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Biomedical subjects

Carl F Weems

Publications and source records attributed to Carl F Weems.

At least 19 recordsLinked to original sources
PubMed2006

An integrative model of control: implications for understanding emotion regulation and dysregulation in childhood anxiety.

Theorists and investigators have emphasized an important role for control in emotional problems such as anxiety and anxiety disorders in youth. However, the term "control" is subject to theoretical ambiguities because of the broad conceptual bases for the term. In this article, we examine the concepts of locus of control, learned helplessness/attributional style, self-efficacy, and perceived control to develop an integrative model of control based on research and theory. The review emphasizes each of the theories distinguishing features in order to show how these distinctive features relate to real versus perceived control and how they may be differentially associated with childhood anxiety. We attempt to clarify the various definitions of control and the implications of these various definitions with respect to childhood anxiety, its disorders and their treatment and present a model of control that is integrative but also addresses the complexities of the different definitions of control (i.e., is multifaceted). The model developed from our review of the literature postulates that individuals differ in the extent to which they actually have control and differ, also on a continuum, in their perceptions of control. The need for this integrative model is highlighted by methodological, developmental, and clinical considerations. In particular, research has operationalized control and related constructs such as emotion regulation in ways that may be confounding actual control and perceived control. The need for an integrative but also multifaceted conceptualization of the role of control in childhood anxiety is also highlighted by clinical and developmental considerations. For instance, different facets of control may have differential relevance to clinical anxiety and at different points in childhood.

Affect↗
PubMed2006

Do anxiety and depression cluster into distinct groups?: a test of tripartite model predictions in a community sample of youth.

Because of their high comorbidity and strong associations, the distinctiveness of anxiety and depression in youth continues to be debated. In this study we used cluster analysis in a community sample (n=225) of youth to test tripartite model predictions regarding the grouping of individuals based on their levels of anxiety and depression symptoms. Findings were consistent with tripartite model predictions that four groups would emerge (primarily elevated on anxiety symptoms only, elevated on depression symptoms only, elevated on both anxiety and depression symptoms, and a low symptom group). Analyses using specific tripartite model variables and parent report of internalizing symptoms provided additional support for the groupings and tripartite model predictions. Across age groupings, the clustering of anxiety and depression symptoms was consistent with some hypothesized developmental differences in the expression of internalizing symptoms in youth. Findings add support for the tripartite model in youth, and support the idea that anxiety and depression do represent unique syndromes in youth. Depression and Anxiety 23:453-460, 2006. Published 2006 Wiley-Liss, Inc.

Adolescent↗
PubMed2006

IQ and posttraumatic stress symptoms in children exposed to interpersonal violence.

BACKGROUND: The literature is mixed as to the relationship between intelligence quotient (IQ) and Posttraumatic Stress Disorder (PTSD) symptomatology in adult populations. Even less is known about the relationship in children who have been traumatized. METHODS: Fifty-nine children and adolescents (mean age = 10.6) with a history of interpersonal violence were evaluated with respect to PTSD symptomatology, number of traumas, and estimated Verbal, Performance and Full scale IQ scores. PTSD symptomatology included symptom levels for cluster B (re-experiencing), cluster C (avoidance and numbing), and cluster D (Hypervigilance) and criterion F, functional impairment. RESULTS: Results indicated that Full scale and Verbal IQ were significantly associated with the number of traumas, re-experiencing symptoms, and impairment. Performance IQ was only associated with impairment. Regression analyses suggested that together PTSD symptomatology predicted Full scale and Verbal IQ but nor Performance IQ and impairment was the single best predictor of IQ generally. CONCLUSIONS: Findings provide support for an association between PTSD symptoms and IQ, particularly verbal IQ. Two possible reasons for this relationship are that higher levels of Verbal IQ may serve as a premorbid protective factor against the development of re-experiencing symptoms, or performance on post-trauma Verbal IQ measures may be negatively impacted by expression of PTSD symptoms. Longitudinal studies are needed to clarify which of these two possibilities explains the association.

