The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis

Efficacy of Mentalization-based group therapy for adolescents: the results of a pilot randomised controlled trial

BACKGROUND

Mentalization Based Therapy (MBT) has yielded promising outcomes for reducing self-harm, although to date only one study has reported MBT's effectiveness for adolescents (Rossouw and Fonagy, J Am Acad Child Adolesc Psychiatry 51:1304-1313, 2012) wherein the treatment protocol consisted of an intensive programme of individual and family therapy. We sought to investigate an adaptation of the adult MBT introductory manual in a group format for adolescents.

METHODS

The present study is a randomised controlled single blind feasibility trial that aims to (1) adapt the original explicit MBT introductory group manual for an adolescent population (MBT-Ai) and to (2) assess the feasibility of a trial of MBT-Ai through examination of consent rates, attendance, attrition and self-harm. Repeated measures ANOVAs were conducted to examine change over time in independent and dependent variables between groups, and multi level models (MLM) were conducted to examine key predictors in relation to change over time with self-report self-harm and emergency department presentation for harm as the primary outcome variables.

RESULTS

Fifty-three young people consented to participate and were randomised to MBT-Ai + TAU or TAU alone. Five participants withdrew from the trial. Trial procedures seemed appropriate and safe, with acceptable group attendance. Self-reported self-harm and emergency department presentation for self-harm significantly decreased over time in both groups, though there were no between group differences. Social anxiety, emotion regulation, and borderline traits also significantly decreased over time in both groups. Mentalization emerged as a significant predictor of change over time in self reported self harm and hospital presentation for self-harm.

CONCLUSIONS

It was feasible to carry out an RCT of MBT-Ai for adolescents already attending NHS CAMHS who have recently self-harmed. Our data gave signals that suggested a relatively brief group-based MBT-Ai intervention may be a promising intervention with potential for service implementation. Future research should consider the appropriate format, dosage and intensity of MBT for the adolescent population.

TRIAL REGISTRATION

NCT02771691 ; Trial Registration Date: 25/04/2016.

The Revised Mental Health Inventory-5 (MHI-5) as an ultra-brief screening measure of bidimensional mental health in children and adolescents

The Mental Health Inventory-5 (MHI-5) is a brief, valid, and reliable international instrument for assessing mental health in adults. The aim of the present study is to examine the psychometric properties of the MHI-5 in children and adolescents. A sample of 595 students (10-15 years old) completed the MHI-5 Spanish version adapted for this study, as well as another measure of anxiety and depression symptoms, and a clinical interview as a gold standard. The overall coefficient obtained indicate good internal consistency. A unique factor solution explaining a 53.70% and a two-factor structure explaining 69.20% of the total variance were obtained. The correlations with total and subscale scores of anxiety and depression were significant. A ROC analysis showed good properties as a screening test to predict anxiety and depressive diagnoses in children and adolescents. The Revised MHI-5 presents two essential changes: a simplified 4-point response format and a new factor solution including distress and well-being. These outcomes show that the Revised MHI-5 is a brief, valid, and reliable measure to bidimensionally assess mental health and screening emotional disorders in children and adolescents.

Pathways Into Psychosocial Adjustment in Children: Modeling the Effects of Trait Emotional Intelligence, Social-Emotional Problems, and Gender

Trait Emotional intelligence (Trait EI) can be understood as a personality trait related to individual differences in recognition, processing, and the regulation of emotionally charged information. Trait EI has been considered a variable of great importance in determining psychosocial adjustment. However, most research on Trait EI has focused on adult and adolescent populations, while very few studies have explored its influence on children. The aim of this study was to analyze possible pathways into psychosocial adjustment in children by examining the combined effects of Trait EI and emotional and social problems. It also aimed to assess the possible mediating role of gender in this relationship. A total of 268 Spanish children participated in this study, ranging in age from 8 to 12 years (mean age = 10.09, SD = 1.32, 45.10% male). Selected measures were applied through a web-based survey called DetectaWeb. The regression and mediation/moderation analyses confirmed that psychosocial adjustment in children was determined by Trait EI directly and by emotional and social problems in an indirect way. Together, the three variables explained 46% of the variance in psychosocial adjustment, although Trait EI was the most powerful predictor (44%), demonstrating incremental validity over and above social and emotional problems. In addition, gender was shown to be a moderating variable between Trait EI and psychosocial adjustment; for girls specifically, lower Trait EI scores were a determinant of lower levels of psychosocial adjustment, regardless of emotional and social problems. It can be concluded that the identified pathways provide keys for emotional education interventions aimed at promoting psychosocial adjustment, well-being, and good mental health among children. Our findings support the buffer role of Trait EI against maladjustment risk in children, but more clearly in girls.

