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Hathway T, McLellan LF, Dear BF, Trompeter N, Carl T, Wuthrich V, Hudson JL, Rapee RM. The psychometric properties of the Mini Social Phobia Inventory in a treatment seeking sample of children and their caregivers. Cogn Behav Ther 2024:1-19. [PMID: 39235930 DOI: 10.1080/16506073.2024.2397673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/15/2024] [Indexed: 09/07/2024]
Abstract
The Mini Social Phobia Inventory (Mini-SPIN) is a short 3-item measure of social anxiety disorder (SAD). Using existing data, the current study examined the psychometric properties of the Mini-SPIN using a large, treatment seeking sample of children aged 6-16 years with data available for youth (n = 695, 170) and their caregivers (n = 703, 177) at pre-treatment and follow-up, respectively. The ability of the Mini-SPIN to discriminate between those with and without SAD was examined at pre-treatment and 6-month follow-up, across caregiver and child report. The criterion group validity, internal consistency and construct validity of the measure was also examined. Results revealed that at pre-treatment the Mini-SPIN demonstrated good discriminant validity in detecting cases of SAD from non-SAD (with cut-off of 4 on child report, and 6 on caregiver report). At 6-month follow-up, the discriminant ability of the Mini-SPIN was found to be less than acceptable for child reported scores, but acceptable for caregiver reported scores. The Mini-SPIN further demonstrated good criterion group validity, internal consistency and construct validity across caregiver and child report. Overall, the findings from the current study lend further support for the use of the Mini-SPIN as a screening tool for SAD.
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Affiliation(s)
- Taylor Hathway
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Lauren F McLellan
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Blake F Dear
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Nora Trompeter
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Talia Carl
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Viviana Wuthrich
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Jennifer L Hudson
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Ronald M Rapee
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
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2
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Spencer SD, Pinciotti CM, Murphy C, Hertz A, Wiese AD, Wood JJ, Kendall PC, Storch EA. Concurrent Validity of the Anxiety Disorders Section of the Anxiety Disorder Interview Schedule- Autism Spectrum Addendum (ADIS-ASA) in Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06496-y. [PMID: 39096461 DOI: 10.1007/s10803-024-06496-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Examine the concurrent validity of specific Anxiety Disorders Section of the Anxiety Disorder Interview Schedule for DSM-IV-Autism Spectrum Addendum (ADIS-ASA)-Parent Interview in a sample of 167 autistic youth who met diagnostic criteria for an anxiety-related disorder (Mage = 9.91; 78.4% male; 82% non-Hispanic; 77.67% White). METHODS Concurrent validity of Diagnostic and Statistical Manual (DSM)-defined ADIS-ASA anxiety disorder diagnostic caseness was examined via relations with (a) parent-reported dimensions of youth anxiety symptomology and (b) dimensional measures of youth anxiety-related functional impairment, respectively, using logistic regression models and point-biserial correlations. RESULTS Significant relations were found between separation anxiety disorder and social anxiety disorder (but not generalized anxiety disorder nor obsessive-compulsive disorder) caseness, respectively, and theoretically consistent facets of dimensional youth anxiety symptomology. Relations between ADIS-ASA diagnostic caseness and youth functional impairment-related variables revealed that only separation anxiety disorder demonstrated robust evidence of convergent validity. CONCLUSION Despite mixed findings concerning relations between ADIS-ASA anxiety disorder diagnostic caseness and dimensional measures of anxiety severity and anxiety-related impairment, the present findings provide further support for the status of the ADIS-ASA as a gold standard for assessment of anxiety in autistic youth. This work also highlights the importance of continuing to improve precision in measurement of anxiety symptomology in autistic youth, with implications for clinical assessment.
