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Malloy LC, Dykstra VW, Steen LAR, Filoso D, Salem H, Comer JS, Peris TS, Pincus DB, Ehrenreich-May J, Evans AD. Avoidant Parent-Child Communication About COVID-19: A Longitudinal Investigation of Associations with Youth Adjustment Across the First 6 Months of the Pandemic. Res Child Adolesc Psychopathol 2024; 52:253-266. [PMID: 37801269 DOI: 10.1007/s10802-023-01133-1] [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] [Accepted: 09/27/2023] [Indexed: 10/07/2023]
Abstract
In the aftermath of discrete disasters, how families discuss the event has been linked with child well-being. There is less understanding, however, of how family communication affects adjustment to a protracted and ongoing public health crisis such as the COVID-19 pandemic. The present research leveraged a large longitudinal sample of families (N = 1884) across the United States and Canada to investigate factors that predicted family communication styles (active versus avoidant communication) about the COVID-19 pandemic and examined the longitudinal sequelae of mental health outcomes for youth associated with different family communication styles. Parents of youth between 5 to 17 years old completed surveys about their own mental health, their child's mental health, and family communication about the COVID-19 pandemic at two time points 6 months apart. Overall, findings indicated that poorer parental mental health was related to greater use of avoidant communication, and avoidant communication styles were associated with poorer youth mental health over time. Findings suggest potential perils of avoidant family communication about ongoing threats and can help identify families at risk of negative mental health outcomes.
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Affiliation(s)
- Lindsay C Malloy
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, ON, Canada.
| | | | | | - Daniella Filoso
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, ON, Canada
| | - Hanan Salem
- Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, CA, USA
| | - Jonathan S Comer
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Tara S Peris
- Department of Psychiatry & Biobehavioral Sciences / Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA, USA
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
| | | | - Angela D Evans
- Department of Psychology, Brock University, St. Catharine's, ON, Canada
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2
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Abstract
Anxiety disorders (ADs) frequently lead to significant impairment across important domains of youth functioning. Yet until recently, clinical research and assessment have largely neglected the measurement of anxiety-related impairment. In this article, we review the evidence for five extant rating scales of youth anxiety-related impairment, guided by widely used evaluative criteria. Emerging psychometric data show the potential utility of these rating scales for achieving different assessment functions. Of the five scales, the Child Anxiety Impact Scale, particularly the parent-report version, has been the most researched one. Promising psychometric data support its use for assessing anxiety-related impairment in school, social, and family/home domains of functioning. We conclude with recommendations for growing this research base and for incorporating these rating scales into the youth AD clinical and research assessment process.
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Affiliation(s)
- Rebecca G Etkin
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Eli R Lebowitz
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Wendy K Silverman
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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3
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Hiller TS, Hoffmann S, Teismann T, Lukaschek K, Gensichen J. Psychometric evaluation and Rasch analyses of the German Overall Anxiety Severity and Impairment Scale (OASIS-D). Sci Rep 2023; 13:6840. [PMID: 37100805 PMCID: PMC10133318 DOI: 10.1038/s41598-023-33355-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
The Overall Anxiety Severity and Impairment Scale (OASIS) is a 5-item self-report measure that captures symptoms of anxiety and associated functional impairments. This study evaluates a German version (OASIS-D) that was administered to a convenience sample of 1398 primary care patients of whom 419 were diagnosed with panic disorder with/without agoraphobia. Psychometric properties were analyzed using classical test theory as well as probabilistic test theory. Factor analyses suggested a unitary (latent) factor structure. The internal consistency was good to excellent. Convergent as well as discriminant validity with other self-report measures was found. A sum score (range 0-20) of ≥ 8 emerged as optimal cut-score for screening purposes. A difference score of ≥ 5 was indicative of reliable individual change. A Rasch analysis of local item independence suggested response dependency between the first two items. Rasch analyses of measurement invariance detected noninvariant subgroups associated with age and gender. Analyses of validity and optimal cut-off score were solely based on self-report measures, which may have introduced method effects. In sum, the findings support the transcultural validity of the OASIS and indicate its applicability to naturalistic primary care settings. Caution is warranted when using the scale to compare groups that differ in age or gender.
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Affiliation(s)
- Thomas S Hiller
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany
| | - Sabine Hoffmann
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Marchioninistr. 15, 81377, Munich, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstraße 9-13, 44787, Bochum, Germany
| | - Karoline Lukaschek
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany.
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany.
