The Longitudinal Structure of the Children's Depression Inventory: Testing a Latent Trait-State Model

Individual and systemic variables associated with prolonged grief and other emotional distress in bereaved children

Most children confronted with the death of a loved one do not experience persisting psychological problems. However, for some, acute grief reactions develop into prolonged grief disorder (PGD) and other mental health problems. Research findings suggest that bereavement outcomes in children are associated with negative cognitions and avoidant coping and with different parenting behaviours. However, knowledge about factors influencing grief in children is still limited and few studies have examined the relative impact of psychological (individual-level) variables and systemic (family-level) variables in affecting their responses to loss. The aim of the current study was to examine the association of different bereavement outcomes in 8-18 year old children (including levels of self-rated PGD, depression, and posttraumatic stress (PTS)) with sociodemographic variables, individual-level variables (including negative cognitions and anxious and depressive avoidance), and family-level variables (including the severity of caregiver's PGD, depression, and anxiety, and indices of parenting behaviours, rated both by children and by their caregivers). Questionnaire data were used from 159 children plus one of their caregivers, gathered as part of the pre-treatment assessment in a randomized controlled trial. Results showed that most of the children's bereavement outcomes, including PGD severity and PTS severity, were associated with indices of negative cognitions and avoidance behaviours. Caregiver's depression and anxiety showed a very small, yet significant, association with two children's outcomes. Caregiver-rated reasoning/induction (one index of parenting behaviours) showed a small association with children's PTS-related functional impairment. Exploratory analyses indicated that the linkage between parenting behaviour and children's outcomes may be moderated by whether the behaviour comes from father or mother. This is one of the first studies examining how individual cognitive behavioural variables plus the mental health of caregivers and indices of parenting may affect PGD and other outcomes in bereaved children. The findings provide tentative indications that individual and family-level variables influence these outcomes, albeit that more research is urgently needed.

Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study

Children with sickle cell anemia (SCA) usually face psychological complications especially depression. Assessment of depression in resource-limited settings may help identify the extent to which the children with SCA in such settings may need its introduction as part of routine care. This study aimed to assess depression in children and adolescents with SCA in a low-resource setting. This cross-sectional observational study involved 84 children and adolescents with SCA aged 7-17 years who were selected using a systematic random sampling technique. Their controls were 84 age- and sex-matched individuals with AA hemoglobin genotype. A structured questionnaire was used to collect socio-demographic data while depression was assessed with the Children's Depression Inventory. The prevalence of depression was non-significantly higher in subjects compared to the controls (8.3% vs. 2.4%) (Fisher's χ² = 1.88, p = 0.171). Though not statistically significant, the subjects had 3.7 times higher odds of having depression compared to the controls (OR = 3.7; 95% CI 0.75-18.50; p = 0.107). Of the 5 depression subscales, the subjects had a significantly higher difference in the negative mood (p = 0.042). Despite the comparable prevalence of depression with their normal controls, children and adolescents with SCA had a higher negative mood and higher odds of having depression than normal individuals. Thus, there is a need for the introduction of depression assessment as a complement to routine care of these children with SCA in resource-poor settings.

Disentangling trait versus state characteristics of the Pain Catastrophizing Scale and the PHQ-8 Depression Scale

BACKGROUND

Research on the role of trait versus state characteristics of a variety of measures among persons experiencing pain has been a focus for the past few decades. Studying the trait versus state nature of the Pain Catastrophizing Scale (PCS) and the Patient Health Questionnaire (PHQ-8) depression scale would be highly informative given both are commonly measured in pain populations and neither scale has been studied for trait/state contributions.

METHODS

The PHQ-8 and PCS were obtained on persons undergoing knee arthroplasty at baseline, 2-, 6- and 12-month post-surgery (N = 402). The multi-trait generalization of the latent trait-state model was used to partition trait and state variability in PCS and PHQ-8 item responses simultaneously. A set of variables were used to predict trait catastrophizing and trait depression.

RESULTS

For total scores, the latent traits and latent states explain 63.2% (trait = 43.2%; state = 20.0%) and 50.2% (trait = 29.4%; state = 20.8%) of the variability in PCS and PHQ-8, respectively. Patients with a high number of bodily pain sites, high levels of anxiety, young patients and African-American patients had high levels of trait catastrophizing and trait depression. The PCS and the PHQ-8 consist of both enduring trait and dynamic state characteristics, with trait characteristics dominating for both measures.

CONCLUSION

Clinicians and researchers using these scales should not assume the obtained measurements solely reflect either trait- or state-based characteristics.

SIGNIFICANCE

Clinicians and researchers using the PCS or PHQ-8 scales are measuring both state and trait characteristics and not just trait- or state-based characteristics.

