Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample

Profiles of socioemotional functioning in children with and without CPS-subtantiated maltreatment: Associations with child maltreatment and dating violence

OBJECTIVE

Person-centered approaches are essential for characterizing heterogeneity in child development as it relates to child maltreatment (CM) and dating violence. The present study had two aims: 1) identify person-centered patterns of childhood socioemotional functioning, 2) examine whether patterns of child socioemotional functioning mediate the association between CM and dating violence.

PARTICIPANTS AND SETTING

Wave 1 comprised N = 680 children ages 10-12 years with and without experiences of CPS-substantiated CM facing socio-economic challenge. Wave 2 included N = 407 emerging adults ages 18-24 years old.

METHODS

Children participated in a summer camp research program at Wave 1 and a follow up interview at Wave 2. Participant CM history and socioemotional functioning was assessed at Wave 1. Exposure to dating violence was assessed at Wave 2. A latent profile analysis identified patterns of socioemotional functioning. Then regression analyses examined associations of socioemotional functioning with CM and dating violence.

RESULTS

Three profiles of child socioemotional functioning were identified (well-regulated/low distress, high externalizing/high aggression, high internalizing). CM was significantly associated with membership in the high externalizing/high aggression class. Patterns of child socioemotional functioning did not mediate the association between CM and dating violence, although number of subtypes of CM had a significant positive direct effect on dating violence.

CONCLUSIONS

Results underscore the multidimensional nature of socioemotional functioning and the predictive power of number of subtypes of CM on dating violence. Results can be harnessed by clinicians and policy makers to identify those at risk and interrupt cycles of violence.

Early adolescent perceived friendship quality aids affective and neural responses to social inclusion and exclusion in young adults with and without adverse childhood experiences

Friendships increase mental wellbeing and resilient functioning in young people with childhood adversity (CA). However, the mechanisms of this relationship are unknown. We examined the relationship between perceived friendship quality at age 14 after the experience of CA and reduced affective and neural responses to social exclusion at age 24. Resilient functioning was quantified as psychosocial functioning relative to the degree of CA severity in 310 participants at age 24. From this cohort, 62 young people with and without CA underwent functional Magnetic Resonance Imaging to assess brain responses to social inclusion and exclusion. We observed that good friendship quality was significantly associated with better resilient functioning. Both friendship quality and resilient functioning were related to increased affective responses to social inclusion. We also found that friendship quality, but not resilient functioning, was associated with increased dorsomedial prefrontal cortex responses to peer exclusion. Our findings suggest that friendship quality in early adolescence may contribute to the evaluation of social inclusion by increasing affective sensitivity to positive social experiences and increased brain activity in regions involved in emotion regulation to negative social experiences. Future research is needed to clarify this relationship with resilient functioning in early adulthood.

Prevalence of mental health symptoms and associated risk factors among healthcare workers in specialized COVID-19 hospitals in Anyang, China: A cross-sectional survey

Background

The novel coronavirus disease 2019 (COVID-19) pandemic spread worldwide and brought unprecedented challenges to healthcare systems. Healthcare workers experienced tremendous pressure and psychological issues.

Methods

A cross-sectional online survey was conducted from January 2022 to April 2022 among healthcare workers in Anyang, Henan Province, China. Insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and problematic internet use (PIU) were evaluated. Logistic regression analyses were used to explore the factors that were associated with mental health problems.

Results

A total of 242 participants (mean [SD] age, 34.7 [6.6] years, 187 female [77.3 %]) were included in the study. The prevalence of symptoms of insomnia, anxiety, depression, PTSD and PIU during the COVID-19 pandemic in China was 53.7 %, 100.0 %, 7.0 %, 20.3 %, and 19.4 %, respectively. Participants who smoked, used sedative-hypnotic drugs and may need psychological assistance were at a higher risk for mental health problems. Respondents who were older than 45 years and were married displayed a lower risk of insomnia and PTSD, respectively.

Conclusions

Mental health symptoms are pervasive among healthcare workers in specialized COVID-19 hospitals during the outbreak. Risk factors include smoking, sedative-hypnotic drug use, and the need for psychological assistance, while protective factors include age and marital status. Developing social media platforms and providing psychological assistance may be effective interventions for healthcare workers.

Parent-coached exposure therapy versus cognitive behavior therapy for childhood anxiety disorders

Cognitive-behavioral therapy (CBT) is the strongest evidenced-based therapy for childhood anxiety disorders (CADs). However, CBT's impact is limited by its lack of clear superiority over treatment as usual, excessive length, and greater than 50% of patients remaining symptomatic. Parent-coached exposure therapy (PCET) is designed to treat CADs more effectively and efficiently through a focus on exposure and working with parents and youth together. In a randomized controlled trial, 78 patients (78% female) aged 7 to 17 with CADs were assigned to PCET or the gold-standard CBT. The primary outcome was independent evaluator ratings of anxiety severity at mid- and post-treatment. Secondary outcomes were parent- and child-reported symptoms. Patients receiving PCET had significantly lower mean scores than those receiving CBT on the primary outcome measure at mid-treatment (3.03 ± 0.14, 95% CI, 2.75-3.32 vs. 3.77 ± 0.16 95% CI, 3.45-4.08, p = 0.0010) and post-treatment (2.79 ± 0.14, 95% CI, 2.50-3.07 vs. 3.33 ± 0.16, 95% CI, 2.02-3.64, p = 0.0153). Similar significant results were found with the secondary parent- and child-reported outcomes. These superior results were achieved in PCET with fewer sessions (6.62, SD = 2.8) than those in CBT (8.00, SD = 3.1), p = 0.041. The superior effectiveness and efficiency of PCET likely results from the greater focus on implementing exposure exercises compared to traditional CBT.

Association of adolescent postural tachycardia syndrome classifications with anxiety: a cross sectional study

BACKGROUND

Postural tachycardia syndrome (POTS), a subset of orthostatic dysregulation, has been reported to be associated with anxiety. POTS can be classified into two forms based on the degree of tachycardia during orthostasis. Reportedly, POTS with decreased orthostatic heart rate increase is associated with suppressed cardiac parasympathetic activity and increased sympathetic activity in the supine position. In this study, the relationship between the two types of POTS and anxiety was evaluated in terms of autonomic function.

