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Fernández-Martínez I, Muris P. The Youth Anxiety Measure for DSM-5 (YAM-5): An Updated Systematic Review of its Psychometric Properties. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01712-3. [PMID: 38839642 DOI: 10.1007/s10578-024-01712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 06/07/2024]
Abstract
The Youth Anxiety Measure for DSM-5 (YAM-5) is a self- and parent-report scale specifically developed to assess symptoms of major anxiety disorders (part 1 or YAM-5-I) and specific phobias/agoraphobia (part 2 or YAM-5-II) in children and adolescents in terms of the contemporary psychiatric classification system. Since its introduction, the measure has been increasingly used in research, making it feasible to provide a summary of its psychometric properties. The present article presents a systematic review of 20 studies that employed the YAM-5, involving 5325 young participants. Overall, the results supported the hypothesized factor structure of both parts of the measure, although there were also some studies that could not fully replicate the original five-factor model of YAM-5-I. The internal consistency of the YAM-5 was generally high for the total scores of both parts, while reliability coefficients for the subscales were more variable across studies. Research also obtained evidence for other psychometric properties, such as test-retest reliability, parent-child agreement, convergent/divergent validity, and discriminant validity. Results further revealed that girls tend to show significantly higher anxiety levels on the YAM-5 than boys. Overall, these findings indicate that the YAM-5 is a promising tool for assessing symptoms of anxiety disorders including specific phobias in young people. Some directions for future research with the YAM-5 and recommendations regarding the use of the measure are given.
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Affiliation(s)
- Iván Fernández-Martínez
- Department of Health Psychology, Centro de Investigación de la Infancia/Child Research Center, Miguel Hernández University, Av. de la Universidad S/N, 03202, Elche, Alicante, Spain.
| | - Peter Muris
- Maastricht University, Maastricht, The Netherlands
- Stellenbosch University, Stellenbosch, South Africa
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2
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Freitag GF, Coxe S, Cardinale EM, Furr JM, Herrera A, Comer JS. Phasic Versus Tonic Irritability and Associations with Family Accommodation Among Youth with Selective Mutism: A Latent Profile Analysis. Res Child Adolesc Psychopathol 2024; 52:905-917. [PMID: 38270833 DOI: 10.1007/s10802-023-01161-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/26/2024]
Abstract
Clinical presentations of selective mutism (SM) vary widely across affected youth. Although studies have explored general externalizing problems in youth with SM, research has not specifically examined patterns of irritability. Relatedly, research has not considered how affected families differentially accommodate the anxiety of youth with SM as a function of the child's temper outbursts (i.e., phasic irritability) and general angry mood (i.e., tonic irritability). Data were drawn from a sample of treatment-seeking children and adolescents with a primary diagnosis of selective mutism (N = 152; Mean age = 6.12 years; 67.11% female), and their caregivers. Latent profile analysis (LPA) was used to identify distinct profiles in SM youth that were characterized by varying levels of phasic and/or tonic irritability. Analyses further examined whether these different profiles were associated with different levels of family accommodation and global impairment. LPA identified 5 profiles: SM with No irritability, SM with Low Phasic Irritability, SM with High Phasic Irritability, SM with High Phasic and Moderate Tonic Irritability, and SM with High Phasic and High Tonic Irritability. Patterns of family accommodation and global impairment were highest among youth belonging to profiles characterized by high phasic irritability. Findings highlight separable patterns of irritability across youth with SM, with phasic irritability (i.e., temper outbursts) appearing particularly linked with increased family accommodation and overall global impairment. Assessing phasic irritability is critical for optimizing treatment in youth with SM and can be useful for flagging possible patterns of family accommodation contributing to overall impairment.
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Affiliation(s)
- Gabrielle F Freitag
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Stefany Coxe
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Elise M Cardinale
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Jami M Furr
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Aileen Herrera
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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Sevincok D, Ozaydin Y, Ozgur BG, Ozbek MM, Aksu H, Sevincok L. The relationship between parental obsessive-compulsive disorder and children's cognitive disengagement syndrome (Sluggish Cognitive Tempo). Clin Child Psychol Psychiatry 2024:13591045241257019. [PMID: 38807463 DOI: 10.1177/13591045241257019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Although the impact of parental obsessive-compulsive disorder (OCD) on children is well known, there is a still need to investigate additional psychopathological effects that parental OCD may have on children. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), previously referred to as Sluggish Cognitive Tempo CDS in children and parents' OCD has not been investigated to date. In this study, we examined the relationship between parental OCD and children's CDS, while adjusting for parental anxiety, depression, as well as symptoms of internalization, externalization, and Attention Deficit Hyperactivity Disorder (ADHD) in their children. 50 parents with OCD and 45 healthy parents were assessed through Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory, and Beck Anxiety Inventory (BAI). The children were applied Child Behavior Checklist, Children ADD/ADHD DSM-IV Based Diagnostic Screening, and Barkley Child Attention Scale (BCAS). BCAS showed significant correlations with BAI (r = 0.280, p = .049), child ADHD-hyperactivity/impulsivity (r = 0.407, p = .003), and ADHD-inattention (r = 0.628, p < .001). The severity of ADHD-inattention (β = 0.618, p = .001) and parental OCD (β = 0.275, p = .016) were significant predictors of CDS severity in the children. Our findings may suggest a significant association between the severity of CDS and ADHD-inattention in children and parental OCD, even after controlling for parental anxiety.
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Affiliation(s)
- Doga Sevincok
- Department of Child and Adolescent Psychiatry, Balikli Rum Hospital, Turkey
| | - Yigit Ozaydin
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | - Borte Gurbuz Ozgur
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | | | - Hatice Aksu
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Aydin Adnan Menderes University, Turkey
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Lisøy C, Neumer SP, Adolfsen F, Ingul JM, Potulski Rasmussen LM, Wentzel-Larsen T, Patras J, Sund AM, Ytreland K, Waaktaar T, Holen S, Askeland AL, Haug IM, Bania EV, Martinsen K. Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trial. Behav Res Ther 2024; 176:104520. [PMID: 38522127 DOI: 10.1016/j.brat.2024.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 12/12/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
Identifying effective components can lead to interventions that are less resource-intensive and better suited for real-world needs. In this 2×2×2 cluster-randomized factorial trial (clinicaltrials.gov NCT04263558), we investigated the effects of three components of an indicated, transdiagnostic CBT intervention for children: 1) Intervention Delivery Format (child group format versus a blended format with group sessions and automated web-based sessions), 2) Parental Involvement in the intervention (group-based versus psychoeducational brochure), and 3) a Measurement Feedback System (MFS; on versus off). The intervention was delivered at schools in a group-based format. The participants (N = 701 children) were school children (age 8-12 years) with elevated symptoms of anxiety or depression, and their parents. The main outcomes were self-reported (N = 633) and parent-reported (N = 725) symptoms of child anxiety and depression post-intervention. The secondary outcome was children's user satisfaction with the intervention. We did not find significant main or interaction effects of Delivery Format, Parental Involvement, or MFS on children's symptom levels. There were no significant effects on children's user satisfaction. Results were compatible with retaining the least resource intensive combination (i.e., blended format, parental brochure, no MFS) in an optimized intervention.
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Affiliation(s)
- Carina Lisøy
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway; Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
| | - Simon-Peter Neumer
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Lene-Mari Potulski Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Tore Wentzel-Larsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Joshua Patras
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Kristin Ytreland
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Trine Waaktaar
- Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
| | - Solveig Holen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Anne Liv Askeland
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Ida Mari Haug
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Elisabeth Valmyr Bania
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Kristin Martinsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway; Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
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5
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Lipinski S, Sünkel U, Totzeck C, Dresler T, Baskow I, Bea M, Hannig R, Dziobek I. [Patient and public involvement at the German Center for Mental Health: achievements and challenges]. DER NERVENARZT 2024; 95:458-466. [PMID: 38506976 PMCID: PMC11068695 DOI: 10.1007/s00115-024-01630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Patient and public involvement (PPI) describes the participation of patients and relatives, i.e., experts by experience (EE), in the research process. The PPI has not been widely adopted in the fields of medicine and clinical psychology in Germany and there is a notable absence of institutional support. The German Center for Mental Health (DZPG), which has been under construction since May 2023, aims to achieve nationwide and cross-center implementation of PPI, constituting one of its primary objectives. Participation of EE is to be implemented in the DZPG at all levels of decision-making. OBJECTIVES The article describes the origins, development and challenges associated with the implementation of participation structures and projects in the DZPG. The central political PPI committee in the DZPG, the Trilogue Center Council (TZR), developed a comprehensive PPI strategy for the DZPG in almost 3 years of work, before the beginning of the financial support of the DZPG. Among various measures, the strategy entails establishing a far-reaching representation for EE in all decision-making bodies of the DZPG, to involve EE as reviewers in evaluating research proposals, to integrate participatory elements into all studies of the DZGG and to foster user-initiated research endeavors. The implementation of the strategy is ensured by a cross-center PPI infrastructure, the Center for PPI, and scientific PPI consultants. The Center for PPI's tasks include supporting the voice of the EE and developing instruments and guidelines for participatory research, bringing together EE and researchers for joint DZPG projects as well as the documentation and quality assurance for participatory research. One of the particular challenges for the successful implementation of the PPI strategy is the limited experience with PPI in Germany in the field of mental health research and the widespread lack of structural implementation. Currently developed solution strategies include training for researchers and EE to communicate the benefits and pathways in the realization of PPI and thus enable shared decision-making and research. In addition, extensive access to knowledge and resources for EE will be created and uniform remuneration regulations for EE will be developed. CONCLUSION A PPI strategy at the DZPG has been successfully developed and is currently being implemented by the cross-center infrastructure Center for PPI.
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Affiliation(s)
- Silke Lipinski
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinische Psychologie Sozialer Interaktion, Institut für Psychologie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Deutschland
- Aspies e. V., Berlin, Deutschland
| | - Ulrike Sünkel
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Aspies e. V., Berlin, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Christina Totzeck
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Forschungs- und Behandlungszentrum für psychische Gesundheit (FBZ), Ruhr-Universität Bochum, Bochum, Deutschland
| | - Thomas Dresler
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Deutschland
- LEAD Graduate School & Research Network, Universität Tübingen, Tübingen, Deutschland
| | - Irina Baskow
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Myriam Bea
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- ADHS Deutschland e. V., Berlin, Deutschland
| | - Rüdiger Hannig
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Bundesverband der Angehörigen psychisch erkrankter Menschen e. V., Bonn, Deutschland
| | - Isabel Dziobek
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG), .
- Klinische Psychologie Sozialer Interaktion, Institut für Psychologie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Deutschland.
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Lin S, Wang C, Jiang X, Zhang Q, Luo D, Li J, Li J, Xu J. Using machine learning to develop a five-item short form of the children's depression inventory. BMC Public Health 2024; 24:1118. [PMID: 38654267 DOI: 10.1186/s12889-024-18657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Many adolescents experience depression that often goes undetected and untreated. Identifying children and adolescents at a high risk of depression in a timely manner is an urgent concern. While the Children's Depression Inventory (CDI) is widely utilized in China, it lacks a localized revision or simplified version. With its 27 items requiring professional administration, the original CDI proves to be a time-consuming method for predicting children and adolescents with high depression risk. Hence, this study aimed to develop a shortened version of the CDI to predict high depression risk, thereby enhancing the efficiency of prediction and intervention. METHODS Initially, backward elimination is conducted to identify various version of the short-form scales (e.g., three-item and five-item versions). Subsequently, the performance of five machine learning (ML) algorithms on these versions is evaluated using the area under the ROC curve (AUC) to determine the best algorithm. The chosen algorithm is then utilized to model the short-form scales, facilitating the identification of the optimal short-form scale based on predefined evaluation metrics. Following this, evaluation metrics are computed for all potential decision thresholds of the optimal short-form scale, and the threshold value is determined. Finally, the reliability and validity of the optimal short-form scale are assessed using a new sample. RESULTS The study identified a five-item short-form CDI with a decision threshold of 4 as the most appropriate scale considering all assessment indicators. The scale had 81.48% fewer items than the original version, indicating good predictive performance (AUC = 0.81, Accuracy = 0.83, Recall = 0.76, Precision = 0.71). Based on the test of 315 middle school students, the results showed that the five-item CDI had good measurement indexes (Cronbach's alpha = 0.72, criterion-related validity = 0.77). CONCLUSIONS This five-item short-form CDI is the first shortened and revised version of the CDI in China based on large local data samples.
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Affiliation(s)
- Shumei Lin
- College of Psychology, Sichuan Normal University, Chengdu, Sichuan, China
| | - Chengwei Wang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiuyu Jiang
- College of Psychology, Sichuan Normal University, Chengdu, Sichuan, China
| | - Qian Zhang
- College of Psychology, Sichuan Normal University, Chengdu, Sichuan, China
| | - Dan Luo
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junyi Li
- College of Psychology, Sichuan Normal University, Chengdu, Sichuan, China.
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Sichuan Normal University, Chengdu, China.
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Kitt ER, Zacharek SJ, Odriozola P, Nardini C, Hommel G, Martino A, Anderson T, Spencer H, Broussard A, Dean J, Marin CE, Silverman WK, Lebowitz ER, Gee DG. Responding to threat: Associations between neural reactivity to and behavioral avoidance of threat in pediatric anxiety. J Affect Disord 2024; 351:818-826. [PMID: 38290579 PMCID: PMC10981528 DOI: 10.1016/j.jad.2024.01.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Despite broad recognition of the central role of avoidance in anxiety, a lack of specificity in its operationalization has hindered progress in understanding this clinically significant construct. The current study uses a multimodal approach to investigate how specific measures of avoidance relate to neural reactivity to threat in youth with anxiety disorders. METHODS Children with anxiety disorders (ages 6-12 years; n = 65 for primary analyses) completed laboratory task- and clinician-based measures of avoidance, as well as a functional magnetic resonance imaging task probing neural reactivity to threat. Primary analyses examined the ventral anterior insula (vAI), amygdala, and ventromedial prefrontal cortex (vmPFC). RESULTS Significant but distinct patterns of association with task- versus clinician-based measures of avoidance emerged. Clinician-rated avoidance was negatively associated with right and left vAI reactivity to threat, whereas laboratory-based avoidance was positively associated with right vAI reactivity to threat. Moreover, left vAI-right amygdala and bilateral vmPFC-right amygdala functional connectivity were negatively associated with clinician-rated avoidance but not laboratory-based avoidance. LIMITATIONS These results should be considered in the context of the restricted range of our treatment-seeking sample, which limits the ability to draw conclusions about these associations across children with a broader range of symptomatology. In addition, the limited racial and ethnic diversity of our sample may limit the generalizability of findings. CONCLUSION These findings mark an important step towards bridging neural findings and behavioral patterns using a multimodal approach. Advancing understanding of behavioral avoidance in pediatric anxiety may guide future treatment optimization by identifying individual-specific targets for treatment.
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Affiliation(s)
| | | | | | | | - Grace Hommel
- Yale University, New Haven, CT, United States of America
| | - Alyssa Martino
- Yale University, New Haven, CT, United States of America
| | - Tess Anderson
- Yale University, New Haven, CT, United States of America
| | - Hannah Spencer
- Yale University, New Haven, CT, United States of America
| | | | - Janice Dean
- Yale University, New Haven, CT, United States of America
| | - Carla E Marin
- Yale University, New Haven, CT, United States of America
| | | | - Eli R Lebowitz
- Yale University, New Haven, CT, United States of America
| | - Dylan G Gee
- Yale University, New Haven, CT, United States of America.
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8
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Ko K, Jones A, Francis D, Robidoux S, McArthur G. Physiological correlates of anxiety in childhood and adolescence: A systematic review and meta-analysis. Stress Health 2024:e3388. [PMID: 38451702 DOI: 10.1002/smi.3388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/18/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Abstract
Anxiety is one of the most prevalent problems that affects children and adolescents. The vast majority of diagnostic tools for anxiety depend on written or verbal reports from children and adolescents or their significant others. The validity and reliability of such reports can be compromised by their subjective nature. Thus, there is growing interest in whether anxiety can be indexed with objective physiological measures. The key aim of this systematic review and meta-analysis was to determine which physiological measures are most reliably associated with elevated levels of anxiety amongst children and adolescents. Online databases (e.g., PsycINFO, Embase, Medline) were searched for relevant studies according to pre-determined criteria. Twenty-five studies comprising 2502 participants (N = 1160 with high anxiety) met inclusion, identifying 11 groups of physiological measures. Our meta-analysis revealed that skin conductance level is the most sensitive measure of anxiety (d = 0.83), followed by electromyography (EMG) measures (d = 0.71) and skin conductance response (d = 0.58). However, the included studies varied in terms of subjective measures, study designs, experimental task measures, and physiological measures. Consideration of these differences in methodology offer potential directions for future research.
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Affiliation(s)
- Katherine Ko
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alana Jones
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Deanna Francis
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Serje Robidoux
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Genevieve McArthur
- Australian Centre for the Advancement of Literacy, Australian Catholic University, Sydney, New South Wales, Australia
- Dyslexia-SPELD Foundation Literacy and Clinical Services, South Perth, Western Australia, Australia
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9
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Shipkova M, Butera CD, Flores GD, Kilroy E, Jayashankar A, Harrison L, Cermak SA, Aziz-Zadeh L. Caregiver and youth inter-rater assessment agreement in autism spectrum disorder, developmental coordination disorder, and typical development. Autism Res 2024; 17:610-625. [PMID: 38450955 PMCID: PMC11022856 DOI: 10.1002/aur.3110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024]
Abstract
Youth diagnosed with autism spectrum disorder (ASD) and those with developmental coordination disorder (DCD) are at heightened risk for co-occurring mental health diagnoses, especially anxiety and attention-deficit/hyperactivity disorder (ADHD). However, caregiver-child agreement on presence of related symptoms in populations with neurodevelopmental conditions is not well understood. Here, we examine the extent to which 37 ASD, 26 DCD, and 40 typically developing children and their caregivers agree on the degree of the child's symptoms of anxiety and ADHD. All caregiver-child dyads completed the Screen for Child Anxiety Related Emotional Disorders and Conners 3 ADHD Index. Across groups, intraclass correlations indicated generally poor agreement on anxiety and ADHD symptomatology. Although youth generally reported greater internalizing symptoms (i.e., anxiety), caregivers tended to report more observable externalizing behaviors (i.e., ADHD). Together, the results of this study support the need for a multi-informant approach in assessments of anxiety and ADHD in youth with neurodevelopmental disorders.
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Affiliation(s)
- Michelle Shipkova
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christiana D Butera
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Genesis D Flores
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Emily Kilroy
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Aditya Jayashankar
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Laura Harrison
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Lisa Aziz-Zadeh
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
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10
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Nair TK, Waslin SM, Rodrigues GA, Datta S, Moore MT, Brumariu LE. A meta-analytic review of the relations between anxiety and empathy. J Anxiety Disord 2024; 101:102795. [PMID: 38039916 DOI: 10.1016/j.janxdis.2023.102795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/27/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
Although theory suggests that empathy may signal a risk for anxiety (Tone & Tully, 2014), the relation between these constructs remains unclear due to the lack of a quantitative synthesis of empirical findings. We addressed this question by conducting three meta-analyses assessing anxiety and general, cognitive, and affective empathy (k's = 70-102 samples; N's = 19,410-25,102 participants). Results suggest that anxiety has a small and significant association with general empathy (r = .08). The relation of clinical anxiety with cognitive empathy was significant but very weak (r = -.03), and small for affective empathy (r = .16). Geographic region and the type of cognitive (e.g., perspective taking, fantasy) and affective empathy (e.g., affective resonance, empathic concern) emerged as moderators. Results suggest that anxiety has a weaker association with general empathy but a stronger association with affective empathy in participants from predominantly collectivistic geographic regions. Further, greater anxiety was weakly associated with less perspective-taking and greater fantasy, and anxiety had a more modest association with empathic concern than other types of affective empathy. Targeting affective empathy (e.g., promoting coping strategies when faced with others' distress) in interventions for anxiety may be beneficial.
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Affiliation(s)
- Travis K Nair
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA.
| | - Stephanie M Waslin
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Gabriela A Rodrigues
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Saumya Datta
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Michael T Moore
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Laura E Brumariu
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
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11
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Etkin RG, Lebowitz ER, Silverman WK. Assessing Anxiety-Related Impairment in Children and Adolescents. Assessment 2024; 31:94-109. [PMID: 37840296 DOI: 10.1177/10731911231194972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Anxiety disorders (ADs) frequently lead to significant impairment across important domains of youth functioning. Yet until recently, clinical research and assessment have largely neglected the measurement of anxiety-related impairment. In this article, we review the evidence for five extant rating scales of youth anxiety-related impairment, guided by widely used evaluative criteria. Emerging psychometric data show the potential utility of these rating scales for achieving different assessment functions. Of the five scales, the Child Anxiety Impact Scale, particularly the parent-report version, has been the most researched one. Promising psychometric data support its use for assessing anxiety-related impairment in school, social, and family/home domains of functioning. We conclude with recommendations for growing this research base and for incorporating these rating scales into the youth AD clinical and research assessment process.
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Affiliation(s)
- Rebecca G Etkin
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Eli R Lebowitz
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Wendy K Silverman
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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12
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Viglione J, Childs KK, Peck JH, Chapman JE, Drazdowski TK, McCart MR, Sheidow AJ. Examining the measurement precision of behavior problems among a sample of primarily rural youth on juvenile probation and their parents. CHILDREN AND YOUTH SERVICES REVIEW 2023; 152:107039. [PMID: 38312220 PMCID: PMC10836716 DOI: 10.1016/j.childyouth.2023.107039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Accurate and timely intervention in the justice system is particularly critical in rural communities, given documented barriers to accessible, evidence-based services for youth. As youth in the juvenile justice system have a high prevalence of behavioral health needs, accurate assessment of those needs is a critical first step in linking youth to appropriate care. The goal of the current study is to examine the reliability of a brief assessment (the Brief Problem Checklist [BPC]) among a sample of 222 justice-involved youth and their caregivers who primarily reside in rural communities in the United States. Using a series of reliability analyses and tests of agreement, we examined whether youth and caregiver BPC produces reliable scales, the strength of the convergence among each of the BPC scales, and youth and caregiver agreement on the BPC scales. Findings support the reliability of the BPC, but not inter-rater reliability. Poor agreement between youth and caregiver reports exists for both youth internalizing and externalizing problems. Additionally, the BPC was significantly related to several theoretically relevant constructs, including treatment, substance use disorder severity, and family history of substance use. These findings lend merit to discussions about the need for more research on the reliability and validity of assessment instruments before their widespread use in guiding youth- and agency case planning decisions, along with informing conclusions about program effectiveness.
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Affiliation(s)
- Jill Viglione
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Kristina K. Childs
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Jennifer H. Peck
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Jason E. Chapman
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Tess K. Drazdowski
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Michael R. McCart
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Ashli J. Sheidow
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
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13
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Guedes M, Maia R, Matos I, Antunes M, Rolão T, Chronis-Tuscano A, Rubin KH, Veríssimo M, Santos AJ. Preliminary perceived intervention changes and engagement in an evidence-based program targeted at behavioral inhibition during early childhood, delivered in-person and online. Front Psychol 2023; 14:1187255. [PMID: 37303908 PMCID: PMC10254805 DOI: 10.3389/fpsyg.2023.1187255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Behavioral inhibition during early childhood is one of the strongest risk factors for the development of later anxiety disorders. Recently developed in-person interventions that target both young children who are highly inhibited and their parents (e.g., the Turtle Program), have decreased children's anxiety and have increased social participation in the peer group. However, researchers have yet to examine the effects of intervention mode of delivery. In the present study, we compared the pre-to post-intervention changes in child and parenting functioning of families participating in the Turtle Program, delivered in-person and online with those changes made in families allocated to a waiting-list condition; compared session attendance, homework completion and satisfaction with the intervention outcomes of families involved in the Turtle Program, delivered in-person and online; and explored the predictive role of parenting and child factors in session attendance, homework completion and satisfaction with the outcomes of families involved in the Turtle Program, depending on the mode of delivery (in-person vs. online). Method Fifty-seven parents of highly inhibited preschoolers (3-5 years), with no diagnosis of selective mutism or developmental disorders, who were randomly allocated to waiting-list (n = 20), Turtle Program delivered in-person (n = 17) and online (n = 20) conditions completed the Portuguese versions of the Behavioral Inhibition Questionnaire, the Preschool Anxiety Scale, the Social Behavior and Competence Scale, the Modified Child-Rearing Practices Questionnaire at pre- and post-intervention assessment. Parents also completed the Preschool Shyness Study Satisfaction Survey at post-intervention assessment. Results Independent of intervention mode of delivery, generalized equation estimates revealed a reduction in children's total anxiety symptoms and an improvement in parental nurturing behaviors. Child anxiety and social competence at pre-assessment were the most prominent predictors of session attendance and satisfaction with post-intervention child and parenting outcomes. Discussion Overall, this study showed that parents in both intervention conditions perceived comparable positive changes in child functioning from pre- to post-intervention assessment and similar levels of session attendance, homework completion, and satisfaction. Significantly, however, perceived satisfaction with post-intervention child and parenting outcomes was higher, when children were reported to display higher SEL skills at baseline, independent of the intervention mode of delivery.
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Affiliation(s)
- Maryse Guedes
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | - Rita Maia
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | - Inês Matos
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | - Marta Antunes
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | - Teresa Rolão
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | | | - Kenneth H. Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States
| | - Manuela Veríssimo
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
| | - António J. Santos
- William James Center for Research, ISPA – Instituto Universitário, Lisbon, Portugal
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14
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Bailey M, Meiser‐Stedman R, Hiller R, Haag K, Lobo S, Halligan SL. Child posttraumatic stress symptoms in an acute injury sample: Patterns of associations among child report, parent report, and child heart rate parameters. J Trauma Stress 2023; 36:333-345. [PMID: 36787341 PMCID: PMC10946953 DOI: 10.1002/jts.22913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 02/15/2023]
Abstract
Parent-child agreement on measures of child posttraumatic stress disorder (PTSD) is moderate at best, and understanding of this discrepancy is limited. To address this, we conducted an item-level investigation of parent-child symptom agreement to examine the potential influence of parental posttraumatic stress symptoms (PTSS) on parents' reports of their child's PTSS. We also examined heart rate (HR) indices as possible independent indicators of child PTSD, examining patterns of association with parent versus child report. Parent-child dyads (N = 132, child age: 6-13 years, 91.7% White) were recruited after the child's hospital admission following an acute, single-incident traumatic event. At 1-month posttrauma, questionnaires assessing children's PTSS (self- and parental reports) and parental PTSS were administered. For a subset of participants (n = 70), children's HR recordings were obtained during a trauma narrative task and analyzed. Parent and child reports of child PTSS were weakly positively correlated, r = .25. Parental PTSS were found to be stronger positive predictors of parental reports of child PTSS than the children's own symptom reports, β = 0.60 vs. β = 0.14, and were associated with higher parent-reported child PTSS relative to child reports. Finally, children's self-reported PTSS were associated with HR indices, whereas parent reports were not, βs = -.33-.30 vs. βs = -.15-.01. Taken together, children's self-reported PTSS could be a more accurate reflection of their posttrauma physiological distress than parent reports. The potential influence of parental PTSS on their perceptions of their child's symptoms warrants further consideration.
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Affiliation(s)
- Megan Bailey
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Richard Meiser‐Stedman
- Department of Clinical Psychology and Psychological TherapiesNorwich Medical SchoolUniversity of East AngliaUnited Kingdom
| | - Rachel Hiller
- Division of Psychology & Language SciencesUniversity College LondonLondonUnited Kingdom
- Anna Freud National Centre for Children & FamiliesLondonUnited Kingdom
| | - Katharina Haag
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah Lobo
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUnited Kingdom
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
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15
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Gozpinar N, Cakiroglu S, Gormez V. Sluggish Cognitive Tempo Self Report Scale (SCT-SR): Development and Initial Validation Study. J Atten Disord 2023; 27:510-520. [PMID: 36799440 DOI: 10.1177/10870547231153879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Sluggish Cognitive Tempo (SCT) is a psychological construct consisting of daydreaming, confusion, slowness in movements, lethargy, and low motivation. It is important to develop a self-report scale to evaluate SCT symptoms in children and adolescents in order to meet the following needs; (1) Considering the closeness of SCT symptoms with internalized symptoms, it can provide more reliable information, (2) It allows information to be obtained from multiple informants, and (3) The main symptoms of SCT include subjective experiences such as daydreaming and mind wandering that may be difficult to observe from the outside. Therefore, it was aimed to develop a self-report SCT scale. METHOD A total of 467 adolescents and 178 parents participated in the study. Data were collected with scales. RESULTS The scale consists of 20 items and a single factor. Factor loadings were between 0.60 and 0.81. CONCLUSION Sluggish Cognitive Tempo Self-Report Scale is a valid and reliable self-report scale.
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Affiliation(s)
- Nuran Gozpinar
- Department of Child and Adolescent Psychiatry, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey
| | - Suleyman Cakiroglu
- Department of Child and Adolescent Psychiatry, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey
| | - Vahdet Gormez
- Department of Child and Adolescent Psychiatry, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey
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16
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Freitag GF, Salem H, Conroy K, Busto C, Adrian M, Borba CPC, Brandt A, Chu PV, Dantowitz A, Farley AM, Fortuna L, Furr JM, Lejeune J, Miller L, Platt R, Porche M, Read KL, Rivero-Conil S, Hernandez RDS, Shumway P, Sikov J, Spencer A, Syeda H, McLellan LF, Rapee RM, McMakin D, Pincus DB, Comer JS. The Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the Kids FACE FEARS sample. J Anxiety Disord 2023; 94:102677. [PMID: 36773484 DOI: 10.1016/j.janxdis.2023.102677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
There is tremendous need for brief and supported, non-commercial youth- and caregiver-report questionnaires of youth anxiety. The pediatric and parent proxy short forms of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety scale (8a v2.0) are free, brief, publicly accessible measures of youth- and caregiver-reported anxiety in children and adolescents. Despite increased use of the PROMIS, no study has evaluated performance of its anxiety scales in a sample of treatment-engaged anxious youth. Analyses were conducted on baseline data from the first 265 families (child MAge=11.14 years, 70% racial/ethnic minoritized youth) to enroll in the Kids FACE FEARS trial, a multisite comparative effectiveness trial of therapist-led vs. self-administered treatment for elevated youth anxiety. Confirmatory factor analysis (CFA) examined factor structure; omega coefficients and regression models examined internal consistency, convergent validity, and cross-informant reliability. CFA supported adjusted single-factor solutions across youth and caregiver reports, and internal consistency was high. Convergent validity was supported by medium-to-large associations with anxiety-related impairment and severity. Moderate cross-informant reliability between reports was found. Results showcase the first psychometric study of the PROMIS Anxiety scale short forms among treatment-engaged youth with elevated anxiety. Findings highlight the PROMIS Anxiety scale's utility in typical care settings for youth anxiety.
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Affiliation(s)
- Gabrielle F Freitag
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA.
| | - Hanan Salem
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Carolina Busto
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Molly Adrian
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Amelia Brandt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Annie Dantowitz
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Alyssa M Farley
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Lisa Fortuna
- University of California San Francisco, San Francisco, CA, USA
| | - Jami M Furr
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Julia Lejeune
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Leslie Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michelle Porche
- University of California San Francisco, San Francisco, CA, USA
| | - Kendra L Read
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | | | | | | | - Jennifer Sikov
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Andrea Spencer
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Haniya Syeda
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Lauren F McLellan
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Dana McMakin
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA; Nicklaus Children's Hospital, Miami, FL, USA
| | - Donna B Pincus
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
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17
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Koh ZH, Skues J, Murray G. Digital self-report instruments for repeated measurement of mental health in the general adult population: a protocol for a systematic review. BMJ Open 2023; 13:e065162. [PMID: 36693693 PMCID: PMC9884895 DOI: 10.1136/bmjopen-2022-065162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Digital technologies present tremendous opportunities for enabling long-term measurement of mental health in the general population. Emerging studies have established preliminary efficacy of collecting self-report data digitally. However, a key challenge when developing a new self-report instrument is navigating the abundance of existing instruments to select relevant constructs for measurements. This review is a precursor to developing a novel future integrated digital instrument for repeated measurements. We interrogate the literature as the first step towards optimal measurement of the multifaceted mental health concept, in the context of digital repeated measurement. This review aims to identify (1) digital self-report instruments administered repeatedly to measure the mental health of the general adult population; (2) their structure and format; (3) their psychometric properties; (4) their usage in empirical studies; and (5) the constructs these instruments were designed to measure (as characterised in the original publication), and the constructs the instruments have been used to measure in the identified empirical studies. METHODS AND ANALYSIS Five major electronic databases will be searched. Studies administering mental health instruments (in English) repeatedly to community dwellers in the general adult population are eligible. A reviewer will preliminarily screen for eligible studies. Then, two reviewers will independently screen the full text of the eligible articles and extract data. Both reviewers will resolve any disagreement through discussion or with a third reviewer. After the data extraction, a reviewer will manually search for the structure, format, psychometric properties and the original constructs these instruments were developed to measure. This review will synthesise the results in a narrative approach. The reporting in this review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. ETHICS AND DISSEMINATION Ethical approval is not required as no data will be collected. Findings of the systematic review will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022306547.
