Results indicate that behavioral questionnaires cannot be used interchangeably with neuropsychological testing for the assessment of EFDs in adults with ADHD.
According to diathesis-stress models, temperament traits, such as negative emotionality (NE), may moderate the effects of stressors on the development of symptoms of psychopathology, although very little research has tested such models in children. Moreover, there are few data on whether specific facets of NE (sadness, fear, or anger) may specifically moderate the effects of stress on depression versus anxiety. Finally, there is a paucity of research examining whether childhood temperament moderates the effect of disaster exposure on depressive or anxiety symptoms. Hurricane Sandy, which affected many thousands of people in New York State and surrounding regions in October 2012, offers a unique opportunity to address these gaps. Seven years prior to Hurricane Sandy, 332 three-year-old children completed lab-based measures of NE and its facets. Six years later, when they were nine years old, one parent rated their child’s depressive and anxiety symptoms. Approximately eight weeks post-Sandy (an average of one year after the age nine assessment), a parent again rated their child’s depressive and anxiety symptoms, as well as a measure of exposure to stress from Hurricane Sandy. Adjusting for symptom levels at age 9, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms only in participants with high levels of temperamental sadness, and predicted elevated levels of anxiety symptoms only in participants high in temperamental fearfulness. These findings support the role of early childhood temperament as a diathesis for psychopathology, and highlight the importance of considering facets of temperament when examining their relationship to psychopathology.
There are effective treatments for depression in primary care. More research is needed to address the optimum treatment of depression with medical co-morbidity and to elucidate the role of newer psychological interventions. Collaborative care between primary care and specialist services is a promising new avenue for management.
Objective
Although most people will experience a traumatic event, only some will develop significant psychological symptoms in the aftermath. In the current study, we utilize a preexisting longitudinal study located in Long Island to examine the impact of Hurricane Sandy on internalizing symptoms in a large sample of children. We focused on temperamental fear and a biomarker of risk for anxiety, the error-related negativity (ERN). The ERN is a negative deflection in the event-related potential (ERP) occurring when individuals make mistakes and is increased in anxious individuals.
Method
The final sample consisted of 223 children who had undergone an observational assessment of fear at age 3 and an electroencephalogram assessment of the ERN at age 6. At the age 9 assessment, internalizing symptoms were assessed, and then again after the hurricane (approximately 65 weeks later).
Results
A significant three-way interaction between fearfulness, hurricane stressors, and the ERN in predicting post-hurricane increases in internalizing symptoms suggested that children who were high in fear at age 3 and experienced elevated hurricane stressors were characterized by subsequent increases in internalizing symptoms, but only when they were also characterized by an increased ERN at age 6.
Conclusion
These findings support a diathesis-stress model, suggesting that early temperament and pre-stressor biological markers confer risk for increased psychological symptoms following environmental stressors.
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