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Affiliation(s)
- Samuel D Spencer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Caitlin M Pinciotti
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Callie Murphy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alyssa Hertz
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey J Wood
- Department of Education, University of California, Los Angeles, USA
- Department of Psychiatry, University of California, Los Angeles, USA
| | - Philip C Kendall
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Burrows CA, Lasch C, Gross J, Girault JB, Rutsohn J, Wolff JJ, Swanson MR, Lee CM, Dager SR, Cornea E, Stephens R, Styner M, John TS, Pandey J, Deva M, Botteron KN, Estes AM, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Gilmore JH, Shen MD, Piven J, Elison JT. Associations between early trajectories of amygdala development and later school-age anxiety in two longitudinal samples. Dev Cogn Neurosci 2024; 65:101333. [PMID: 38154378 PMCID: PMC10792190 DOI: 10.1016/j.dcn.2023.101333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Amygdala function is implicated in the pathogenesis of autism spectrum disorder (ASD) and anxiety. We investigated associations between early trajectories of amygdala growth and anxiety and ASD outcomes at school age in two longitudinal studies: high- and low-familial likelihood for ASD, Infant Brain Imaging Study (IBIS, n = 257) and typically developing (TD) community sample, Early Brain Development Study (EBDS, n = 158). Infants underwent MRI scanning at up to 3 timepoints from neonate to 24 months. Anxiety was assessed at 6-12 years. Linear multilevel modeling tested whether amygdala volume growth was associated with anxiety symptoms at school age. In the IBIS sample, children with higher anxiety showed accelerated amygdala growth from 6 to 24 months. ASD diagnosis and ASD familial likelihood were not significant predictors. In the EBDS sample, amygdala growth from birth to 24 months was associated with anxiety. More anxious children had smaller amygdala volume and slower rates of amygdala growth. We explore reasons for the contrasting results between high-familial likelihood for ASD and TD samples, grounding results in the broader literature of variable associations between early amygdala volume and later anxiety. Results have the potential to identify mechanisms linking early amygdala growth to later anxiety in certain groups.
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Affiliation(s)
| | - Carolyn Lasch
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Julia Gross
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joshua Rutsohn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Chimei M Lee
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Stephen R Dager
- Deptartment of Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - Emil Cornea
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Stephens
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Tanya St John
- University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Meera Deva
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Annette M Estes
- University of Washington Autism Center, University of Washington, Seattle, WA, USA; Deptartment of Speech and Hearing Science, University of Washington, Seattle, WA, USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jed T Elison
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Clyde A, Bismar D, Agnew G, Kuper LE. Autism Spectrum Disorder and Anxiety Among Transgender Youth: Use of the Social Communication Questionnaire (SCQ). J Autism Dev Disord 2024; 54:615-627. [PMID: 36422761 DOI: 10.1007/s10803-022-05814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
Abstract
Autism spectrum disorder (ASD) and ASD symptoms are overrepresented among gender-diverse youth across studies. Gender-diverse and ASD youth are at risk for anxiety, but anxiety is unclear among gender-diverse youth with ASD. The Social Communication Questionnaire (SCQ) is a commonly used ASD screener, including in multidisciplinary gender-affirming programs, but scholars have disagreed on the most optimal cut-off score. To date, no study has investigated the sensitivity and specificity of its established cut-off score of 15 with a sample of transgender youth. Gaining more accurate information about the utility of ASD screening tools with gender diverse youth is critical in order to help refer youth to needed services. Among a sample of 325 transgender youth, this study sought to determine an optimal cut-off score for the SCQ, the prevalence of ASD and ASD symptoms, and the relationship between ASD and anxiety within this population. The current study found that a lower cut-off score of 11 yielded optimal sensitivity and specificity (i.e., the best balance of accurately identifying individuals with ASD based on the screener), and analyses found an overrepresentation of ASD (5.2%) and ASD traits (12.1%). Transgender youth with ASD or ASD symptoms had higher anxiety, and all youth perceived themselves as more anxious than their parents. Future research is needed to identify the needs of this population, with particular consideration for the lived experiences of gender diverse and transgender youth.
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Affiliation(s)
- Alexis Clyde
- Children's Health System of Texas, 1935 Medical District Dr., Mail Code CH 12.01, Dallas, TX, 75235, USA.