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Affiliation(s)
- Zhao Hui Koh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jason Skues
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
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18
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Comparative analysis of pediatric anxiety measures in clinical sample: evaluation of the PROMIS pediatric anxiety short forms. Qual Life Res 2022; 32:1621-1630. [PMID: 36580192 DOI: 10.1007/s11136-022-03333-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Examine the psychometric properties, validity in relation to a legacy measure, and diagnostic accuracy of the PROMIS Anxiety Short Form 2.0 (PROMIS A-SF) Caregiver and Youth Reports in a clinical sample. METHODS Participants were 301 youth and caregivers referred to a behavioral health clinic by their pediatrician. Participants and their caregivers completed PROMIS A-SF (youth and caregiver proxy), SCARED (youth and caregiver proxy), and a semi-structured interview. Descriptive, correlational, test-retest reliability, and receiver operating characteristic (ROC) analyses were conducted for both measures. RESULTS PROMIS A-SF measures were highly correlated with SCARED total scores and the panic subscale. PROMIS A-SF measures had AUCs ranging from .49-.79 for the detection of any of three primary subtypes of anxiety: Generalized Anxiety, Separation Anxiety, and Social Anxiety. IMPLICATIONS Dimensional anxiety subtypes, such as Social Anxiety may not be well detected on the PROMIS youth measure. Use of the PROMIS A-SF as a part of Evidence Based Assessment process is discussed.
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19
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Psychiatric Outcomes of Childhood Maltreatment: A Retrospective Chart Review from a Children's Psychiatric Inpatient Program. Child Psychiatry Hum Dev 2022; 53:1281-1292. [PMID: 34156637 DOI: 10.1007/s10578-021-01209-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 01/04/2023]
Abstract
Childhood maltreatment is linked to deleterious outcomes, whereby post-traumatic stress disorder (PTSD) has been identified as one of the most debilitating. This retrospective chart review examined whether self-reported affective measures (anxiety, depression, trauma), type of maltreatment (sexual, physical, emotional/verbal abuses), and demographics predicted a diagnosis of anxiety or PTSD among 169 children in a psychiatric inpatient hospital. Secondly, this study identified significant predictors of a PTSD diagnosis. Results indicated self-reported anxiety predicted a diagnosis of PTSD, while self-reported depression predicted PTSD only in maltreated children. Self-reported trauma predicted an anxiety diagnosis. PTSD risk variables including duration of stay, sex, self-reported anxiety, presence of sexual abuse, and presence of emotional/verbal abuse, showed sound sensitivity/specificity as predictors of risk for a PTSD diagnosis in an inpatient setting. Clinical implications are discussed.
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20
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Aune T, Nordahl HM, Beidel DC. Social anxiety disorder in adolescents: Prevalence and subtypes in the Young-HUNT3 study. J Anxiety Disord 2022; 87:102546. [PMID: 35248811 DOI: 10.1016/j.janxdis.2022.102546] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 02/03/2022] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have examined the prevalence of social anxiety disorder (SAD) among adolescents and the associated sex-specific fears. No previous studies have reported variance in SAD prevalence among adolescents based on a stepwise diagnostic approach. METHODS Using various diagnostic thresholds from the Anxiety Disorders Interview Schedule child version, and the diagnostic criteria from both the 4th and 5th editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), we explored the point prevalence of SAD among a population-based sample of 8216 adolescents aged 13-19 years. RESULTS Overall, 2.6% of adolescents met the SAD diagnostic criteria. The prevalence varied from 2.0% to 5.7% depending on the criteria-set. Twice as many females met the overall SAD criteria. The DSM-IV generalized SAD subtype was assigned to 86.5% of the sample, while 3.5% met the DSM-5 performance-only subtype. Compared with males aged 16-19 years, significantly more of those aged 13-15 years met the SAD criteria; no significant age group differences were found among females. CONCLUSIONS This is the first study to demonstrate variance in SAD prevalence among adolescents based on the diagnostic threshold method. Depending on the threshold applied, SAD prevalence among adolescents varied from 2.0% to 5.7%. Age and sex differences in social fear experiences highlight the importance of considering developmental heterogeneity in SAD, especially for adapting prevention and treatment interventions.
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Affiliation(s)
- Tore Aune
- Norwegian Directorate for Children, Youth and Family Affaires, Bomvegen 3, 7725 Steinkjer, Norway; Faculty of Nursing and Health Sciences, Nord University, Norway.
| | - Hans M Nordahl
- Department of Mental Health, NTNU, Trondheim, Norway; St. Olavs Hospital, Division of Psychiatry, Nidaros DPS, Trondheim, Norway
| | - Deborah C Beidel
- UCF RESTORES, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816, USA
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Pagsberg AK, Uhre C, Uhre V, Pretzmann L, Christensen SH, Thoustrup C, Clemmesen I, Gudmandsen AA, Korsbjerg NLJ, Mora-Jensen ARC, Ritter M, Thorsen ED, Halberg KSV, Bugge B, Staal N, Ingstrup HK, Moltke BB, Kloster AM, Zoega PJ, Mikkelsen MS, Harboe GS, Larsen KF, Clemmesen LKH, Lindschou J, Jakobsen JC, Engstrøm J, Gluud C, Siebner HR, Thomsen PH, Hybel K, Verhulst F, Jeppesen P, Jepsen JRM, Vangkilde S, Olsen MH, Hagstrøm J, Lønfeldt NN, Plessen KJ. Family-based cognitive behavioural therapy versus family-based relaxation therapy for obsessive-compulsive disorder in children and adolescents: protocol for a randomised clinical trial (the TECTO trial). BMC Psychiatry 2022; 22:204. [PMID: 35305587 PMCID: PMC8933964 DOI: 10.1186/s12888-021-03669-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is the recommended first-line treatment for children and adolescents with obsessive-compulsive disorder (OCD), but evidence concerning treatment-specific benefits and harms compared with other interventions is limited. Furthermore, high risk-of-bias in most trials prevent firm conclusions regarding the efficacy of CBT. We investigate the benefits and harms of family-based CBT (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in youth with OCD in a trial designed to reduce risk-of-bias. METHODS This is an investigator-initiated, independently funded, single-centre, parallel group superiority randomised clinical trial (RCT). Outcome assessors, data managers, statisticians, and conclusion drawers are blinded. From child and adolescent mental health services we include patients aged 8-17 years with a primary OCD diagnosis and an entry score of ≥16 on the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). We exclude patients with comorbid illness contraindicating trial participation; intelligence quotient < 70; or treatment with CBT, PRT, antidepressant or antipsychotic medication within the last 6 months prior to trial entry. Participants are randomised 1:1 to the experimental intervention (FCBT) versus the control intervention (FPRT) each consisting of 14 75-min sessions. All therapists deliver both interventions. Follow-up assessments occur in week 4, 8 and 16 (end-of-treatment). The primary outcome is OCD symptom severity assessed with CY-BOCS at end-of-trial. Secondary outcomes are quality-of-life and adverse events. Based on sample size estimation, a minimum of 128 participants (64 in each intervention group) are included. DISCUSSION In our trial design we aim to reduce risk-of-bias, enhance generalisability, and broaden the outcome measures by: 1) conducting an investigator-initiated, independently funded RCT; 2) blinding investigators; 3) investigating a representative sample of OCD patients; 3) using an active control intervention (FPRT) to tease apart general and specific therapy effects; 4) using equal dosing of interventions and therapist supervision in both intervention groups; 5) having therapists perform both interventions decided by randomisation; 6) rating fidelity of both interventions; 7) assessing a broad range of benefits and harms with repeated measures. The primary study limitations are the risk of missing data and the inability to blind participants and therapists to the intervention. TRIAL REGISTRATION ClinicalTrials.gov : NCT03595098, registered July 23, 2018.
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Affiliation(s)
- Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Camilla Uhre
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Valdemar Uhre
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.4973.90000 0004 0646 7373Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Linea Pretzmann
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Heidenheim Christensen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Christine Thoustrup
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Iben Clemmesen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Amanda Aaen Gudmandsen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Nicoline Løcke Jepsen Korsbjerg
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Anna-Rosa Cecilie Mora-Jensen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Melanie Ritter
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Emilie D. Thorsen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Klara Sofie Vangstrup Halberg
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Birgitte Bugge
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Nina Staal
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Helga Kristensen Ingstrup
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Birgitte Borgbjerg Moltke
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Anne Murphy Kloster
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Pernille Juul Zoega
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Marie Sommer Mikkelsen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Gitte Sommer Harboe
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Katrin Frimann Larsen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Line Katrine Harder Clemmesen
- grid.5170.30000 0001 2181 8870Applied Mathematics and Computer Science, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Jane Lindschou
- grid.4973.90000 0004 0646 7373Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus Christian Jakobsen
- grid.4973.90000 0004 0646 7373Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark ,grid.10825.3e0000 0001 0728 0170Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Janus Engstrøm
- grid.4973.90000 0004 0646 7373Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Gluud
- grid.4973.90000 0004 0646 7373Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark ,grid.10825.3e0000 0001 0728 0170Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Hartwig Roman Siebner
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.4973.90000 0004 0646 7373Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark ,grid.411702.10000 0000 9350 8874Department of Neurology, Copenhagen University Hospital Bispebjerg and Fredriksberg, Copenhagen, Denmark
| | - Per Hove Thomsen
- grid.154185.c0000 0004 0512 597XDepartment of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Copenhagen, Denmark
| | - Katja Hybel
- grid.154185.c0000 0004 0512 597XDepartment of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Copenhagen, Denmark
| | - Frank Verhulst
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Pia Jeppesen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.480615.e0000 0004 0639 1882Child and Adolescent Psychiatric Department, Region Zealand Psychiatry, Research Unit, Roskilde, Denmark
| | - Jens Richardt Møllegaard Jepsen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.4973.90000 0004 0646 7373Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Signe Vangkilde
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Psychology, Faculty Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Markus Harboe Olsen
- grid.4973.90000 0004 0646 7373Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark ,grid.475435.4Department of Neuroanaesthesiology, The Neuroscience Centre, The Neuroscience Centre, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Julie Hagstrøm
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Nicole Nadine Lønfeldt
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark
| | - Kerstin Jessica Plessen
- grid.4973.90000 0004 0646 7373Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Copenhagen, Denmark ,grid.8515.90000 0001 0423 4662Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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Comer JS, Conroy K, Cornacchio D, Furr JM, Norman SB, Stein MB. Psychometric evaluation of a caregiver-report adaptation of the Overall Anxiety Severity and Impairment Scale (OASIS) for use with youth populations. J Affect Disord 2022; 300:341-348. [PMID: 34979182 PMCID: PMC8828693 DOI: 10.1016/j.jad.2021.12.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 01/09/2023]
Abstract
Background Despite progress in youth anxiety assessment, there is need for a measure that is simultaneously (a) free, (b) brief, (c) focused broadly on anxiety and avoidance severity, frequency, and interference, and (d) concerned with the past week. The adult overall anxiety severity and impairment scale (OASIS) was adapted to yield a caregiver-report of past week youth anxiety and interference (OASIS-Y). Methods In a sample of diverse youth seeking anxiety services (N = 132; 67% racial/ethnic minority) and their caregivers, analyses examined the OASIS-Y factor structure, internal consistency, and convergent and divergent validity. Hierarchical linear modeling in a participant subset examined OASIS-Y sensitivity to treatment-related change. Results OASIS-Y internal consistency was high and confirmatory factor analysis supported a single-factor structure similar to that found in adults. OASIS-Y convergent validity was supported by a medium-sized association with an established, commercially available measure of youth anxiety, and divergent validity was supported by the absence of unique associations with measures of youth attention and externalizing problems. In a sample subset, session-by-session OASIS-Y scores significantly declined across treatment, and declined at a steeper rate among treatment "responders" versus "non-responders," providing evidence of OASIS-Y sensitivity to treatment-related change. Limitations This study focused on a clinical sample and cannot speak to OASIS-Y performance in community settings. Shared method-variance may have also influenced findings. Conclusions This study offers the first psychometric evaluation of the OASIS-Y, and underscores the promising clinical utility of the measure for assessing past week youth anxiety and impairment and for supporting routine outcome monitoring.