Child↗
PubMed2006

Associations among selective attention, memory bias, cognitive errors and symptoms of anxiety in youth.

The purpose of this study was to examine the linkages among selective attention, memory bias, cognitive errors, and anxiety problems by testing a model of the interrelations among these cognitive variables and childhood anxiety disorder symptoms. A community sample of 81 youth (38 females and 43 males) aged 9-17 years and their parents completed measures of the child's anxiety disorder symptoms. Youth completed assessments measuring selective attention, memory bias, and cognitive errors. Results indicated that selective attention, memory bias, and cognitive errors were each correlated with childhood anxiety problems and provide support for a cognitive model of anxiety which posits that these three biases are associated with childhood anxiety problems. Only limited support for significant interrelations among selective attention, memory bias, and cognitive errors was found. Finally, results point towards an effective strategy for moving the assessment of selective attention to younger and community samples of youth.

Adolescent↗
PubMed2006

Mixed lateral preference in posttraumatic stress disorder.

Recent research indicates that adults with posttraumatic stress disorder (PTSD) have a higher incidence of mixed laterality with respect to handedness than the rest of the population. To test if this relationship also occurs early in life, we evaluated children with history of interpersonal trauma. Fifty-nine traumatized children were evaluated with the Clinician Administered PTSD Scale for Children and Adolescents and the Edinburgh Handedness Inventory. Forty matched healthy controls were used for comparison. Increased mixed laterality was found in all children exhibiting symptoms of PTSD when compared with healthy controls, and children who met DSM-IV diagnostic criteria for PTSD had more mixed laterality than the subthreshold traumatized group (F = 7.71; df = 2,96; p = 0.001). Within the entire traumatized group, there was a positive correlation between PTSD symptom severity and mixed laterality. Mixed laterality was positively associated with PTSD symptoms in traumatized children, suggesting that neurological abnormalities may be related to degree of PTSD symptom expression.

Adolescent↗
PubMed2005

The relation between identity status and romantic attachment style in middle and late adolescence.

This study examined the linkages between identity formation and romantic attachment in an ethnically diverse sample of high school (n=189) and college students (n=324). Individuals in the foreclosed identity status group had significantly lower relationship avoidance scores than the diffused identity status group, and the foreclosed group had significantly lower relationship anxiety scores than both the achieved identity and moratorium groups. Identity status and romantic attachment style were significantly related among the college sample, but not among the high school sample. Some ethnic differences in attachment style were noted. Developmental implications are discussed.

Adolescent↗
PubMed2005

Anxiety disorders in childhood: casting a nomological net.

Empirical research highlights the need for improving the childhood anxiety disorder diagnostic classification system. In particular, inconsistencies in the stability estimates of childhood anxiety disorders and high rates of comorbidity call into the question the utility of the current DSM criteria. This paper makes a case for utilizing a nomological net model for advancing the understanding of childhood anxiety disorders. In this article, we discuss measurement and assessment issues related to improving the childhood anxiety disorder diagnostic system and show how these issues can be addressed by employing the nomological net of childhood anxiety. Because employing the nomological net involves drawing from etiological process theories to facilitate classification and assessment, an integrative model of childhood anxiety disorders is presented as a tentative heuristic. Then evidence for the existing symptom sets is discussed in the context of how process theory mechanisms may be utilized to improve classification and assessment. Testable hypotheses are presented. Measurement, disorder definition, treatment, and policy implications are also discussed.

Anxiety Disorders↗
PubMed2005

A cross-sectional evaluation of the factorial invariance of anxiety sensitivity in adolescents and young adults.

This study examined the cross-sectional factorial invariance of anxiety sensitivity in an ethnically diverse sample of adolescents (n = 173; mean age 15.5 years) and young adults (n = 291; mean age 20.1 years). Research in adult and youth samples suggests that anxiety sensitivity is best understood as a hierarchical construct with several lower-order factors. Factor models based on previous research using both adult and youth samples were compared and a hierarchical model with three lower-order factors provided the best fit to the data. Results supported the hypothesis that the factor structure of the Anxiety Sensitivity Index was invariant across age and gender. The factor scores also demonstrated differential correlations with symptoms of anxiety and depression. Results are discussed with regard to construct validation and understanding the structure of anxiety sensitivity in youth.