METHODS

Fifty-two patients (23 male, age 10-15 years) who were diagnosed with POTS at the Department of Pediatrics, Osaka Medical and Pharmaceutical University from 2019 to 2021, completed a standing test and were accordingly classified into a Su group, with tachycardia from the supine position and a low heart rate increase on standing, a SI group, with a high heart rate increase during standing. They then completed the State-Trait Anxiety Scale for Children (STAIC) questionnaire. Autonomic function was assessed by frequency analysis (MemCalc method) based on heart rate, blood pressure changes, heart rate and blood pressure variability during the orthostatic test.

RESULTS

Patients in the Su group had higher trait anxiety and state anxiety, lower cardiac parasympathetic activity (RR-HF) in the supine position, and greater variability in cardiac parasympathetic activity during orthostasis than were found for patients in the SI group. The Su group had a greater decrease in cardiac index on standing than that of the SI group.

CONCLUSIONS

The Su group results may be partly attributed to chronically low venous return. We also found that patients in the Su group had low parasympathetic activity in the supine position, which may interact with the anxiety-prone characteristics of these patients. Therefore, it seems necessary to consider both physical and psychosomatic treatment approaches for patients with POTS.

The impact of a guided paced breathing audiovisual intervention on anxiety symptoms in Palestinian children: a pilot randomized controlled trial

BACKGROUND

Children in Palestine may be at high risk for anxiety symptoms. However, access to mental health services is limited. Therefore, the objective of this study was to conduct a pilot randomized controlled trial to examine whether a guided audiovisual paced breathing intervention was feasible, acceptable, and improved anxiety symptoms in Palestinian children.

METHODS

Students (6-10 years old) in an after-school program in Palestine were randomly assigned to the intervention or control condition. All participants completed a pre- and post-intervention measure of anxiety using the Revised Children's Manifest Anxiety Scale. Participants in the intervention completed 24 sessions over 8 weeks and rated breathing ease as well as pre- and post-session relaxation on a 5-point Likert scale. To examine condition differences in post-intervention anxiety, four analyses of covariance were conducted, adjusting for age, sex, and pre-intervention anxiety.

RESULTS

A total of 144 participants (65.3% girls; Mage  = 7.5 ± 1.2; 50% per condition) enrolled in the study. There were no differences in demographics or baseline anxiety between the two conditions (ps > .05). Participants reported that it was easy to breathe during the sessions (Ms = 4.1-4.7, SDs = 0.5-1.1). For all but the first session, participants reported being more relaxed after the breathing session than before (ps < .003). Post-intervention, participants in the intervention reported fewer anxiety symptoms compared to participants in the control condition (ps < .01).

CONCLUSION

A guided paced breathing audiovisual intervention was feasible and had a significant positive impact on anxiety symptoms in Palestinian children compared to a control condition. Future research should examine whether the audiovisual guided breathing intervention significantly improves long-term outcomes.

The effects of a Journey of the Brave Counseling Program on anxiety, well-being, and life adjustment in Taiwanese children

The purposes of the current study are two-fold. Study 1 aimed to examine the psychometric properties of the Spence Children's Anxiety Scale (SCAS) in a Taiwanese sample. Study 2 aimed to explore the immediate and follow-up effects of Journey of the Brave Counseling Program (JBCP) on children's' anxiety, well-being, and life adjustment. A review and suggestions were provided for future research and practitioners in educational and counseling fields as reference. In Study 1, the pilot study included 150 to 200 children between ages 11 and 12 in Taoyuan City. In Study 2, we conducted a pretest-posttest nonequivalent groups quasi-experimental design. The participants in this stage were 16 children in an elementary school in Taoyuan City, between ages 11 and 12. After obtaining consent forms from the participants' guardians, we randomly assigned these participants to an experimental group (N = 8) and a control group (N = 8). The experimental group received a 40-minute JBCP session weekly for ten weeks. The control group received a 40-minute career exploration small group counseling weekly for ten weeks. We administered the SCAS, Psychological Well-Being Scale, and School Life Adjustment Scale in the pretest, posttest, and follow-up test to measure change of anxiety, well-being, and life adjustment of the participants. In addition, the current study implemented some qualitative data, such as group progress notes, group member feedback questionnaires, and semi-structured interviews with participants' homeroom teachers as supplementary data to clarify the effects of the JBCP. In Study 1, we found that the SCAS had a good validity and reliability for Taiwanese children. The results of Study 2 indicated that the JBCP had immediate and follow-up effects on the separation anxiety in the experimental group. With the pretest impact eliminated, the immediate and follow-up effects on overall anxiety in the experimental group were better than those on the control group. However, even though the immediate and follow-up effects of the JBCP on the experimental group were better than the control group but were not significant. Besides, the group member feedback questionnaires and participants' homeroom teachers all indicated that the experimental group participants had positive attitude toward the JBCP, and they also positively improved their emotions and interpersonal relationships with others.

More prevalent and more severe: gender differences of depressive symptoms in Chinese adolescents

Background

Adolescent depression has become a leading problem around the world, especially as the COVID-19 pandemic has remained prevalent and heavily influenced people's mental health. While gender difference has always been a topic in the field of psychiatry, there are cultural differences across the world that must be taken into account. The current study is examining gender differences in symptoms of Chinese adolescents with depression.

Methods

The sample was obtained from a total of 574 adolescent patients (172 males and 402 females) diagnosed with depression following the DSM-IV/ICD-10 diagnostic criteria; patients who also had other severe mental or physical illnesses were excluded. The ages of participants ranged from 10 to 19 years. Additionally, independent t-test and one-way ANOVA were used to examine differences in symptoms between different gender and age groups. The LPA was used to examine whether females and males were having different patterns of symptoms.

Results

Our analysis showed that compared to males, females exhibited higher rates of depression and more severe depressive symptoms across age groups. Likewise, the analysis also revealed an earlier onset of depression among Chinese adolescents compared to that in Western countries in previous studies. Finally, the LPA showed that mild to moderate depression was predominant in male patients, while severe depression was predominant in female patients.

Conclusion

This study highlights the gender differences in the prevalence and severity of depressive symptoms in Chinese adolescents. The current study highlighted the importance of gender equality and developing gender-friendly interventions in maintaining the overall mental health of adolescents in China.

