Stress, anxiety, and
depression in care-givers of
children with chromosome
22q11.2 deletion syndrome
Elliott Beaton, Nina Q. Cung, Ingrid
Leckliter, Kathleen Angkustsiri, Tony J.
Simon
http://cabil.mindinstitute.org
eabeaton@ucdavis.edu
This project is supported by K99MH086616 awarded to EAB
and R01HD042974 to TJS from the National Institute Of Mental
Health.
Kids with 22qDS and their families
have a lot to cope with!
•  Early major medical interventions and
ongoing health and development issues
•  Socioemotional impairments
•  Cognitive impairments that complicate
education
•  Co-morbid for other Dx (ADHD, OCD)
•  Problems become more prominent with
increasing social and academic demands.
1
Stress and Chromosome 22q11.2DS
Stress and allostatic load in 22qDS likely
results from a multivariate and reciprocal
interaction of:
–  Atypical brain development
–  Early traumatic experiences
–  Medical, behavioral, cognitive, and
socioemotional challenges associated with the
syndrome borne by the children and their
families
–  Genetically derived temperament, coping
capacity, and resilience
Elevated anxiety in 22q11.2DS vs. TD kids
22q (n = 42)
65
p = 0.008
p = 0.008
p = 0.0001
p = 0.004
p = 0.046
p = 0.04
p = 0.03
NS,
p = 0.06
50
45
40
35
A
Ph
nx
ys
ie
ic
ty
al
Sy
m
pt
om
Te
s
ns
e/
Re
stl
es
s
So
m
at
iz
at
H
io
ar
n
m
A
vo
id
an
ce
Pe
rf
ec
tio
ni
A
sm
nx
io
us
C
op
in
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g
ci
al
H
A
um
nx
ili
ie
at
ty
io
n
/R
Pe
ej
rf
ec
or
tio
m
an
n
ce
A
Se
nx
pa
ie
ra
ty
tio
n
A
nx
A
ie
nx
ty
ie
ty
D
iso
rd
er
30
To
ta
l
Mean Scores (+/-SEM)
60
55
p = 0.004
TD (n = 34)
2
Elevated depression in 22q11.2DS vs. TD kids
22q (n =39)
TD ( n = 32)
60
p = 0.04
55
p = 0.01
50
45
N
eg
at
iv
e
Se
lfes
te
em
nh
ed
on
ia
A
s
In
ef
fe
ct
iv
en
es
s
Pr
ob
le
m
oo
d
M
In
te
rp
er
so
na
l
eg
at
iv
e
N
D
ep
re
ss
io
n
40
To
ta
l
Mean Score (+/-SEM)
65
Anxiety has measurable
and important behavioral
implications for kids with
22q11.2DS.
3
Separation anxiety does not abate in 22q
(p = 0.015)
Beaton et al. (ongoing study)
Understanding the child’s
ecology…
•
•
•
•
Socioeconomics
School environment and community supports
Environmental health
Community factors (safety and crime, access
to health care, social support, urbanization)
•  Cultural factors, language, and racism
•  Parental stress and mental health
4
Understanding the child’s
ecology…
•
•
•
•
Socioeconomics
School environment and community supports
Environmental health
Community factors (safety and crime, access
to health care, social support, urbanization)
•  Cultural factors, language, and racism
•  Parental stress and mental health
Maternal Depression (BDI)
22Q moms n = 17
Beaton et al. (ongoing study)
5
Maternal Quality-of-Life Scale
Beaton et al. (ongoing study)
Negative and Positive Life Events Over
the Past Year
Beaton et al. (ongoing study)
