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

Comparative randomized trial addressing childhood emotional problems: Computerized vs. traditional transdiagnostic Super Skills program

BACKGROUND

Super Skills for Life is a structured intervention rooted in cognitive-behavioral therapy and a transdiagnostic approach, aimed at preventing childhood emotional problems. Over the past decade, it has demonstrated positive outcomes in various formats and countries. This study evaluated the comparative effectiveness of two individual modalities: the computerized and the traditional version enriched with multimedia content, through a comparative randomized effectiveness trial.

METHOD

109 children (55.24 % female) aged 8-12 years participated, randomly assigned to either the traditional (n = 54) or computerized (n = 51) groups. Pre- and post-intervention assessments involved emotional problem measures completed by children and parents.

RESULTS

Both groups exhibited significant reductions in all outcomes according to parent reports, including depression, anxiety, and anxiety-related life interference. Children's self-reports indicated improvements across all general measures. Generalized Estimating Equations indicated marginally better improvements in the traditional group.

LIMITATIONS

Limitations included the absence of follow-up assessment, variability in participant regions across Spain, and input from other informants like teachers.

CONCLUSIONS

This study pioneers the examination of short-term effects of the program in both a fully computerized format supervised by a specialized therapist and an enriched traditional individual format, and the promising results suggest their potential for indicated prevention of childhood emotional problems.

Validation of the Parent Version of the Nighttime Fears Scale (NFS-P) for Children Aged 3-8 Years

BACKGROUND

Nighttime fears are highly prevalent in children, ranging from normative fears to triggering fear-related anxiety disorders. The lack of available assessment instruments recently prompted the development of the Nighttime Fears Scale (NFS) for children aged 8-12 years. The present study aimed to adapt and psychometrically evaluate the parent-reported version for children aged 3-8 years (NFS-P) as a complement for younger children.

METHODS

Two hundred eighty-four Spanish-speaking parents (47% girls) completed the NFS-P and anxiety measures.

RESULTS

Confirmatory factor analyses supported a four-factor structure of the NFS-P. Strong internal consistency and validity evidence were obtained. No significant differences were found in NFS-P scores between sexes and age groups.

CONCLUSIONS

The findings offer support for the use of the NFS-P as a valuable instrument in clinical and research settings, supplementing the NFS for older children. Both scales provide an efficient means to comprehensively assess the presence and intensity of typical nighttime fears across preschool and school years.

Treating Emotional Disorders in Spanish Children: A Controlled Randomized Trial in a Clinical Setting

Super Skills for Life (SSL) is a CBT-transdiagnostic group intervention currently being translated and validated in multiple countries. In Spanish children, it has shown a positive impact on anxious and depressive symptoms, as well as other variables such as self-concept, prosocial behaviors, or behavioral problems. However, the effectiveness of the program to treat internalizing symptoms in children with a mental disorder in a clinical setting has not been examined so far. The aim of this study was to evaluate the effectiveness of SSL in a Spanish sample of children with a major internalizing disorder. Participants aged 8-12 years (71.6% boys) were randomly allocated to the SSL group (n = 43) or the waiting list control (WLC) group (n = 43). All children and their parents completed a series of measures before the first session and after the last session or at about the same time in the WLC group. The effectiveness of the intervention was assessed using generalized estimating equations. Significant reductions from pretest to posttest across multiple outcomes were found in children who participated in SSL group compared to those in the WLC group, including anxiety symptoms (SCAS, p = .02), anxiety interference (CALIS, p = .002), depressive symptoms (CDI, p = .033) and remission from diagnosis (K-SADS, p < .001). This study provides initial support for SSL as an effective treatment for children with emotional disorders in clinical settings. Future studies are needed to analyze long-term effects and broader benefits of the program in clinical contexts.

