Health> Vol.5 No.11, November 2013

Investigating a comorbid pattern of ill-health among late adolescents in relation to transdiagnostic processes: A prospective community study

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ABSTRACT

An increase in anxiety, depressed mood and sleep problems has been observed among adolescents. These symptoms have high rates of comorbidity and shared psychological processes have been proposed as maintaining factors. This study examined the occurrence and development of individual profiles of depressive symptoms, anxiety and sleeps problems and investigated them in relation to catastrophic thinking and cognitive avoidance. We used longitudinal data from a community sample of 379 senior high school students at two time points, one year apart. Five clusters were identified: a low scores cluster, a sleep problems cluster, a comorbidity cluster (high on all variables), a low mood cluster and a cluster with elevation on anxiety and depressed mood (“distress”). In general, the clusters showed stability across time. However, for the low mood and “distress” cluster, there was also an increased odds of developing sleep problems. The comorbidity and the “distress” cluster displayed the highest levels of catastrophic thinking. In conclusion, symptom patterns differed among adolescents and were stable over time. Anxiety and/or depressive symptoms were a risk factor for the development of sleep problems. Symptom constellations were related to differences in catastrophic thinking and cognitive avoidance and this may explain maintenance and exacerbation of problems over time.

Cite this paper

Boersma, K. and Tillfors, M. (2013) Investigating a comorbid pattern of ill-health among late adolescents in relation to transdiagnostic processes: A prospective community study. Health, 5, 1835-1847. doi: 10.4236/health.2013.511247.