A person-centered data analytic approach to dopaminergic polygenic moderation of child maltreatment exposure

The present study illustrates the utility of latent class analysis, a person-centered data analytic approach, as an innovative method for identifying naturally occurring patterns of polygenic risk, specifically within the dopaminergic system. Moreover, this study tests whether latent classes of polygenic variation moderate the effect of child maltreatment exposure on internalizing symptoms among African ancestry youth. African ancestry youth were selected for this study because youth of color are overrepresented in the child welfare system and because African ancestry individuals are significantly underrepresented in genomics research. Results identified three latent classes of dopaminergic gene variation. Class 1 was marked predominately by homozygous minor alleles, Class 2 was characterized by homozygous major and heterozygous presentations, and Class 3 was marked by heterozygous alleles on the DAT-1 single-nucleotide polymorphisms (SNPs) and a combination of homozygous major and minor alleles on the other SNPs. Results indicated that a greater number of maltreatment subtypes experienced were associated with higher internalizing symptoms only for children with the latent polygenic Class 2 pattern. This latent class was distinctly characterized by more homozygous major or heterozygous allelic presentations along all three DAT-1 SNPs. This significant latent polygenic class by environment interaction was replicated in an independent replication sample. Together, findings suggest that African ancestry children with a pattern of dopaminergic variation characterized by this specific combination of polygenic variation are more vulnerable to developing internalizing symptoms following maltreatment exposure, relative to their peers with other dopamine-related polygenic patterns.

The Legacy of Mental Distress Following Physical Illness in Childhood: Findings From the Australian Temperament Project

OBJECTIVE

Childhood physical illnesses have been associated with heightened risk for mental health problems in adolescence and young adulthood; however, little is known about the natural history of this relationship. Here, we examine the nature of mental health adjustment to illness from diagnosis in childhood into adolescence and young adult life.

METHODS

Data were drawn from a large population-based cohort. Parents reported whether their child had a physical illness at 5-6 and 7-8 years and whether they believed their child was so sick it was thought they might die. Depression and anxiety symptoms were reported by parents (for children 7-10 years) and self-reports (11-28 years).

RESULTS

A total of 1,001 (56%) parents reported their child had a physical illness. Of these parents, 143 (8%) believed their child might die. Findings indicated there was some evidence of higher levels of depressive and anxious symptoms across late childhood and into early adolescence for those reporting a physical illness in childhood. A similar pattern was observed for those who were so sick it was thought they might die, although symptoms were elevated to a greater extent.

CONCLUSION

Although physical illness in middle childhood is associated with higher levels of depressive and anxious symptoms, by early adolescence, these differences diminish, indicating a process of adaptation that persists into young adulthood. This suggests a potentially sensitive period of adjustment to illness for some, especially for children who it was feared might die. Additional psychosocial assessment and support may be warranted across the "acute" illness period.

Parent problem drinking trajectory classes predict anxiety in adolescence and emerging adulthood

BACKGROUND

This study identified latent trajectory classes for maternal problem drinking and paternal problem drinking and examined the associations between these trajectory classes and offspring anxiety symptoms during adolescence and emerging adulthood.

METHODS

Participants (n = 870; 54% female; 59% non-Hispanic White; Mage = 16.10, SD = 0.71) were administered surveys during the spring of 2007, 2008, and 2009, and 2014.

RESULTS

Fit indices from parallel process growth mixture models suggested three dual trajectory classes: (1) Low initial levels of maternal problem drinking and paternal problem drinking that increased over time (Low-Both); (2) Low initial levels of maternal problem drinking that increased over time and high initial levels of paternal problem drinking that increased slightly over time (Low-Mom/High-Dad); (3) High initial levels of maternal problem drinking that increased slightly over time and low initial levels of paternal problem drinking that remained relatively stable over time (High-Mom/Low-Dad). Girls were more likely than boys to be classified in the Low-Mom/High-Dad and High-Mom/Low-Dad classes, relative to the Low-Both trajectory class. In addition, adolescents in the High-Mom/Low-Dad trajectory class reported the most anxiety symptoms during adolescence and emerging adulthood.

LIMITATIONS

Limitations include the reliance on one informant (the adolescent/emerging adult) and the geographically limited sample (northeastern United States).

CONCLUSIONS

Prevention and intervention programs aimed at reducing anxiety should consider changes in alcohol use in both the father and the mother over time. Moreover, special attention should be paid to maternal problem drinking given that it appears to be a salient risk factor for anxiety during adolescence and emerging adulthood.

Using Technology to Promote Therapist Use of Exposure Therapy for Childhood Anxiety Disorders: A Randomized Pilot Study

Increasing the use of exposure by community therapists during the treatment of childhood anxiety disorders is critical to improving the quality of available treatment. The aim of the current study was to investigate whether a brief training in the delivery of an exposure-focused and technology-assisted treatment protocol increased community therapist openness to exposure therapy, use of exposure in treatment, and improvement in patient symptoms. Participants were 17 therapists recruited from a large health system to provide outpatient therapy to 32 youth ages 8-18 (M = 12.13, 78.1% girls) with treatment as usual or with the Anxiety Coach application (AC-app). Consistent with two of three hypotheses, therapists in the AC-app condition increased their openness to, and use of, exposure-however, these changes did not translate into improved therapeutic outcomes. Comparisons to benchmark studies suggest that the community therapists did not implement enough in vivo exposure of sufficient intensity or include parents enough to improve outcome. Results support the ability of exposure-focused treatment protocols to increase community therapists' use of evidence-based treatment and suggest that future efforts should focus on improving the quality, in addition to quantity, of therapist-delivered exposure.

The Relationship Between Anxiety, Coping, and Disordered-Eating Attitudes in Adolescent Military-Dependents at High-Risk for Excess Weight Gain

Adolescent military-dependents are an understudied population who face unique stressors due to their parents' careers. Research suggests that adolescent military-dependents report more anxiety and disordered-eating than their civilian counterparts. While anxiety symptoms predict the onset and worsening of disordered-eating attitudes, the mechanisms underlying this relationship remain unclear. One factor that may underlie this relationship, and be particularly relevant for military-dependent youth, is coping. Therefore, we examined adolescent military-dependents (N=136; 14.5±1.5 years; 59.6% female; BMI-z: 1.9±0.4) who were at-risk for adult obesity and binge-eating disorder due to an age- and sex-adjusted BMI ≥ 85th percentile and loss-of-control eating and/or elevated anxiety. Participants completed an interview assessing disordered-eating attitudes and questionnaires on anxiety symptoms and coping strategies at a single time point. Bootstrapping models were conducted to examine the indirect paths between anxiety symptoms and disordered-eating attitudes through five coping subscales (aggression, distraction, endurance, self-distraction, and stress-recognition). Adjusting for relevant covariates, no significant indirect paths through the coping subscales (ps > .05) were found in any models. General coping, non-specific to eating, may not be a pathway between anxiety symptoms and disordered-eating attitudes among adolescents. Future research should examine other potential mediators of this relationship.