How children's anxiety symptoms impact the functioning of the hypothalamus-pituitary-adrenal axis over time: A cross-lagged panel approach using hierarchical linear modeling

Anxiety symptoms in childhood and adolescence can have a long-term negative impact on mental and physical health. Although studies have shown dysregulation of the hypothalamus-pituitary-adrenal axis is associated with anxiety disorders, it is unclear how and in what direction children's experiences of anxiety symptoms, which include physiological and cognitive-emotional dimensions, impact the functioning of the hypothalamus-pituitary-adrenal axis over time. We hypothesized that higher physiological symptoms would be contemporaneously associated with hypercortisolism, whereas cognitive-emotional symptoms would be more chronic, reflecting traitlike stability, and would predict hypocortisolism over time. One hundred twenty children from the Concordia Longitudinal Risk Research Project were followed in successive data collection waves approximately 3 years apart from childhood through midadolescence. Between ages 10-12 and 13-15, children completed self-report questionnaires of anxiety symptoms and provided salivary cortisol samples at 2-hr intervals over 2 consecutive days. The results from hierarchical linear modeling showed that higher physiological symptoms were concurrently associated with hypercortisolism, involving cortisol levels that remained elevated over the day. In contrast, longitudinal results over the 3 years between data collection waves showed that chronic worry and social concerns predicted hypocortisolism, showing a low and blunted diurnal cortisol profile. These results have implications for broadening our understanding of the links between anxiety, the stress response system, and health across the course of development.

Modelling the factor structure of the Child Depression Inventory in a population of apparently healthy adolescents in Nigeria

Background

Childhood and adolescent depression is common and often persists into adulthood with negative implications for school performances, peer relationship and behavioural functioning. The Child Depression Inventory (CDI) has been used to assess depression among adolescents in many countries including Nigeria but it is uncertain if the theoretical structure of CDI appropriately fits the experiences of adolescents in Nigeria. This study assessed varying theoretical modelling structure of the CDI in a population of apparently healthy adolescents in Benue state, Nigeria.

Methods

Data was extracted on CDI scale and demographic information from a total of 1, 963 adolescents (aged 10–19 years), who participated in a state wide study assessing adolescent psychosocial functioning. In addition to descriptive statistics and reliability tests, Exploratory Factor Analysis (EFA) and Confirmatory Factor analysis (CFA) were used to model the underlying factor structure and its adequacy. The suggested new model was compared with existing CDI models as well as the CDI’s original theoretical model. A model is considered better, if it has minimum Root Mean Square Error of Approximation (RMSEA<0.05), Minimum value of Discrepancy (CMIN/DF<3.0) and Akaike information criteria. All analyses were performed at 95% confidence level, using the version 21 of AMOS and the R software.

Results

Participants were 14.7±2.1 years and mostly male (54.3%), from Monogamous homes (67.9%) and lived in urban areas (52.2%). The measure of the overall internal consistency of the 2-factor CDI was α = 0.84. The 2-factor model had the minimum RMSEA (0.044), CMIN/DF (2.87) and least AIC (1037.996) compared to the other five CDI models.

Conclusion

The child depression inventory has a 2-factor structure in a non-clinical general population of adolescents in Nigeria. Future use of the CDI in related setting may consider the 2-factor model.

Time-varying and time-invariant dimensions of depression in children and adolescents: Implications for cross-informant agreement

The longitudinal structure of depression in children and adolescents was examined by applying a Trait-State-Occasion structural equation model to 4 waves of self, teacher, peer, and parent reports in 2 age groups (9 to 13 and 13 to 16 years old). Analyses revealed that the depression latent variable consisted of 2 longitudinal factors: a time-invariant dimension that was completely stable over time and a time-varying dimension that was not perfectly stable over time. Different sources of information were differentially sensitive to these 2 dimensions. Among adolescents, self- and parent reports better reflected the time-invariant aspects. For children and adolescents, peer and teacher reports better reflected the time-varying aspects. Relatively high cross-informant agreement emerged for the time-invariant dimension in both children and adolescents. Cross-informant agreement for the time-varying dimension was high for adolescents but very low for children. Implications emerge for theoretical models of depression and for its measurement, especially when attempting to predict changes in depression in the context of longitudinal studies. (PsycINFO Database Record

Strong Homotypic Continuity in Common Psychopathology-, Internalizing-, and Externalizing-Specific Factors Over Time in Adolescents

Dimensional models of psychopathology have recently gained prominence that posit a general psychopathology factor (i.e., p factor), in addition to specific internalizing and externalizing factors. However, the stability of these factors, and the specificity with which they are related to one another over time (e.g., homotypic or heterotypic continuity), have not been investigated. The current study addressed these questions. We estimated bifactor models, with p, internalizing-specific and externalizing-specific factors, with youth and caretaker report of symptoms at two time points (18 months apart), in a large community sample of adolescents. Results showed strong stability over time with highly specific links (i.e., p factor at Time 1 to Time 2; internalizing-specific at Time 1 to Time 2, externalizing-specific at Time 1 to Time 2), suggesting strong homotypic continuity between higher-order latent psychopathology factors.

Longitudinal Invariance of the Children’s Depression Inventory for Urban Children in Hunan, China

Abstract. This study was designed to examine the invariance of item parameters in the Children’s Depression Inventory (CDI) and changes in childhood depression over time among urban children in the Hunan Province of China. A total of 1,364 primary school students from the second to sixth grades participated in the study and completed four measurement waves, in which childhood depression was assessed with the CDI. The results were analyzed using the multilevel longitudinal Rasch measurement model. Seven items showed time effects in five subscales. Statistically significant negative linear time effects were observed in five subscales, and positive quadratic time effects were found in three subscales (i.e., Interpersonal Problems, Negative Self-esteem, and Negative Mood). Although a few items of the CDI were found to change with time following repeated administration, most of the CDI items showed strong longitudinal invariance of their item location parameters.

Disentangling vulnerabilities from outcomes: Distinctions between trait affect and depressive symptoms in adolescent and adult samples

BACKGROUND

Trait negative affect and trait positive affect are affective vulnerabilities to depressive symptoms in adolescence and adulthood. While trait affect and the state affect characteristic of depressive symptoms are proposed to be theoretically distinct, no studies have established that these constructs are statistically distinct. Therefore, the purpose of the current study was to determine whether the trait affect (e.g. temperament dimensions) that predicts depressive symptoms and the state affect characteristic of depressive symptoms are statistically distinct among early adolescents and adults. We hypothesized that trait negative affect, trait positive affect, and depressive symptoms would represent largely distinct factors in both samples.

METHOD

Participants were 268 early adolescents (53.73% female) and 321 young adults (70.09% female) who completed self-report measures of demographic information, trait affect, and depressive symptoms.

RESULTS

Principal axis factoring with oblique rotation for both samples indicated distinct adolescent factor loadings and overlapping adult factor loadings. Confirmatory factor analyses in both samples supported distinct but related relationships between trait NA, trait PA, and depressive symptoms.

LIMITATIONS

Study limitations include our cross-sectional design that prevented examination of self-reported fluctuations in trait affect and depressive symptoms and the unknown potential effects of self-report biases among adolescents and adults.

CONCLUSIONS

Findings support existing theoretical distinctions between adolescent constructs but highlight a need to revise or remove items to distinguish measurements of adult trait affect and depressive symptoms. Adolescent trait affect and depressive symptoms are statistically distinct, but adult trait affect and depressive symptoms statistically overlap and warrant further consideration.

Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C)

Negative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in adults we developed a questionnaire for children, the Grief Cognitions Questionnaire for Children (GCQ-C). This study investigated several psychometric properties of the GCQ-C. Both reliability and validity were investigated in this study, in which hundred fifty-one children and adolescents (aged 8-18 years) participated. Findings showed that items of the GCQ-C represented one underlying dimension. Furthermore, the internal consistency and temporal stability were found to be adequate. Third, the findings supported the concurrent validity (e.g., significant positive correlations with self-report indices of PGD, depression and posttraumatic stress disorder), convergent and divergent validity of the GCQ-C. This study provides further evidence for the importance of negative thinking in PGD in children and adolescents.

Spousal similarity in life satisfaction before and after divorce

Previous research has explored possible origins of individual differences in subjective well-being, focusing largely on stable, internal characteristics of traits as predictors of life satisfaction (Diener & Lucas, 1999). Although past work has demonstrated that life satisfaction is largely stable over the life span, other evidence has also demonstrated the lasting impact of life events. In this study, we use married couples as a test of the impact of life circumstances on life satisfaction, focusing on similarity in life satisfaction before and after divorce. If life satisfaction is impacted by shared life circumstances, married couples (who share life circumstances) should show greater similarity in life satisfaction before divorce than after. We tested this possibility using a dyadic latent-state-trait model that examined cross-spouse similarity in the stable and changing components of life satisfaction. Using a nationally representative panel study from Germany (Wagner, Frick & Schupp, 2007), we showed that similarity declined substantially following divorce. This suggests that life satisfaction is related to shared life circumstances.

The Dopamine D2 Receptor Polymorphism (DRD2 TaqIA) Interacts with Maternal Parenting in Predicting Early Adolescent Depressive Symptoms: Evidence of Differential Susceptibility and Age Differences

Most gene-environment interaction research on depression has largely focused on negative environment and to a lesser extent on positive environment. Moreover, to date few studies have directly examined G × E at different periods in development, particularly during early adolescence. The present study addressed these issues by examining the concurrent and prospective longitudinal effects of maternal parenting, DRD2 TaqIA polymorphism, and their interaction on adolescent depressive symptoms in a sample of 1026 Chinese adolescents (Mage = 11.33 ± 0.47 years at T1, 50.3% girls) in a three-wave longitudinal study from age 11 to 13. Results indicated that maternal positive and negative parenting significantly concurrently predicted adolescent depressive symptoms at all three waves, whereas TaqIA polymorphism had no main effect on depressive symptoms. TaqIA polymorphism interacted with negative parenting in predicting concurrent depressive symptoms at age 11 and 12. A1 carriers were more susceptible to negative parenting compared to A2A2 homozygotes, such that adolescents carrying A1 alleles experiencing high negative parenting reported more depressive symptoms but fared better when experiencing low negative parenting. However, the interaction became nonsignificant at age 13, indicating the interaction of TaqIA polymorphism and maternal parenting may vary with development. Also, there was no G × E effect on longitudinal change in depression. The findings provided evidence in support of the differential susceptibility hypothesis and shed light on the potential for dynamic change in gene-environment interactions over development.