Impact of Repeated Infantile Exposure to Surgery and Anesthesia on Gut Microbiota and Anxiety Behaviors at Age 6-9

(1) Background: Preclinical as well as population studies have connected general anesthesia and surgery with a higher risk of abnormal cognitive development, including emotional development. Gut microbiota dysbiosis in neonatal rodents during the perioperative period has been reported, however, the relevance of this to human children who undergo multiple anesthesia for surgeries is unknown. Given the emerging role of altered gut microbes in propagating anxiety and depression, we sought to study whether repeated infantile exposures to surgery and anesthesia affect gut microbiota and anxiety behaviors later in life. (2) Methods: This is a retrospectively matched cohort study comparing 22 pediatric patients of less than 3 years of age with multiple exposures (≥3) to anesthesia for surgeries and 22 healthy controls with no history of exposure to anesthesia. The parent report version of the Spence Children's Anxiety Scale (SCAS-P) was applied to evaluate anxiety in children aged between 6 and 9 years old. Additionally, the gut microbiota profiles of the two groups were compared using 16S rRNA gene sequencing. (3) Results: In behavioral tests, the p-SCAS score of obsessive compulsive disorder and social phobia were significantly higher in children with repeated anesthesia exposure relative to the controls. There were no significant differences between the two groups with respect to panic attacks and agoraphobia, separation anxiety disorder, physical injury fears, generalized anxiety disorder, and the total SCAS-P scores. In the control group, 3 children out of 22 were found to have moderately elevated scores, but none of them had abnormally elevated scores. In the multiple-exposure group, 5 children out of 22 obtained moderately elevated scores, while 2 scored as abnormally elevated. However, no statistically significant differences were detected in the number of children with elevated and abnormally elevated scores. The data show that repeated anesthesia and surgical exposures in children led to long-lasting severe gut microbiota dysbiosis. (4) Conclusions: In this preliminary study, our findings demonstrated that early repeated exposures to anesthesia and surgical predisposes children to anxiety as well as long-term gut microbiota dysbiosis. We should confirm these findings in a larger data population size and with detailed analysis. However, the authors cannot confirm an association between the dysbiosis and anxiety.

Perceptions of intelligence & sentience shape children's interactions with robot reading companions

The potential for robots to support education is being increasingly studied and rapidly realised. However, most research evaluating education robots has neglected to examine the fundamental features that make them more or less effective, given the needs and expectations of learners. This study explored how children's perceptions, expectations and experiences are shaped by aesthetic and functional features during interactions with different robot 'reading buddies'. We collected a range of quantitative and qualitative measures of subjective experience before and after children read a book with one of three different robots. An inductive thematic analysis revealed that robots have the potential offer children an engaging and non-judgemental social context to promote reading engagement. This was supported by children's perceptions of robots as being intelligent enough to read, listen and comprehend the story, particularly when they had the capacity to talk. A key challenge in the use of robots for this purpose was the unpredictable nature of robot behaviour, which remains difficult to perfectly control and time using either human operators or autonomous algorithms. Consequently, some children found the robots' responses distracting. We provide recommendations for future research seeking to position seemingly sentient and intelligent robots as an assistive tool within and beyond education settings.

The effect of anxiety on working memory and language abilities in elementary schoolchildren with and without Additional Health and Developmental Needs

Although excessive childhood anxiety is recognised as a significant public health, education and socioeconomic concern, the specific effects of such anxiety on language development and working memory, particularly visual working memory, are relatively unknown. Thus, this study aimed to examine parent-reported trait anxiety, parent-reported functional language (daily communication skills) and clinical measures of non-verbal intelligence, receptive and expressive vocabulary, phonological awareness, and visual and auditory-verbal short-term and working memory in elementary schoolchildren. The final sample included 41 children categorised as Additional Health and Developmental Needs (AHDN) due to medical, neurodevelopmental or educational concerns and 41 age- and IQ-matched neurotypical (NT) children, aged 5- to 9-years. Results showed that 26% of all children in our entire sample (AHDN and NT) experienced moderate, sub-clinical anxiety (as reported by parents), and that AHDN children were 10.5 times more likely to experience high anxiety than the NT group (odds ratio). Parents of AHDN children reported lower functional language in their children than parents of NT children. Cognitive testing indicated that the AHDN group also had poorer visual and auditory-verbal working memory than the NT group. Further, High Anxiety children (drawn from both AHDN and NT groups) showed poorer parent-reported functional language skills, and lower visual and auditory-verbal working memory capacities. Our findings are amongst the first to confirm that the presence of high parent-rated trait anxiety is associated with reduced visual working memory in children, which is consistent with biological and theoretical expectations of the impact of anxiety on visually driven, goal-directed attention and working memory. Our results regarding the high prevalence of sub-clinical anxiety in both ADHD and neurotypical children highlight the need for early assessment of anxiety in all schoolchildren, especially those classified as AHDN.

