MIRIAM studies a range of topics related to anxiety and mood, with a particular emphasis on understanding and assessing relevant risk factors and mechanisms of change; including, temperamental contributions, parental influences, self-control and self-management, monitoring and blunting, and mindfulness.
Common Cognitive and Behavioural Mechanisms in Adult Anxiety and Depression
Dr. Mezo’s research interests focus on examining mechanisms of maintenance and change in the affective disorders of anxiety and depression. The advent of psychological clinical science in the past several decades has resulted in the proliferation of numerous empirically sound cognitive and behavioural mechanisms for promoting and sustaining mental health. More recent research in the anxiety and mood disorders has begun to investigate how these mechanisms may overlap, and the extent to which they represent common mechanisms of vulnerability. Dr. Mezo’s program of research is designed to participate in the empirical movement to distill and operationalize common mechanisms in anxiety and mood disorders. Currently, he is investigating and comparing three classes of mechanisms that have been shown to have promise among the affective disorders: (1) Self-Management, Self-Control, and Self-Regulation, (2) Mindfulness, and (3) Monitoring and Blunting.
Much of this empirical work has been established in previous psychometric studies that have produced potentially valuable instruments in the assessment of self-management as well as monitoring and blunting. Currently, plans are underway to further establish the validity of these instruments in mental healthcare settings in St. John’s. In addition, these validity studies will provide insights into the relationships between different mechanisms of change and suggest future avenues for prevention and intervention work.
Parental Contributions to Child Anxiety - The Clinic Study
The research project in which Dr. Francis is primarily involved at present draws upon the developmental and parenting literatures. This research program investigates the transmission of anxious symptomatology from parents to children and is guided by three specific aims: (1) identifying parent, child, and family factors that play a role in the development and maintenance of anxiety disorders among youth, (2) developing psychometrically sound assessment instruments to validly measure these factors, and (3) using these assessment instruments to expand existing theories of the nature of anxiety among children and adolescents. Heritability studies, learning theory, and social-cognitive theories have provided a wealth of information with respect to better understanding factors that initiate and sustain anxiety (e.g., Beidel & Turner, 1997; Dadds & Barrett, 1996; Rapee, 1997). However, few clinically useful assessment instruments that are specifically applicable to youth and families have emerged out of this body of research, despite the articulation of a need for such instruments (e.g., Cobham, 1998). As such, a primary focus of this work is to develop instruments designed to measure familial psychosocial variables relevant to the development and maintenance of anxiety disorders among youth. In particular, these instruments will be designed for ease of use by clinicians to identify targets of treatment and measure treatment progress, both during and following treatment.
One key part of this intergenerational transmission research is to develop a parent-report instrument designed to assess parental beliefs about child anxiety that serve to initiate or sustain heightened levels of anxious symptomatology. This research also seeks to elucidate the role of numerous other child, parent, and family characteristics in the transactional relationship between parent and child anxiety. Such characteristics include temperamental variables, such as positive and negative affectivity; general dimensions of parenting, such as warmth, consistency, and punishment and reward use; family environment variables, such as cohesion, organization, conflict, and control; and related psychological variables, including depression and anger. Studying child anxiety within this multifaceted context will allow for an identification of the intersection of heritable (temperament) and learned (family environment) variables in explaining the development and maintenance of anxiety disorders among youth. This research will provide the field with enhanced theoretical models of child anxiety by illustrating the interaction of child, parental, and familial factors in these disorders. Moreover, it will help health practitioners working with youth gain knowledge of which factors to target in order to ameliorate the impact of anxiety disorders on these individuals. Findings yielded from this line of research will augment and extend existing knowledge in this area as contributed by prominent investigators in the field (e.g., Barrett, Dadds, & Rapee, 1996; Cobham, Dadds, & Spence, 1999; Hudson & Rapee, 2001).