Longitudinal Stability of the Beck Depression Inventory II

In a six-wave longitudinal study with two cohorts (660 adolescents and 630 young adults), this study investigated the longitudinal stability of the Beck Depression Inventory II (BDI-II) using the Trait-State-Occasion (TSO) model. The results revealed that the full TSO model was the best fitting representation of the depression measured by the BDI-II for both cohorts. It was found that the trait components explained more than 50% of the state variance of the BDI-II scores in both cohorts, and the occasion-specific factor explained about 7% to 12% of variances. The occasion-specific variance was more stable (occasion stability) and somewhat higher in the younger cohort. Implications regarding the longitudinal stability of the BDI-II measure are discussed.

Diabetes-related quality of life and the demands and burdens of diabetes care among emerging adults with type 1 diabetes in the year after high school graduation

The roles of glycemic control, diabetes management, diabetes care responsibility, living independently of parents, and time since high school graduation in predicting diabetes-related quality of life (DQOL) were examined in 184 emerging adults with type 1 diabetes. Data were collected at graduation and 1 year later. Analyses controlling for selected covariates were completed using generalized linear mixed models. Better diabetes management was associated with more positive responses on all four dimensions of DQOL. Impact and worry of DQOL were greater in the presence of depressive symptoms, and life satisfaction was lower. DQOL life satisfaction was lower in those living independently of parents. Young women reported poorer diabetes-related health status than did young men. Time since graduation was not linked to DQOL. Further research is needed on ways to improve DQOL in conjunction with diabetes management and on ways that families can support DQOL when youth live independently.

Etiological heterogeneity of symptom dimensions of adolescent depression

The aim was to investigate the underlying factor structure of adolescent depression and etiological heterogeneity in the symptom dimensions of adolescent depression. The sample included 842 pairs of same-sex adolescent twins, among which 613 pairs were monozygotic twins and 229 pairs were dizygotic twins. The ages of the participants ranged from 11 to 17 years (M = 13.64, SD = 1.80). Adolescents' depressive symptoms were assessed using the self-reported Children's Depression Inventory. Exploratory and confirmatory factor analyses were used to explore the factor structure of youth depression and twin genetic analyses were employed to estimate genetic and environmental influences on the derived dimensions. Results showed that adolescent depression encompassed five correlated dimensions: dysphoria mood, somatic symptoms, study and externalizing problems, anhedonia symptoms, and cognitive symptoms. These five symptom dimensions had heterogeneous etiologies: Dysphoria mood, somatic symptoms, and cognitive symptoms were moderately heritable (heritability ranged from 33 to 40%), whereas study and externalizing problems, and anhedonia symptoms were mainly environmentally influenced with minimal genetic basis. Our findings supported the multidimensionality of adolescent depression and the etiological heterogeneity of these symptom dimensions.

Genetic and environmental influences on adolescent rumination and its association with depressive symptoms

Rumination is an important cognitive vulnerability for adolescent and adult depression. However, little is known about the aetiological origins of rumination, as well as its association with depression. Adolescent rumination (self-report) and depressive symptoms (self- and parent-report) were assessed in 674 pairs of same-gender Chinese adolescent twins (11-17 years of age). Females accounted for 53.7 % of the sample. There were significant correlations between self-reported rumination and self-reported depression (r = 0.41), as well as parent-reported adolescent depression (r = 0.22). Genetic influences were significant and modest on all three measures, ranging from 24 % to 42 %. The three measures were also significantly influenced by shared environment, ranging from 20 % to 28 %, and non-shared environmental factors, ranging from 30 % to 56 %. Moreover, the genetic correlations between rumination and depression were significant (within-rater: r(g) = 0.99; cross-rater: r(g) = 0.59) and largely accounted for the phenotypic correlations (within-rater: 68 %; cross-rater: 77 %), while non-shared environmental correlations were also significant (within-rater: r(e) = 0.26; cross-rater: r(e) = 0.12) and accounted for the remainder of the phenotypic correlations (within-rater: 32 %; cross-rater: 23 %). The shared environmental correlations were non-significant. No significant gender and age differences were found in aetiological models. These findings suggest that rumination may be an endophenotype reflecting genetic risk for depression.

