EVALUATION of the PROPOSED SOCIAL ANXIETY DISORDER SPECIFIER CHANGE for DSM-5 in a TREATMENT-SEEKING SAMPLE of ANXIOUS YOUTH.

EVALUATION OF THE PROPOSED SOCIAL ANXIETY DISORDER SPECIFIER CHANGE FOR DSM-5 IN A TREATMENT-SEEKING SAMPLE OF ANXIOUS YOUTH.

Depress Anxiety. 2013 Mar 14;
Kerns CE, Comer JS, Pincus DB, Hofmann SG

BACKGROUND: The current proposal for the DSM-5 definition of social anxiety disorder (SAD) is to replace the DSM-IV generalized subtype specifier with one that specifies fears in performance situations only. Relevant evaluations to support this change in youth samples are sparse. METHODS: The present study examined rates and correlates of the DSM-IV and proposed DSM-5 specifiers in a sample of treatment-seeking children and adolescents with SAD (N = 204). RESULTS: When applying DSM-IV subtypes, 64.2% of the sample was classified as having a generalized subtype of SAD, with the remaining 35.2% classifying as having a nongeneralized subtype SAD. Youth with generalized SAD, relative to those with nongeneralized SAD, were older, had more clinically severe SAD, showed greater depressive symptoms, and were more likely to have a comorbid depressive disorder. No children in the current sample endorsed discrete fear in performance situations only in the absence of fear in other social situations. CONCLUSIONS: The present findings call into question the meaningfulness of the proposed changes in treatment-seeking youth with SAD. HubMed – depression

ANXIETY SYMPTOMS AS PRECURSORS OF MAJOR DEPRESSION AND SUICIDAL IDEATION.

Depress Anxiety. 2013 Mar 14;
Batterham PJ, Christensen H, Calear AL

BACKGROUND: Relative to depression symptoms, the role of anxiety symptoms in the development of depression and suicidal ideation has not been well established. This study aimed to identify the anxiety and depression symptoms that confer the greatest amount of risk for depression and suicidal ideation at the population level. METHOD: The PATH through Life study is an Australian community-based longitudinal cohort study of 7,485 younger, middle-aged, and older adults. Adjusted population attributable risk (PAR) for incident depression and suicidal ideation after 4 years was assessed for 18 symptoms of anxiety and depression. RESULTS: Anxiety symptoms contributed greater risk overall to both depression (45%) and suicidal ideation (23%) incidence than depression symptoms (35% and 16%, respectively). Anxiety symptoms had largest PARs among younger age groups. CONCLUSIONS: Prevention programs for depression and suicide should aim to reduce anxiety symptoms in addition to depression symptoms, and target individuals reporting symptoms such as worrying or irritability. HubMed – depression

Neighborhoods and Infectious Disease Risk: Acquisition of Chlamydia during the Transition to Young Adulthood.

J Urban Health. 2013 Mar 14;
Ford JL, Browning CR

Adolescents and young adults have the highest rates of sexually transmitted infections (STIs) in the USA despite national priority goals targeting their reduction. Research on the role of neighborhoods in shaping STI risk among youth has increased in recent years, but few studies have explored the longitudinal effects of neighborhoods on STI acquisition during the adolescent to young adult transition. The aims of this study were to examine: (1) the longitudinal relationships between the neighborhood context (poverty, residential instability, and racial/ethnic concentration) of exposure during adolescence and young adults’ acquisition of chlamydia, and (2) the extent to which sexual risk behaviors and depression over the transition from adolescence to young adulthood mediate the relationship between the neighborhood context of exposure during adolescence and young adults’ acquisition of chlamydia. A longitudinal observational design was employed using data from the National Longitudinal Study of Adolescent Health (Add Health), waves 1-3 (1994-2002). The sample was composed of 11,460 young adults aged 18 to 27 years. Neighborhood measures during adolescence were derived from the 1990 US Census appended to adolescents’ interview data. Chlamydia infection was measured via urine assay at wave 3 and 4.6 % of the young adults in the sample tested positive for chlamydia. Multilevel logistic regression analyses were conducted adjusting for numerous neighborhood and individual risk factors. Multivariate findings indicated exposure to neighborhood poverty during adolescence increased the likelihood of a positive urine test for chlamydia during young adulthood (AOR?=?1.23, 95 % CI?=?1.06, 1.42), and the association was not mediated by sexual risk behaviors or depression. Further research is needed to better understand the pathways through which exposure to neighborhood poverty contributes to chlamydia over the life course as are comprehensive STI prevention strategies addressing neighborhood poverty. HubMed – depression

Modifying and validating the Composite International Diagnostic Interview (CIDI) for use in Nepal.

Int J Methods Psychiatr Res. 2013 Mar 13;
Ghimire DJ, Chardoul S, Kessler RC, Axinn WG, Adhikari BP

Background: Efforts to develop and validate fully-structured diagnostic interviews of mental disorders in non-Western countries have been largely unsuccessful. However, the principled methods of translation, harmonization, and calibration that have been developed by cross-national survey methodologists have never before been used to guide such development efforts. The current report presents the results of a rigorous program of research using these methods designed to modify and validate the Composite International Diagnostic Interview (CIDI) for an epidemiological survey in Nepal. Methods: A five-step process of translation, harmonization, and calibration was used to modify the instrument. A blinded clinical reappraisal design was used to validate the instrument. Results: Preliminary interviews with local mental health expert led to a focus on major depressive episode, mania/hypomania, panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and intermittent explosive disorder. After an iterative process of multiple translations-revisions guided by the principles developed by cross-national survey methodologists, lifetime DSM-IV diagnoses based on the final Nepali CIDI had excellent concordance with diagnoses based on blinded Structured Clinical Interview for DSM-IV (SCID) clinical reappraisal interviews. Conclusions: Valid assessment of mental disorders can be achieved with fully-structured diagnostic interviews even in low-income non-Western settings with rigorous implementation of replicable developmental strategies. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression