Factor structure and psychometric properties of the Multidimensional Anxiety Scale for Children in an African American adolescent sample

Social anxiety disorder in Black American adolescents: Cultural considerations in conceptualization, assessment, and treatment

Social anxiety disorder (SAD) is characterized by significant distress and avoidance surrounding social and performance situations, with marked interpersonal and academic impairment. This review article highlights cultural considerations relevant to the conceptualization, identification, and treatment of SAD in Black youth. Research evaluating the utility of evidence-based measures to assess SAD suggests they are culturally relevant; however, gaps in knowledge regarding the psychometric properties of even the most widely used instruments are evident. In regard to intervention, cognitive behavioral therapy (CBT) approaches hold promise, yet there is a lack of research on the use of CBT with Black adolescents. Recommendations to incorporate cultural factors into CBT are provided, and future work investigating culturally adapted interventions is needed. Finally, given significant disparities in access and utilization of mental health services among Black youth, strategies to increase treatment engagement, such as school-based services, are important to consider.

Anxiety, self-efficacy, and their determinants in school students during the COVID-19 pandemic: a survey in Southeastern Iran

BACKGROUND

The COVID-19 pandemic has been linked to various psychological disorders, including anxiety, particularly among the general public. It is crucial to monitor the mental health of school students, who are considered a vulnerable group in society, and assess their self-efficacy, as it can significantly affect their mental health. This study aimed to investigate the levels of anxiety and self-efficacy among school students during the COVID-19 pandemic.

METHODS

This cross-sectional study utilized convenience sampling to examine a sample of 335 school students from Sistan and Baluchestan province in southeastern Iran. An online questionnaire, distributed through social media platforms, was used to collect data. The questionnaire included demographic information, COVID-19 related items, the Multidimensional Anxiety Scale for Children-MASC, and the Self-Efficacy Questionnaire for Children-SEQ-C. Data analysis was conducted using IBM SPSS version 24, with a significance level set at < 0.05.

RESULTS

The study revealed a significant negative correlation between children's anxiety and self-efficacy (r = -0.23, P < 0.001). Several factors were identified as predictors of anxiety, including low self-efficacy (β = -0.29, P < 0.001), female gender (β = 0.27, P < 0.001), concern about family members contracting COVID-19 (β = 0.18, P < 0.001), persistent advice of others to adopt preventive measures (β = 0.14, P < 0.005), level of education (β = -0.12, P < 0.017), and perceived risk of COVID-19 infection (β = -0.11, P < 0.030). These variables collectively accounted for 17% of the variance in anxiety.

CONCLUSION

The findings of the study highlight the importance of addressing the mental health of school students, specifically their anxiety levels, during epidemics. The results also indicate that enhancing self-efficacy among students during a pandemic could be a beneficial strategy for promoting their mental health.

Levels and Instability of Daily Self-Esteem in Adolescents: Relations to Depressive and Anxious Symptoms

The current study examined whether individual differences in depressive and anxious symptoms relate to level of daily self-esteem and instability of daily self-esteem in adolescence. Participants were a racially and ethnically diverse sample of adolescents (79 girls, 65 boys; M age = 13.53 years). Adolescents reported on their depressive and anxious symptoms during a baseline home visit. Then, adolescents reported on their daily self-esteem over the course of 12 consecutive days. Using hierarchical linear modeling analyses, level of daily self-esteem was negatively associated with depressive but not anxious symptoms. In addition, a positive relation emerged between instability of daily self-esteem and depressive symptoms when controlling for level of self-esteem; a similar relation did not emerge for anxious symptoms. The differential findings that emerged between both level and instability of daily self-esteem and depressive versus anxious symptoms may be linked to differences in the temporal orientation of these two types of internalizing symptoms; specifically, depressive symptoms result from backward-looking rumination over previous experiences, whereas anxious symptoms emerge from forward-looking worry about future events (Wenze et al., 2012).

Using Evaluative Criteria to Review Youth Anxiety Measures, Part I: Self-Report

Evidence-based assessment serves several critical functions in clinical child psychological science, including being a foundation for evidence-based treatment delivery. In this Evidence Base Update, we provide an evaluative review of the most widely used youth self-report measures assessing anxiety and its disorders. Guided by a set of evaluative criteria (De Los Reyes & Langer, 2018), we rate the measures as Excellent, Good, or Adequate across their psychometric properties (e.g., construct validity). For the eight measures evaluated, most ratings assigned were Good followed by Excellent, and the minority of ratings were Adequate. We view these results overall as positive and encouraging, as they show that these youth anxiety self-report measures can be used with relatively high confidence to accomplish key assessment functions. Recommendations and future directions for further advancements to the evidence base are discussed.

