The assessment of contemporary fears in adolescents using a modified version of the Fear Survey Schedule for Children-Revised

A topography of 21 phobic fears: network analysis in an epidemiological sample of adult twins

BACKGROUND

Few factor analyses and no network analyses have examined the structure of DSM phobic fears or tested the specificity of the relationship between panic disorder and agoraphobic fears.

METHODS

Histories of 21 lifetime phobic fears, coded as four-level ordinal variables (no fear to fear with major interference) were assessed at personal interview in 7514 adults from the Virginia Twin Registry. We estimated Gaussian Graphical Models on individual phobic fears; compared network structures of women and men using the Network Comparison Test; used community detection to determine the number and nature of groups in which phobic fears hang together; and validated the anticipated specific relationship between panic disorder and agoraphobia.

RESULTS

All networks were densely and positively inter-connected; networks of women and men were structurally similar. Our most frequent and stable solution identified four phobic clusters: (i) blood-injection, (ii) social-agoraphobia, (iii) situational, and (iv) animal-disease. Fear of public restrooms and of diseases clustered with animal and not, respectively, social and blood-injury phobias. When added to the network, the three strongest connections with lifetime panic disorder were all agoraphobic fears: being in crowds, going out of the house alone, and being in open spaces.

CONCLUSIONS

Using network analyses applied to a large epidemiologic twin sample, we broadly validated the DSM-IV typography but did not entirely support the distinction of agoraphobic and social phobic fears or the DSM placements for fears of public restrooms and diseases. We found strong support for the specificity of the relationship between panic disorder and agoraphobic fears.

Adolescent Dental Fear and Anxiety: Background, Assessment, and Nonpharmacologic Behavior Guidance

Adolescence, the period from 11 to 21 years of age, bridges the chasm between childhood and adulthood. Adolescence can be challenging as bodies, cognition, and personality go through major transformations, but it is also a time of great joy as confident adults with a clear identity develop. Dentists need to be knowledgeable about the developmental characteristics of this group because some of the cognitive and emotional changes make adolescents vulnerable to new fears. Dentists must tailor behavior guidance to this developing psyche in a way that respects independence and promotes confidence to foster lifelong positive views of dentistry.

Children's Perspectives on Outpatient Physician Visits: Capturing a Missing Voice in Patient-Centered Care

Actively involving children in their healthcare is a core value of patient-centered care. This is the first study to directly obtain children's detailed perspectives on positive and negative aspects of outpatient physician visits in a primary care setting (e.g., checkups) and their preferred level of participation. Individual interviews were conducted with 167 children (female n = 82, male n = 85; ages 7-10, Mage = 8.07 years, SD = 0.82). Open-ended questions were used so that children's responses were not confined to researchers' assumptions, followed by close-ended questions to meet specific objectives. Quantitative content analysis, correlations, logistic regression, and Cochran's Q were used to explore the data. Children were highly fearful of needle procedures (61%), blood draws (73%), pain (45%), and the unknown (21%). Children indicated that they liked receiving rewards (32%) and improving their health (16%). Children who were more fearful during physician visits wanted more preparatory information (ExpB = 1.05, Waldx2(1) = 9.11, p = 0.003, McFadden's R2 2 = 0.07) and more participation during the visit (ExpB = 1.04, Waldx2(1) = 5.88, p = 0.015, McFadden's R2 2 = 0.03). Our results can inform efforts to promote positive physician visit experiences for children, reduce procedural distress, and foster children's ability to take an active role in managing their health.

Parent- and Child-Factors in Specific Phobias: The Interplay of Overprotection and Negative Affectivity

Specific phobias are among the most prevalent anxiety disorders in children and adolescents. Although brief and intensive treatments are evidence-based interventions (Davis III et al. Annual Review of Clinical Psychology, 15, 233-256, 2019), up to one-third of youth do not show significant change in their symptoms following these interventions. Hence, consideration of additional factors influencing treatment response is necessary. Child-factors such as temperament and parent-factors such as parenting behaviors both contribute to the development of specific phobias and their maintenance over time. Specifically, we addressed child temperament (negative affectivity) and parenting behaviors (overprotection) that could uniquely predict clinical outcomes for specific phobias and that might interact to inform goodness-of-fit in the context of these interventions. We also considered whether child- and/or parent-gender shaped the effects of temperament or parenting on clinical outcomes. Participants were 125 treatment-seeking youth (M age = 8.80 years; age range = 6-15 years; 51.5% girls) who met criteria for specific phobia and their mothers and fathers. Mothers' reports of children's negative affectivity uniquely predicted poorer specific phobia symptom severity and global clinical adjustment at post-treatment. Interaction effects were supported between parental overprotection and child negative affectivity for post-treatment fearfulness. The direction of these effects differed between fathers and mothers, suggesting that goodness-of-fit is important to consider, and that parent gender may provide additional nuance to considerations of parent-child fit indices.