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | | - Gabrielle Agnew
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laura E Kuper
- Children's Health System of Texas, 1935 Medical District Dr., Mail Code CH 12.01, Dallas, TX, 75235, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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McDonald EJ, Bedard C, Kirkpatrick SI, Perlman CM, Ferro MA. Psychometric properties and informant agreement of the WHODAS 2.0 in youth with mental disorder. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2023; 32:38-49. [PMID: 36776927 PMCID: PMC9879036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 12/03/2022] [Indexed: 02/14/2023]
Abstract
Objective This study examined psychometric properties, parent-youth agreement, and factors associated with agreement on the 12-item and 36-item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Methods Data come from a clinical sample of 56 youth, aged 14-17 years, receiving mental health care at a pediatric hospital. Correlations between the WHODAS 2.0, KIDSCREEN-27, and demographic variables were used to assess validity. Internal consistency was measured using ordinal alpha. The Bland-Altman method and intraclass correlation coefficients (ICC) were used to assess parent-youth agreement. Logistic regression examined factors associated with disagreement > 0.5 standard deviation. Results For both parent and youth, correlations were low to moderate in exploring convergent (τ= -0.42 to 0.01) and divergent validity (τ/r = -0.12 to 0.32). Internal consistency was adequate (α > 0.7). Parent WHODAS 2.0 scores were significantly lower than youth scores and Bland-Altman plots revealed poor parent-youth agreement (ICC = -0.04 to 0.33). Lower household income was associated with lower odds of disagreement on the 35-item WHODAS 2.0 (OR= 0.28, 95% CI= 0.08-0.99), and older youth age was associated with lower odds of disagreement on the 12-item WHODAS 2.0 (OR= 0.40, 95% CI= 0.19-0.84). Conclusion The psychometric properties of both WHODAS 2.0 versions were similar, so the abbreviated version may be sufficient to measure functional impairment in a clinical context. Additional research is needed to better understand the factors that influence discrepancies between informants and the implications for care. However, reports from both youth and parents appear valuable in understanding functional impairment.
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Affiliation(s)
- Erica J. McDonald
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
| | - Chloe Bedard
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
| | | | | | - Mark A. Ferro
- University of Waterloo, School of Public Health Sciences, Waterloo, Ontario
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6
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Anksiyete Bozukluğu Tanılı Ergenlerin Belirtileri Açısından Ergen-Ebeveyn Uyumu. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1148404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim: Considering the role of the parent in the children and adolescent's access to treatment, it is important that the symptoms are adequately noticed by the parents. In this study, it was aimed to examine the adolescent-parent agreement in terms of symptoms of adolescents with anxiety disorder.
Material and Method: 100 adolescents who applied to the child and adolescent psychiatry outpatient clinic and were diagnosed with anxiety disorder according to the DSM-5 diagnostic criteria were included in the study. In the study, the sociodemographic form and the Revised Child Anxiety and Depression Scale (RCADS) adolescent and parent form were used for data collection.
Results: When the parent and adolescent forms of RCADS were compared, the adolescent scores were significantly higher than the parents in all subscales and scale total scores, except for the separation anxiety subscale. The ICC (95% CI) value between the parent and adolescent forms of RCADS ranged from 0.06 to 0.74.
Conclusion: In our study, it was found that adolescents scored their symptoms higher than their parents, and the correlation between parent-child reporting was low-moderate. Age, gender, comorbidity, and parental psychopathology were among the factors affecting adolescent-parent agreement.
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Bendezú JJ, Calhoun CD, Wadsworth ME. Within-person patterns of psychobiological stress response correspondence: links to preadolescent internalizing problems and coping behaviors. ANXIETY, STRESS, AND COPING 2022; 35:592-608. [PMID: 34632877 PMCID: PMC8994789 DOI: 10.1080/10615806.2021.1982912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Though correspondence across the affective experience and physiologic arousal levels of the stress response is thought to support efficacious coping and buffer against internalizing problems, little evidence has demonstrated such correspondence. Using a community sample of preadolescents (N=151, Mage=10.33 years, Minage=8.92, Maxage=12.00, 51.7% male), this person-centered study examined internalizing problem and coping-linked variability in psychobiological stress response correspondence. Preadolescents were exposed to the Trier Social Stress Test and self-reported negative affect (NA) and salivary cortisol (SC) levels were assessed. Multitrajectory modeling revealed four subgroups. Relative to In-Touch (i.e., Moderate NA-Moderate SC; n=65), Unmindful (i.e., Moderate NA-Low SC; n=49) were more likely to present with parent-reported but not self-reported internalizing problems; Vigilant (i.e., High NA-Low SC; n=13) were more likely to present with self- and parent-reported internalizing problems, less likely to use engagement coping, and more likely to use wishful thinking (e.g., "I wish problems would just go away."); Denial (i.e., Low NA-High SC; n=24) self-reported similarly low internalizing problems, but were also more likely to report reliance on denial (e.g., "I pretend problems don't exist."). Findings illustrate meaningful heterogeneity in preadolescent psychobiological correspondence with implications for multimodal assessment and outcome monitoring in coping-based preventative interventions.
