Symptom network analysis of parent-child depression and anxiety in treatment-seeking youth.

Youth of parents who are experiencing psychopathology are more likely to develop emotional concerns, and these mental health symptoms can have a deleterious impact on parents' mental health. However, the relationship between the presentation of specific symptoms in parents and youth is infrequently examined. Symptom network analysis is an analytic approach that is increasingly being used to better understand the relationship of symptoms within and between disorders and can also be used to examine symptom relations within a dyad. The present study used symptom network analysis to examine bidirectional relationships among depressive and anxiety psychopathology in a transdiagnostic sample of treatment-seeking youth and their primary caregiver. Parental anhedonia and child worthlessness exhibited the greatest centrality within the network, suggesting that these may act as risk and maintenance factors for parent-child psychopathology and may be important intervention targets. Findings support the use of symptom network analysis to inform an understanding of the complex relationships among parent and child depressive and anxiety symptoms. Future research should consider the use of network analytic methods to examine the temporal relationships between parent and child psychopathology and to inform joint parent-child interventions for those with internalizing concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Initial Effects of a Brief Transdiagnostic Intervention on Parent Emotion Management During COVID-19.

Parents are a vulnerable group to increased distress resulting from the COVID-19 pandemic. In this study, 80 parents with at least mildly elevated internalizing symptoms were randomized to receive a four session, transdiagnostic intervention via telehealth during the height of the COVID-19 pandemic based on the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders (UP-Caregiver), immediately or 6-weeks after receipt of psychoeducational materials. Results showed no between-condition differences in slopes of primary outcome measures; however, significant group differences in intercepts indicated that those receiving UP-Caregiver immediately had greater improvements in distress tolerance and intolerance of uncertainty than those in the delayed condition. Analyses also suggested within-condition improvements in emotional functioning and high satisfaction with UP-Caregiver. Results suggest that psychoeducation and symptom monitoring may be helpful to some distressed parents. Future investigations should utilize a larger sample to identify which parents might benefit the most from interventions like UP-Caregiver during crises.

Symptom-level networks of youth- and parent-reported depression and anxiety in a transdiagnostic clinical sample.

Depression and anxiety disorders confer a significant public health concern for youth and their co-occurrence places youth at a higher risk for poorer psychosocial outcomes. In the present study, we use network analysis to investigate the role of and interactions among individual depression and anxiety symptoms in a treatment-seeking clinical sample. METHODS: We estimate regularized partial correlation networks for youth- and parent reported symptoms in a transdiagnostic sample of youth (N = 417, ages 8-18). We examined features of the symptom-level networks such as network stability, centrality, bridge symptoms, and communities in both youth- and parent-reported networks. RESULTS: Results indicate stable networks with disorder-specific clustering, such that symptoms were more interconnected within compared to between disorders. Symptoms related to self-comparison to peers and negative views of the future were most central in both networks. Symptoms of depression and anxiety were connected by worries for the future and hopelessness in the youth-reported network, whereas self-comparison to peers and low self-efficacy were bridge symptoms in the parent network. Distinct symptom clusters emerged in the parent- and youth-reported networks. CONCLUSIONS: Our findings indicate that negative self-evaluation, negative views of the future, and repetitive negative thinking more generally are influential symptoms in the presentation and co-occurrence of depression and anxiety and as such may be promising targets in the treatment and prevention of depression and anxiety in youth.

Brief Transdiagnostic Intervention for Parents With Emotional Disorder Symptoms During the COVID-19 Pandemic: A Case Example.

Concerns regarding parent mental health and well-being during the COVID-19 pandemic are justifiably on the rise. Although anxiety, depression, and traumatic stress levels have risen precipitously across all demographics during the pandemic, parents residing with their children are under particular and unique strain. Caregivers with children in the home are responsible not only for their own health, financial security, and safety during this time, but often full-time caregiving, household management and, in many cases, their children's schooling. In this case paper, we describe the development of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Caregivers (UP-Caregiver) and provide a case example of its implementation. This 4-session indicated prevention for caregivers is a modification of existing versions of the Unified Protocols for adults and children, modified to maximize its responsiveness to issues faced by parents and caregivers living with youth (ages 6-13) during the current pandemic. UP-Caregiver was offered as part of a randomized, controlled trial via telehealth in a small group format to any parent with a child in the specified age range with mild or greater anxiety, depression or traumatic stress symptoms during an initial screening. The case example provided is of a White, Hispanic mother with a range of self-reported emotional disorder concerns at an initial assessment. Declines in anxiety, depression and traumatic stress symptoms were all noted, as well as improvements in parenting self-efficacy and distress tolerance 6-weeks after initiating UP-Caregiver. An ongoing randomized, controlled trial of UP-Caregiver will further evaluate the utility and feasibility of this approach to alleviate parental distress during COVID-19.

Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth.

BACKGROUND: Structural research on the construct of affect intolerance (an overarching latent construct indicated by distress tolerance and anxiety sensitivity) has only been conducted in adults. Given that a self-report measure of distress tolerance was recently validated for youth and affect intolerance may be a core mechanism of transdiagnostic interventions for internalizing disorders, we examined how affect intolerance relates to internalizing symptoms in youth. We predicted that a latent affect intolerance factor (indicated by distress tolerance and anxiety sensitivity) would be associated with self and parent-reports of youth anxiety, depressive, and obsessive-compulsive symptoms, controlling for age and gender. METHODS: At a pre-treatment evaluation, youth with a primary depressive, anxiety, or obsessive-compulsive spectrum disorder (N=277) aged 8-17, and their parent, completed questionnaires. RESULTS: Greater levels of the affect intolerance factor predicted greater youth- and parent-reported youth anxiety, depression, and obsessive-compulsive symptoms, controlling for age. LIMITATIONS: Future research should replicate findings in a sample with a greater proportion of depressed youth and utilize experimental or longitudinal methods. CONCLUSIONS: Importantly, distress tolerance and anxiety sensitivity are core transdiagnostic processes that can be targeted in cognitive-behavioral interventions. Future research should examine how transdiagnostic interventions for youth with internalizing disorders can target these cross-cutting emotional vulnerabilities.