Dental anxiety: An understudied problem in youth

Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward.

A randomized efficacy trial of a cognitive-behavioral group intervention to prevent Internet Use Disorder onset in adolescents: The PROTECT study protocol

Background

The reduction of prevalence rates of Internet Use Disorder (IUD) and its effective treatment are at high priority in both public health and educational policies. School-based preventive interventions facilitate a low-threshold approach for individuals with IUD, who are typically characterized by high therapy avoidance. Moreover, indicated approaches which target adolescents at high-risk show larger effects than universal prevention programs. Simultaneously, they reduce unnecessary burden for the majority of high-school students that is not at-risk. The PROTECT group intervention for indicated prevention of IUD in school settings was developed based on these preventive strategies.

Methods

Three-hundred and forty adolescents, aged 12–18 years, from 40 secondary schools in Germany, screened for high-risk of IUD onset, are randomly assigned to a) PROTECT preventive intervention group or b) assessment only control group. The tested intervention consists of a cognitive-behavioral 4-session brief-protocol. Follow-up assessments are at 1, 4 and 12 months after admission. Primary outcome is the 12-months incidence rate of IUD. Secondary outcomes are the reduction of IUD and comorbid symptoms as well as the promotion of problem solving, cognitive restructuring and emotion regulation skills.

Conclusion

The indicated preventive intervention PROTECT follows the APA-guidelines for psychological prevention, i.e., it is theory- and evidence-based and addresses both risk-reduction and strength-promotion, it considers current research and epidemiology and ethical standards such as professional secrecy and is designed as a systemic intervention at the school-level. It is expected that the intervention decreases risk of IUD onset (incidence rate).

Trial registration

ClinicalTrials.gov: NCT02907658.

Psychometric Properties of Farsi Version of the Revised Fear Survey Schedule for Children

This study examined the psychometric properties of the Farsi version of the Revised Fear Survey Schedule for Children (Ollendick, 1983), namely the FSSC-FA, in a sample of Iranian children and adolescents (N = 394, 206 girls) aged 9-11:11 years. The internal consistency coefficient was found to range from .79 to .96 for total and subscale scores. The authors used exploratory and confirmatory factor analyses to determine the factor structure of the FSSC-FA. The results showed that a 71-item, six-factor model provided a satisfactory fit for the structure of the FSSC-FA (RMSEA = .07, 90% CIs [.068, .072], CFI = .94, NNFI = .94, χ2/df = 2.94). With regard to gender and age differences in fears of the present sample, girls typically reported more fears than boys (Cohen's d = .28, 95% CIs [.08, .48], p < .001), but differences between older and younger participants were modest. The study also reported most common fears in the sample which were very similar to those reported by other studies except one item being specific to the Iranian population. Bearing in mind the limitations discussed, the results generally show that the FSSC-FA scores are valid and reliable to assess fears in Iranian youth.

Fears in the General Population: More Frequent in Females and Associated With the Serotonin Transporter Promoter Polymorphism and Perceived Relationship With Mothers

This study aimed to examine the structure of fears of youth, and its associations with gender, genetic variation of the serotonin transporter (5-HTTLPR), and perceived maternal acceptance/rejection and control, in a population-representative sample. Participants were 453 adolescents and 540 young adults. Fears were assessed by a 18-item Fear Questionnaire, and perceived maternal relationships by the Mother Acceptance-Rejection/Control Questionnaire. A structured psychiatric interview was used to assess current and lifetime psychiatric disorders in participants from the older cohort. A principal component analyses indicated 2 components, named Fear/Phobia and Panic/Despair. Females expressed higher level of fears and symptoms of despair regardless of the serotonin transporter genotype. The 5-HTTLPR genotype nevertheless played a role in the association between fears and perceived relationships: in S/S-genotype, more Fear/Phobia was reported by the participants who perceived greater maternal acceptance in combination with strict maternal control, and had a history of psychiatric disorder.