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Affiliation(s)
- Jason José Bendezú
- Department of Psychology, S463 Elliott Hall, University of Minnesota, Minneapolis, MN 55455
| | - Casey D. Calhoun
- Department of Psychiatry, UNC School of Medicine, 101 Manning Drive, CB 7160 Chapel Hill, NC 27599
| | - Martha E. Wadsworth
- Department of Psychology, 216 Moore Building, The Pennsylvania State University, University Park, PA 16802
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Robe A, Dobrean A, Balazsi R, Georgescu RD, Păsărelu CR, Predescu E. Factor Structure and Measurement Invariance Across Age, Gender, and Clinical Status of the Screen for Children Anxiety Related Emotional Disorders. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2022. [DOI: 10.1027/1015-5759/a000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The purpose of this study was to examine evidence of reliability, validity, and equity, for the Romanian version of The Screen for Child Anxiety Related Emotional Disorders (SCARED), the 41-item child- (1,106 children and adolescents ranging from 9 to 16 years old) and parent-ratings (485 parents). Both versions of the instrument showed moderate to high internal consistency, with most subscales reaching acceptable levels. Results showed support for the original five-factor structure of the scale. Positive correlations with other measures of anxiety symptoms, such as The Penn State Worry Questionnaire, The Social Anxiety Scale for Adolescents, The Children’s Automatic Thoughts Scale, whereas weak correlations with the syndrome scales for rule-breaking and aggressive behavior of the Youth Self-Report, respectively, Child Behavioral Checklist have demonstrated similar construct validity for the Romanian version of the scale as compared to the original one. Also, strict measurement invariance across age, gender, and clinical status was established. The current research provides evidence of reliability, validity, and equity for SCARED, arguing for its utility as a screening instrument for anxiety symptoms. Implications for theory, assessment, and future research are discussed.
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Affiliation(s)
- Andreea Robe
- Doctoral School “Evidence-based assessment and psychological interventions”, Babeş-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Anca Dobrean
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Robert Balazsi
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Raluca D. Georgescu
- Doctoral School “Evidence-based assessment and psychological interventions”, Babeş-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Costina R. Păsărelu
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Elena Predescu
- Department of Neuroscience, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Romania
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McDonald E, Whitney S, Horricks L, Lipman EL, Ferro MA. Parent-Child Agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:264-272. [PMID: 34777509 PMCID: PMC8561856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Multiple informants are often used in the assessment of child psychopathology; however, parent-child agreement is low in child psychiatry. The objective of this exploratory study was to assess informant agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a clinical sample of children with mental disorders and their parents, and to examine health and demographic factors associated with agreement. METHOD MINI-KID results were analyzed for 88 parent-child dyads. Children were between 8-17 years old and were receiving in- or outpatient services for at least one mental disorder at a pediatric hospital. Kappas were calculated to assess parent-child agreement and logistic regression models were used to identify factors associated with agreement. RESULTS Agreement was low to moderate (κ=0.19-0.41) across the MINI-KID modules. Household income was associated with agreement for major depression, generalized anxiety, and attention-deficit hyperactivity disorder. Recruitment setting and parent psychological distress were associated with agreement for generalized anxiety and separation anxiety, respectively. Age, sex, and child disability/impairment were not associated with agreement. CONCLUSIONS Parent-child agreement on the MINI-KID was low to moderate, and few factors were associated with agreement. These initial findings reaffirm the need for multiple informants when assessing psychopathology in children and can be used by health professionals to facilitate parent-child discussions in clinical settings in child psychiatry.