Validation of the Revised Children's Anxiety and Depression Scales (RCADS) and RCADS short forms adapted for adults

BACKGROUND

The life span nature of anxiety and depression has led to an interest in whether assessments designed for use with children and young people are also valid for adults. The Revised Children's Anxiety and Depression Scales (RCADS) is a commonly used measure and we aimed to explore its structural validity in adults.

METHODS

We examined the factorial validity of the original and two short form versions of the (RCADS) adapted for adults, using confirmatory factor analysis with a convenience sample (n = 371) aged 18-67.

RESULTS

All versions of the RCADS were found to provide reliable measures of general anxiety and depression in adults and of most subdimensions of anxiety corresponding to the original version of the RCADS. However, anxiety subdimension reliability was primarily driven by the strong general anxiety dimension, due to the high comorbidity between anxiety subtypes.

LIMITATIONS

We did not include data for children as well as adults in our analyses and small changes were made to the wording of five RCADS items to make them appropriate for adults.

CONCLUSIONS

Results suggest that all versions could be helpful for longitudinal and comparative research and evaluation of clinical outcomes, in situations where the focus is on general anxiety and depression, rather than clinical subtypes.

Psychometric properties of two adolescent depression scales in a colombian community sample: ADRS and RCADS -major depression

La depresión puede presentarse a cualquier edad; sin embargo, cuando ocurre en etapas tempranas de la vida el pronóstico es menos favorable. La identificación y el tratamiento tempranos necesitan herramientas válidas y confiables para evaluar la depresión en niños y adolescentes. El presente estudio analizó, en una muestra comunitaria colombiana, las propiedades psicométricas de dos escalas breves de depresión, utilizando métodos de la Teoría Clásica de los Test: Escala de Valoración de Depresión Adolescente (ADRS) versión de auto-reporte y la Escala de Ansiedad y Depresión Infantil Revisada (RCADS)– Subescala de Depresión Mayor. El análisis de las dos escalas mostró correlaciones ítem-ítem e ítemescala, moderadas y significativas. La consistencia interna fue significativa y adecuada para ambas escalas, ADRS (0.67) y RCADS-Depresión Mayor (0.71). Para ADRS, dos factores explicaron 37.39% de la varianza, mientras que la soluciónde un solo factor explicó 25.99% de la varianza. Para RCADS-Depresión Mayor, dos factores explicaron el 41.81% de varianza y un factor único explicó 29.14%. La validez de constructo fue satisfactoria, ambas escalas mostraron correlaciones moderadas y significativas con el criterio convergente (KADS-11) y el criterio discriminante (RCADS-Ansiedad Generalizada); aunque más fuertes en el primer caso. Los resultados evidencian que ADRS y RCADS-Depresión Mayor son herramientas efectivas para la valoración de síntomas depresivos en niños y adolescentes.

UCLA PTSD reaction index for DSM-5 (PTSD-RI-5): a psychometric study of adolescents sampled from communities in eleven countries

Background: Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed. Objective: The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms. Method: Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated. Results: The PTSD-RI-5 total score for the entire sample shows very good reliability (α = .92) as well as across all countries included (α ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance. Conclusions: The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.

Does sickle cell disease have a psychosomatic component? A particular focus on anxiety and depression

Sickle cell disease, an early-age genetic condition, encompasses a range of blood disorders with severe complications. This disease is characterized by the synthesis of abnormal hemoglobin molecules, which tend to polymerize due to their low solubility upon deoxygenation in the peripheral capillary beds, resulting in sickle-like red blood cells. Sickled cells lose their normal functioning and hemodynamic properties, leading to chronic fatigue as well as to episodes of painful crises. Over the last two decades, a growing body of clinical evidence has pointed out that these somatic complaints can give rise to neuropsychiatric disorders, among which anxiety and depression are the most common, that worsen the health-related quality of life in patients. At first glance, this somatic influence may be unsurprising, as both anxiety and depressive signs are prevalent in almost all chronic diseases. However, in the case of a genetic condition such as sickle cell disease whose somatic disturbances are predetermined, the fact that mood disorders can increase fatigue and pain through a psychosomatic component has attracted increasing attention. In this review, we address the hypothesis of a psychosomatic component in patients with sickle cell disease by underlining the most relevant clinical studies that have highlighted the existence of a bidirectional link between physical and psychological sequelae, which are reported to be relieved not only by pharmacological cotreatments but also by the concomitant application of cognitive behavioral therapy.