Dimensionality of the State-Trait Inventory of Cognitive and Somatic Anxiety

The State-Trait Inventory of Cognitive and Somatic Anxiety (STICSA) is a commonly administered self-report instrument of state-trait cognitive and somatic anxiety. Extant research has consistently supported the intended oblique two-factor scoring structure for the STICSA. However, this model assumes that population-level data have (or approximate) a simple structure and that item-level variance is unidimensional. These assumptions may not be tenable and have unintended consequences for STICSA subscore interpretation. Consequently, we tested these assumptions by fitting confirmatory and exploratory structural equation models to STICSA scores for a diverse sample of college students enrolled at a large Southwestern university in the United States (n = 635). Results indicated that cognitive and somatic factors are not equally robust and that STICSA items appear to measure a nonnegligible mixture of both latent cognitive and somatic anxiety. It is recommended that future research use exploratory structural equation model in tandem with CFA to directly model data complexity.

Comparison between the effects of muscle relaxation and support groups on the anxiety of nursing students: A randomized controlled trial

OBJECTIVE

To compare the effects of the two methods of muscle relaxation and support group on the anxiety levels of the nursing students.

METHODS

In this randomized controlled trial, 150 nursing students who met the inclusion criteria were divided into three equal groups-muscle relaxation, support group, and control-using the permuted-block randomization method. The experimental groups received 5 sessions of intervention, while the control group did not receive any intervention at all. Using Spielberger's inventory, the researchers measured the anxiety levels of all three groups before and after the intervention.

RESULTS

The results showed that both methods had a significant impact on anxiety levels of the nursing students; however, a comparison between their effects revealed that muscle relaxation had been more effective than support group.

CONCLUSIONS

Considering the seriousness of the issue of anxiety for nursing students, it is important that measures be taken to reduce anxiety in this group.

Emotional and behavior problems in an urban pediatric primary care setting

We sought to identify needs for behavioral health care in a large, urban pediatric primary care (PPC) clinic serving a population covered by Medicaid. Specifically, children (N = 197; 120 girls; 91 % African American) ages 8-17 years and their caregivers completed measures of internalizing and externalizing symptoms (RCADS, RCADS-P, MASC, and SDQ). Clinical elevations on all but one domain of the SDQ were significantly higher than expected. However, self-reported anxiety and depression symptoms were consistent with expectations. These findings suggest urban, low-income, primarily African American youth presenting at a PPC clinic demonstrate significant levels of behavioral and emotional symptoms. Implications of the findings include the need to ask both parents and children about child behavioral health problems and the possible influence of screening tool selection on detection.

The phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with autism spectrum disorders

This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N = 102; range 7-16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity, functional impairment, and behavioral and emotional problems. Approximately 11 % of youth displayed suicidal thoughts and behaviors. Children with autism were more likely to have suicidal thoughts and behaviors whereas children with Asperger's disorder were less likely. Suicidal thoughts and behaviors were associated with the presence of depression and post-traumatic stress disorder. Overall, results suggest that suicidal thoughts and behaviors are common in youth with ASD, and may be related to depression and trauma.

The multidimensional anxiety scale for children: a further validation with Australian adolescents with and without ADHD

OBJECTIVE

To examine the factor structure of the Multidimensional Anxiety Scale for Children (MASC) with Australian adolescents with and without ADHD.

METHOD

The MASC was administered to 210 high school-aged adolescents (109 males, 101 females), 115 of whom were clinically diagnosed as ADHD (86 males, 29 females). The remaining 95 were non-ADHD community comparisons.

RESULTS

Analyses supported a three-factor model, with a reduced item pool, which combined the Harm Avoidance and Separation Anxiety scales together. This model was invariant across younger and older participants, and across boys and girls. The model was largely invariant across ADHD and non-ADHD groups. The ADHD group had significantly higher Physical Symptom factor scores than the non-ADHD group.

CONCLUSION

The MASC is useful for assessing anxiety in adolescents with and without ADHD, but items reflecting the Harm Avoidance and Separation Anxiety scales may need revising.

Factor structure of measures of anxiety and depression symptoms in African American youth

Previous research has suggested that the factor structure of anxiety measures is different in African American samples compared to majority population samples. However, these findings may be due to misuse of analytic methods rather than meaningful differences in the underlying presentation of anxiety. To address this, we examined the factor structure of two measures of child anxiety: the Revised Children's Anxiety and Depression Scale and the Multidimensional Anxiety Scale for Children in a sample of 229 African American youth. Contrary to previous research, confirmatory factor analyses yielded good fit for the original factor structures of both measures. These results suggest that the underlying factor structure of these measures may not be significantly different for African American and majority population youth as previously thought. The effect of data analytic procedures on subsequent conclusions and theory is discussed and recommendations are made.