Adolescent↗
PubMed2005

Development of anxiety disorders in a traumatized pediatric population: a preliminary longitudinal evaluation.

OBJECTIVE: The current study was conducted to determine if post-traumatic stress disorder (PTSD) symptomatology predicted later development of non-PTSD anxiety disorders in children and adolescents victimized by interpersonal trauma. METHODS: Thirty-four children with a history of interpersonal trauma and no initial diagnosis of anxiety disorder participated in the study. Children were assessed at time one (T1) and then 12-18 months later at time two (T2). At T1, the Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA) and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) were used to evaluate children's PTSD symptoms and comorbid non-PTSD anxiety disorder diagnosis. At T2, the CAPS-CA and the K-SADS-PL were repeated. RESULTS: The diagnosis of PTSD and PTSD symptoms in children exposed to interpersonal trauma at T1, particularly the symptoms associated with avoidance and constricted emotional expression (criteria C) as well as physiological hyperarousal (criteria D), predicted the development of other anxiety disorders at T2. CONCLUSION: Traumatized children with initial PTSD symptomatology may be at risk of later development of other anxiety disorders.

Adolescent↗
PubMed2005

Developmental differences in the expression of childhood anxiety symptoms and fears.

OBJECTIVE: To examine age differences in the expression of childhood fears and anxiety symptoms. METHOD: A cross-sectional design was used to test recently formulated developmental hypotheses regarding the differential expression of childhood anxiety symptoms and fears in a community sample of youths (N = 145). Three groups of youths were compared: children aged 6-9 years (n = 47), preteens aged 10-13 years (n = 52), and adolescents aged 14-17 years (n = 46). Symptoms of separation anxiety, generalized anxiety, and social anxiety were assessed using a dimensional approach by both parent and child report. Fears were assessed by child report. RESULTS: The results indicated that there are systematic age differences in the expression of childhood fears and anxiety symptoms. Results also point toward specific symptoms predominant at certain ages (i.e., separation anxiety symptoms in youths aged 6-9 years, death and danger fears in youths aged 10-13 years, and social anxiety symptoms as well as failure and criticism fears in youths aged 14-17 years) in partial support of predictions. CONCLUSIONS: Models of the etiology of childhood anxiety disorders tracing continuity and change over time should consider differences in the developmental expression of childhood fears and anxiety symptoms. Attention to developmental issues concerning symptom expression may be important in the clinical understanding of childhood anxiety.

Adolescent↗
PubMed2005

Physiological response and childhood anxiety: association with symptoms of anxiety disorders and cognitive bias.

This study examined the physiological response (skin conductance and heart rate [HR]) of youth exposed to a mildly phobic stimulus (video of a large dog) and its relation to child- and parent-reported anxiety symptoms and cognitive bias in a community-recruited sample of youth (n = 49). The results of this study indicated that HR and skin-conductance response were associated with youth report but not parent report of their child's symptoms of anxiety disorders and that HR response was more strongly associated with anxiety symptoms than skin-conductance response. Physiological response was uniquely associated with youth-reported symptoms of anxiety rather than youth-reported depression. Finally, HR response interacted with cognitive bias in predicting childhood anxiety disorder symptoms in a manner consistent with theories of the etiology of anxiety disorders.

Adolescent↗
PubMed2005

Synchronizing programs using macromedia director plug-ins: an example from the field of developmental psychopathology.

Synchronizing the display of a stimulus with physiological recording or subjects' behavioral responses is crucial for acquiring valid measures of performance. This article describes a technique for integrating the presentation of stimuli, behavior reports, and physiological data employing Macromedia Director and a standard biometric program using an example from the field of developmental psychopathology. Our experience has been that the use of this technique is effective in creating complex protocols for research. Although the temporal accuracy available from this particular method is adequate for some experiments, it is not suited for investigations requiring single millisecond accuracy. Considerations and suggestions for utilizing this and similar techniques for integrating data collection and stimuli presentation are discussed.