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Affiliation(s)
- Erica McDonald
- University of Waterloo, School of Public Health and Health Sciences, Waterloo, Ontario
| | - Sydney Whitney
- University of Waterloo, School of Public Health and Health Sciences, Waterloo, Ontario
| | - Laurie Horricks
- Department of Child Psychiatry, McMaster Children's Hospital, Hamilton, Ontario
| | - Ellen L Lipman
- Department of Child Psychiatry, McMaster Children's Hospital, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Mark A Ferro
- University of Waterloo, School of Public Health and Health Sciences, Waterloo, Ontario
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10
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Behrens B, Swetlitz C, Pine DS, Pagliaccio D. The Screen for Child Anxiety Related Emotional Disorders (SCARED): Informant Discrepancy, Measurement Invariance, and Test-Retest Reliability. Child Psychiatry Hum Dev 2019; 50:473-482. [PMID: 30460424 PMCID: PMC7339086 DOI: 10.1007/s10578-018-0854-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a measure widely used to assess childhood anxiety based on parent and child report. However, while the SCARED is a reliable, valid, and sensitive measure to screen for pediatric anxiety disorders, informant discrepancy can pose clinical and research challenges. The present study assesses informant discrepancy, measurement invariance, test-retest reliability, and external validity of the SCARED in 1092 anxious and healthy parent-child dyads. Our findings indicate that discrepancy does not vary systematically by the various clinical, demographic, and familial variables examined. There was support for strict measurement invariance, strong test-retest reliability, and adequate external validity with a clinician-rated measure of anxiety. These findings further support the utility of the SCARED in clinical and research settings, but low parent-child agreement highlights the need for further investigation of factors contributing to SCARED informant discrepancy.
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Affiliation(s)
- Brigid Behrens
- Emotion and Development Branch, The National Institute of Mental Health, Bethesda, MD, 20892, USA.
| | - Caroline Swetlitz
- Emotion and Development Branch, The National Institute of Mental Health, Bethesda, MD 20892
| | - Daniel S. Pine
- Emotion and Development Branch, The National Institute of Mental Health, Bethesda, MD 20892
| | - David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY 10032
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11
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Burrows CA, Usher LV, Becker-Haimes EM, McMahon CM, Mundy PC, Jensen-Doss A, Henderson HA. Profiles and Correlates of Parent-Child Agreement on Social Anxiety Symptoms in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:2023-2037. [PMID: 29332179 DOI: 10.1007/s10803-018-3461-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study characterized patterns and correlates of parent-youth agreement on social anxiety in youth with and without autism spectrum disorder (ASD). Participants (279 verbally-fluent youth aged 8-16 years, NASD = 144, NTD = 135) completed the SASC-R. Youth with ASD exhibited higher social anxiety across informants. While TD youth endorsed higher anxiety than did parents, self- and parent-reports did not differ in youth with ASD. For children with ASD, higher parent-youth agreement was associated with lower lifetime ASD symptoms and higher adaptive skills. For TD youth, agreement on high anxiety was associated with lowest adaptive skills. Demographic factors (age, verbal IQ, gender) did not relate to agreement for either group. In ASD, parent-child agreement on youth anxiety, either high or low, was associated with better outcomes.
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Affiliation(s)
- Catherine A Burrows
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.
| | - Lauren V Usher
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.,Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Emily M Becker-Haimes
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.,Center for Mental Health Policy & Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Camilla M McMahon
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.,Department of Social and Behavioral Sciences, Miami University, Hamilton, OH, USA
| | - Peter C Mundy
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.,University of California-Davis MIND Institute, Davis, CA, USA
| | - Amanda Jensen-Doss
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA
| | - Heather A Henderson
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33156, USA.,Department of Psychology, University of Waterloo, Waterloo, ON, Canada
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12
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Becker SP, Schindler DN, Holdaway AS, Tamm L, Epstein JN, Luebbe AM. The Revised Child Anxiety and Depression Scales (RCADS): Psychometric Evaluation in Children Evaluated for ADHD. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019; 41:93-106. [PMID: 30930533 PMCID: PMC6438181 DOI: 10.1007/s10862-018-9702-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Co-occurring internalizing symptoms are common and important to assess in children with attention-deficit/hyperactivity disorder (ADHD). One frequently used child self-report measure of internalizing symptoms is the Revised Child Anxiety and Depression Scales (RCADS), yet the psychometric properties of the RCADS remain unexamined in children referred for ADHD specifically. The present study evaluated the RCADS in 117 children (ages 8-12; 66% male) evaluated for suspected ADHD at an ADHD specialty clinic (83% met criteria for ADHD). In addition to the RCADS, children completed measures of social anxiety and depression. Parents completed the RCADS-Parent Version (RCADS-P) in addition to other measures of internalizing and externalizing symptoms. Children and parents both completed a measure of aggression. Factor structure, reliability, and convergent/discriminant validity of the RCADS were examined. Results supported the six-factor structure of the child-report RCADS (Separation Anxiety, Social Phobia, Generalized Anxiety Disorder, Panic Disorder, and Obsessive Compulsive Disorder, Major Depressive Disorder). The RCADS demonstrated adequate reliability as well as convergent and discriminant validity with other child ratings. The total anxiety score on the RCADS also demonstrated convergent and discriminant validity with parent measures, though the depression score on the RCADS did not. Findings provide preliminary psychometric support for the RCADS in children referred for ADHD.