Oxytocin and Vasopressin Levels and Related Factors in Adolescents with Social Phobia and Other Anxiety Disorders

Objective

This study aimed to determine whether a difference exists in plasma oxytocin and vasopressin levels among social anxiety disorder, other anxiety disorders, and healthy control groups in adolescents. The relationship between several psychiatric variables (i.e., state and trait anxiety, social anxiety, childhood trauma, and behavioral inhibition) and oxytocin or vasopressin levels were also investigated in adolescents with anxiety disorders.

Methods

The study included three groups of adolescents: social anxiety disorder (n = 29), those with other anxiety disorders (n = 27), and the control group (n = 28). The participants filled out self-report scales to determine various psychological variables. Oxytocin and vasopressin levels were determined from the blood samples of the participants.

Results

The oxytocin levels did not show a significant difference between the social anxiety disorder group and the other anxiety disorders group. However, the oxytocin levels were significantly higher in the social anxiety disorder and other anxiety disorders groups than in the control group. The vasopressin levels did not show a significant difference among the groups. According to the hierarchical regression analysis, the state and trait anxiety levels predicted oxytocin in opposite directions. Oxytocin showed positive and negative relationship with trait and state anxiety respectively. No predictive factors were found for the vasopressin levels.

Conclusion

We found that the oxytocin levels of adolescents with social anxiety disorder were not different from those of adolescents with other anxiety disorders. Further studies can improve our knowledge of the relationship among anxiety disorders and oxytocin or vasopressin.

Using the Child Sheehan Disability Scale to Differentiate Severity Level in Youth With Anxiety Disorders and Obsessive Compulsive Disorder

The current study extends the psychometric support for the Child Sheehan Disability Scale (CSDS) as a measure of impairment associated with childhood anxiety disorders, including obsessive compulsive disorder. The CSDS was completed by 1,481 predominately Caucasian youth (55.4% female) ages 8 to 17 (M = 12.68, SD = 2.78) from primarily two-parent households and a parent across community, outpatient, intensive outpatient treatment, and residential settings. The results replicated and extended the previously found strong convergent validity, discriminant validity, and treatment sensitivity with a revised parent-report item in the larger sample. Moreover, the CSDS successfully differentiated between patients receiving treatment of different levels of intensity. These data were used to develop preliminary qualitative descriptors associating individual scores with a likely level of indicated treatment to enhance the clinical applicability of the CSDS. This study establishes the CSDS as one of the briefest and most rigorously evaluated measures of impairment associated with child anxiety. However, the performance of the CSDS must be examined in more representative samples before being applied to diverse populations.

Association between developmental dyslexia and anxiety/depressive symptoms among children in China: The chain mediating of time spent on homework and stress

BACKGROUND

The relationship between dyslexia and anxiety/depressive symptoms among children in China is unclear. Besides, the pathways to explain the risks are also undefined.

METHODS

3993 primary school students from grade 2 to 6 were recruited in this study. The Dyslexia Checklist for Chinese Children and the Pupil Rating Scale-Revised Screening for Learning Disabilities were used to filter the dyslexic children. The Chinese perceived stress scale, the Screen for Child Anxiety Related Emotional Disorders, and the Children's Depression Inventory-Short Form were used separately to assess stress, anxiety symptoms, and depressive symptoms of the children. Time spent on homework was obtained by asking their parents: "How long does it take the children to complete the homework every day?". The chain mediation models were examined using SPSS PROCESS macro 3.3 software.

RESULTS

Dyslexic children spend more time on homework (2.61±1.15), and have higher scores for depression (4.75±3.60) and stress (26.55±7.40) compared to normal children (1.87±0.77, 3.25±3.32, and 23.20±8.43, respectively). The differences are statistically significant (all P<0.01). There is no direct association between dyslexia and anxiety symptoms, while dyslexia has a direct link with depressive symptoms. Dyslexia could affect anxiety/depressive symptoms via the independent mediating effect of stress and the chain mediating effect of time spent on homework and stress. The total indirect effect is 0.21 and 0.25, respectively.

LIMITATIONS

The data used in our study is self-reported and this is a cross-sectional study.

CONCLUSIONS

Time spent on homework and stress could mediate the association between dyslexia and anxiety/depressive symptoms.

Quantifying Session Content in the Delivery of Parent Coached Exposure Therapy

Despite exposure therapy having been identified as the active ingredient in the treatment of childhood anxiety disorders (CADs), available protocols deliver a variety of anxiety management strategies (AMS) in addition to exposure. To increase the effectiveness and efficiency of treatment, Parent Coached Exposure Therapy (PCET): 1) begins exposure early (e.g., session 2 or 3) to increase session time spent on exposure, 2) does not include other AMS, and 3) involves parents at all times. The current manuscript uses audio recordings from a previous pilot study to descriptively quantify the manner in which these key components of PCET are implemented by therapists closely involved in the development of the protocol. Results indicate that implementation of PCET accurately reflected the protocol in that the majority of session time was devoted to exposure activities (.60, s.d. = 0.2), AMS were effectively excluded from treatment (.01, s.d. = .03), and that parents and youth attended almost the entirety of session time together (.98, s.d. = 0.1). These findings suggest that PCET differs meaningfully from traditional CBT for CADs and provide preliminary guidelines for how much time per session to dedicate to in-session exposure work while delivering PCET.

Psychometric Properties of Scared-C Scale in a Romanian Community Sample and Its Future Utility for Dental Practice

The psychological management of children and adolescents in need of pedodontics or orthodontic treatments continues to be an essential objective in dental activity because along with the accuracy of the techniques that are used, anxiety reduction, and knowledge of how to approach the patient are necessary for the treatment to be successful. Therefore, our study aimed to validate the Screen for Child Anxiety Related Emotional Disorders questionnaire, the child version of 41 items (SCARED-C) in the Romanian population for later use in pediatric dentistry. The instrument showed moderate to good internal consistency (α Cronbach from 0.63 to 0.91 for the total scale) and good test-retest reliability (0.70) on a subset of a sample comprising 85 children. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of the SCARED-C; the results showed that SCARED-C has good psychometric properties that can be used for screening anxiety in Romanian children and adolescents. The implications of using the SCARED-C in dental practice are discussed. Future studies need to be conducted to explore the convergent and discriminative validity of the instrument and its sensitivity to current DSM-V criteria. Application on a pediatric dental sample is also required.