Cognition↗
PubMed2003

A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth.

This article examined sociodemographic and clinical characteristics of child treatment completers and noncompleters who received exposure-based cognitive-behavioral treatment. A total of 137 children (46% girls) and their parents (predominantly Euro-American and Hispanic/Latino) participated in this study (106 completers, 31 noncompleters). The majority of noncompleters received an average of 5 sessions. Findings were generally consistent with past research in terms of lack of differences between completers and noncompleters. Results are discussed in the context of previous child attrition research and directions for future research.

Adolescent↗
PubMed2003

Exposure-based cognitive-behavioral treatment for phobic and anxiety disorders: treatment effects and maintenance for Hispanic/Latino relative to European-American youths.

OBJECTIVE: To examine treatment response and maintenance to exposure-based cognitive-behavioral therapy (CBT) for Hispanic/Latino relative to European-American youths with phobic and anxiety disorders. METHOD: A total of 131 Hispanic/Latino and European-American youths (aged 6-16 years) who participated in two previous clinical trials for phobic and anxiety disorders were compared along diagnostic recovery rates, clinically significant improvement, and youth- and parent-completed questionnaire scores using traditional hypothesis tests, including effect sizes, and statistical equivalence tests. RESULTS: After treatment, Hispanic/Latino and European-American youths responded similarly to exposure-based CBT in their diagnostic recovery rates and questionnaires. Effect sizes for questionnaire data were also more similar than different across the two groups. With regard to treatment maintenance, Hispanic/Latino and European-American youths also responded more similarly than differently, albeit with some variations within specific assessment points in questionnaire data. CONCLUSIONS: Exposure-based CBT for phobic and anxiety disorders produced positive treatment gains and maintenance for Hispanic/Latino youths who participated in the trials. The treatment response that can be expected is generally similar (i.e., favorable) and equivalent to that found with European-American youths based on all the available indices of change.

Adolescent↗
PubMed2003

A prospective test of the association between hyperarousal and emotional numbing in youth with a history of traumatic stress.

Investigated the hypothesis that emotional numbing may develop as a result of hyperarousal using a prospective design. Forty-two children between the ages of 7 and 14 with a history of trauma and posttraumatic stress disorder (PTSD) symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA; Nader et al., 1996) and were reassessed 1 year later. Results indicated that hyperarousal symptoms were concurrently positively correlated with emotional numbing at both time points. Moreover, Time 1 hyperarousal symptoms were associated with emotional numbing at Time 2 and predicted Time 2 emotional numbing even when controlling for each of the other symptom clusters of PTSD at Time 1 as well as other concurrent (i.e., Time 2) PTSD symptoms. Results are discussed in terms of the implications of the findings for enhancing the understanding of PTSD symptoms in youth.

Affective Symptoms↗
PubMed2002

Diurnal salivary cortisol in pediatric posttraumatic stress disorder.

BACKGROUND: The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). Additional information on basal cortisol levels in children exposed to trauma and experiencing PTSD symptoms may contribute to the understanding of the role of this axis in PTSD. METHODS: Fifty-one children (30 boys and 21 girls, mean age 10.7 years) with a history of exposure to trauma and PTSD symptoms were compared with 31 age- and gender-matched healthy control subjects. Salivary cortisol was obtained from participants during home measurements and was collected four times a day (prebreakfast, prelunch, predinner, and prebed) for up to 3 consecutive days. RESULTS: The clinical group demonstrated significantly elevated cortisol levels when compared with the control group. In addition, exploratory analyses revealed that girls with PTSD symptoms had significantly elevated cortisol levels when compared with boys with PTSD symptoms. CONCLUSIONS: The physiologic response of children with history of trauma and with PTSD symptoms may be characterized by heightened adrenal activity.

Adolescent↗
PubMed2002

Toward an empirical definition of pediatric PTSD: the phenomenology of PTSD symptoms in youth.

OBJECTIVE: To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages. METHOD: Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents. RESULTS: Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty. CONCLUSIONS: Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.

Adolescent↗