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.

Randomized controlled evaluation of the effect of music therapy with cognitive-behavioral therapy on social anxiety symptoms

OBJECTIVE

This study examined the effects of music therapy with cognitive behavioral therapy on social anxiety in a sample of schooling adolescents in south-east Nigeria.

METHODS

We adopted a randomized controlled trial design involving a treatment group and a waiting-list control group. A total of 155 schooling adolescents served as the study sample. The sample size was ascertained using GPower software. A 12-week MTCBP manual for social anxiety was employed to deliver the intervention. Data analyses were completed using repeated measures analysis of variance.

RESULTS

We found that social anxiety significantly decreased in the treatment group over time, whereas the waitlist control group showed no significant changes in social anxiety. Therefore, music therapy with cognitive-behavioral therapy was significantly beneficial in decreasing social anxiety symptoms of the treatment group. The follow-up assessment performed after 3 months revealed a significant reduction in social anxiety for the treatment group.

CONCLUSION

The study, therefore, suggests that the use of music therapy with cognitive-behavioral therapy is significant in reducing social anxiety among schooling adolescents.

Integrating etiological models of social anxiety and depression in youth: evidence for a cumulative interpersonal risk model

Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the diagnostic level. We find core risk factors of temperament, genetics, and parent psychopathology (i.e., depression and anxiety) are neither necessary nor sufficient for the development of social anxiety and/or depression. Instead, aspects of children's relationships with parents and/or peers either mediates (i.e., explains) or moderates (i.e., interacts with) these core risks being related to social anxiety and/or depression. We then examine various parent- and peer-related constructs contained in the separate models of social anxiety and depression (i.e., parent-child attachment, parenting, social skill deficits, peer acceptance and rejection, peer victimization, friendships, and loneliness). Throughout our review, we report evidence for a Cumulative Interpersonal Risk model that incorporates both core risk factors and specific interpersonal risk factors. Most studies fail to consider comorbidity, thus little is known about the specificity of these various constructs to depression and/or social anxiety. However, we identify shared, differential, and cumulative risks, correlates, consequences, and protective factors. We then put forth demonstrated pathways for the development of depression, social anxiety, and their comorbidity. Implications for understanding comorbidity are highlighted throughout, as are theoretical and research directions for developing and refining models of social anxiety, depression, and their comorbidity. Prevention and treatment implications are also noted.

The correlates and consequences of early appearing social anxiety in young children

Social anxiety is the fear of social situations and being negatively evaluated by others. Most previous studies of childhood social anxiety have employed clinical samples of children aged 10 years and older. The current study explored the correlates of social anxiety in an unselected sample of young children. Participants were n=178 elementary school children in grade 2 (aged 7-8 years). Children were individually administered the Social Anxiety Scale for Children-Revised (SASC-R), as well as measures of socio-emotional adjustment. Teachers completed measures of children's socio-emotional problems and school adjustment. Results indicated that social anxiety was positively associated with self-reported loneliness, school avoidance, and internalizing coping, and negatively related to school liking. However, social anxiety was mostly unrelated to teacher-rated outcomes. Findings are discussed in terms of use of the SASC-R for this type of population and reasons for the disparity between child and teacher reports of adjustment outcomes.

Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R)

The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.

Psychological adjustment of children with short stature: a comparison of clinic-referred children with short stature and type 1 diabetes mellitus

This study compared the psychological adjustment between children with short stature and youth with type 1 diabetes mellitus (DM1). The Child Behavior Checklist, Children's Depression Inventory, Social Anxiety Scale for Children--Revised, and Asher Loneliness Scale were administered to 58 children (26 with short stature and 32 with DM1) and a parent during a regularly scheduled clinical appointment for endocrinology care. Results show that the parents of children with short stature rated their children as having more social, thought, and attention problems, and exhibiting greater delinquent behavior, as compared to parental ratings of children with DM1. No diagnostic group differences in child or parent-rated internalizing symptoms were found. Implications of these findings for personnel working with children with short stature are discussed.

Social-psychological correlates of peer victimization in children with endocrine disorders

OBJECTIVE

To examine the relation between victimization by peers and child and parent reports of social-psychological adjustment.

STUDY DESIGN

The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 93 children diagnosed with various endocrine disorders. The child's parent/guardian completed the Child Behavior Checklist.

RESULTS

For the entire sample, peer victimization was positively related to child-reported depression, social anxiety, loneliness, and parent-reported externalizing symptoms. Those children with endocrine disorders without observable features had a stronger relation between peer victimization and depression and internalizing and externalizing behavior problems than did those who had endocrine disorders with observable physical features.

CONCLUSIONS

Recognition of the magnitude of the problem and means of evaluating for peer victimization is important for clinicians who see children with chronic diseases.