Parents' perception of children's fear: from FSSC-IT to FSSC-PP

Studies involving parents' reports about children's fears and multiple informant comparisons are less extended than investigations on children's self-reporting fear schedules. Starting with the Italian version of FSSC-R, the FSSC-IT, the main aims of this study were to adapt a schedule for parents' perception of their children's fear: the FSSC-Parent Perception. Its psychometric properties were examined in a large sample of parents (N = 2970) of children aged 8-10 years. Exploratory and confirmatory factorial structures were examined and compared with the Italian children's ones. Mother vs. father, children's gender and school age group effects were analyzed. The confirmatory factor analysis confirmed a four correlated factors solution model (Fear of Danger and Death; Fear of Injury and Animals; Fear of Failure and Criticism; Fear of the unknown and Phobic aspects). Some effects related to child gender, age group, mother vs. father, were found. The FSSC-PP properties supported its use by parents to assess their children's fears. A qualitative analysis of the top 10 fears most endorsed by parents will be presented and compared with children's fears. Clinical implications about the quality of parent-child relationships where discussed, comparing mothers and fathers, and parents' perception about daughters' and sons' most endorsed fears.

Ruminative and catastrophizing cognitive styles mediate the association between daily hassles and high anxiety in Hong Kong adolescents

This study assessed rumination, catastrophizing and daily hassles as predictors of anxiety when controlling for depressive symptoms in a community sample of adolescents reporting high anxiety. Adolescents aged 12-18 (N = 2,802, mean age of 14.9) completed the Screen For Child Anxiety-Related Emotional Disorders. With a total score of 30 as the cutoff, a group of high anxiety adolescents was identified (a prevalence rate of 28.02%). Path analyses results showed that amongst the high anxiety boys, catastrophizing but not rumination was a positive predictor of anxiety and it mediated the effects of daily hassles on anxiety. In the high anxiety girls, both rumination and catastrophizing predicted anxiety but only catastrophizing was the mediator between daily hassles and anxiety. It is suggested that such gender differences in cognitive responses styles should be considered in cognitive-behavioral therapeutic approaches designed to help adolescents showing high anxiety.

The structure of genetic and environmental risk factors for fears and phobias

BACKGROUND

Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli.

METHOD

We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus.

RESULTS

The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia).

CONCLUSIONS

This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably.

Structure of the Italian Fear Survey Schedule for Children (FSSC-IT)

Psychometric properties of the Italian Fear Survey Schedule for Children (FSSC-IT) were examined in a large community sample of children aged 6 to 10 years. PCA and CFA yielded and confirmed a six correlated factor model, named FSSC-IT54. Internal consistency estimates of the FSSC-IT54 total score and of most of its factors were acceptable. Analyses of variance were carried out considering gender and age sub-groups and confirmed findings in the extant literature. Convergent validity of the FSSC-IT54 scores was supported by its positive correlations with a measure of childhood anxiety, the Spence Children's Anxiety Scale.

Examining the cultural validity of fear survey schedule for children: the contemporary fears of Turkish children and adolescents

The authors examined the cultural validity of Fear Survey Schedule for Children (FSSC-AM) developed by J. J. Burnham (2005) with Turkish children. The relationships between demographic variables and the level of fear were also tested. Three independent data sets were used. The first data set comprised 676 participants (321 women and 355 men) and was used for examining factor structure and internal reliability of FSSC. The second data set comprised 639 participants (321 women and 318 men) and was used for testing internal reliability and to confirm the factor structure of FSCC. The third data set comprised 355 participants (173 women and 182 men) and used for analyses of test-retest reliability, inter-item reliability, and convergent validity for the scores of FSSC. The sum of the first and second samples (1,315 participants; 642 women and 673 men) was used for testing the relationships between demographic variables and the level of fear. Results indicated that FSSC is a valid and reliable instrument to examine Turkish children's and adolescents' fears between the ages of 8 and 18 years. The younger, female, children of low-income parents reported a higher level of fear. The findings are discussed in light of the existing literature.