Genetic and environmental influences on depressive symptoms in Chinese adolescents

Adolescent depression is common and has become a major public health concern in China, yet little research has examined the etiology of depression in Chinese adolescents. In the present study, genetic and environmental influences on Chinese adolescent depressive symptoms were investigated in 1,181 twin pairs residing in Beijing, China (ages 11-19 years). Child- and parent-versions of the children's depression inventory were used to measure adolescents' depressive symptoms. For self-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 50, 5, and 45 % of the variation in depressive symptoms, respectively; for parent-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 51, 18, and 31 % of the variation, respectively. These estimates are generally consistent with previous findings in Western adolescents, supporting the cross-cultural generalizability of etiological model of adolescent depression. Neither qualitative nor quantitative sex differences were found in the etiological model. Future studies are needed to investigate how genes and environments work together (gene-environment interaction, gene-environment correlation) to influence depression in Chinese adolescents.

The interacting effect of the BDNF Val66Met polymorphism and stressful life events on adolescent depression is not an artifact of gene-environment correlation: evidence from a longitudinal twin study

BACKGROUND

Confounding introduced by gene-environment correlation (rGE) may prevent one from observing a true gene-environment interaction (G × E) effect on psychopathology. The present study investigated the interacting effect of the BDNF Val66Met polymorphism and stressful life events (SLEs) on adolescent depression while controlling for the rGE by two means: separating pure environmental factors (independent SLEs) from the environmental factors under partial genetic control (dependent SLEs) and adopting a prospective longitudinal design.

METHODS

A total of 780 pairs of Chinese twins, aged 11-17 years (mean = 13.6, SD = 1.8) at intake, were followed up twice. Self-reported depression symptoms at Time 1 and Time 2 were assessed by the Children's Depression Inventory (CDI). SLEs occurring between Time 1 and Time 2 were assessed by a self-reported checklist. SLEs were differentiated into independent and dependent ones and were validated by heritability analyses using twin design. The interacting effects between the BDNF Val66Met polymorphism and numbers of SLEs (total SLEs and independent SLEs) on intraindividual change of depression symptoms were examined.

RESULTS

After controlling for sex, age, age square, and Time 1 depression, both total SLEs × BDNF Val66Met genotype and independent SLEs × BDNF Val66Met genotype significantly predicted Time 2 depression. Val allele carriers (Val/Val and Val/Met) were more susceptible to the detrimental effects of stress.

CONCLUSIONS

There is a true G × E effect underlying the observed interaction between BDNF Val66Met polymorphism and environmental stress on depression.

Longitudinal course of depressive symptoms in adulthood: linear stochastic differential equation modeling

BACKGROUND

Although many studies have addressed the topic of stability versus change in depressive symptoms, few have further decomposed the change to continuous accumulation versus non-systematic state fluctuations or measurement errors. This further step requires a longitudinal follow-up and an appropriate stochastic model; it would, for example, evaluate the hypothesis that women accumulate more susceptibility events than men. Method A linear stochastic differential equation model was estimated for a 16-year longitudinal course of depressive symptoms in the Young Finns community sample of 3596 participants (1832 women, 1764 men). This model enabled us to decompose the variance in depression symptoms into a stable trait, cumulative effects and state/error fluctuations.

RESULTS

Women showed higher mean levels and higher variance of depressive symptoms than men. In men, the stable trait accounted for the majority [61%, 90% confidence interval (CI) 48.9-69.2] of the total variance, followed by cumulative effects (23%, 90% CI 9.9-41.7) and state/error fluctuations (16%, 90% CI 5.6-23.2). In women, the cumulative sources were more important than among men and accounted for 44% (90% CI 23.6-58.9) of the variance, followed by stable individual differences (32%, 90% CI 18.5-54.2) and state fluctuations (24%, 90% CI 19.1-27.3).

CONCLUSIONS

The results are consistent with previous observations that women suffer more depression than men, and have more variance in depressive symptoms. We also found that continuously accumulating effects are a significant contributor to between-individual differences in depression, especially for women. Although the accumulating effects are often confounded with non-systematic state fluctuations, the latter are unlikely to exceed 27% of the total variance of depressive symptoms.

Validation of Children's Depression Scale in the Basque-speaking population

The aim of this study was to validate the Basque version of the CDS (Children's Depression Scale, Lang & Tisher, 1978), one of the most widely used questionnaires for the assessment of childhood depression, which has already been proved to be a valid and reliable tool in different cultures. The questionnaire was administered to a community sample of 886 participants (432 males and 454 females) aged between 8 and 16. A two-factor solution was obtained (Depressive dimension and Positive Dimension), which accounted for 29.86 % of the variance. Reliability with regard to internal consistency level and long-term stability was good (alpha = .95 and .79; and R = .73 and .59 for Depressive and Positive dimensions, respectively). Analysis of Differential Item Functioning with respect to age and gender showed that 91% and 88% of the items, respectively, did not present DIF. External validity evidence for the questionnaire was also obtained. We consider that the present work offers researchers and professionals interested in this area of study a valid and reliable tool for assessing depressive symptoms in Basque-speaking children and adolescents.