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one's ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.

Stress Mediates the Within-Person Longitudinal Associations Between Depression and Different Anxiety Syndromes in Youth

Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of these within-person associations remain understudied. The current study examined whether overall stress, interpersonal stress, and achievement stress mediate the associations between depressive symptoms and physical, social, and separation anxiety symptoms for girls and boys in a sample of 680 community youth aged 8-18 (M = 11.8, SD = 2.4; 55% female) using a random intercept cross-lagged panel model (RI-CLPM). Participants completed measures of anxiety symptoms, depression symptoms, and stress (Adolescent Life Events Questionnaire) every 3 months for 3 years (13 total assessments). Overall and interpersonal stress partly mediated the longitudinal, within-person associations between depression symptoms and physical symptoms of anxiety and between depression symptoms and social anxiety symptoms. Stress did not mediate the longitudinal associations between depression and separation anxiety symptoms. Multigroup models indicated that total stress mediated the associations between depression and physical symptoms of anxiety, and between depression and social anxiety for girls but not for boys. Results support the role of stress as a mediator of the association between depression and anxiety symptoms and suggest that, as youth experience depression-related impairment, they may generate additional stressors, which increase their symptoms of physical and social anxiety.

Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence

Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.

Role of food neophobia and early exposure in children's implicit attentional bias to fruits and vegetables

Children often struggle to eat the daily recommended servings of fruits and vegetables, and as a result many have poor nutrient intake. This is especially problematic for neophobic children; or those who are hesitant to try new foods. Maratos and Staples [Appetite, 91, 220-225 (2015)] found that children who are high in food neophobia show attentional biases to unfamiliar fruits and vegetables, which may be related to their low consumption of these healthy foods. The present study sought to replicate and extend these findings, by using a visual dot-probe task that paired images of fruits and vegetables to perceptually matched neutral control stimuli. Seventy-eight 5-8 year-old children (M_age = 6.4 years, SD = 1.1, 42% girls) participated. Initial analyses failed to reveal significant attentional biases to the foods in children who were high in neophobia. Subsequent exploratory analyses included children's previous exposure to the foods in the task as a moderator variable. These analyses revealed that overall, children showed an attentional bias away from familiar fruits and vegetables. Moreover, previous exposure to the foods moderated the effect of food neophobia on attentional bias. For children who were low in food neophobia, as their fruit and vegetable exposure increased, their attentional bias away from the familiar foods decreased. In contrast, for food neophobic children, as fruit and vegetable exposure increased, they showed more attentional bias away from familiar foods. Although these findings failed to replicate those reported by Maratos and Staples (2015), they suggest that children's attentional biases to healthy foods may be a result of the interplay between food neophobia and the food environment to which they are exposed.

Associations between weight-based teasing and disordered eating behaviors among youth

Weight-based teasing (WBT) is commonly reported among youth and is associated with disinhibited and disordered eating. Specifically, youth who experience WBT may engage in disordered eating behaviors to cope with the resultant negative affect. Therefore, we examined associations between WBT and disordered eating behaviors among youth and assessed whether negative affect mediated these relationships. Two hundred one non-treatment seeking youth (8-17y) completed questionnaires assessing WBT, disinhibited eating, depression, and anxiety. Disordered eating and loss-of-control (LOC) eating were assessed via semi-structured interview. Analyses of covariance were conducted to examine relationships between WBT and eating-related variables, and bootstrapping mediation models were used to evaluate negative affect (a composite of depressive and anxiety symptoms) as a mediator of these associations. All models were adjusted for sex, race, age, and adiposity. Among 201 participants (13.1 ± 2.8y; 54.2% female; 30.3% Black; 32.8% with overweight/obesity), WBT was associated with emotional eating, eating in the absence of hunger, and disordered eating attitudes and behaviors (ps ≤ 0.02). These associations were all mediated by negative affect. WBT was also associated with a threefold greater likelihood of reporting a recent LOC eating episode (p = .049). Among boys and girls across weight strata, WBT was associated with multiple aspects of disordered eating and these relationships were mediated by negative affect. Longitudinal studies are needed to clarify the directionality of these associations and to identify subgroups of youth that may be particularly vulnerable to WBT and its sequelae.

The interplay between adolescent friendship quality and resilient functioning following childhood and adolescent adversity

Background

Child and adolescent adversity ('CA') is a major predictor of mental health problems in adolescence and early adulthood. However, not all young people who have experienced CA develop psychopathology; their mental health functioning can be described as resilient. We previously found that resilient functioning in adolescence following CA is facilitated by adolescent friendships.However, during adolescence, friendships undergo significant change. It is unknown whether resilient functioning after CA fluctuates with these normative changes in friendship quality.

Methods

We used Latent Change Score Modelling in a large sample of adolescents (i.e. the ROOTS cohort; N=1238) to examine whether and how emergent friendship quality and resilient functioning at ages 14 and 17 inter-relate and change together.

Results

We found that friendships quality and resilient functioning had strong associations at age 14, although friendships at 14 did not predict higher resilient functioning at 17. Higher resilient functioning in 14-year-olds with a history of CA was associated with a positive change in friendships from age 14 to 17. Finally, improvements in friendship quality and resilient functioning went hand in hand, even when taking into account baseline levels of both, the change within friendship quality or resilient functioning over time, and the association between resilient functioning and change in friendship quality over time.

Conclusions

We show that friendship quality and resilient functioning after CA inter-relate and change together between ages 14 and 17. Our results suggest that improving friendship quality or resilient functioning within this timeframe may benefit this vulnerable adolescent group, and this should be tested in future research.

Social media use and internalizing symptoms during early adolescence: The role of co-rumination

BACKGROUND

This study examined the longitudinal associations between social media use, co-rumination (repeatedly discussing personal problems with peers), and internalizing symptoms during early adolescence.

METHODS

Self-report measures were administered to a diverse sample of 1,205 early adolescents (51% girls; 51% non-Hispanic White; M_age= 12.75, SD = .71) at three time points (during the fall of 2016, spring of 2017, and fall of 2017).

RESULTS

Findings indicated that daily social media use predicted engagement in co-rumination, which in turn predicted increases in internalizing symptoms. Specifically, co-rumination significantly mediated social media use and anxiety symptoms.