Early detection of anxiety problems in childhood: Spanish validation of the brief Spence Children's Anxiety Scale for parents

The small percentage of children with anxiety problems who receive psychological treatment, and the negative psychological consequences associated with these problems highlight the need for early detection. Although assessment instruments with appropriate measurement properties exist, they tend to be extensive, making it difficult to apply them in clinical settings, schools, or primary care practices. This study aimed to adapt the Spanish brief version for parents of the Spence Children's Anxiety Scale (SCAS-P-8). For this purpose, information on 215 children between 8 and 12 years of age was reported by 163 parents. The Spanish version of the SCAS-P-8 adequately fit a one-factor structure, χ² = 44.25; df = 19; comparative fit index = .97; Tucker-Lewis index = .96; root mean square error of approximation: .07 (.04, .09); standardized root mean squared residual = .08. Evidence of internal consistency of the total SCAS-P-8 score was good (α = 0.82), and the direct correlations obtained between the SCAS-P-8 and internalizing problems showed evidence of convergent validity. Moreover, the appropriate measurement properties of the SCAS-P-8 were shown to be independent of gender. Differences in sociodemographic variables and SDQ-P between children with anxiety symptoms and those without anxiety symptoms were also discussed. Information reported by parents can help the clinician carry out an accurate diagnosis. A brief assessment scale can be easily applied in schools or primary care settings.

Effects of anxiety on sedation among pediatric patients undergoing esophagogastroduodenoscopy

We investigated whether the severity of anxiety among children undergoing endoscopy could affect sedation. We prospectively recruited patients under 18 years of age who were scheduled to undergo esophagogastroduodenoscopy (EGD). Baseline anxiety was evaluated using the Spence Children's Anxiety Scale (SCAS). Our analysis considered the type and dose of sedative drugs, degree of sedation, and complications associated with sedation according to the scale score. The mean total SCAS T-scores and each subscale score were significantly higher in the 6-12-year age group. The mean T-score among patients who exhibited irritability during EGD was higher than that among other patients, with significant differences in the Total, Obsessive Disorder, Panic Agoraphobia and General Anxiety subscales. The midazolam doses of children exhibiting irritability were more likely to need higher (p = 0.006). Other sedation-related complications were not associated with the T-scores in each subscale. Total sleep time was not associated with any T-score subscales. Anxiety levels were significantly higher among 6-12-year-olds and children exhibiting irritability. Anxiety was often associated with irritability, difficulties achieving adequate sedation during EGD, and additional sedative drug administration. We recommend higher doses or more potent drugs to facilitate endoscopy for children with high anxiety levels.

Effects as a function of implementation fidelity of a transdiagnostic prevention program in young school-aged children

Super Skills for Life (SSL) is a transdiagnostic prevention program for school-aged children with internalizing problems. The current study aimed to examine the short- and long-term (12-month follow-up) effectiveness of SSL, depending on implementation fidelity. Participants were 123 Spanish-speaking children aged 6-8 years with internalizing symptoms and their parents. High (n = 41) and low fidelity (n = 26) groups were established and compared with a control group (CG) (n = 56). Compared to CG, the high-fidelity group (HFG) achieved better outcomes than the low-fidelity group (LFG) at short and long term, including symptoms of anxiety, depression, and internalizing problems, and also externalizing problems at long-term. The LFG improved key symptoms at short term (depression) and long term (anxiety and depression). Findings suggest that SSL is beneficial even if not delivered at maximum fidelity, although considering the influence of implementation fidelity is critical because the high-fidelity implementation yielded the greatest effects when compared to the CG. This research provides valuable data, analyzing for the first time the influence of fidelity on SSL outcomes in young school-aged children exhibiting internalizing symptoms, while there is still a lack of studies of these characteristics concerning transdiagnostic prevention programs targeting childhood anxiety and depression.

Validation of the brief version of the Spence Children's Anxiety Scale for Spanish children (SCAS-C-8)

OBJECTIVE

This study aimed to validate the self-reported brief version of the Spence Children's Anxiety Scale-Children (SCAS-C-8) in pre-adolescent Spanish children.