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Affiliation(s)
- Jonathan S. Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University
| | | | - Jami M. Furr
- Center for Children and Families, Department of Psychology, Florida International University
| | - Sonya B. Norman
- Department of Psychiatry, University of California, San Diego
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego
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23
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Silverman WK, Rey Y, Marin CE, Jaccard J, Pettit JW. Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths' Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation. Clin Psychol Sci 2022; 10:355-373. [PMID: 35599840 PMCID: PMC9122107 DOI: 10.1177/21677026211016402] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
We conducted a dismantling design treatment study comparing individual CBT, CBT targeting parents' reinforcement skills (CBT+Reinf), and CBT targeting parents' relationship skills (CBT+ Relat) in 341 youths with primary anxiety diagnoses. At posttreatment, youths in CBTs with parent involvement had lower anxiety than youths in CBT. At 12-month follow-up, youths in CBT+Relat maintained lower anxiety relative to CBT. At posttreatment, negative reinforcement was significantly lower in CBT+Reinf than CBT+Relat and CBT; negative reinforcement partially mediated youth anxiety reduction. Reducing parental negative reinforcement in CBT+Reinf was associated with lower parental psychological control which also partially mediated youth anxiety reduction. Some of these mediational dynamics continued through follow-up. Targeting concrete behavioral parenting skills, especially negative reinforcement, produced treatment specificity and partial mediation relative to less concrete targeting, and enhanced CBT. Findings highlight complexities in identifying mechanisms through which targeting of parenting skills produces youth anxiety reduction and suggest avenues for future research.
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24
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Whiteside SPH, Riemann BC, McCarthy DM. Using the Child Sheehan Disability Scale to Differentiate Severity Level in Youth With Anxiety Disorders and Obsessive Compulsive Disorder. Assessment 2022; 30:998-1008. [PMID: 35187974 DOI: 10.1177/10731911221077232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current study extends the psychometric support for the Child Sheehan Disability Scale (CSDS) as a measure of impairment associated with childhood anxiety disorders, including obsessive compulsive disorder. The CSDS was completed by 1,481 predominately Caucasian youth (55.4% female) ages 8 to 17 (M = 12.68, SD = 2.78) from primarily two-parent households and a parent across community, outpatient, intensive outpatient treatment, and residential settings. The results replicated and extended the previously found strong convergent validity, discriminant validity, and treatment sensitivity with a revised parent-report item in the larger sample. Moreover, the CSDS successfully differentiated between patients receiving treatment of different levels of intensity. These data were used to develop preliminary qualitative descriptors associating individual scores with a likely level of indicated treatment to enhance the clinical applicability of the CSDS. This study establishes the CSDS as one of the briefest and most rigorously evaluated measures of impairment associated with child anxiety. However, the performance of the CSDS must be examined in more representative samples before being applied to diverse populations.
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25
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Tangjittiporn T, Sottimanon A, Ularntinon S. Psychometric properties of the Screen for Child Anxiety Related Disorders Thai version. Pediatr Int 2022; 64:e15093. [PMID: 34897896 DOI: 10.1111/ped.15093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anxiety disorders are the most common psychiatric disorders among children. Because of their internalizing nature, anxiety disorders are underdiagnosed and untreated. Therefore, self-report screening tools play an important role in the early identification of these cases. This study aimed to examine the psychometric properties of the Screen for Child Anxiety Related Disorders (SCARED)-Thai version in a clinical population. METHODS One hundred and eight participants were enrolled from patients aged 9-16 years with any psychiatric diagnosis and their parents who visited a child and adolescent psychiatric clinic in Thailand. All the parent-child pairs completed the SCARED and the Strengths and Difficulties Questionnaire (SDQ)-emotional subscale. Clinical diagnosis of an anxiety disorder was endorsed through a standard clinical interview by certified child and adolescent psychiatrists blinded to the results of the SCARED and SDQ. Internal consistency, predictive validity, and convergent validity of the screens were assessed. RESULTS This study found that the SCARED-Thai version had very good reliability, with internal consistency (Cronbach's alpha) of 0.913 for the SCARED-Child form and 0.925 for the SCARED-Parent form. With an optimal cut-off point of 23, the SCARED-Child version significantly distinguished anxious from non-anxious young people in clinical settings with a sensitivity of 0.74 and a specificity of 0.50, while the SCARED-Parent version had a sensitivity of 0.74 and a specificity of 0.67 at the same threshold. The convergent validity between the SCARED-Thai (total) and SDQ (emotional subscale) was at a highly suitable range (r = 0.81). CONCLUSION The SCARED-Thai version exhibited good psychometric quality for identifying young people with comorbid anxiety disorders when used in clinical settings.
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Affiliation(s)
- Thiraporn Tangjittiporn
- Department of Child and Adolescent Psychiatry, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Arunsiri Sottimanon
- Department of Child and Adolescent Psychiatry, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Sirirat Ularntinon
- Department of Child and Adolescent Psychiatry, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
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26
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Dechant MJ, Frommel J, Mandryk RL. The Development of Explicit and Implicit Game-Based Digital Behavioral Markers for the Assessment of Social Anxiety. Front Psychol 2021; 12:760850. [PMID: 34975652 PMCID: PMC8715901 DOI: 10.3389/fpsyg.2021.760850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Social relationships are essential for humans; neglecting our social needs can reduce wellbeing or even lead to the development of more severe issues such as depression or substance dependency. Although essential, some individuals face major challenges in forming and maintaining social relationships due to the experience of social anxiety. The burden of social anxiety can be reduced through accessible assessment that leads to treatment. However, socially anxious individuals who seek help face many barriers stemming from geography, fear, or disparities in access to systems of care. But recent research suggested digital behavioral markers as a way to deliver cheap and easily accessible digital assessment for social anxiety: As earlier work shows, players with social anxiety show similar behaviors in virtual worlds as in the physical world, including tending to walk farther around other avatars and standing farther away from other avatars. The characteristics of the movement behavior in-game can be harnessed for the development of digital behavioral markers for the assessment of social anxiety. In this paper, we investigate whether implicit as well as explicit digital behavioral markers, proposed by prior work, for social anxiety can be used for predicting the level of social anxiety. We show that both, explicit and implicit digital behavioral markers can be harnessed for the assessment. Our findings provide further insights about how game-based digital behavioral markers can be used for the assessment of social anxiety.
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Affiliation(s)
- Martin Johannes Dechant
- Human-Computer-Interaction Laboratory, Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
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27
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Pestana-Santos M, Pestana-Santos A, Santos MR, Lomba L. Adolescents' perioperative experiences in relation to inpatient and outpatient elective surgery - a qualitative study. Scand J Caring Sci 2021; 36:493-503. [PMID: 34761406 DOI: 10.1111/scs.13046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/31/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Perioperative experience can be very distressing in adolescence if not managed properly by healthcare professionals. In the clinical context, the emotional expression of the adolescent is less spontaneous, which makes the assessment of anxiety, pain or even the desire to be involved in the perioperative process, difficult. Listening to their perioperative experiences will permit an understanding of their difficulties and expectations, regardless of the surgical intervention undergone. AIM To explore the adolescents' perioperative experiences in relation to inpatient and outpatient elective surgery. METHODS Qualitative exploratory study, with thematic analysis approach. A purposive sample of 40 adolescents aged 14-18 years and in the perioperative period, from two paediatric surgery settings in a university hospital, was questioned from January to July 2020. Data were collected using a semi-structured interview and analysed inductively with qualitative thematic analysis. RESULTS The data yielded one major theme, five themes, and 14 sub-themes. The major theme, Adolescent in perioperative period, included the five themes: (1) emotional and psychological aspects; (2) physical aspects; (3) social aspects; (4) organizational aspects; (5) previous surgical experience. Adolescents expressed fear of the unknown, anxiety, difficulty in pain control, and feelings of autonomy loss. Issues related to withdrawal from school and friends is also a focus of adolescent concern during the perioperative period. Despite showing satisfaction with the way they were cared for, they complained about the lack of pre- and post-operative preparation. CONCLUSION There are aspects that should be considered when caring for adolescents in perioperative period. As far as possible, programmes to prevent adolescents' anxiety in perioperative period should be designed in a holistic perspective, with aim at the psychological, physical, sociocultural, and organisational aspects.
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Affiliation(s)
- Marcia Pestana-Santos
- Institute of Biomedical Sciences, Abel Salazar of Porto University, Porto, Portugal.,Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.,Pediatric Department, Coimbra University and Hospital Centre, Coimbra, Portugal
| | | | - Margarida Reis Santos
- Institute of Biomedical Sciences, Abel Salazar of Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Lurdes Lomba
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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28
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Etuk REO, Forestell CA. Role of food neophobia and early exposure in children's implicit attentional bias to fruits and vegetables. Appetite 2021; 167:105647. [PMID: 34403721 DOI: 10.1016/j.appet.2021.105647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/07/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022]
Abstract
Children often struggle to eat the daily recommended servings of fruits and vegetables, and as a result many have poor nutrient intake. This is especially problematic for neophobic children; or those who are hesitant to try new foods. Maratos and Staples [Appetite, 91, 220-225 (2015)] found that children who are high in food neophobia show attentional biases to unfamiliar fruits and vegetables, which may be related to their low consumption of these healthy foods. The present study sought to replicate and extend these findings, by using a visual dot-probe task that paired images of fruits and vegetables to perceptually matched neutral control stimuli. Seventy-eight 5-8 year-old children (Mage = 6.4 years, SD = 1.1, 42% girls) participated. Initial analyses failed to reveal significant attentional biases to the foods in children who were high in neophobia. Subsequent exploratory analyses included children's previous exposure to the foods in the task as a moderator variable. These analyses revealed that overall, children showed an attentional bias away from familiar fruits and vegetables. Moreover, previous exposure to the foods moderated the effect of food neophobia on attentional bias. For children who were low in food neophobia, as their fruit and vegetable exposure increased, their attentional bias away from the familiar foods decreased. In contrast, for food neophobic children, as fruit and vegetable exposure increased, they showed more attentional bias away from familiar foods. Although these findings failed to replicate those reported by Maratos and Staples (2015), they suggest that children's attentional biases to healthy foods may be a result of the interplay between food neophobia and the food environment to which they are exposed.
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Affiliation(s)
- Repairer E O Etuk
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA
| | - Catherine A Forestell
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA.