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Freitag GF, Salem H, Conroy K, Busto C, Adrian M, Borba CPC, Brandt A, Chu PV, Dantowitz A, Farley AM, Fortuna L, Furr JM, Lejeune J, Miller L, Platt R, Porche M, Read KL, Rivero-Conil S, Hernandez RDS, Shumway P, Sikov J, Spencer A, Syeda H, McLellan LF, Rapee RM, McMakin D, Pincus DB, Comer JS. The Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the Kids FACE FEARS sample. J Anxiety Disord 2023; 94:102677. [PMID: 36773484 DOI: 10.1016/j.janxdis.2023.102677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
There is tremendous need for brief and supported, non-commercial youth- and caregiver-report questionnaires of youth anxiety. The pediatric and parent proxy short forms of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety scale (8a v2.0) are free, brief, publicly accessible measures of youth- and caregiver-reported anxiety in children and adolescents. Despite increased use of the PROMIS, no study has evaluated performance of its anxiety scales in a sample of treatment-engaged anxious youth. Analyses were conducted on baseline data from the first 265 families (child MAge=11.14 years, 70% racial/ethnic minoritized youth) to enroll in the Kids FACE FEARS trial, a multisite comparative effectiveness trial of therapist-led vs. self-administered treatment for elevated youth anxiety. Confirmatory factor analysis (CFA) examined factor structure; omega coefficients and regression models examined internal consistency, convergent validity, and cross-informant reliability. CFA supported adjusted single-factor solutions across youth and caregiver reports, and internal consistency was high. Convergent validity was supported by medium-to-large associations with anxiety-related impairment and severity. Moderate cross-informant reliability between reports was found. Results showcase the first psychometric study of the PROMIS Anxiety scale short forms among treatment-engaged youth with elevated anxiety. Findings highlight the PROMIS Anxiety scale's utility in typical care settings for youth anxiety.
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Affiliation(s)
- Gabrielle F Freitag
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA.
| | - Hanan Salem
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Carolina Busto
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Molly Adrian
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Amelia Brandt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Annie Dantowitz
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Alyssa M Farley
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Lisa Fortuna
- University of California San Francisco, San Francisco, CA, USA
| | - Jami M Furr
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Julia Lejeune
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Leslie Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michelle Porche
- University of California San Francisco, San Francisco, CA, USA
| | - Kendra L Read
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | | | | | | | - Jennifer Sikov
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Andrea Spencer
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Haniya Syeda
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Lauren F McLellan
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Dana McMakin
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA; Nicklaus Children's Hospital, Miami, FL, USA
| | - Donna B Pincus
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
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Fear of illness & virus evaluation (FIVE) COVID-19 scales for children-parent/caregiver-report development and validation. J Anxiety Disord 2022; 89:102586. [PMID: 35640483 PMCID: PMC9125994 DOI: 10.1016/j.janxdis.2022.102586] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Commonly-used youth anxiety measures may not comprehensively capture fears, worries, and experiences related to the pervasive impact of the COVID-19 pandemic. This study described the development of the Fear of Illness and Virus Evaluation (FIVE) scales and validated the caregiver-report version. METHOD After initial development, feedback was obtained from clinicians and researchers, who provided suggestions on item content/wording, reviewed edits, and provided support for the updated FIVE's content and face validity. Factor structure, measurement invariance, and psychometric properties were analyzed using data from a multi-site, longitudinal study of COVID-19-related effects on family functioning with 1599 caregivers from the United States and Canada. RESULTS Confirmatory factor analyses indicated a hierarchical five-factor structure best fit the data, resulting in a 31-item measure with four lower-order subscales: (1) Fears about Contamination and Illness; (2) Fears about Social Distancing, (3) Avoidance Behaviors, and (4) Mitigation Behaviors, and a higher-order factor, (5) Total Fears, indicated by the two fear-related lower-order subscales. Measurement invariance by country of residence, child age, and child sex was found. All subscales demonstrated strong internal consistency, appropriate item-scale discrimination, and no floor or ceiling effects. The Total Fears subscale demonstrated appropriate test-retest reliability. Concurrent validity supported by strong correlation with a youth anxiety measure. DISCUSSION The FIVE provides a psychometrically-sound measure of COVID-19-related fears and behaviors in youth in a caregiver-report format. Future research is necessary to evaluate correlates and longitudinal symptom patterns captured by the FIVE caregiver-report, as well as the validity and reliability of a youth self-report version of the FIVE.
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