Using Trait-State Models to Evaluate the Longitudinal Consistency of Global Self-Esteem From Adolescence to Adulthood

The present research used a latent variable trait-state model to evaluate the longitudinal consistency of self-esteem during the transition from adolescence to adulthood. Analyses were based on ten administrations of the Rosenberg Self-Esteem scale (Rosenberg, 1965) spanning the ages of approximately 13 to 32 for a sample of 451 participants. Results indicated that a completely stable trait factor and an autoregressive trait factor accounted for the majority of the variance in latent self-esteem assessments, whereas state factors accounted for about 16% of the variance in repeated assessments of latent self-esteem. The stability of individual differences in self-esteem increased with age consistent with the cumulative continuity principle of personality development.

A prospective mediational model of sexual aggression among college men

Guided by the Theory of Planned Behavior (TPB), the authors examined prospective associations of attitudes, norms, and control with sexual aggression (SA) perpetration 1 year later among male college students. Data were collected from 652 males via confidential, self-report surveys at the end of their 1st and 2nd years in college. Results indicated that attitudes conducive to SA and perceived norms supportive of SA were associated with a higher likelihood of engaging in SA 1 year later, and mediated the associations of some established risk factors for SA. The findings identify potentially changeable risk factors for perpetrating SA and can thus contribute to the foundation on which to build theoretical and empirically based prevention programs.

Psychometric properties of the Dutch Inventories of Prolonged Grief for Children and Adolescents

A significant minority of bereaved adults develops prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief distinct from depression and anxiety. Few studies have examined the phenomenology and correlates of PGD among children and adolescents. In part, this is due to the lack of a psychometrically sound questionnaire to assess PGD symptoms in these groups. Based on an adult measure of PGD, we developed two questionnaires of PGD symptoms for children and adolescents named the Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A), respectively. Psychometric properties of these measures were examined in three samples, including mostly parentally bereaved children (aged 8-12 years, total sample n = 169) and adolescents (aged 13-18 years, total sample n = 153). First, findings showed that items of the IPG-C and IPG-A represented one underlying dimension. Second, the internal consistency and temporal stability of both questionnaires were adequate. Third, findings supported the concurrent validity (e.g., significant correlations with measures of depression and post-traumatic stress-disorder [PTSD]), convergent and divergent validity (stronger correlations with similar questionnaires of 'traumatic grief' than with two dissimilar questionnaires of 'ongoing presence' and 'positive memories') and incremental validity (significant correlations with an index of functional impairment, even when controlling for concomitant depression and PTSD) of the IPG-C and IPG-A. This report provides further evidence of the clinical significance of PGD symptoms among children and adolescents and promising psychometric properties of questionnaires that can be used to assess these symptoms.

KEY PRACTITIONER MESSAGE

The Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A) were developed to be able to assess symptoms of Prolonged Grief Disorder (PGD) among children and adolescents. In different samples, the internal consistency, temporal stability, and concurrent and construct validity of these questionnaires were found to be adequate. The IPG-C and the IPG-A can be used in research examining causes and consequences of PGD, and the effectiveness of bereavement interventions for children and adolescents. This study provides further evidence of the existence and clinical significance of PGD symptoms among children and adolescents and supports the inclusion of a new category for bereavement-related disorders in DSM-5.

Validation of the Child Posttraumatic Symptom Scale in a sample of treatment-seeking Israeli youth

We evaluated the psychometric properties of the Hebrew version of the Child Posttraumatic Symptom Scale (CPSS), a self-report measure assessing the severity of posttraumatic distress in youth. Participants (N= 156, ages 8-18) were treatment-seeking victims of diverse traumas. Internal consistency of the Hebrew version in these data was .91 for the total score, .77 for intrusion, .67 for avoidance, and .72 for arousal, similar to the original version. Test-retest reliability over 1 week in a subsample of 45 was r = .81. The point biserial correlation with a clinician-based diagnosis of PTSD was .54. Other convergent and divergent relationships expand the existing literature on the measure and support it as a valuable assessment tool for children exposed to traumatic events.

Are anxiety and depression just as stable as personality during late adolescence? Results from a three-year longitudinal latent variable study

Although considerable evidence shows that affective symptoms and personality traits demonstrate moderate to high relative stabilities during adolescence and early adulthood, there has been little work done to examine differential stability among these constructs or to study the manner in which the stability of these constructs is expressed. The present study used a three-year longitudinal design in an adolescent/young adult sample to examine the stability of depression symptoms, social phobia symptoms, specific phobia symptoms, neuroticism, and extraversion. When considering one-, two-, and three-year durations, anxiety and personality stabilities were generally similar and typically greater than the stability of depression. Comparison of various representations of a latent variable trait-state-occasion (TSO) model revealed that whereas the full TSO model was the best representation for depression, a trait stability model was the most parsimonious of the best-fitting models for the anxiety and personality constructs. Over three years, the percentages of variance explained by the trait component for the anxiety and personality constructs (73-84%) were significantly greater than that explained by the trait component for depression (46%). These findings indicate that symptoms of depression are more episodic in nature, whereas symptoms of anxiety are more similar to personality variables in their expression of stability.