As a first step in executing this program of research, Dr. Francis is currently collecting data from a clinical sample. In collaboration with a group of child psychiatrists working with children and adolescents at the Janeway Child Health and Rehabilitation Centre, Dr. Francis is collecting preliminary data on the Parental Beliefs about Anxiety Questionnaire (PBA-Q), which she developed as part of her dissertation research (Francis & Chorpita, 2009a, 2009b). Three posters based on these data were presented at the November 2008 meeting of the Association for Behavioral and Cognitive Therapies (ABCT). These posters examined: (a) the contributions of parental stress to childhood anxiety, (b) the predictive value of parental anxiety sensitivity for child anxiety, and (c) the moderational role of behavioural disturbances on the relationship between parental anxiety and child social anxiety. Ultimately, findings yielded from this research will provide further data with respect to the reliability and validity of the PBA-Q, while simultaneously speaking to the mediational role of parental beliefs about anxiety in the transmission of anxiety from parent to child.
Initial data collected from this research project has already allowed for the formation of a dataset which can be used to address questions related to factors associated with parent and child anxiety, such as anxiety sensitivity, negative affectivity, positive affectivity, and various sociodemographic characteristics (e.g., child age, family composition, socioeconomic status).
Parental Contributions to Child Anxiety - The School Study
This study serves as a parallel investigation to the study investigating the role parental cognitive biases play in the child's anxiety amongst a child clinical sample. Collecting data from a psychiatric sample and a general population sample will allow for important comparisons to be made with respect to the role of parental beliefs about anxiety in the child's experience of anxious symptoms both among children receiving clinical attention and children in the general population. Findings from this study will speak to whether the ways in which parents think about their child's experience of anxiety is a meaningful variable in normative childhood anxiety.
Data collection in local St. John's school is anticipated to be completed in the fall of 2012.
The Child Anxiety Sensitivity Study
The construct of parental beliefs about anxiety refers to specific beliefs that parents might hold about their child’s experience of anxiety, particularly the notion that anxiety is harmful for the child. This construct is closely related to the construct of anxiety sensitivity, which is defined as the fear of anxiety-related symptoms (e.g., a fast beating heart) and the consequences that may follow from these symptoms (e.g., a heart attack). However, parental beliefs focuses on the harmful nature of symptoms of anxiety for the child rather than for the individual him or herself. As such, a very salient area of inquiry is the extent to which parental beliefs about anxiety is related to the parent’s own anxiety sensitivity and how parental anxiety sensitivity relates to not only child anxiety but to child anxiety sensitivity as well. Accordingly, it is important to examine the construct of anxiety sensitivity in both parents and their children in the context of a network of related variables, including temperamental, cognitive, and behavioural risk factors. The intent of this line of research is to not only gain a contextualized understanding of anxiety sensitivity amongst children and adolescents, but to also evaluate parental contributions to this construct and to the child’s experience of symptoms of anxiety.
This project involves collecting data from a community sample of children and their parents, employing multiple means of data collection, including questionnaires, behavioural observation, and interviews. Data collection for this project commenced in the winter of 2011 and is anticipated to be completed in the winter of 2012. Participants will be recruited from St. John’s local area schools.
The FRIENDS Study
The FRIENDS for Life program is an anxiety and depression prevention program that is administered in schools with children in grades 4, 5, and 6 (ages 8-11 approx.). By focusing on feelings, coping strategies, and positive relationship skills, the FRIENDS for Life program aims to decrease anxiety and depression while increasing child resiliency. The program is administered by trained guidance counsellors within the school system. Designed by Dr. Paula Barrett, the FRIENDS programs have spread across the globe and are currently being administered in numerous countries such as Australia, the Netherlands, the United States, and Canada. The FRIENDS for Life program is just one of four FRIENDS programs, as different programs target different age groups across the life span. The FRIENDS programs have been shown to be effective in decreasing both anxiety and depression while improving resiliency in participants. Programs of this nature are of grave importance as the prevention, detection, and treatment of mood and anxiety disorders early on is essential for our mental health.
The MIRIAM lab’s FRIENDS study will serve as the first evaluation of the FRIENDS for Life program in Newfoundland. Data will be collected from elementary school students in the St. John’s and surrounding areas. Data collection will consist of both questionnaire packages and observational methods. Data collection is set to begin during the winter of 2014.