METHOD

Participants were 824 children aged 8-12 from a community sample. The results revealed a good fit to the one-factor structure, adequate internal consistency (α = 0.75), and evidence of test-retest reliability (α = 0.77).

RESULTS

The strong relationship between the SCAS-C-8 and emotional problems provided evidence of convergent validity. Also, the results showed factorial gender invariance.

CONCLUSION

The SCAS-C-8 is a suitable instrument for pre-adolescent Spanish children. The brevity and simplicity of this scale may facilitate early detection and help to narrow the existent gap between the presence of anxiety problems and psychological assistance-seeking.

Spanish version of Super Skills for Life in individual modality: Improvement of children's emotional well-being from a transdiagnostic approach

OBJECTIVE(S)

This study analyzed the short-term effects of the Super Skills for Life (SSL) program in its individual format from the parents' perspective.

METHODS

Parents of 70 Spanish children aged 8-11 years (M = 9.31; SD = 1.16) completed assessment instruments about their children's emotional state at the baseline and postintervention.

RESULTS

Analyses revealed significantly lower scores in depression (The Mood and Feelings Questionnaire), anxiety, and specific disorders (The Spence Children's Anxiety Scale) (i.e., panic attack/agoraphobia, separation anxiety, social phobia, and generalized anxiety). Significant improvements were also found in anxiety life interference at home (The Child Anxiety Life Interference Scale), total difficulties, internalized and externalized problems, emotional symptoms, peer problems, and hyperactivity/inattention (The Strengths and Difficulties Questionnaire) at posttest. SSL was effective in reducing psychopathological symptoms similarly in both girls and boys.

CONCLUSIONS

These promising results provide preliminary support for the usefulness of the SSL program in individual format for the indicated prevention of children's emotional problems. This study provides a valuable resource for research and clinical practice.

The Nighttime Fears Scale: Development and psychometric evidence of a standardized self-report scale to assess nighttime fears in children

Nighttime fears are highly prevalent in children and are linked to children's distress and internalizing problems, especially childhood anxiety. Although its assessment may be critical, there is a lack of available standardized self-reports. This study aimed to describe the development and psychometric evaluation of the Nighttime Fears Scale (NFS), a new standardized self-report for assessing nighttime fears in school-aged children. The construction of the scale was based on prior relevant research and involvement of researchers and clinicians, experts in childhood anxiety, and fears. A total of 794 Spanish-speaking children (51.1 % girls) aged 8-12 years completed the NFS along with measures of anxiety, sleep problems, internalizing and externalizing problems, and positive behaviors. Exploratory and confirmatory factor analyses supported a four-factor structure of the NFS, consisting of 21 items measuring a range of potentially fear-provoking stimuli at nighttime. Strong internal consistency (alphas ranging from .87 to .94), adequate test-retest reliability, and evidence of convergent, divergent and incremental validity was found. This study provides initial support for the use of the NFS by clinicians and researchers, suggesting that it is a promising tool for a rapid and easily-administered assessment to identify the presence and intensity levels of a set of common children's nighttime fears.

Spanish Adaptation and Psychometric Properties of the Parent Version of the Short Mood and Feelings Questionnaire (SMFQ-P) in a Non-Clinical Sample of Young School-Aged Children

The parent version of the Short Mood and Feelings Questionnaire (SMFQ-P) is a brief 13-item tool for the screening of depression in children from the age of 6 years. Despite the wide use of the SMFQ-P, its psychometric properties and factor structure remain understudied, with few data available for young school-aged children. The objective of this study was to examine for the first time the factorial structure and psychometric properties of the SMFQ-P in a non-clinical sample of Spanish-speaking children aged 6-8 years. Participants were 181 children whose parents completed the Spanish-adapted version of the SMFQ-P along with the parent version of other measures of anxiety and general difficulties and positive attributes. The SMFQ-P demonstrated adequate internal consistency (α = .83) and test-retest reliability over an eight-week period (ICC = .80), and good convergent and divergent validity. Factor analysis confirmed the original 13-item model, thus supporting the unidimensionality of the measure in the Spanish sample. Overall, this study provides initial empirical evidence for the utility of the SMFQ-P with Spanish-speaking children from early school ages, and extends the international support of the measure.