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Affiliation(s)
- Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Dana N. Schindler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alex S. Holdaway
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Leanne Tamm
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jeffery N. Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Aaron M. Luebbe
- Department of Psychology, Miami University, Oxford, Ohio, USA
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13
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Spence SH. Assessing anxiety disorders in children and adolescents. Child Adolesc Ment Health 2018; 23:266-282. [PMID: 32677290 DOI: 10.1111/camh.12251] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Susan H Spence
- Australian Institute for Suicide Research and Prevention and School of Applied Psychology, Griffith University, Mt Gravatt, Australia
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14
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Walter F, Nitkowski D, Petermann F. Wie gut stimmen Eltern- und Kinderurteile bei der Einschätzung von Kinderängsten überein? KINDHEIT UND ENTWICKLUNG 2018. [DOI: 10.1026/0942-5403/a000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Im Rahmen der vorliegenden Studie soll die Interrater-Reliabilität des Eltern- und Kinderurteils für alle Skalen des Bereichsspezifischen Angstfragebogens für Kinder und Jugendliche (BAK) und der Einfluss von möglichen Variablen (Alter und Geschlecht des Kindes) auf die Übereinstimmung von Eltern- und Kindurteil ermittelt werden. Es wurden 572 Kinder und Jugendliche (295 Mädchen; 277 Jungen) im Alter von 9 bis 16 Jahren aus der Allgemeinbevölkerung und ihre Eltern anhand des BAK zu den Ängsten befragt. Berechnet wird die Interrater-Reliabilität sowohl für die intervallskalierten Daten (T-Werte) als auch für die daraus resultierenden kategorialen Daten. Es zeigt sich ausschließlich ein Alterseffekt auf die Übereinstimmung in den Punktwerten für die Skala Naturgewalten des BAK. Für alle Skalen des BAK mit Ausnahme der Skalen Medizinischer Bereich und Trennung/Unbekanntes konnte ein Geschlechtseffekt belegt werden. Die Interrater-Reliabilitäten sind als gering bis mittelmäßig einzustufen (ICC = .33 bis .62; Krippendorffs αü = .25 bis .57; Gewichtetes Cohens ϰ = .29 bis .58). Die Beurteiler-Übereinstimmungen fallen über alle Skalen hinweg bei den Mädchen höher aus als bei den Jungen. Die Ergebnisse verdeutlichen, dass es sinnvoll ist, bei der Beurteilung der Angstsymptomatik eines Kindes sowohl das Selbsturteil als auch das Elternurteil einzuholen.
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Affiliation(s)
- Franziska Walter
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Dennis Nitkowski
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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15
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Taylor JH, Lebowitz ER, Jakubovski E, Coughlin CG, Silverman WK, Bloch MH. Monotherapy Insufficient in Severe Anxiety? Predictors and Moderators in the Child/Adolescent Anxiety Multimodal Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2018; 47:266-281. [PMID: 28956620 PMCID: PMC6191182 DOI: 10.1080/15374416.2017.1371028] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This secondary analysis of the Child/Adolescent Anxiety Multimodal Study (CAMS) used baseline patient characteristics to identify prognostic subgroups of children based on likelihood of remission. We also investigated predictors and moderators of outcome. CAMS randomized 488 youths with generalized, social, and separation anxiety disorders to cognitive behavioral therapy (CBT), sertraline, both, or pill placebo. Outcomes were Week 12 child, parent, and independent evaluator (IE) ratings of child anxiety. We used receiver operating characteristics analysis and stepwise regression to identify predictors and moderators of outcome. Severe anxiety, lower socioeconomic status, and comorbid obsessive-compulsive disorder predicted higher IE-rated anxiety posttreatment; child-rated social anxiety predicted poorer outcomes reported by all informants. Regarding moderators, Hispanic ethnicity predicted higher IE-rated anxiety after CBT and higher parent-rated anxiety after sertraline. In youths with severe anxiety (Pediatric Anxiety Rating Scale ≥ 20, <italic>n</italic> = 220), combination treatment increased remission (relative risk [RR] = 2.85, <italic>p</italic> < .001), 95% confidence interval (CI) [1.51, 5.39], whereas CBT (RR = 1.55, <italic>p</italic> = .20), 95% CI [0.77, 3.10], and sertraline (RR = 1.27, <italic>p</italic> = .53), 95% CI [0.59, 2.73], did not significantly increase remission relative to placebo. These are the first findings demonstrating that a combination of CBT and a selective serotonin reuptake inhibitor, not monotherapy, is likely key for achieving remission in severe anxiety. CAMS was not powered to detect treatment efficacy after stratification by anxiety severity, so further research is needed regarding effective treatments in severe anxiety. Our main effect findings suggest youth with severe anxiety (especially social phobia), low socioeconomic status and obsessive-compulsive disorder benefit less from current first-line treatments relative to other anxious youth. ClinicalTrials.gov: NCT00052078.