6
Maternal Depression, Anxiety, and Stress
22q Mothers (n=17)
TD Mothers (n = 5)
Beaton et al. (ongoing study)
Maternal Depression, Anxiety, and Stress
22q Mothers (n=17)
TD Mothers (n = 5)
Ss 001
Beaton et al. (ongoing study)
7
Av
oi
da
nc
e
Pe
rf e
ct
io
ni
sm
An
xi
ou
s
C
op
in
g
So
ci
al
A
H
nx
um
ie
ili a
ty
tio
n
R
ej
ec
Pe
t io
rf o
n
rm
an
ce
Fe
ar
Se
s
pe
ra
ti o
An
n/
Pa
xi
et
ni
y
c
D
is
or
de
rI
nd
ex
M
AS
C
To
ta
l
to
no
m
ic
95
ar
m
at
ic
/A
u
MASC t-scores
So
m
pt
om
s
es
t le
ss
at
ic
/A
ut
on
om
H
ic
ar
m
Av
oi
da
nc
e
Pe
rf e
ct
io
ni
sm
An
xi
ou
s
C
op
in
g
So
ci
al
A
H
nx
um
ie
ili a
ty
tio
n
R
ej
ec
Pe
t io
rf o
n
rm
an
ce
Fe
ar
Se
s
pe
ra
ti o
An
n/
Pa
xi
et
ni
y
c
D
is
or
de
rI
nd
ex
M
AS
C
To
ta
l
Te
ns
e/
R
ym
Ph
ys
ic
al
S
MASC t-scores
95
H
So
m
pt
om
s
es
t le
ss
ym
Te
ns
e/
R
Ph
ys
ic
al
S
Multidimensional Anxiety Scale for
Children
100
90
Ss 001
Ss 001
22q (n = 51 no Ss 001)
22q (n = 51 no Ss 001)
TD (n = 41)
85
80
75
70
65
60
55
50
45
40
35
30
25
Multidimensional Anxiety Scale for
Children
100
90
TD (n = 41)
85
80
75
70
65
60
55
50
45
40
35
30
25
8
N
eg
at
ive
S
ni
a
el
fE
st
ee
m
An
he
do
ne
ss
Ss 001
N
eg
at
ive
S
s
el
fE
st
ee
m
ni
a
ne
ss
An
he
do
In
ef
fe
ct
iv
e
I
oo
d
D
lP
ro
bl
em
eg
at
ive
M
In
te
rp
er
so
na
N
To
ta
lC
Ss 001
In
ef
fe
ct
iv
e
s
oo
d
I
65
lP
ro
bl
em
eg
at
ive
M
D
CDI t-scores
65
In
te
rp
er
so
na
N
To
ta
lC
CDI t-scores
Children’s Depression Scale
70
22q (n = 47)
TD (n = 39)
60
55
50
45
40
35
30
Children’s Depression Scale
70
22q (n = 47)
TD (n = 39)
60
55
50
45
40
35
30
9
SUMMARY – The Child’s Ecology
•  As a group, children with 22q11.2DS report
greater levels of anxiety and depression vs. TD
•  Parental stress, anxiety, and depression is
variable and should be addressed to improve
QOL for parents but also but may affect child
health
•  A family- and community- focused perspective
(eg. parental mental health) needs to be added
Elliott Beaton is joining the
Department of Psychology faculty at
the University of New Orleans
We will be continuing our research on stress,
development and health in children with
22q11.2DS at the MIND Institute and at the:
Stress, Cognition, and Affective
Neuroscience (SCAN) Laboratory
http://psyc.uno.edu/
10
Thank you.
Cognitive Analysis and Brain Imaging
Laboratory
►  Dr. Tony Simon (Primary Mentor)
►  Dr. Flora Tassone (Genetics)
►  Dr. Kathy Angkustsiri (Pediatrics)
►  Dr. Ingrid Leckliter (Clinical Psych)
►  Nina Cung
►  Yingratana (Bella) McLennan, B.S.
►  Margie Cabaral, B.S.
K99 Mentorship
►  Dr. Cameron Carter
►  Dr. Bruce McEwen
►  Dr. Louis Schmidt
►  Dr. Blythe Corbett
►  Dr. Robert McCarron
►  Dr. Richard Maddock
Most importantly, thank you to the participants
and their families.
This project is supported by K99MH086616
awarded to EAB and R01HD042974 to
TJS from the National Institute Of Mental
Health.
11