Assessing separation anxiety in Italian youth: preliminary psychometric properties of the Separation Anxiety Assessment Scale

This study examined the internal consistency and construct validity of the Separation Anxiety Assessment Scale for Children in a non-clinical Italian sample of 358 children ages 6 to 10 years. Statistically significant differences were examined by sex and age. Two exploratory factor analyses were carried out: (a) on the symptom sub-dimensions which led to three interpretable factors of Fear of Abandonment and of Physical Illness, Fear of Calamitous Events, Fear of Being Alone and (b) on all Separation Anxiety Assessment Scale for Children items, which led to three interpretable factors: Fear of Abandonment and Safety Signals, Fear of Calamitous Events, and Fear of Being Alone and Left Alone. Preliminary findings for validity were described with the Separation Anxiety Symptoms Inventory for Children and the Italian Fear Schedule for Children (convergent validity). Implications regarding the clinical utility of the Separation Anxiety Assessment Scale for Children are discussed.

Early evidence for factorial structure of the separation anxiety symptom inventory in Italian children

The aim of this study was to explore the internal consistency and confirm the factor structure of the separation anxiety symptom inventory for children (SASI-C) in a community sample of 329 Italian children, ages 6 to 10 years. A confirmatory factor analysis yielded two interpretable factors. Correlations between scores for the SASI-C and the Italian Fear Survey Schedule for Children were calculated to estimate convergent validity; medium effect sizes are hypothesized. Implications regarding the clinical utility of the SASI-C are discussed.

Construction and validation of the South African version of the Fear Survey Schedule for Children: an exploratory factor analysis

The Fear Survey Schedule for Children-Revised (Ollendick, 1983) is an 80-item self-report instrument that has been used internationally to asses the number of fears and general level of fearfulness among children. Despite its widespread use, this instrument has not been adapted to the South African context. The present study addressed this gap by means of a 2-phase investigation aimed at developing a South African version of the instrument. In Phase 1, semistructured interviews were conducted with 40 children (7 to 13 years of age). Qualitative data obtained from these interviews were used to construct additional items for inclusion in the South African Fear Survey Schedule for Children-Revised. The modified scale, consisting of 97 items, was then administered to a sample of 646 children between the ages of 7 and 13 years. Further psychometric considerations resulted in the final version of the scale consisting of 74 items with high internal consistency (α=.97). The factor structure was explored by means of principal component analysis with varimax rotation and a 5-factor solution was found to provide the best conceptual fit. The factors identified were as follows: Fear of Death and Danger; Fear of the Unknown; Fear of Small Animals and Minor Threats to Self; Large Animal Fears; and Situational Fears. Differences between the South African version and the original Fear Survey Schedule for Children-Revised are noted and implications for the study of fear in South Africa and other countries are discussed.

Fears of South African children affected by HIV/AIDS

Although fears are part of normal development, the living environment of HIV/AIDS affected children is conducive to the development of particular fears. This study examined the fears of 39 South African children (7-13 years) living in a low socioeconomic community with a high prevalence of HIV/AIDS. The aim was to consider if these children were a special population with regard to their fears. The Free Option Method was used to identify the children's fears. Data were analyzed by means of a priori thematic analysis, followed by a qualitative analysis. The expressed fears could be described with fear categories previously reported by normative samples. The wild animal category and specifically snake fears were reported most. The second analysis revealed a substantial minority of fears reflecting life in the South African HIV/AIDS affected context. It was concluded that the children represented a normative population who experienced particular fears due to their special circumstances. Further investigation of HIV/AIDS affected children's fears and related psychological issues is recommended.

The Fear Survey Schedule for Children-Revised: Normative Developmental Data in Italy

The aim of the study was to explore children's fear content. Using the Italian Fear Survey Schedule for Children, an Italian-language version of Ollendick's Fear Survey Schedule for Children–Revised (1983), the study assessed the reliability of the survey and reported intensity, prevalence, and content of fears in children aged six to 10 years, using this questionnaire. 1,845 school children (931 girls, 914 boys; M age = 8.3 yr., SD = 1.4) were asked to complete the survey, indicating what they thought were their fears, and the intensity of those fears. Sex and age differences were also examined. Girls endorsed significantly higher fearfulness than did boys. Few age differences were found, with seven-year-olds appearing more fearful than 10- to 11-year-old children. Results were interpreted in relation to developmental changes. Cross-national comparisons were discussed.