A systematic overview of measurement-based care in the treatment of childhood and adolescent depression

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders affecting children and adolescents. The significant psychiatric, social, and functional impairments associated with this disorder coupled with the high incidence of relapse indicate a need for continued efforts to enhance treatment. Current empirically supported treatments for childhood and adolescent MDD include psychotropic medications, psychotherapy, and a combination of both treatments, with selection of the most appropriate strategy depending on symptom severity. One strategy to enhance treatment outcome is the use of measurement-based care. This article provides a systematic review of measurement-based care in the treatment of childhood and adolescent MDD. It also presents a comprehensive analysis of widely used depression rating scales and discusses their utility in clinical practice. This review found evidence supporting the utility and benefit of depression rating scales to document depression severity in children and adolescents. We also found evidence suggesting that many of these scales are time efficient, and that both clinician-rated and self-rated scales provide accurate assessment of depressive symptomatology. Future research is warranted to examine the utility of measurement-based care in clinical practice with child and adolescent populations.

Childhood anxiety and depressive symptoms: trajectories, relationship, and association with subsequent depression

The development of child anxiety and depressive symptoms from mean ages 5.3 to 9.3 years was examined in a community sample of 133 girls and 134 boys, using parent and teacher ratings. Reliable individual differences in anxiety and depressive symptoms at mean age 5.3 and in their change to mean age 9.3 were observed, with significant correlations between depressive and anxiety symptoms at mean age 5.3 years and between their changes with age. Positive cross-lagged correlations from anxiety to depressive symptoms and negative cross-lagged correlations from depressive to anxiety symptoms were apparent in teachers' ratings at 6- to 12-month intervals. Developmental changes in teacher-rated child anxiety symptoms were robust predictors of child self-reported depressive symptoms at mean age 9.3 years. These results suggest assessment and interventions for emotional problems may be usefully implemented during childhood in school and peer social environments.

Intolerance of uncertainty in adolescents: correlations with worry, social anxiety, and depression

The current study examined Intolerance of Uncertainty (IU)-the tendency to react negatively to situations that are uncertain-in psychological problems among adolescents. Using data from 191 adolescents, aged 14 to 18, we examined (a) the dimensionality of IU as tapped by the Intolerance of Uncertainty Scale short-form (IUS-12), (b) the relationship of IU with worry, social anxiety, and depression, (c) the specificity of IU to these variables, and (d) the role of IU as a mediator of the linkages between negative affectivity (NA) and worry, social anxiety, and depression. Results showed that the IUS-12 encompassed 2 components of IU, named Prospective Anxiety and Inhibitory Anxiety. Furthermore, IU was specifically related with worry and social anxiety, but not depression, when controlling the shared variance between these variables and NA, age, and gender. Finally, IU and its 2 components were found to mediate the linkages of NA with worry and social anxiety.

Statistical methods for risk-outcome research: being sensitive to longitudinal structure

The relation between risk and outcome consists of myriad, complex, longitudinal processes. To study these relations requires research designs and statistical methods that are sensitive to the longitudinal structure of the risk, the outcome, and the risk-outcome relation. This review presents four longitudinal characteristics that can complicate psychopathology risk-outcome research. We represent each complication with an example data set. We demonstrate how conventional statistical approaches can yield highly misleading results. Finally, we review alternative statistical approaches that can handle these complications quite well.

Assessment of depression in children and adolescents

Depression assessment instruments are valuable tools in the treatment of children and adolescents. Available instruments include diagnostic interviews, self-administered rating scales, and observer-rated scales. To select an appropriate instrument, the user must define the goal of the assessment and then identify instruments with the properties that match this goal. This article discusses how to choose an assessment instrument and gives an overview of currently available depression assessment instruments. Important considerations include how and by whom an instrument is administered, what kind of data are obtained by the instrument, and the validity and reliability of the instrument. Standardized instruments can greatly improve the assessment process, but the user must not overinterpret or misinterpret the results.

Whose depression relates to discrepancies? Testing relations between informant characteristics and informant discrepancies from both informants' perspectives

This study examined whether mothers' and children's depressive symptoms were each uniquely related to mother-child rating discrepancies on a multidimensional dyadic construct: domains associated with parental monitoring (i.e., Child Disclosure, Parental Knowledge, and Parental Solicitation). Participants included a community sample of 335 mother/female-caregiver and child dyads (182 girls, 153 boys; 9-16 years old). Children's depressive symptoms were consistently related to each of the three domains of mother-child discrepancies. Mothers' depressive symptoms were related to perceived discrepancies in two domains (Child Disclosure and Parental Knowledge). Furthermore, these relations could not be accounted for by other informant characteristics (maternal stress, child age, child gender, child ethnicity). Findings provide important empirical support for theory suggesting that both informants' perspectives meaningfully contribute to their discrepancies in perceived behavior. Consideration of both informants' perspectives leads to valuable information as to whether any particular characteristic is an important correlate of discrepancies.