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16
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Predictors of Parent-Teacher Agreement in Youth with Autism Spectrum Disorder and Their Typically Developing Siblings. J Autism Dev Disord 2018; 47:2575-2585. [PMID: 28547408 DOI: 10.1007/s10803-017-3173-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study evaluated the magnitude of informant agreement and predictors of agreement on behavior and emotional problems and autism symptoms in 403 children with autism and their typically developing siblings. Parent-teacher agreement was investigated on the Child Behavior Checklist (CBCL) and Social Responsiveness Scale (SRS). Agreement between parents and teachers fell in the low to moderate range. Multiple demographic and clinical variables were considered as predictors, and only some measures of parent broad autism traits were associated with informant agreement. Parent report on the SRS was a positive predictor of agreement, while teacher report was a negative predictor. Parent report on the CBCL emerged as a positive predictor of agreement, while teacher report emerged as a negative predictor.
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17
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Plourde V, Daya H, Low TA, Barlow KM, Brooks BL. Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents. Child Neuropsychol 2018; 25:44-59. [PMID: 29382257 DOI: 10.1080/09297049.2018.1432585] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents' symptom reporting. Participants (N = 33; 9-18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children - C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents' reports of anxiety and depression symptoms and considering potential discrepancies between informants' answers.
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Affiliation(s)
- Vickie Plourde
- a Faculty Saint-Jean, University of Alberta , Alberta , Canada
| | - Hussain Daya
- b Department of Psychology , University of Lethbridge , Lethbridge , Canada
| | - Trevor A Low
- c Department of Neuroscience , Cumming School of Medicine, University of Calgary , Alberta , Canada
| | - Karen M Barlow
- d Dr. Paul Hopkins Chair of Paediatric Rehabilitation, Child Health Research Centre, Faculty of Medicine , The University of Queensland , South Brisbane , Australia.,e Department of Pediatrics , Cumming School of Medicine, University of Calgary , Alberta , Canada
| | - Brian L Brooks
- e Department of Pediatrics , Cumming School of Medicine, University of Calgary , Alberta , Canada.,f Alberta Children's Hospital Research Institute , University of Calgary , Alberta , Canada.,g Neurosciences Program , Alberta Children's Hospital , Alberta , Canada.,h Department of Psychology, Faculty of Arts , University of Calgary , Alberta , Canada
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18
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Linking Mother–Child Discrepancies to Behavioral Observations of Children’s Anxiety. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9441-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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19
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Becker-Haimes EM, Jensen-Doss A, Birmaher B, Kendall PC, Ginsburg GS. Parent-youth informant disagreement: Implications for youth anxiety treatment. Clin Child Psychol Psychiatry 2018; 23:42-56. [PMID: 28191794 PMCID: PMC5988273 DOI: 10.1177/1359104516689586] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Greater parent-youth disagreement on youth symptomatology is associated with a host of factors (e.g., parental psychopathology, family functioning) that might impede treatment. Parent-youth disagreement may represent an indicator of treatment prognosis. Using data from the Child/Adolescent Anxiety Multimodal Study, this study used polynomial regression and longitudinal growth modeling to examine whether parent-youth agreement prior to and throughout treatment predicted treatment outcomes (anxiety severity, youth functioning, responder status, and diagnostic remission, rated by an independent evaluator). When parents reported more symptoms than youth prior to treatment, youth were less likely to be diagnosis-free post-treatment; this was only true if the youth received cognitive-behavioral therapy (CBT) alone, not if youth received medication, combination, or placebo treatment. Increasing concordance between parents and youth over the course of treatment was associated with better treatment outcomes across all outcome measures ( ps < .001). How parents and youth "co-report" appears to be an indicator of CBT outcome. Clinical implications and future directions are discussed.