The acting White accusation, racial identity, and anxiety in African American adolescents

Acting White is one of the most negative accusations an African American adolescent can receive from another. The accusation can either be made directly or indirectly. Research suggests that receiving the accusation may create distress for some African American adolescents. The current study examined the relationship between experiencing the acting White accusation, racial identity, and anxiety among African American adolescents. High school students completed the Multigroup Ethnic Identity Measure (MEIM), the Multidimensional Anxiety Scale for Children (MASC) and the Acting White Experiences Questionnaire (AWEQ). Results indicated that adolescents who both directly and indirectly experienced the AWA reported higher anxiety than those who only indirectly experienced the AWA. Additionally, adolescents who reported experiencing more indirect aspects of the accusation or being "bothered" more by the accusation reported higher levels of anxiety. Findings suggest that the acting White accusation may be a culturally relevant factor influencing anxiety among African American adolescents.

Emotional and behavioral functioning of offspring of African American mothers with depression

Extensive research demonstrates the negative impact of maternal depression on their offspring. Unfortunately, few studies have been explored in African American families. This study examined emotional and behavioral functioning among children of African American mothers with depression. African American mothers (n = 63), with a past year diagnosis of a depressive disorder, and one of their children (ages 7-14) completed behavioral rating scales in a cross-sectional design. Results showed that 6.5 and 15% scored within the clinical range for depression and anxiety symptoms, respectively. Approximately a third of the offspring reported suicidal ideation. Based on mothers' report, 25.4 and 20.6% of the offspring exhibited internalizing and externalizing symptoms in the clinical range, respectively. Offspring whose mothers were in treatment exhibited higher levels of self-reported anxiety symptoms. Offspring of African American mothers with depression were exhibiting socioemotional problems in ways that are similar to offspring of European American mothers with depression.

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents

The aim of this study was to evaluate the psychometric properties of the Brazilian-Portuguese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of Brazilian children and adolescents. A total of 2410 students completed the 41-item Brazilian-Portuguese version of the SCARED. The one-factor and the five-factor structure of the SCARED fit this sample well. However, the five-factor model had a significantly better fit than the one-factor model and an adequate fit for age and gender subgroups. Anxiety symptoms in Brazilian youth were reported at a moderate-high level as compared to other studies. Females were found to score significantly higher on the total score and on all of the subscales as compared to the males. The total score and each of the five factors for both children and adolescents showed good internal consistency, test-retest and construct validity. According to our findings the Brazilian-Portuguese version of the SCARED is a reliable and valid instrument to assess anxiety in Brazilian children and adolescents.

Factor structure, reliability and validity of the Taiwanese version of the Multidimensional Anxiety Scale for Children

The aims of this study were to examine the factor structure, internal consistency 1 month test-retest reliability and the discriminant validity for the diagnosis of anxiety disorder of the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T). A total of 12,536 Taiwanese children and adolescents in the community were recruited to examine the adequacy of the original four-factor structure of the MASC-T by confirmatory factor analysis and the internal-consistency reliability by Cronbach's alpha across gender and age. The 1 month test-retest reliability was examined using intraclass correlation coefficients (ICC) in 105 children and adolescents in the community. The discriminant validity of the MASC-T for the diagnosis of anxiety disorder was examined in 132 children and adolescents from clinical units. The results of this study supported the four-factor structure of the MASC-T in Taiwanese children and adolescents and the four-factor structure was invariant across gender and age. The 1 month test-retest reliability of the MASC-T was in the satisfactory to excellent range and the internal consistency reliability of the Physical Symptoms, Harm Avoidance, and Social Anxiety scales was acceptable. The discriminant validity of the total MASC-T and the anxiety disorder index for the diagnosis of any anxiety disorder was also confirmed. These results indicate that the MASC-T is appropriate for assessing anxiety in Taiwanese children and adolescents.

A pilot investigation of the rates and predictors of mental health services utilization among depressed African American mothers and their children

OBJECTIVE

Depressed mothers, especially those who are African American, are likely to underutilize mental health services. Children of depressed mothers are an at-risk population with mental health needs that are often unmet. This prospective pilot study examined 3-month frequency rates and predictors of mental health utilization for a sample of African American depressed mothers and their children.

METHODS

Mothers and 1 of their children completed assessment interviews. Three months later, mothers completed a telephone interview of maternal and child mental health utilization.

RESULTS

Overall, 65.3% of depressed mothers and 36.7% of their children had utilized mental health services. Logistic regression analyses indicated that initial mental health treatment significantly predicted maternal mental health utilization. Maternal reports of child behavioral problems significantly predicted child mental health utilization.

CONCLUSIONS

The findings were consistent with other research and showed evidence of mental health use among African Americans who are in need of such services.