Children's fears: a survey of Italian children ages 6 to 10 years

The aim of this study was to explore children's fears. The article reports on average factor scores of a study carried out in Italy using the Fear Survey Schedule for Children (here, the "Fear Survey"; Ollendick, 1983) with normal 6- to 10-yr.-old children (931 girls, 914 boys). Participants were 1,845 children, recruited in mainstream classrooms. Respondents were asked to complete the schedule indicating their fears and the intensity of such fears. A principal components analysis yielded a four-factor structure (1: Death and Danger, 2: Injury and Animals, 3: Failure and Criticism, 4: Fear of the Unknown). Average factor scores showed significant differences across the factors and according to sex and age. Girls reported significantly higher fearfulness than boys. Age differences were found on some factors.

Brave men and timid women? A review of the gender differences in fear and anxiety

Substantial evidence indicates that women report greater fear and are more likely to develop anxiety disorders than men. Women's greater vulnerability for anxiety disorders can be partly understood by examining gender differences in the etiological factors known to contribute to anxiety. This review examines evidence for gender differences across a broad range of relevant factors, including biological influences, temperamental factors, stress and trauma, cognitive factors, and environmental factors. Gender differences are observed with increasing consistency as the scope of analysis broadens to molar levels of functioning. Socialization processes cultivate and promote processes related to anxiety, and moderate gender differences across levels of analysis.

Anxieties in Mainland Chinese and Singapore Chinese adolescents in comparison with the American norm

There is a growing literature base on child and adolescent anxiety. Cross-cultural research on child and adolescent anxiety, however, has been relatively limited. This study examined whether there were similarities and differences in the self reported anxieties in Mainland Chinese and Singapore Chinese adolescents (12-17 years of age), and whether these similarities or differences were related to gender and/or grade. This study also compared anxiety levels of Mainland Chinese and Singapore Chinese adolescents with the American normative sample (12-17 years of age). The results indicate that the levels of anxieties did not differ based on country (China and Singapore). Gender differences were evident. Gender and grade interaction effects were found on the anxiety scales. Mixed results were found when comparing Mainland Chinese and Singapore Chinese with the American normative sample on the different anxiety scales.

Changes in social fears across childhood and adolescence: age-related differences in the factor structure of the Fear Survey Schedule for Children-Revised

The (in)variance of the structure of fear across child and adolescent development was investigated using the response of 3,803 young people (aged 6-18 years) to the Fear Survey Schedule for Children-Revised (FSSC-R). It was hypothesized that the structure of fear, particularly social fear, would become more differentiated during adolescence. Confirmatory factor analysis was utilized to test the goodness-of-fit of a 5-factor solution (with one social factor, that is Failure and Criticism) and a 7-factor solution (with social items divided into three distinct subfactors) among three age groups. Results indicated that a 5-factor solution (including just one social factor) adequately characterizes the structure of fear in childhood (6-9 years), whereas a 7-factor solution (including three social factors) more appropriately characterizes the structure of fear in adolescence (10-13 and 14-18 years). It appears that a global social fear exists until around the age of 9, and that social fears becomes more differentiated thereafter.

A preliminary investigation of the relationship of dental fear to other specific fears, general fearfulness, disgust sensitivity and harm sensitivity

OBJECTIVES

People with dental fear often suffer from other psychological disorders, as well as from a number of other specific fears. Fear of going to the dentist may be associated not only with general fearfulness, but also with underlying personality dispositions. This exploratory study, therefore, investigated the associations between dental fear and 67 other specific fears, general fearfulness, disgust sensitivity and harm sensitivity.

METHODS

Participants were 88 Australian adults who were administered the Fear Survey Schedule III (FSS-III), the Harm Sensitivity Index and the Disgust Sensitivity Index. Principle axis factor analysis with Promax rotation was used to examine how dental fear related to other specific fears as measured with the FSS-III.

RESULTS

Dental fear was significantly correlated with most of the other specific fears, with factor analysis indicating that it tended to load more with fears related to lack of control rather than with what have often been classed as 'medical' fears. Significant associations were found between dental fear and the personality dispositions of general fearfulness, harm sensitivity and disgust sensitivity, although these associations were not linear.

CONCLUSIONS

Findings reveal extensive co-occurrence of other specific fears with dental fear, while the associations of dental fear with personality traits suggest enduring aspects to dental fear which may translate into difficulties in fear alleviation. Dental fear was more related to a diverse range of fears relating to a loss of control than to medical-specific fears.

