shown by a significant reduction in social phobia and generalised anxiety symptoms, and a significant improvement in behaviour and physiological (cardiac) function during a stressful situation. [ABSTRACT FROM AUTHOR]

Background: The association between decreased heart rate variability (HRV) and increased internalizing symptoms is well documented. Adolescence is a critical period for the development of mental health problems, in particular internalizing symptoms. Previous research has illustrated sex differences in adolescent HRV, such that females have reduced short-term resting state HRV compared to males. Studies on long-term ecological recordings of HRV in adolescents are scarce. The aims of the present study were, (a) to test if adolescent females show decreased long-term HRV and cardiac complexity (CC) compared to males, and (b) to explore whether sex and HRV and CC measures, as well as their interaction, would predict internalizing symptoms. Materials and Methods: HRV was recorded in n = 166 adolescents (86 girls), on a normal school day. HRV and CC measures were calculated on the interbeat interval time series. Results: Females showed lower HRV and CC in most of the assessed indices. Internalizing symptoms were mainly predicted by HRV whereas sex only predicted symptoms of social anxiety. The interaction between sex and HRV did not predict internalizing symptoms. Conclusions: Results suggest that reduced HRV should be considered as a potential contributor to exacerbating internalizing symptoms in adolescence. Girls with reduced HRV and CC might be prone to the development of internalizing disorders. HRV is a promising tool for the early identification of vulnerability. [ABSTRACT FROM AUTHOR]

Background and Objectives: Diminished heart rate variability has been found to be associated with high anxiety symptomatology. Since adolescence is the period of onset for many anxiety disorders, this study aimed to determine sex- and anxiety-related differences in heart rate variability and complexity in adolescents.Methods: We created four groups according to sex and anxiety symptomatology: high-anxiety girls (n = 24) and boys (n = 25), and low-anxiety girls (n = 22) and boys (n = 24) and recorded their cardiac function while they performed regular school activities. A series of two-way (sex and anxiety) MANOVAs were performed on time domain variability, frequency domain variability, and non-linear complexity.Results: We obtained no multivariate interaction effects between sex and anxiety, but highly anxious participants had lower heart rate variability than the low-anxiety group. Regarding sex, girls showed lower heart rate variability and complexity than boys.Conclusions: The results suggest that adolescent girls have a less flexible cardiac system that could be a marker of the girls' vulnerability to developing anxiety disorders. [ABSTRACT FROM AUTHOR]

Many physiological systems are multistable, i.e. they operate at different time scales under an allometric control process. The multistability of affective fluctuations has been clearly illustrated in a sample of adults, but little is known about their dynamics in adolescents. The main aim of this study was to determine whether affective fluctuations in adolescents show multistability and to explore their relationship with anxiety symptomatology and temperamental factors. Twenty-five early adolescents self-reported their daily mood, anxiety and worry levels twice a day over a 100-day period. The time series were analysed using the allometric aggregation method to obtain the scaling exponent h. Almost all the (Hurst) scaling exponents were 0.5 > h > 1. The worry exponents were related to temperament factors, whereas the anxiety exponents were related to social phobia symptoms. The results substantiate that affective fluctuations in adolescents are multistable, lending support to the presence of allometric control mechanisms. [ABSTRACT FROM AUTHOR]

Daily life entails having to cope with many stressful situations. Although stress-related reactions could sometimes provoke impairments in physiological processes due to the frequency of exposure or the stress burden of the event, physiological recovery after coping with stressors is highly implied in the aversive consequences of stress. To analyze the effects of listening to relaxing music (generated by the Melomics computer system) on the cardiovascular recovery and subjective feelings of anxiety after undergoing an acute-stress episode, a double-blind randomized controlled trial was conducted in healthy adults (N = 24; M = 23.05 years, SD = 2.97). Participants reported their levels of psychiatric symptomatology and anxiety and were then exposed to a stress induction protocol. Afterward, they underwent a period of recovery where they would be exposed to either a relaxing music track or silence, depending on a random assignation. Heart-derived functioning and self-reported anxiety were monitored throughout the study stages. All the participants showed stress-related reactions throughout the study stages, as it was shown for the study outcomes. Regarding the effect of listening to music, participants who listened to relaxing music during the recovery stage showed higher levels of sample entropy than controls, highlighting a large effect size on this difference (η2partial =.59). Relaxing music promotes more adaptive emotional regulation after coping with an acutely stressful event. This study aims to shed light on the actual effects of music interventions, and encourage the use of music-based interventions on health services. [ABSTRACT FROM AUTHOR]

During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach. [ABSTRACT FROM AUTHOR]

Public health measures to contain the spread of COVID-19 have resulted in adverse effects, including high level of psychological distress, anxiety, and depression. This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19. The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis. Four psychopathological profiles were identified: "low-symptom class" (60.17% of participants), "high-symptom class" (23.01% of participants), "substance/behavioural addictions class" (12.03% of participants), and "emotion-dysregulation class" (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period. Adolescent psychopathological profiles predicted mental health impacts of the COVID-19 outbreak. • Four psychopathological profiles: low-symptom, high-symptom, substance/behavioural addictions, and emotion-dysregulation. • High-symptom and emotional-dysregulation profiles were associated with high levels of stress and loneliness. • Emotional-dysregulation profile was associated with high alcohol consumption.. [ABSTRACT FROM AUTHOR]

Suicide is an international health concern with immeasurable impact from the perspective of human and social suffering. Prior suicide attempts, anxious and depressive symptoms, and relatively lower health-related quality of life (HRQoL) are among the most replicated risk factors for suicide. Our goal was to visualize the distribution of these features and their interconnections with use of a network analysis approach in individuals who recently attempted suicide. Individuals with a recent suicide attempt were recruited from nine University Hospitals across Spain as part of the SURVIVE cohort study. Anxious and depressive symptoms, and perceived HRQoL were included in the network analysis. Network structures were estimated with the EBICglasso model. Centrality measures and bridge symptoms connecting communities were explored. Subnetworks comparing younger and older individuals, and women and men were analyzed. A total of 1106 individuals with a recent suicide attempt were included. Depressed mood was the symptom with the greatest influence in the overall network, followed by anxiety symptoms such as feeling nervous, worrying, restless, and having difficulties to relax. Perceived general health was associated with increased suicidal ideation in the whole sample. Older people showed a specific connection between perceived general health and depressed mood. The cross-sectional design does not allow determination of established causality. Depressed mood was the core network's symptom and, therefore, an important target in the management and prevention of suicide. HRQoL had more influence on the network of older populations, in which it should be a primary focus. • Identifying risk factors for suicide is crucial for developing prevention programs. • Network analysis allows studying interrelations of symptoms in suicidal behaviors. • Depressed mood is the core symptom in individuals who recently attempted suicide. [ABSTRACT FROM AUTHOR]

The aim of this paper is to introduce the TrANS Project and the first results obtained from two studies. This Project allows to examine trajectories of anxiety symptoms and state anxiety in adolescents by means of ICT, in particular a secure social network for data collection. Study 1 describes the structure and functioning of the secure social network XS2 and provides results of the participant's login and use. Study 2 presents the fluctuations of the daily emotional state and the use of maladaptive emotion regulation strategies during an exam period, as well as the influence of risk factors on these fluctuations. In conclusion, the advantages derived from the use of a secure social network are emphasized, in comparison to other traditional data collection methods, in the study of the adolescent anxiety [ABSTRACT FROM AUTHOR]