LIMITATIONS

Study limitations include the use of self-report data and the geographically limited sample (restricted to the Northeastern United States).

CONCLUSIONS

Findings from this study highlight an important interpersonal pathway by which social media use may confer risk for internalizing problems. Prevention and intervention programs designed to reduce the negative effects that social media use may have on adolescent internalizing problems should target co-rumination as a modifiable behavior and provide skills training in the use of more positive, adaptive coping strategies.

Inhibitory control and negative affect in relation to food intake among youth

Negative affect and poor inhibitory control are related to disinhibited eating behaviors in youth and may contribute to the development and/or maintenance of obesity. Although few studies have jointly examined these constructs in youth, it has been theorized that poor inhibitory control may be driven by negative affect. If supported, impaired inhibitory control, driven by negative affect, could represent a modifiable neurocognitive treatment target for disinhibited eating. The current study examined whether inhibitory control mediates the relationship between negative affect and eating among youth. Youth (8-17 years) participated in a Food Go/No-Go neurocognitive task to measure inhibitory control as the percentage of commission errors. A composite negative affect score was created from self-report measures of anxiety and depression. A laboratory buffet meal modeled to simulate disinhibited eating was used to measure total and snack food intake. Cross-sectional mediation models with bias-corrected bootstrap confidence intervals (CI) were conducted using negative affect as the independent variable, inhibitory control as the mediator, and intake patterns as dependent variables. One-hundred-eighty-one youths (13.2 ± 2.7y; 55% female; BMIz 0.6 ± 1.0) were studied. Total Go/No-Go commission errors mediated the relationship between negative affect and total intake (95%CI = [0.3, 31.6]), but not snack intake (95%CI = [-2.5, 7.3]). Commission errors for Food-Go blocks significantly mediated the relationship between negative affect and total intake (95%CI = [7.7, 44.4]), but not snack intake (95%CI = [-3.4, 9.5]). Commission errors on Neutral-Go blocks did not significantly mediate any of these relationships. Negative affect may lead to poorer inhibitory control as well as a stronger approach tendency toward food, increasing the likelihood of engaging in disinhibited eating. Future research should determine if, in combination with approaches to reduce negative affect, improved inhibitory control could help prevent overeating in youths with depressive or anxiety symptoms.

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.

The feasibility of verbal and virtual reality exposure for youth with academic performance worry

With exposure emerging as a key ingredient in anxiety treatment for childhood anxiety disorders (CADs), expansion of exposure techniques is a promising avenue for improving treatment efficacy. The present study examined use of imaginal exposure (IE), a technique understudied in the treatment of CADs. Specifically, the study tested whether two forms of exposure to worries (verbal IE and virtual reality exposure therapy, VRET) would be effective and acceptable forms of exposure with youth. Twenty youth with fears of academic failure completed both types of worry exposure, presented in randomized order. Regardless of order of presentation, both verbal IE and VRET elicited moderate anxiety that decreased to mild over the span of the exposures. Both were found to be acceptable by youth and neither was associated with negative side effects. Youth found VRET to be slightly more interesting and novel, but noted that verbal IE was more realistic and individualized. The present study supports the use of standalone worry exposure as an effective and acceptable treatment for general worries in youth and suggests VRET could be more effective with improved realism.

Police Involvement in Intimate Partner Violence and Children's Anxiety Symptoms

This study examined whether police involvement in intimate partner violence (IPV) is associated with children's anxiety symptoms and threat appraisals. Participants were 117 mothers and their children (7-10 years) recruited from domestic violence shelters and followed for 6 months. Mothers reported on IPV and police involvement in the past 6 months; children reported their own anxiety symptoms and threat appraisals. Police involvement in IPV incidents at Time 1 was positively related to children's anxiety symptoms at both the Time 1 and Time 2 assessments, even after controlling for the severity of the IPV. Police involvement was not associated with children's threat appraisals. Police involvement in IPV may inadvertently contribute to an increase in children's anxiety symptoms. Efforts to mitigate adverse outcomes should be investigated.

Adaptation of the Screen for Child Anxiety Related Emotional Disorders in Spanish with Nonspecific Intellectual Disability

Anxiety continues to be one of the most frequent disorders with typically developing children and youth. However, people with intellectual disability (ID) lack validated diagnostic tests backed by sufficient methodological rigor. Analyze the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in this clinical population, specifically in children and young Spanish with Nonspecific Intellectual Disability. Descriptive statistics and item analysis (N = 542), exploratory factorial analysis (n = 245) and confirmatory (n = 297) and scale reliability analyses were performed and evaluated the internal consistency with various indices (Cronbach's alpha and omega) and the stability of the measurement (test-retest) of the resulting scale with better goodness-of-adjustment indices. A new scale called SCARED-DI was obtained in this clinical sample with three factors and a smaller number of items (22), offering important goodness-of-fit indices (RMSEA [95% CI] 03[0.01; .04]; CFI = 0.99; TLI = 0.98; GFI = 0.88; AGFI = 0.89) and high internal consistency (α = 0.91; ω = 0.93) and adequate measurement stability (r_xx = 0.92). The importance of validating psychopathological anxiety tests for children and youth with ID in order to build good mental health is discussed, emphasizing the need to provide easy, short-duration tests on both cognitive and emotional aspects in this clinical sub-population. In addition, the results are assessed in terms of future research and practical implications. This new version of SCARED-ID represents a valid and reliable tool to evaluate the anxiety in people with intellectual disabilities.

Gaze-Contingent Music Reward Therapy for Clinically Anxious 7- to 10-Year-Olds: An Open Multiple Baseline Feasibility Study

This multiple-baseline open pilot trial examined feasibility, compliance, acceptability, and preliminary indices of efficacy of Gaze-Contingent Music Reward Therapy (GC-MRT) for anxious 7- to 10-year-old children. GC-MRT is a novel therapy for anxiety disorders that relies on eye-tracking technology and operant conditioning principles to divert attention toward neutral over threat stimuli, with music serving as a reward. Using a multiple-baseline design, 12 children (M age = 8.3 years, SD = .72, range = 7-10; 4 girls) with social anxiety disorder, generalized anxiety disorder, or separation anxiety disorder received 8 therapy sessions. Clinical status was determined via semistructured interviews and questionnaires. Patients were randomized to wait 1, 3, or 5 weeks between initial assessment and beginning of therapy. Self-reported anxiety was recorded weekly, and comprehensive clinical assessments were obtained pre- and posttreatment. All 12 patients completed the full course of GC-MRT within the allocated therapy period. Therapy credibility rates were moderate to high as reported by both children and parents. Clinician-rated anxiety levels remained consistent during baseline measurement and decreased significantly following treatment. Parent-reports also yielded significant reductions in child anxiety symptoms from pre- to posttreatment. However, child-reported anxiety did not change significantly. The results provide preliminary evidence for feasibility, acceptability, and efficacy of GC-MRT for young children with anxiety disorders. Efficacy should now be tested in randomized controlled trials.