Developmental trajectories of adolescent anxiety disorder symptoms: a 5-year prospective community study

OBJECTIVE

This study prospectively examined the developmental trajectories of anxiety disorder symptoms in a large sample of adolescents from the general population.

METHOD

Two cohorts of early and middle adolescents (1,318 junior high and high school students) completed the Screen for Child Anxiety Related Emotional Disorders during 5 consecutive years. The Screen for Child Anxiety Related Emotional Disorders is a questionnaire that measures self-rated child and adolescent anxiety symptoms that map onto DSM-IV-TR anxiety disorders. At the first wave of measurement, the early and middle adolescent cohorts were an average of 12 and 16 years of age, respectively. Age and sex differences in the developmental trajectories of adolescent anxiety disorder symptoms over time were examined by means of latent growth modeling.

RESULTS

Over the course of 5 years, there was a slight decrease in the panic disorder, school anxiety, and separation anxiety disorder symptoms for all of the adolescents, with the exception of social phobia symptoms, which remained fairly stable over time. Adolescent girls showed a slight increase of generalized anxiety disorder symptoms over time, whereas these symptoms decreased among adolescent boys.

CONCLUSIONS

This study replicates and extends earlier findings on the developmental trajectories of anxiety symptoms during adolescence. By using individually focused, trajectory-based analyses rather than group score differences, this study extends earlier findings and advances our understanding of age and sex differences in the development of adolescent anxiety symptoms.

Why are students with LD depressed? A goal orientation model of depression vulnerability

The thesis of the present study was that failure in achievement tasks may constitute a stress factor that can trigger a depression episode, particularly for students with learning disabilities (LD), and that a particular motivational pattern may constitute a cognitive diathesis for depression. Participants were 104 students referred for LD who were drawn from a pool of approximately 900 students from Grades 5 and 6. Students were challenged with a series of difficult math exercises, and their achievement behaviors were examined as a function of achievement goal orientations. Results from structural equation modeling provided empirical support of the contention that performance-avoidance goals may account for a series of negative cognitions and affect. Direct positive paths linked performance-avoidance goals to anxiety, depression, and negative affect; negative paths were revealed with regard to self-esteem and positive affect. Thus, performance-avoidance goals may possess elements of the diathesis mechanism described by Dykman, constituting a vulnerability factor that triggers the mechanism of depression when negative events are in place.

Validation of the emotional eating scale adapted for use in children and adolescents (EES-C)

OBJECTIVE

Eating in response to negative emotions is associated with binge or loss of control (LOC) eating in adults. Although children report engaging in LOC eating, data on emotional eating among youth are limited.

METHOD

We adapted the adult Emotional Eating Scale (Arnow et al., Int J Eat Disord, 18, 79-90, 1995) to be used with children and adolescents (EES-C). Fifty-nine overweight (BMI > or = 95th percentile for age and sex) and 100 non-overweight (BMI 5th-94th percentile) participants (mean age +/- SD 14.3 +/- 2.4 years) completed the EES-C, and measures of recent LOC eating and general psychopathology. Test-retest reliability was assessed in 64 children over a 3.4 +/- 2.6 month interval.

RESULTS

A factor analysis generated three subscales: eating in response to anxiety, anger, and frustration (EES-C-AAF), depressive symptoms (EES-C-DEP), and feeling unsettled (EES-C-UNS). Internal consistency for the subscales was established; Cronbach's alphas for the EES-C-AAF, EES-C-DEP, and EES-C-UNS were 0.95, 0.92, and 0.83, respectively. The EES-C had good convergent validity: children reporting recent LOC eating episodes scored higher on all subscales (p's < 0.05). The EES-C-AAF and EES-C-UNS subscales demonstrated good discriminant validity and the EES-C-DEP revealed adequate discriminant validity. Intra-class correlation coefficients revealed good temporal stability for each subscale (EES-C-AAF = 0.59, EES-C-DEP = 0.74, EES-C-UNS = 0.66; p's < 0.001).

CONCLUSION

The EES-C has good convergent and discriminant validity, and test-retest reliability for assessing emotional eating in children. Further investigation is required to clarify the role emotional eating may play in children's energy intake and body weight.

Stress exposure and stress generation in child and adolescent depression: a latent trait-state-error approach to longitudinal analyses

In 2 longitudinal studies of negative life events and depressive symptoms in adolescents (N = 708) and in children (N = 508), latent trait-state-error structural equation models tested both the stress generation hypothesis and the stress exposure hypothesis. Results strongly suggested that self-reports of depressive symptoms reflect the influence of a perfectly stable trait factor as well as a less stable state factor. Support emerged for both the stress generation model and the stress exposure model. When the state depression factor was modeled as predicting stress, support for the stress generation model appeared to increase with age. When the trait depression factor was modeled as the predictor of stress, support for the stress generation model did not vary with the child's age. In both models, support for the stress exposure remained relatively constant across age.