References

[1] SOU (2006) Ungdomar, stress och psykisk ohalsa— Analyser och forslag till atgarder. Edita Sverige AB, Stockholm.
[2] Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R. and Walters, E.E. (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 593-602.
http://dx.doi.org/10.1001/archpsyc.62.6.593
[3] Ohayon, M.M. (2002) Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews, 6, 97-111.
http://dx.doi.org/10.1053/smrv.2002.0186
[4] Merikangas, K.R., He, J.-P., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K. and Swendsen, J. (2010) Lifetime prevalence in mental disorders of US adolescents: Results from the National Comorbidity Study-Adolescents Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980-989.
http://dx.doi.org/10.1016/j.jaac.2010.05.017
[5] Rossner, S. (1998) Childhood obesity and adulthood consequences, Acta Paediatrica, 87, 1-5.
http://dx.doi.org/10.1111/j.1651-2227.1998.tb01375.x
[6] Cerdá, M., Sagdeo, A. and Galea, S. (2008) Comorbid forms of psychopathology: Key patterns and future research directions. Epidemiologic Reviews, 30, 155-177.
http://dx.doi.org/10.1093/epirev/mxn003
[7] Brooks, T.L., Harris, S.K., Thrall, J.S. and Woods, E.R. (2002) Association of adolescent risk behaviors with mental health symptoms in high school students. Journal of Adolescent Health, 31, 240-246.
http://dx.doi.org/10.1016/S1054-139X(02)00385-3
[8] Harvey, A., Watkins, E., Mansell, W. and Shafran, R. (2004) Cognitive behavioral processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press Inc., New York.
[9] Wittchen, H.-U., Beesdo, K., Bittner, A. and Goodwin, R.D. (2003) Depressive episodes evidence for a causal role of primary anxiety disorders? European Psychiatry, 18, 384-393.
http://dx.doi.org/10.1016/j.eurpsy.2003.10.001
[10] Jansson, M. and Linton, S.J. (2007) Psychological mechanisms in the maintenance of insomnia: Arousal, distress and sleep-related beliefs. Behaviour Research and Therapy, 45, 511-521.
http://dx.doi.org/10.1016/j.brat.2006.04.003
[11] Johnson, E.O., Roth, T. and Breslau, N. (2006) The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. Journal of Psychiatric Research, 40, 700-708.
http://dx.doi.org/10.1016/j.jpsychires.2006.07.008
[12] Taylor, D.J., Lichstein, D.L. and Durrence, H.H. (2003) Insomnia as a health risk factor. Behavioral Sleep Medicine, 1, 227-247.
http://dx.doi.org/10.1207/S15402010BSM0104_5
[13] Talbot, L.S., McGlinchey, E.L., Kaplan, K.A., Dahl, R.E. and Harvey, A.G. (2010) Sleep deprivation in adolescents and adults: Changes in affect. Emotion, 10, 831-841.
http://dx.doi.org/10.1037/a0020138
[14] Ehring, T. and Watkins, E.R. (2008) Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1, 192-205.
http://dx.doi.org/10.1521/ijct.2008.1.3.192
[15] Stober, J. and Borkovec, T.D. (2002) Reduced concreteness of worry in generalized anxiety disorder: Findings from a therapy study. Cognitive Therapy and Research, 26, 89-96. http://dx.doi.org/10.1023/A:1013845821848
[16] Bergman, L.R. and El-Khouri, B.M. (2002) SLEIPNER-a statistical package for pattern oriented analyses. Department of Psychology, Stockholm University, Stockholm.
[17] Bergman, L.R. (1998) A pattern-oriented approach to studying individual development. Snapshots and processes. In: Cairns, R.B., Bergman, L.R., Kagan, J., Eds., Methods and Models for Studying the Individual, Sage, Thousand Oaks, 83-121.
[18] Von Eye, A. and Bergman, L.R. (2003) Research strategies in developmental psychopathology: Dimensional identity and the preson oriented approach. Development and Psychopathology, 15, 553-580.
http://dx.doi.org/10.1017/S0954579403000294
[19] Bergman, L.R., Magnusson, D. and El-Khouri, B. (2003) A person-oriented approach: Methods for today and methods for tomorrow. New Directions for Child and Adolescent Development, 101, 25-38.
http://dx.doi.org/10.1002/cd.80
[20] Olsson, G. and von Knorring, A.-L. (1997) Depression among Swedish adolescents measured by the self-rating scale Center for Epidemiology Studies-Depression Child (CES-DC). European Child and Adolescent Psychiatry, 6, 81-87.
[21] Zigmond, A.S. and Snaith, R.P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370.
http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x
[22] Bjelland, I., Dahl, A.A., Haug, T. and Neckelmann, D. (2002) The validity of the hospital anxiety and depression scale. An updated literature review. Journal of Psychosomatic Research, 52, 69-77.
http://dx.doi.org/10.1016/S0022-3999(01)00296-3
[23] Lisspers, J., Nygren, A. and Soderman, E. (1997) Hospital anxiety and depression Scale (HAD): Some psychometric data for a Swedish sample. Acta Psychiatrica Scandinavica, 96, 281-286.
http://dx.doi.org/10.1111/j.1600-0447.1997.tb10164.x
[24] Partinen, M. and Gislason, T. (1995) Basic Nordic Sleep Questionnaire (BNSQ): A quantitative measure of subjective sleep complaints. Journal of Sleep Research, 4, 150-155.
http://dx.doi.org/10.1111/j.1365-2869.1995.tb00205.x
[25] Liljenberg, B., Almqvist, M., Hetta, J., Roos, B.-E. and Agren, H. (1988) The prevalence of insomnia: The importance of operationally defined criteria. Annals of Clinical Research, 20, 393-398.
[26] Linton, S.J. and Bryngelsson, I.L. (2000) Insomnia and its relationship to work and health in a working-age population. Journal of Occupational Rehabilitation, 10, 169-183. http://dx.doi.org/10.1023/A:1009408204694
[27] American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders. 4th Edition, American Psychiatric Association, Washington DC.
[28] MacDonald, S., Linton, S.J., and Jansson-Frojmark, M. (2008) Avoidant safety behaviors and catastrophizing: Shared cognitive behavioral processes and consequences in co-morbid pain and sleep disorders. International Journal of Behavioral Medicine, 15, 201-210.
http://dx.doi.org/10.1080/10705500802222675
[29] MacDonald, S., Linton, S.J. and Jansson-Frojmark, M. (2010) Cognitive vulnerability in the development of concomitant pain and sleep disturbances. British Journal of Health Psychology, 15, 417-434.
http://dx.doi.org/10.1348/135910709X468089
[30] Snaith, R.P. (2003) The hospital anxiety and depression scale. Health and Quality of Life Outcomes, 1, 29.
http://dx.doi.org/10.1186/1477-7525-1-29
[31] Hair, J., Anderson, R., Tathan, R. and Black, B. (1998) Multivariate data analysis. 5th Edition, Pearson Prentice Hall, Upper Saddle River.
[32] Jansson, M. and Linton, S.J. (2006) The role of anxiety and depression in the development of insomnia: Crosssectional and prospective analyses. Psychology and Health, 21, 383-397.
http://dx.doi.org/10.1080/14768320500129015
[33] Trost, K., Biesecker, G., Stattin, H.K. and Kerr, M. (2007) Not wanting parents’ involvement: Sign of autonomy or sign of problems? European Journal of Developmental Psychology, 4, 314-331.
http://dx.doi.org/10.1080/17405620601008980
[34] Bergman, L.R., Magnusson, D. and El-Khouri, B. (2003) Studying individual development in an interindividual context: A person oriented approach. Lawrence Erlbaum, Mahwah.

  
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