Examination of the Interpersonal Model With Adolescent Military Dependents at High Risk for Adult Obesity

OBJECTIVE

Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents.

METHODS

Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMIz, and presence of reported loss-of-control eating and anxiety.

RESULTS

Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05).

CONCLUSIONS

The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.

Trait Mindfulness as a Mediator of Anxiety and Psychosocial Functioning in Young People with Acquired Brain Injury

Objective: Following acquired brain injury (ABI), young people may experience increased anxiety as well as difficulties with their psychosocial functioning. This study examined trait mindfulness as a mediator of the relationship between anxiety and psychosocial domains of School and Leisure Activities (SLA), Interpersonal Relationships (IR) and Daily Living Skills (DLS).Method: Participants were adolescents with ABI (aged 12-19 years, N = 38). Standardised measures were used to assess anxiety, trait mindfulness, and psychosocial functioning.Results: Higher levels of anxiety were found to be associated with reduced IR (p < .05) and DLS (p < .05). Increased trait mindfulness was found to be associated with lowered anxiety (p < .01), as well as with better IR (p < .05) and DLS (p <.01). Mediation analyses found a significant indirect effect for the relationship between anxiety and DLS through trait mindfulness.Conclusion: Findings highlight the contribution of trait mindfulness as a mediator between anxiety and psychosocial functioning, such that increased mindfulness and lower levels of anxiety are related to better DLS.

Co-Rumination Moderates the Relation between Emotional Competencies and Depressive Symptoms in Adolescents: a Longitudinal Examination

Research suggests co-rumination during adolescence has developmental tradeoffs that result in elevated self-disclosure and intimacy between friends but also can be associated with increases in depression (Rose et al. 2007; Rose 2002). The current study further examined this paradox by assessing the role of emotional competencies in co-rumination as they predict depressive symptoms over a 2-year period. We tested whether co-rumination moderated the relation between emotional awareness and emotion regulation and depressive symptoms in reciprocated best friend dyads. At Time 1, 202 adolescents (101 same-sex best friend dyads; M_age = 12.68, 52.5% girls, 76.6% White, middle-class) reported on their emotional competencies (i.e., emotional awareness and perceptions of their friend's anger and sadness regulation), and depressive symptoms as well as engaged in a discussion task where co-rumination was observed. Multilevel modeling (Actor-Partner Interdependence Modeling) was used to account for similarity within friend dyads. The results indicated that when girls engaged in high levels of co-rumination, poor emotional awareness was related to greater depressive symptoms in their friend. Regarding the analyses of emotion regulation, at high levels of co-rumination, Friend A's perceptions of stronger anger regulation by Friend B predicted fewer depressive symptoms in Friend A. Stronger sadness regulation in Friend B at high levels of co-rumination predicted fewer depressive symptoms in Friend B. Our findings highlight the potentially adaptive nature of emotional competencies that may ameliorate the negative sequelae of co-rumination as adolescents are afforded the opportunity to discuss problems, better understand their emotions, skills that are then associated with fewer depressive symptoms over time.

Psychometric properties and factor structure of the Korean version of the screen for child anxiety related emotional disorders (SCARED)

BACKGROUND

The aim of this study was to examine the psychometric properties of the Korean version of Screen for Child Anxiety Related Emotional Disorders (SCARED) on a sample of Korean youths and to examine the cross-cultural differences in adolescents' anxiety.

METHODS

Our study included 147 adolescents (ages 12-17, 92 girls), 93 with major depressive disorder and 54 as controls. Participants were evaluated using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), SCARED, Child Behavior Checklist (CBCL), Disruptive Behavioral Disorder Scale (DBD) and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Pearson's r and Cronbach's α values of the SCARED were calculated, and exploratory factor analysis was conducted.

RESULTS

The Korean SCARED scores were correlated with the total anxiety scores of K-SADS-PL (r = 0.74) and the CBCL anxious/depressed subscale scores (r = 0.35). Results showed a five-factor structure with good internal consistency, in which some items were loaded on different factors compared to previous studies.

CONCLUSIONS

The Korean SCARED demonstrated promising psychometric properties, and could be a valid scale for screening anxiety symptoms in primary care. The fact that different items comprised the factors may reflect the cultural difference between United States and Korea in experiencing anxiety.

Development of Three Web-Based Computerized Versions of the Kiddie Schedule for Affective Disorders and Schizophrenia Child Psychiatric Diagnostic Interview: Preliminary Validity Data

OBJECTIVE

To present initial validity data on three web-based computerized versions of the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-COMP).

METHOD

The sample for evaluating the validity of the clinician-administered KSADS-COMP included 511 youths 6-18 years of age who were participants in the Child Mind Institute Healthy Brain Network. The sample for evaluating the parent and youth self-administered versions of the KSADS-COMP included 158 youths 11-17 years of age recruited from three academic institutions.

RESULTS

Average administration time for completing the combined parent and youth clinician-administered KSADS-COMP was less time than previously reported for completing the paper-and-pencil K-SADS with only one informant (91.9 ± 50.1 minutes). Average administration times for the youth and parent self-administered KSADS-COMP were 50.9 ± 28.0 minutes and 63.2 ± 38.3 minutes, respectively, and youths and parents rated their experience using the web-based self-administered KSADS-COMP versions very positively. Diagnoses generated with all three KSADS-COMP versions demonstrated good convergent validity against established clinical rating scales and dimensional diagnostic-specific ratings derived from the KSADS-COMP. When parent and youth self-administered KSADS-COMP data were integrated, good to excellent concordance was also achieved between diagnoses derived using the self-administered and clinician-administered KSADS-COMP versions (area under the curve = 0.89-1.00).