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He Y, Li A, Li K, Xiao J. Neuroticism vulnerability factors of anxiety symptoms in adolescents and early adults: an analysis using the bi-factor model and multi-wave longitudinal model. PeerJ 2021; 9:e11379. [PMID: 34221704 PMCID: PMC8231313 DOI: 10.7717/peerj.11379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Neuroticism and stress are important vulnerability factors in the development and outcome of anxiety symptoms. However, as neuroticism is a heterogeneity trait, it is still unclear how different neuroticism factors contribute to anxiety symptoms independently or in conjunction with stress. Thus, different factors of neuroticism were extracted in the present longitudinal study using the bi-factor model. The prediction effect of these different factors on anxiety symptoms and their combined effects with stress in both adolescent and adult samples were examined. Method Participants (592 adolescents and 638 young adults) in Hunan China were included. In the initial assessment in our longitudinal study, participants were asked to complete measurements that assessed neuroticism, stress, and anxiety symptoms. Next, a monthly assessment of stress and anxiety symptoms was completed for the subsequent 6 months. The bi-factor model was used to extract different factors of neuroticism. The hierarchical linear model was used to analyze longitudinal multi-wave data. Result Several model fit indices were used to evaluate the bi-factor model fit for neuroticism (adolescent: Tucker-Lewis index (TLI) = 0.957, comparative fit index (CFI) = 0.973, RMSEA = 0.040, Chi-Square = 80.471; early adults: TLI = 0.957, CFI = 0.973, RMSEA = 0.042, Chi-Square = 88.465). The results of hierarchical linear modeling analyses indicated that the general factor of neuroticism possessed a predictive effect on anxiety symptoms (adolescents: F = 36.77, p < 0.0001, early adults: F = 30.44, p < 0.0001); The negative effect factor only had the prediction effect on anxiety symptoms in early adults (adolescents: F = 0.65, p > 0.05; early adults: F = 4.84, p < 0.05); No prediction of self-reproach factor was found on anxiety symptoms (adolescents: F = 3.79, p > 0.05; early adults: F = 0.02, p > 0.05); the interactive effects of the general factor and stress on anxiety symptoms were only found in early adulthood (adolescents: F = 0.13, p > 0.05; early adults: F = 11.55, p < 0.01). Conclusion Our results suggested that the bi-factor model achieved a satisfactory fit for neuroticism measurement and supported that the anxiety symptoms were induced by the main effects of the general factor in both age samples and the negative factor only in adults. The general factor of neuroticism, but not the negative factor could make an additive effect for anxiety symptoms in face of stress, which meant that the homogeneity of neuroticism played a more significant role in further anxiety symptoms than heterogeneity when coping with stress.
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Affiliation(s)
- Yini He
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ang Li
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Kaixin Li
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin, China
| | - Jing Xiao
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
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Jystad I, Bjerkeset O, Haugan T, Sund ER, Vaag J. Sociodemographic Correlates and Mental Health Comorbidities in Adolescents With Social Anxiety: The Young-HUNT3 Study, Norway. Front Psychol 2021; 12:663161. [PMID: 33935922 PMCID: PMC8085386 DOI: 10.3389/fpsyg.2021.663161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/23/2021] [Indexed: 01/29/2023] Open
Abstract
Social anxiety is highly prevalent in adolescents and is often associated with great individual suffering and functional impairment. Psychiatric comorbidity is common and further adds to this burden. The purposes of this study were: (1) to describe the occurrence of diagnosed and self-reported social anxiety among 8,199 Norwegian adolescents aged 13–19 years who participated in the population-based Young-HUNT3 study (2006–2008); (2) to examine associations between sociodemographic characteristics and different subgroups of social anxiety; and (3) to describe the psychiatric health comorbidities among adolescents diagnosed with social anxiety disorder (SAD). In total, 388 (5.9%) of the adolescents screened positive for SAD and were invited into a diagnostic interview, performed by professional nurses, using Anxiety Disorders Interview Schedule for DSM IV: child version (ADIS-C) (response rate = 54.6%). A SAD diagnosis was indicated in 106 individuals (50% of the interview subjects), and more than two-thirds of the adolescents diagnosed with SAD had one or more comorbid psychiatric disorders. Higher mean scores of self-reported social anxiety symptoms, poor self-rated health, sleep problems, poor family economic situation, low physical activity, and having sought professional help within the last year were associated with higher odds of being in the screening positive subgroup. Screening positive subjects who did not meet for a diagnostic interview did not differ notably from the rest of the screening positive group in terms of these sociodemographic characteristics. Based on our results and the fact that individuals with social anxiety often fear interview situations, the use of ADIS-C, screening questions and self-reports seem to be sufficient when aiming to identify epidemiologically representative cohorts of adolescents at risk of social anxiety.
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Affiliation(s)
- Ingunn Jystad
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tommy Haugan
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway
| | - Erik R Sund
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jonas Vaag
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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31
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Conroy K, Hong N, Poznanski B, Hart KC, Ginsburg GS, Fabiano GA, Comer JS. Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 29:381-399. [PMID: 35812004 PMCID: PMC9267952 DOI: 10.1016/j.cbpra.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.
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McLellan LF, Kangas M, Rapee RM, Iverach L, Wuthrich VM, Hudson JL, Lyneham HJ. The Youth Online Diagnostic Assessment (YODA): Validity of a New Tool to Assess Anxiety Disorders in Youth. Child Psychiatry Hum Dev 2021; 52:270-280. [PMID: 32440754 DOI: 10.1007/s10578-020-01007-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study developed an online diagnostic tool for anxiety disorders in youth, and evaluated its reliability and validity amongst 297 children aged 6-16 years (Mage = 9.34, 46% male). Parents completed the online tool, the Youth Online Diagnostic Assessment (YODA), which is scored either using a fully-automated algorithm, or combined with clinician review. In addition, parents and children completed a clinician-administered diagnostic interview and self-report measures of internalizing and externalizing symptoms and wellbeing. The fully-automated YODA demonstrated relatively weak agreement with the diagnostic interview for identifying the presence of any anxiety disorder and specific anxiety disorders, apart from separation anxiety (which had moderate agreement). The clinician-reviewed YODA showed better agreement than fully-automated scoring, particularly for identifying the presence of any anxiety disorder. The YODA demonstrated good agreement with parent-reported measures of symptoms/interference. The YODA offers a fully or largely automated method to determine the presence of anxiety disorders in youth, with particular value in situations where low-resource assessments are needed. While it currently requires further research and improvement, the YODA provides a promising start to the development of such a tool.
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Affiliation(s)
- Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Maria Kangas
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Viviana M Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
| | - Heidi J Lyneham
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia
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Etkin RG, Lebowitz ER, Silverman WK. Using Evaluative Criteria to Review Youth Anxiety Measures, Part II: Parent-Report. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:155-176. [PMID: 33739908 DOI: 10.1080/15374416.2021.1878898] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This Evidence Base Update of parent-report measures of youth anxiety symptoms is a companion piece to our update on youth self-report anxiety symptom measures (Etkin et al., 2021). We rate the psychometric properties of the parent-report measures as Adequate, Good, or Excellent using criteria developed by Hunsley and Mash (2008) and Youngstrom et al. (2017). Our review reveals that the evidence base for parent-report measures is considerably less developed compared with the evidence base for youth self-report measures. Nevertheless, several measures, the parent-report Screen for Child Anxiety-Related Emotional Disorders, Multidimensional Anxiety Scale for Children, and Spence Children's Anxiety Scale, were found to have Good to Excellent psychometric properties. We conclude our review with suggestions about which parent-report youth anxiety measures are best suited to perform different assessment functions and directions for additional research to expand and strengthen the evidence base.
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Trent ES, Viana AG, Raines EM, Conroy HE, Storch EA, Zvolensky MJ. Interpretation biases and depressive symptoms among anxiety-disordered children: The role of individual differences in respiratory sinus arrhythmia. Dev Psychobiol 2021; 63:320-337. [PMID: 32524580 PMCID: PMC8782245 DOI: 10.1002/dev.22002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/22/2020] [Accepted: 05/20/2020] [Indexed: 11/06/2022]
Abstract
Individual differences in interpretation biases-the tendency to interpret ambiguous stimuli as threatening-partially explain the presence of comorbid depressive symptoms among anxious youth. Increasing efforts have examined physiological processes that influence the association between interpretation biases and depressive symptoms in this population, and potential gender differences in this relationship. This study examined the moderating role of respiratory sinus arrhythmia (RSA) suppression (i.e., decrease from baseline)-an index of parasympathetic nervous system reactivity-in the association between interpretation biases and depressive symptoms in clinically anxious youth. One-hundred-and-five clinically anxious children (Mage = 10.09 years, SD = 1.22; 56.7% female; 61.9% racial/ethnic minority) completed measures of self-reported and behaviorally indexed interpretation biases, reported anxiety/depression symptom severity, and participated in a speech task. RSA suppression during the task moderated the association between interpretation biases and depressive symptom severity in the total sample. Separate exploratory moderation analyses were conducted among girls and boys. Among girls, RSA suppression moderated the association between behaviorally indexed interpretation biases and depressive symptoms, and marginally moderated (p = .067) the association between self-reported interpretation biases and depressive symptoms. Among boys, RSA suppression was not a significant moderator. These findings may help identify clinically anxious youth most at-risk for comorbid depressive symptoms.
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Affiliation(s)
- Erika S. Trent
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, TX, USA
- Texas institute of Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | | | - Haley E. Conroy
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Eric A. Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Haig-Ferguson A, Cooper K, Cartwright E, Loades M, Daniels J. Practitioner review: health anxiety in children and young people in the context of the COVID-19 pandemic. Behav Cogn Psychother 2021; 49:129-143. [PMID: 32829718 PMCID: PMC7503041 DOI: 10.1017/s1352465820000636] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023]
Abstract
Health-related fear is a normal and common response in the face of the global pandemic of COVID-19. Children and young people are frequently being exposed to messages about the threat to health, including from the media and authorities. Whilst for most, their anxiety will be proportionate to the threat, for some, existing pre-occupation with physical symptoms and illness will become more problematic. There is a growing body of evidence that health anxiety may occur in childhood, however much of the literature is taken from research using adult samples. This practitioner review aims to give an overview of the assessment and treatment of health-related worries in children and young people in the context of the COVID-19 pandemic. This review is based on the limited existing evidence in this population and the more substantial evidence base for treating health anxiety in adults. We consider the adaptations needed to ensure such interventions are developmentally appropriate.
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Affiliation(s)
| | - K. Cooper
- Department of Psychology, University of Bath, Bath, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - E. Cartwright
- Department of Psychology, University of Bath, Bath, UK
| | - M.E. Loades
- Department of Psychology, University of Bath, Bath, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - J. Daniels
- Department of Psychology, University of Bath, Bath, UK
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Schiltz HK, Magnus BE. Differential Item Functioning Based on Autism Features, IQ, and Age on the Screen for Child Anxiety Related Disorders (SCARED) Among Youth on the Autism Spectrum. Autism Res 2021; 14:1220-1236. [PMID: 33543824 DOI: 10.1002/aur.2481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/04/2021] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
Anxiety commonly occurs among youth on the autism spectrum, yet measurement of anxiety in this population is complicated by a number of factors, including potentially overlapping symptomatology, the child's intellectual functioning, and changes in anxiety across development. Moreover, few studies have examined the psychometric properties of anxiety measures in this population, and no study to date has tested whether there are systematic differences in the measurement of anxiety, or differential item functioning (DIF), across the high degree of heterogeneity and the developmental course of autism. To test this possibility, data were combined across multiple studies using the National Database for Autism Research, an NIH-funded data repository. Parent-report on the Screen for Child Anxiety Related Disorders (SCARED) and Social Communication Questionnaire (SCQ) were used as measures of anxiety and autism features, respectively. A confirmatory factor analysis indicated good fit of the literature standard five-factor structure. Moderated nonlinear factor analysis (MNLFA) revealed multiple items with intercept and loading DIF based on level of autism features, IQ, and age, especially for items related to social behavior. Therefore, although the measure's factor structure is consistent with that found in the general population, the SCARED may not capture differences in anxiety equivalently for all children on the spectrum and across their development. Clinicians and researchers need to be especially vigilant in measuring anxiety symptoms in children with autism by removing items flagged for DIF from the SCARED and/or by using multiple measures and informants. LAY ABSTRACT: Autistic youth often experience clinical levels of anxiety. Many tools used to measure anxiety were developed for the general population, but not for use with autistic youth. This study found that the Screen for Child Anxiety Related Disorders (SCARED) measures the same five dimensions of anxiety as in the general population. Parents, however, may respond differently to questions on the SCARED based on their child's autism features, intellectual functioning, and age, which impacts our ability to accurately measure anxiety among autistic youth.