Assessing anxiety disorders in children and adolescents

BACKGROUND

Given the relatively high prevalence of anxiety problems among young people and their adverse consequences if left untreated, it is important that clinicians and researchers have access to reliable and valid assessment tools to facilitate early detection, case formulation, treatment design and evaluation of outcomes.

METHOD

This paper presents the findings of a pragmatic review of the literature regarding the assessment of anxiety in young people in multiple contexts, including mental health services, school-based screening and research trials.

RESULTS

Commonly used diagnostic interviews, questionnaire measures and alternative assessment methods are described, along with psychometric properties and practical issues. The review indicates the complexities of assessing anxiety problems given the high level of comorbidity between anxiety disorders and with depression. It also highlights the different approaches required for assessment across different age groups, the need for multiple informants and issues relating to the lack of agreement between reporters. There is a strong evidence-base for several diagnostic instruments and anxiety scales, although the accuracy of youth and parent report scales in forming clinical diagnoses is not sufficiently strong to justify their use in isolation for diagnostic purposes.

CONCLUSIONS

The assessment of youth anxiety should ideally include a multiinformant, multimethod approach, with measures tailored to the age of the child, and the purpose of the evaluation. There is now a sufficiently strong research base to enable clinicians and researchers to ensure that they select evidence-based instruments.

Web of Science use in published research and review papers 1997-2017: a selective, dynamic, cross-domain, content-based analysis

Clarivate Analytics's Web of Science (WoS) is the world's leading scientific citation search and analytical information platform. It is used as both a research tool supporting a broad array of scientific tasks across diverse knowledge domains as well as a dataset for large-scale data-intensive studies. WoS has been used in thousands of published academic studies over the past 20 years. It is also the most enduring commercial legacy of Eugene Garfield. Despite the central position WoS holds in contemporary research, the quantitative impact of WoS has not been previously examined by rigorous scientific studies. To better understand how this key piece of Eugene Garfield's heritage has contributed to science, we investigated the ways in which WoS (and associated products and features) is mentioned in a sample of 19,478 English-language research and review papers published between 1997 and 2017, as indexed in WoS databases. We offered descriptive analyses of the distribution of the papers across countries, institutions and knowledge domains. We also used natural language processingtechniques to identify the verbs and nouns in the abstracts of these papers that are grammatically connected to WoS-related phrases. This is the first study to empirically investigate the documentation of the use of the WoS platform in published academic papers in both scientometric and linguistic terms.

The Spanish Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: Study Protocol for a Cluster Randomized Controlled Trial

Background

Anxiety and depression are common, impairing conditions that evidence high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is one of the few existing resources aimed at applying transdiagnostic treatment principles to target core dysfunctions associated with both anxiety and depression within a single protocol. To our knowledge, this is the first study examining the efficacy of the UP-A adapted as a universal preventive intervention program.

Objective

The primary aim of this study is to examine whether the Spanish version of the UP-A is more effective than a waitlist (WL) control group in reducing and preventing symptoms of anxiety and depression when employed as a universal, classroom-based preventive intervention. The secondary aim is to investigate changes in a broad range of secondary outcome measures, including negative and positive affect, anxiety sensitivity, emotional avoidance, top problems ratings, school grades, depression and anxiety-related interference, self-esteem, life satisfaction, quality of life, conduct problems, hyperactivity/inattention symptoms, peer problems, prosocial behavior, school adjustment, and discipline problems. Other aims are to assess a range of possible predictors of intervention effects and to examine the feasibility and the acceptability of implementing UP-A in a prevention group format and in a school setting.

Methods

A cluster, randomized, WL, controlled trial design with classroom as the unit of randomization was used in this study. Five classes including a total of 152 adolescents were randomized to the experimental or WL control groups. Participants in the experimental group received 9 55-minute sessions delivered by advanced doctoral and masters students in clinical psychology. The WL control group will receive the intervention once the 3-month follow-up assessment is completed.

Results

We have recruited participants to the cluster randomized controlled trial (RCT) and have conducted the intervention with the experimental group. We expect the WL control group to complete the intervention in July 2017. Data analysis will take place during the second semester of 2017.

Conclusions

We expect the experimental group to outperform the WL control group at post-intervention and 3-month follow-up. We also expect the WL control group to show improvements in primary and secondary outcome measures after receiving the intervention. Results will have implications for researchers, families, and education providers.

Trial Registration

Clinicaltrials.gov NCT03123991; https://clinicaltrials.gov/ct2/show/NCT03123991 (Archived by WebCite at http://www.webcitation.org/6qp7GIzcR)