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Affiliation(s)
- Emily M Becker-Haimes
- 1 Department of Psychology, University of Miami, USA
- 2 Perelman School of Medicine, University of Pennsylvania, USA
| | | | - Boris Birmaher
- 3 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, USA
| | | | - Golda S Ginsburg
- 5 Department of Psychiatry, University of Connecticut Health Center, USA
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20
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Hale AE, Ginsburg GS, Chan G, Kendall PC, McCracken J, Sakolsky D, Birmaher B, Compton S, Marie Albano A, Walkup J. Mediators of Treatment Outcomes for Anxious Children and Adolescents: The Role of Somatic Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2018; 47:94-104. [PMID: 28278599 PMCID: PMC6129169 DOI: 10.1080/15374416.2017.1280804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors are effective treatments for pediatric anxiety disorders. However, the mechanisms of these treatments are unknown. Previous research indicated that somatic symptoms are reduced following treatment, but it is unclear if their reductions are merely a consequence of treatment gains. This study examined reductions in somatic symptoms as a potential mediator of the relationship between treatment and anxiety outcomes. Participants were 488 anxious youth ages 7-17 (M = 10.7), 50.4% male, 78.9% Caucasian, enrolled in Child/Adolescent Anxiety Multimodal Study, a large randomized control trial comparing 12-week treatments of CBT, sertraline, a combination of CBT and sertraline, and a pill placebo. Causal mediation models were tested in R using data from baseline, 8-, and 12-week evaluations. Somatic symptoms were assessed using the Panic/Somatic subscale from the Screen for Child Anxiety Related Emotional Disorders. Youth outcomes were assessed using the Pediatric Anxiety Rating Scale and Children's Global Assessment Scale. Reductions in somatic symptoms mediated improvement in anxiety symptoms and global functioning for those in the sertraline-only condition based on parent report. Conditions involving CBT and data based on child reported somatic symptoms did not show a mediation effect. Findings indicate that reductions in somatic symptoms may be a mediator of improvements for treatments including pharmacotherapy and not CBT. Although the overall efficacy of sertraline and CBT for anxiety may be similar, the treatments appear to function via different mechanisms.
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Affiliation(s)
- Amy E. Hale
- University of Connecticut Health Center, 65 Kane St, West Hartford, CT 06119
| | - Golda S. Ginsburg
- University of Connecticut Health Center, 65 Kane St, West Hartford, CT 06119
| | - Grace Chan
- University of Connecticut Health Center, 65 Kane St, West Hartford, CT 06119
| | | | - James McCracken
- UCLA Semel Institute of Neuroscience and Human Behavior, Los Angeles, CA
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21
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Developmental relations between amygdala volume and anxiety traits: Effects of informant, sex, and age. Dev Psychopathol 2017; 30:1503-1515. [DOI: 10.1017/s0954579417001626] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AbstractAlthough substantial human and animal evidence suggests a role for the amygdala in anxiety, literature linking amygdala volume to anxiety symptomatology is inconclusive, with studies finding positive, negative, and null results. Clarifying this brain–behavior relation in middle to late childhood is especially important, as this is a time both of amygdala structural maturation and the emergence of many anxiety disorders. The goal of the current study was to clarify inconsistent findings in previous literature by identifying factors moderating the relation between amygdala volume and anxiety traits in a large sample of typically developing children aged 6–13 years (N = 72). In particular, we investigated the moderating effects of informant (parent vs. child), age, and sex. We found that children's reports (i.e., self-reports) were related to amygdala volume; children who reported higher anxiety levels had smaller amygdalae. This negative relation between amygdala volume and anxiety weakened with age. There was also an independent effect of sex, such that relations were stronger in males than in females. These results indicate the importance of considering sample and informant characteristics when charting the neurobiological mechanisms underlying developmental anxiety.
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