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Affiliation(s)
- Hillary K Schiltz
- Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA
| | - Brooke E Magnus
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, Massachusetts, USA
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Etkin RG, Shimshoni Y, Lebowitz ER, Silverman WK. Using Evaluative Criteria to Review Youth Anxiety Measures, Part I: Self-Report. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:58-76. [PMID: 32915074 PMCID: PMC7914129 DOI: 10.1080/15374416.2020.1802736] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
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.
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Monopoli WJ, Evans SW, Benson K, Allan NP, Owens JS, DuPaul GJ, Bunford N. Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD. Int J Methods Psychiatr Res 2020; 29:1-14. [PMID: 32898309 PMCID: PMC7723178 DOI: 10.1002/mpr.1826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Despite advances in understanding associations among attention-deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD-relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent-report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de-escalation. METHODS Participants were 209 adolescents with ADHD (78% male; 13.5-17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent-report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses. RESULTS The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de-escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self-report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity. CONCLUSION These results inform our understanding of ADHD-relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD-related impairment.
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Affiliation(s)
- W John Monopoli
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Steven W Evans
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kari Benson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nóra Bunford
- 'Lendület' Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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Lipton MF, Qasmieh N, Racz SJ, Weeks JW, Reyes ADL. The Fears of Evaluation About Performance (FEAP) Task: Inducing Anxiety-Related Responses to Direct Exposure to Negative and Positive Evaluations. Behav Ther 2020; 51:843-855. [PMID: 33051028 DOI: 10.1016/j.beth.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/17/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Fears of negative and positive evaluation (i.e., evaluative fears) manifest within performance-based situations (e.g., public speaking, group presentations), particularly among those experiencing social anxiety. Within these performance-based situations, individuals experiencing such evaluative fears frequently display a variety of impairments (e.g., avoidance, nervousness) that might manifest within and across various settings (e.g., employment, school). How do those who experience these fears react to in-the-moment feedback about their performance? We constructed the Fear of Evaluation About Performance (FEAP) task to examine ecologically valid experiences with anxiety when reacting to positive and negative feedback. During the task, participants gave a speech, and subsequent to this and in counterbalanced order, received positive and negative feedback about their speech, with continued assessment of anxiety-related arousal throughout the task. We tested the FEAP task among 127 adults, who provided self-reports of fears of positive and negative evaluation before completing the task. Fears of positive evaluation uniquely predicted arousal following receipt of positive feedback, whereas fears of negative evaluation uniquely predicted arousal following receipt of negative feedback. Relative to participants receiving positive feedback first, those receiving negative feedback first experienced elevated post-feedback arousal, followed by a steep decline in arousal post-positive feedback. Conversely, participants receiving positive feedback first experienced a buffer effect whereby arousal post-negative feedback remained low, relative to the arousal experienced post-negative feedback among those who received negative feedback first. We expect the FEAP task to inform basic science on fears of negative and positive evaluation, as well as treatment planning in applied clinical settings.
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Makol BA, De Los Reyes A, Ostrander RS, Reynolds EK. Parent-Youth Divergence (and Convergence) in Reports of Youth Internalizing Problems in Psychiatric Inpatient Care. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1677-1689. [PMID: 30937814 DOI: 10.1007/s10802-019-00540-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
When compared to one another, multiple informants' reports of adolescent internalizing problems often reveal low convergence. This creates challenges in the delivery of clinical services, particularly for severe outcomes linked to internalizing problems, namely suicidal thoughts and behaviors. Clinicians would benefit from methods that facilitate interpretation of multi-informant reports, particularly in inpatient settings typified by high-cost care and high-stakes decision-making. 765 adolescent inpatients (70.3% female; Mage = 14.7) and their parents completed measures of adolescent internalizing problems. We obtained baseline clinical and treatment characteristics from electronic medical records. Latent class analysis revealed four reporting patterns: Parent-Adolescent Low (LL; 49.0%), Parent Low-Adolescent High (PL-AH; 11.5%), Parent High-Adolescent Low (PH-AL; 21.8%), Parent-Adolescent High (HH; 17.6%). Relative to the LL class, adolescents in the PH-AL and PL-AH classes were more likely to be admitted with suicidality. In terms of treatment characteristics and relative to the LL class, HH and PH-AL adolescents were more likely to receive standing antipsychotics, PH-AL adolescents were more likely to be in seclusion, and HH adolescents had longer hospital stays. At discharge and relative to the LL class, HH, PH-AL, and PL-AH adolescents were more likely to receive an anxiety disorder diagnosis. Further, HH, PH-AL, and PL-AH adolescents were more likely to receive partial hospitalization or care in another restrictive environment after inpatient treatment, relative to the LL class. This naturalistic study informs clinical decision-making by aiding our understanding of how multi-informant reports facilitate interpretations of adolescents' clinical presentations as well as predictions about treatment characteristics.
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Affiliation(s)
- Bridget A Makol
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123K, College Park, MD, 20742, USA.
| | - Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123K, College Park, MD, 20742, USA
| | - Rick S Ostrander
- Department of Psychiatry and Behavioral Science, Division of Child and Adolescent Psychiatry, Bloomberg Children's Center (Level 12), Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, USA
| | - Elizabeth K Reynolds
- Department of Psychiatry and Behavioral Science, Division of Child and Adolescent Psychiatry, Bloomberg Children's Center (Level 12), Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, USA
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The Use of Evidence-Based Assessment for Anxiety Disorders in an Australian Sample. J Anxiety Disord 2020; 75:102279. [PMID: 32777601 DOI: 10.1016/j.janxdis.2020.102279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 06/19/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022]
Abstract
Anxiety disorders are common and cause considerable functional impairment. Fortunately, evidence-based treatments are available, however, treatment effectiveness is often reliant on the provision of an accurate diagnosis. Accurate diagnosis requires a multi-method evidence-based assessment (EBA). Assessment techniques available to clinicians include a clinical interview, semi-structured diagnostic interview, self-report/clinician-administered rating scales and direct observation. Research demonstrates that only a small number of therapists utilize EBA, and to date this has not been investigated in an Australian sample. One hundred and two registered Australian psychologists (Mage = 40.98; SD = 12.67; 83.6% female) participated in an online study investigating assessment practices. Participants were asked to indicate EBA frequency of use and the obstacles they face to using EBA. The majority of participants (69% working with adult patients and 51% working with pediatric patients) reported partial use of EBA. Few psychologists (21% working with adult patients and 11% working with child patients) indicated complete use of EBA. Thirty-six percent of participants indicated negative beliefs about the usefulness or helpfulness of EBA. Multiple obstacles to the use of EBA were reported including concerns with the time required to complete assessment (27%), and a lack of access to assessment tools (10%). Implications for training and clinical practice are discussed.
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Walter HJ, Bukstein OG, Abright AR, Keable H, Ramtekkar U, Ripperger-Suhler J, Rockhill C. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. J Am Acad Child Adolesc Psychiatry 2020; 59:1107-1124. [PMID: 32439401 DOI: 10.1016/j.jaac.2020.05.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/08/2020] [Indexed: 11/20/2022]
Abstract
Anxiety disorders are among the most common psychiatric disorders in children and adolescents. As reviewed in this guideline, both cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication have considerable empirical support as safe and effective short-term treatments for anxiety in children and adolescents. Serotonin norepinephrine reuptake inhibitor (SNRI) medication has some empirical support as an additional treatment option. In the context of a protracted severe shortage of child and adolescent-trained behavioral health specialists, research demonstrating convenient, efficient, cost-effective, and user-friendly delivery mechanisms for safe and effective treatments for child and adolescent anxiety disorders is an urgent priority. The comparative effectiveness of anxiety treatments, delineation of mediators and moderators of effective anxiety treatments, long-term effects of SSRI and SNRI use in children and adolescents, and additional evaluation of the degree of suicide risk associated with SSRIs and SNRIs remain other key research needs.
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Becker SP, Marsh NP, Holdaway AS, Tamm L. Sluggish cognitive tempo and processing speed in adolescents with ADHD: do findings vary based on informant and task? Eur Child Adolesc Psychiatry 2020; 29:1371-1384. [PMID: 31776764 PMCID: PMC8010585 DOI: 10.1007/s00787-019-01446-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/19/2019] [Indexed: 01/01/2023]
Abstract
Few studies have examined whether behavioral sluggish cognitive tempo (SCT) symptoms are related to speeded task performance. Mixed findings in existing research could be due to previous studies using a broad conceptualization of processing speed, not including self-report of SCT symptoms, and relying on non-optimal measures of SCT. Using a multi-informant design with both parent- and adolescent-reported SCT symptoms, the present study provides a preliminary test of the hypothesis that SCT symptoms would be associated with slower performance on tasks having greater graphomotor and fine motor demands. Participants were 80 adolescents (ages 13-17 years; 71% male) with attention-deficit/hyperactivity disorder (ADHD). Adolescents and parents completed ratings of SCT. Adolescents were administered the Wechsler Symbol Search and Coding subtests and the Grooved Pegboard Test. When adjusting for age, sex, and ADHD symptom severity, parent-reported SCT symptoms were not significantly associated with Symbol Search or Coding scores but were significantly associated with slower Grooved Pegboard time. Adolescent-reported SCT symptoms were not significantly associated with Symbol Search but were significantly associated with lower Coding scores and slower Grooved Pegboard time. Findings provide preliminary support for the hypothesis that SCT may be more clearly associated with processing speed task performance as motor demands increase and provide a potential explanation for the mixed literature on SCT in relation to processing speed by demonstrating that the presence and magnitude of associations vary by informant and task.