The factor structure of The Fear Survey Schedule for Children--II in Trinidadian children and adolescents

Part of understanding normal and abnormal fear in children and adolescents is having knowledge of how they acquire fears and of how fears change across development. One way to examine the relative contributions of heredity and environment to the experience of fear is to study fear across cultures. The Fear Survey Schedule for Children-II (FSSC-II; Gullone, E., & King, N. J. (1992). Psychometric evaluation of a revised fear survey schedule for children and adolescents. Journal of Child Psychology and Psychiatry, 33, 987-998) is one measure that has some evidence for cross-cultural validity. The present analysis examined the factor structure of the FSSC-II scores of 884 Trinidadian children and adolescents. Factor consistency across age, sex, and nationality (Trinidadian and American) was examined by calculating the coefficients of congruence for each pair of conceptually similar factors. Results indicated a five-factor structure for the overall sample. Although the solution was conceptually similar to those reported in other studies that used versions of the FSSC, the obtained structure was not congruent across age, sex, or nationality.

When disaster becomes commonplace reaction of children and adolescents to prolonged terrorist attacks in Israel

The aim of this study was to examine, in conditions of prolonged terror, the possible influences of yet another terrorist attack as an additional traumatic event on children's reactions in the emotional, behavioral, and cognitive spheres, and to identify any mediating factors. The sample included 747 students in junior high schools in three Israeli cities. None of the participants was directly exposed to terrorist attacks, but they all lived with the possibility of daily terror. The research focused on fear as the most common and widespread reaction to terror and war. Short-term and long-term symptoms of fear were studied. It was found that an additional terrorist attack had no significant influence on children's emotional, cognitive, or behavioral spheres. Terror that has become habitual becomes negligible. Children learn to adjust to loss without experiencing grief.

The Relation Between Gender Role Orientation and Fear and Anxiety in Nonclinic-Referred Children

This study examined the relation between gender role orientation and fear and anxiety in a sample of nonclinic-referred children (N = 209) ages 10 to 13 years. Children and their parents completed questionnaires assessing children's gender role orientation, toy and activity preferences, and fear and anxiety. Results generally indicated that femininity and a preference for girls' toys and activities were positively associated with fear and anxiety, whereas masculinity and a preference for boys' toys and activities were negatively related to these emotions. Furthermore, gender role orientation accounted for more of the variance in fear and anxiety scores than the child's sex.

Fear assessment in brazilian children: the relevance of dental fear

Fear frequently interferes with dental treatment procedures, producing delays and poor technical quality results. Patients exhibit avoidance and escape behaviors that may be related to aversive childhood experiences in dental treatment situations. The aim of this study was to identify the most frequent children's fears, including dental ones, using an adaptation of the FSSC-R. This instrument was used to assess 549 children divided in three groups: (G1) private school children, (G2) public school children and (G3) public school children who were surveyed during dental treatment. Results indicated higher dental fear scores for females when compared with male children. Considering all groups studied, "injection" was the 5th higher fear for the group G3, 8th for the group G1 and 14th for the group G2. Family relationship items such as "parents fighting", "parents yelling at you", "hearing my parents argue", were considered frequent fears, suggesting that family conflicts may contribute to children's emotional problems.

The Koala Fear Questionnaire: a standardized self-report scale for assessing fears and fearfulness in pre-school and primary school children

The Koala Fear Questionnaire (KFQ) is a standardized self-report scale for assessing fears and fearfulness in children aged between 4 and 12 years. The current article presents six studies which examined the reliability and validity of the KFQ. Study 1 (N=108) demonstrated that the visual fear scales of Koala bears as employed in the KFQ are highly comparable to the standard 3-point scales that are used in other childhood fear measures. Study 2 (N=163) provided support for the convergent validity of the KFQ in a sample of 8- to 14-year-old children. That is, the scale correlated substantially with alternative measures of childhood fear and anxiety. Study 3 (N=189) showed that the KFQ possesses good internal consistency and test-retest stability in a group of 8- to 11-year-old children. The results of Studies 4 (N=129) and 5 (N=176) indicated that the KFQ is suitable for children aged 4 to 6 years and demonstrated that the psychometric properties of the scale in younger children are highly similar to those obtained in older children. Study 6 (N=926) showed that the factor structure of the KFQ was theoretically meaningful: although the data clearly pointed in the direction of one factor of general fearfulness, spurs of the commonly found five-factor solution of childhood fear were found in the KFQ. Altogether, the KFQ seems to be a valuable addition to the instrumentarium of clinicians and researchers who are working with fearful and anxious children.