CONCLUSION

The three versions of the KSADS-COMP demonstrate promising psychometric properties, while offering efficiency in administration and scoring. The clinician-administered KSADS-COMP shows utility not only for research, but also for implementation in clinical practice, with self-report preinterview ratings that streamline administration. The self-administered KSADS-COMP versions have numerous potential research and clinical applications, including in large-scale epidemiological studies, in schools, in emergency departments, and in telehealth to address the critical shortage of child and adolescent mental health specialists.

CLINICAL TRIAL REGISTRATION INFORMATION

Computerized Screening for Comorbidity in Adolescents With Substance or Psychiatric Disorders; https://clinicaltrials.gov/; NCT01866956.

Associations between Family Weight-Based Teasing, Eating Pathology, and Psychosocial Functioning among Adolescent Military Dependents

Weight-based teasing (WBT) by family members is commonly reported among youth and is associated with eating and mood-related psychopathology. Military dependents may be particularly vulnerable to family WBT and its sequelae due to factors associated with their parents' careers, such as weight and fitness standards and an emphasis on maintaining one's military appearance; however, no studies to date have examined family WBT and its associations within this population. Therefore, adolescent military dependents at-risk for adult obesity and binge-eating disorder were studied prior to entry in a weight gain prevention trial. Youth completed items from the Weight-Based Victimization Scale (to assess WBT by parents and/or siblings) and measures of psychosocial functioning, including the Beck Depression Inventory-II, The Rosenberg Self-Esteem Scale, and the Social Adjustment Scale. Eating pathology was assessed via the Eating Disorder Examination interview, and height and fasting weight were measured to calculate BMIz. Analyses of covariance, adjusting for relevant covariates including BMIz, were conducted to assess relationships between family WBT, eating pathology, and psychosocial functioning. Participants were 128 adolescent military dependents (mean age: 14.35 years old, 54% female, 42% non-Hispanic White, mean BMIz: 1.95). Nearly half the sample (47.7%) reported family WBT. Adjusting for covariates, including BMIz, family WBT was associated with greater eating pathology, poorer social functioning and self-esteem, and more depressive symptoms (ps ≤ 0.02). Among military dependents with overweight and obesity, family WBT is prevalent and may be linked with eating pathology and impaired psychosocial functioning; prospective research is needed to elucidate the temporal nature of these associations.

Reflective pondering is associated with executive control for emotional information: An adolescent prospective study

BACKGROUND AND OBJECTIVES

In adult populations, rumination and executive control impairments have been highlighted as vulnerability factors for later depression and rumination as a whole construct has recently been linked to lower executive control. However, research with adolescent populations is limited and little is known developmentally of the association between rumination and executive control. A prospective design was used to investigate the relationship between brooding rumination and reflective pondering and executive control for emotional and non-emotional material in adolescence, whilst controlling for the effects of depression and anxiety symptoms.

METHODS

The present study examined the relationship between the subcomponents of rumination and executive control for emotional and non-emotional information, within an adolescent development. A total of 149 adolescents (13-16 years) were tested at two time points, approximately six months between sessions. At each time point, participants completed a computerised, valenced measure of executive control and measures of brooding rumination, reflective pondering, depression symptoms and anxiety symptoms.

RESULTS

Findings indicate that reflective pondering was predictive of greater executive control for processing emotional information over time. Contrary to research with adults, brooding rumination was not associated with executive control.

LIMITATIONS

This study, conducted across two time points 6 months apart, awaits confirmation from further research across multiple time points and different intervals.

CONCLUSIONS

Reflective pondering may act as a protective factor against later impairment in executive control.

Validation of the parent report version of the Spence Children's Anxiety Scale (SCAS-P) for Spanish children

Although Spence Children's Anxiety Scale (SCAS) is a widely used anxiety measure in many countries around the world, until now, research has barely focused on the usefulness of the parent version (SCAS-P) in young children. This study examines the psychometric properties and the factor structure of the SCAS-P in a Spanish community sample of 181 children aged 6-8 years (M = 6.87, SD = 0.78). Confirmatory factor analysis showed a good fit of the original six-factor model to the Spanish sample. The internal consistency and the test-retest reliability of the scale were high. Regarding the validity of this measure, higher and significant correlations between the SCAS-P and internalizing problems and lower correlations with externalizing problems were obtained, as found in the original version. Girls seemed to show more anxiety problems than boys, but no significant differences were found. The results suggest that the SCAS-P is an adequate measure to assess anxious symptomatology in young children. The availability of measures with good psychometric properties allows psychologists to assess and carry out a correct and early diagnosis of anxiety disorders in children, making possible an early clinical intervention.

Symptoms of anxiety and depression in schoolchildren with and without developmental coordination disorder

We examined whether reported higher frequencies of anxiety and depression symptoms are related to the presence of developmental coordination disorder in school-age Brazilian children. A total of 272 children were assigned to six groups according to age and motor performance. The Movement Assessment Battery for Children-Second Edition evaluated the motor performance. The Spence Children's Anxiety Scale and the Child Depression Inventory assessed anxiety and depression symptoms, respectively. Brazilian children are at high risk for anxiety, regardless of motor performance and age. However, children with developmental coordination disorder report significantly more depressive symptomatology in 10-12 years compared to typically developing children.

Mental health problems of children and adolescents, with and without migration background, living in Vienna, Austria

BACKGROUND

Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers.

METHODS

We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres.

RESULTS

Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers.

CONCLUSIONS

We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.

Sensory Over-Responsivity as an Added Dimension in ADHD

Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD). None-the-less there is still much that is poorly understood. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD.

Childhood physical abuse and physical dating violence in young adulthood: The mediating role of adverse mental health

OBJECTIVE

The purpose of this study was to examine whether adverse mental health (i.e., symptoms of anxiety, posttraumatic stress disorder, and depression) mediated the relation between childhood physical abuse (CPA) and physical dating violence (DV) victimization/perpetration in young adulthood.

METHOD

We used four waves of data from an ongoing longitudinal study. The sample consisted of 864 adolescents including 282 Hispanic Americans, 248 European Americans, 240 African Americans, and 94 other, with a mean age of 17 years at Wave 3.

RESULTS

Structural equation modeling suggested that posttraumatic stress disorder symptoms mediated the link between CPA and both physical DV victimization (β = .06, 95% CI: 0.01, 0.11) and perpetration (β = .07, 95% CI: 0.02, 0.13). Anxiety and depressive symptoms, however, did not show significant indirect effects.

CONCLUSIONS

Findings highlight the importance of interventions targeting posttraumatic stress symptoms for adolescents who experienced CPA in preventing physical DV in young adulthood.