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Affiliation(s)
- Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Center for ADHD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA;,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Nicholas P. Marsh
- Division of Behavioral Medicine and Clinical Psychology, Center for ADHD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alex S. Holdaway
- Roberts Center for Pediatric Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leanne Tamm
- Division of Behavioral Medicine and Clinical Psychology, Center for ADHD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA;,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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44
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Keith JM, Jamieson JP, Bennetto L. The Importance of Adolescent Self-Report in Autism Spectrum Disorder: Integration of Questionnaire and Autonomic Measures. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:741-754. [PMID: 30073571 DOI: 10.1007/s10802-018-0455-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety and sensory symptoms are highly prevalent and meaningful in the daily lives of individuals with autism spectrum disorder (ASD). Despite the importance of carefully measuring, researching, and treating these symptoms, current methods in ASD seldom include self-report. This study investigated the consistency of adolescent and parent reports of anxiety and auditory sensitivity in individuals with ASD, and examined their validity via comparisons with sympathetic arousal at baseline and in response to an auditory challenge. Fifty adolescent-parent dyads (n = 26 ASD, n = 24 typically developing; 12-16 years old; IQ>80) completed parallel versions of both anxiety and auditory hypersensitivity scales, which were compared to heart rate collected at rest and during an aversive noise task. Adolescents with ASD exhibited greater anxiety and auditory hypersensitivity than their peers, based on both self and parent report. Across groups, self-report was higher than parent report. In individuals with ASD, a significant relationship was found between self-reported anxiety and autonomic arousal at rest, and between self-reported auditory sensitivity and autonomic reactivity during the noise task. These relationships were not significant for parent-report. These findings extend past work by demonstrating greater self-reported (than parent-reported) anxiety and sensory symptoms. Furthermore, the presence of significant correlations between self-reported symptoms and sympathetic arousal supports the validity of self-report in adolescents with ASD with average or above average cognitive abilities. This indicates that adolescents with ASD have a unique perspective on their internal experience, which can complement parent reports and provide a more comprehensive assessment of symptoms in research and clinical settings.
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Affiliation(s)
- Jessica M Keith
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA.
| | - Jeremy P Jamieson
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA
| | - Loisa Bennetto
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, 14627, USA
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45
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Stewart SL, Babcock SE, Li Y, Dave HP. A psychometric evaluation of the interRAI Child and Youth Mental Health instruments (ChYMH) anxiety scale in children with and without developmental disabilities. BMC Psychiatry 2020; 20:390. [PMID: 32727428 PMCID: PMC7390192 DOI: 10.1186/s12888-020-02785-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 07/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND With 10 to 20% of Canadian children suffering with mental illness, the importance of early identification and accurate assessment systems is clear. Unfortunately, many do not receive the mental health treatment necessary and wait-times for assessment can span up to a year. In response, the interRAI suite of assessments were designed to comprehensively assess early signs of mental health impairments in children from birth to 18 years. METHODS This study assesses the psychometric properties of the Anxiety Scale and addresses the identification of anxiety within children diagnosed with intellectual and developmental disabilities (IDD); a commonly underrepresented sample in mental health psychometric studies. Data was collected from children aged 4-18 years in three different samples. RESULTS Results indicated reliable internal consistency and factor structure, as well as moderate-to-strong convergent validity. CONCLUSIONS We conclude that the Anxiety Scale exhibits psychometric qualities which demonstrate its clinical utility for use within a child sample, as well as in children with IDD. The findings provide support to a larger body of research which show consistent psychometric rigour of the interRAI measures.
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Affiliation(s)
- S. L. Stewart
- grid.39381.300000 0004 1936 8884The University of Western Ontario, Faculty of Education, John George Althouse Building
- 1137 Western Road, London, Ontario N6G 1G7 Canada
| | - S. E. Babcock
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
| | - Y. Li
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
| | - H. P. Dave
- grid.39381.300000 0004 1936 8884Department of Psychology, The University of Western Ontario, Social Sciences Building
- 1151 Richmond St, London, Ontario N6A 3K7 Canada
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46
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Baribeau DA, Vigod S, Pullenayegum E, Kerns CM, Mirenda P, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman-Zait A, Szatmari P. Repetitive Behavior Severity as an Early Indicator of Risk for Elevated Anxiety Symptoms in Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:890-899.e3. [PMID: 31541676 DOI: 10.1016/j.jaac.2019.08.478] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/15/2019] [Accepted: 09/13/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE A significant proportion of children with autism spectrum disorder (ASD) will develop an anxiety disorder during childhood. Restricted and repetitive behavior severity in ASD positively correlates with anxiety severity in cross-sectional surveys. The longitudinal relationship between restricted/repetitive behavior and future anxiety symptoms is unclear. METHOD In a longitudinal cohort of children with ASD (n = 421), restricted/repetitive behavior severity at enrollment (age 2-5 years) was categorized as "mild," "moderate," or "severe" using the Autism Diagnostic Interview-Revised. Elevated anxiety symptoms were defined by a Child Behavior Checklist (parent report) Anxiety subscale T-score of >65 at ages 8 to 11 years. Multivariable logistic regression with multiple imputation for missing data was used to examine the association between restricted/repetitive behavior severity and elevated anxiety symptoms while adjusting for age, sex, adaptive functioning, baseline anxiety, income, and parenting stress, generating adjusted odds ratios (aORs) and 95% CIs. RESULTS Approximately 58% of children with severe restricted/repetitive behavior at enrollment had elevated anxiety symptoms by age 11, compared to 41% of those with moderate, and 20% of those with mild restricted/repetitive behavior, respectively. Moderate and severe restricted/repetitive behavior were both associated with increased odds of elevated anxiety (moderate aOR: 2.5 [1.2-5.3]; severe aOR: 3.2 (1.4-7.5]). CONCLUSION Restricted/repetitive behavior severity at time of ASD diagnosis indicates risk for future anxiety symptoms. This finding increases our understanding of which children with ASD will develop anxiety disorders and may guide research concerning early interventions and etiological mechanisms.
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Affiliation(s)
| | - Simone Vigod
- University of Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Women's College Hospital and Women's College Research Institute, Toronto, Ontario, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | | | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Isabel M Smith
- Dalhousie University, Halifax, Nova Scotia, Canada; Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of, Ottawa, Ontario, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Teresa Bennett
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Wendy J Ungar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Anat Zaidman-Zait
- Constantine School of Education, Tel Aviv University, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, Canada
| | - Peter Szatmari
- University of Toronto, Ontario, Canada; Centre for Addiction and Mental Health and The Hospital for Sick Children, Toronto, Ontario, Canada.
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47
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O'Connor EE, Holly LE, Chevalier LL, Pincus DB, Langer DA. Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms. J Clin Psychol 2020; 76:1390-1407. [PMID: 32060945 PMCID: PMC7282941 DOI: 10.1002/jclp.22941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Parental accommodation contributes to the maintenance of child anxiety and related symptoms. The current study examines the contributions of parent and child factors to parental accommodation in a sample of anxious youth. METHODS Sixty-four treatment-seeking youth (6-16 years) and their mothers, as well as a subset of fathers (N = 41) reported on parental accommodation, parental distress and emotion regulation, child psychopathology, child externalizing behaviors, and child intolerance of uncertainty. RESULTS Parental accommodation was not related to parental distress or emotion regulation. Parents who viewed their child as being more symptomatic (e.g., anxious, externalizing, and intolerant of uncertainty) were more likely to engage in accommodation. For mothers, child anxiety and externalizing symptoms were notable predictors of accommodation. CONCLUSIONS Parent perceptions of child symptomology is an important factor significantly related to accommodation behaviors. This finding can be used to inform programming designed to target parental responses to child anxiety and related disorders.
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Affiliation(s)
- Erin E O'Connor
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lindsay E Holly
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lydia L Chevalier
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Donna B Pincus
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - David A Langer
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
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48
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Spies JP, Woud ML, Kessler H, Rau H, Willmund GD, Köhler K, Herpertz S, Blackwell SE, Bovin M, Marx BP, Cwik JC. Psychometric properties of the German version of the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) in clinical routine settings: study design and protocol of a multitrait-multimethod study. BMJ Open 2020; 10:e036078. [PMID: 32571861 PMCID: PMC7311000 DOI: 10.1136/bmjopen-2019-036078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 04/08/2020] [Accepted: 06/02/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The aim of this study is to investigate the diagnostic accuracy, psychometric properties and clinical utility of the German version of the Clinician-Administered Post-Traumatic Stress Disorder (PTSD) Scale for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) (CAPS-5) in routine clinical settings. METHODS AND ANALYSIS This study is a non-interventional, multitrait-multimethod design, multicentre study that will be carried out at German civil and military inpatient and outpatient clinics. A total sample size of n=219 participants who have experienced at least one traumatic event according to criteria as defined in the DSM-5 will be recruited. For the investigation of the diagnostic accuracy and clinical utility of the CAPS-5, participants will be categorised into one of three groups, depending on their traumatic experiences and post-traumatic symptomatology: (1) monotraumatisation with PTSD; (2) multiple traumatisation with PTSD and (3) traumatisation without PTSD. Interviews will be conducted face to face by interviewers in routine clinical settings. All participants will also be asked to complete a comprehensive set of questionnaires in order to investigate different facets of construct validity and clinical utility. First, differences between all three groups in CAPS-5 sum and subscale scores will be investigated. Test-retest reliability and inter-rater reliability will be determined. Internal consistency will be calculated using structural equation modeling (SEM) based internal consistency coefficients. Construct validity will be measured with Spearman's rank correlation analyses and multivariate analyses of variance with Holm-Bonferroni corrected post hoc analysis of variances. In order to test diagnostic accuracy, receiver operating characteristics and sensitivity and specificity analyses will be conducted. The model structure of the German CAPS-5 will be analysed using confirmatory factor analyses. ETHICS AND DISSEMINATION The study received ethical approval by the Ethics Committees of the Faculty of Psychology at the Ruhr-Universität Bochum (reference numbers: 331 and 358). The results of the study will be presented nationally and internationally at scientific conferences and will be published in scientific journals. TRIAL REGISTRATION NUMBER DRKS00015325.
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Affiliation(s)
- Jan-Peter Spies
- Clinical Psychology and Psychotherapy, Universität zu Köln, Köln, Germany
| | - Marcella Lydia Woud
- Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Heinrich Rau
- German Armed Forces Center for Military Mental Health, Berlin, Germany
| | | | - Kai Köhler
- German Armed Forces Center for Military Mental Health, Berlin, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Simon E Blackwell
- Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Michelle Bovin
- VA Boston Healthcare System, Massachusetts and Boston University School of Medicine, Boston, Massachusetts, USA
| | - Brian P Marx
- VA Boston Healthcare System, Massachusetts and Boston University School of Medicine, Boston, Massachusetts, USA
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De Los Reyes A, Drabick DAG, Makol BA, Jakubovic RJ. Introduction to the Special Section: The Research Domain Criteria’s Units of Analysis and Cross-Unit Correspondence in Youth Mental Health Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:279-296. [DOI: 10.1080/15374416.2020.1738238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Bridget A. Makol
- Department of Psychology, University of Maryland at College Park
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50
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Creswell C, Waite P, Hudson J. Practitioner Review: Anxiety disorders in children and young people - assessment and treatment. J Child Psychol Psychiatry 2020; 61:628-643. [PMID: 31960440 DOI: 10.1111/jcpp.13186] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 01/04/2023]
Abstract
Despite significant advancements in our knowledge of anxiety disorders in children and adolescents, they continue to be underrecognised and undertreated. It is critical that these disorders are taken seriously in children and young people as they are highly prevalent, have a negative impact on educational, social and health functioning, create a risk of ongoing anxiety and other mental health disorders across the life span and are associated with substantial economic burden. Yet very few children with anxiety disorders access evidence-based treatments, and there is an urgent need for widespread implementation of effective interventions. This review aimed to provide an overview of recent research developments that will be relevant to clinicians and policymakers, particularly focusing on the development and maintenance of child anxiety disorders and considerations for assessment and treatment. Given the critical need to increase access to effective support, we hope this review will contribute to driving forward a step change in treatment delivery for children and young people with anxiety disorders and their families.
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Affiliation(s)
- Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Polly Waite
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Jennie Hudson
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
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