儿童焦虑敏感性指数的效度研究

目的:了解儿童焦虑敏感性指数(CASI)在中国青少年群体中的效度。方法:对2850名中小学生施测儿童焦虑敏感性指数、儿童焦虑相关情绪障碍筛查量表(SCARED)、加州大学创伤后应激反应指数修改版(UCLA PTSD IN-DEX)、儿童抑郁自评问卷(DSRSC)和特质焦虑问卷(TAI)。结果:①将样本随机分为两半进行探索性因素分析和验证性因素分析,探索性因素分析显示该量表包括3个因子,分别为躯体关注、精神关注和社交关注,累计贡献率为44.2%;验证性因素分析发现该模型拟合指数良好(χ2/df=3.53;GFI=0.962;NFI=0.924;CFI=0.944;RMSEA=0.042);②CASI得分与各类焦虑症状呈现出中等程度的相关(r=0.426-0.618),具有良好的汇聚效度;③CASI与特质焦虑中等相关,在考虑特质焦虑的情况下,CASI能在很大程度上增加对焦虑的预测效度(β=0.528,P=0.00,ΔR2=0.107);对抑郁的预测效度增加相对较小(β=0.119,P=0.00,ΔR2=0.011),具有良好的区分效度。结论:CASI中文版具有良好的效度,可作为我国儿童和青少年焦虑敏感性的评价工具。     

Behavioral validation of the Childhood Anxiety Sensitivity Index in children

Examined the construct validity of the Childhood Anxiety Sensitivity Index (CASI) in young children through the use of a behavioral challenge task. Elementary-school children completed the CASI as well as seff-report measures of state and trait anxiety and subjective fear prior to and immediately following a stair-stepping task designed to increase physiological arousal. Results indicate that the CASI was a significant predictor of the degree of state anxiety and subjective fear reported in response to the challenge task, even after controlling for pretask levels of state anxiety and fear, respectively. Additionally, the CASI predicted changes in fear experienced in response to the challenge task. The findings lend support to the validity of the CASI in preadolescent children and suggest that the CASI possesses unique clinical utility relative to measures of trait anxiety. However, results of this study must be interpreted cautiously, because a large portion of the variance in response to arousal was left unaccounted for by the CASI and the overall model.     

Cultural Barriers to African American Participation in Anxiety Disorders Research

Anxiety disorders are understudied, underdiagnosed, and undertreated in African Americans. Research focused on the phenomenology, etiology, and treatment of anxiety in African Americans has been hampered by lack of inclusion of this population in clinical research studies. The reason for exclusion is not well understood, although cultural mistrust has been hypothesized as a major barrier to research participation. This article reviews the relevant literature to date and examines the experience of 6 African American adults who participated in a larger clinical assessment study about anxiety. Drawing upon in-depth semistructured interviews about their subjective experiences, we examined participant perspectives about the assessment process, opinions about African American perception of anxiety studies, and participant-generated ideas about how to improve African American participation. Based on a qualitative analysis of responses, feelings of mistrust emerged as a dominant theme. Concerns fell under 6 categories, including not wanting to speak for others, confidentiality, self and group presentation concerns, repercussions of disclosure, potential covert purposes of the study, and the desire to confide only in close others. Suggestions for increasing African American participation are discussed, including assurances of confidentiality, adequate compensation, and a comfortable study environment.     

Orphans No More: A Commentary on Anxiety and African American Youth

Conducting research on anxiety disorders among African American children and adolescents, prior to the early 1990s was considered an "orphan area" of psychology. The articles in this section, first authored by a new generation of researchers, appear to set a direction for future research. The findings underscore the importance of including culturally relevant variables in the assessment of African American children's anxiety and its disorders.     

The Korean Version of the Pediatric Symptom Checklist: Psychometric Properties in Korean School-aged Children

Psychosocial problems increase the risk for mental health problems and increase the need for health care services in children and adolescents. Primary care practice is a valuable avenue for identifying the need for more specialized mental health care. We hypothesized that Korean version of the pediatric symptom checklist (PSC) would be a useful tool for early detection of psychosocial problems in children and adolescents in Korea and we aimed to suggest cut-off scores for detecting meaningful psychosocial problems. A total of 397 children with their parents and 97 child patients with their parents were asked to complete the PSC Korean version and the child behavior checklist (CBCL). The internal reliability and test-retest reliability of the PSC as well as the cut-off score of the PSC was determined via receiver operating characteristic analysis of the CBCL score, clinical group scores and non-clinical group scores. The internal consistency of the PSC-Korean version was excellent (Cronbach''s alpha = 0.95). The test-retest reliability was r = 0.73 (P < 0.001). Using clinical CBCL scores (total score, externalizing score, internalizing score, respectively ≥ 60) and presence of clinical diagnosis, the recommended cut-off score of the PSC was 14. Using 494 Korean children aged 7-12 yr, the current study assessed the reliability and validity of a Korean version of the PSC and suggested a cut-off for recommending further clinical assessment. The present results suggest that the Korean version of the PSC has good internal consistency and validity using the standard of CBCL scores.

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Social Support Factors as Moderators of Community Violence Exposure Among Inner-City African American Young Adolescents

Using both surveys and the experience sampling method (ESM), community violence exposure, social support factors, and depressive and anxiety symptoms were assessed longitudinally among inner-city African American adolescents. Moderator models were tested to determine protective factors for youth exposed to community violence. Several social support factors emerged as protective–stabilizing forces for witnesses of violence both cross-sectionally and longitudinally, including maternal closeness, time spent with family, social support, and daily support (ESM). Contrary to hypotheses, several social support factors demonstrated a promotive–reactive effect such that, in conditions of high victimization, they failed to protect youth from developing symptoms. Effects did not differ by outcome or sex, though sex differences in findings emerged. Protective-stabilizing effects occurred more for witnessing violence, whereas promotive–reactive patterns occurred more for victimization. Results affirm social support factors as protective from the adverse effects of violence exposure, but they also suggest that some factors typically conceived as contributing to resilience might at times fail to protect youth in conditions of extreme risk.     

Psychometric Properties of the Maternal Worry Scale for Children With Chronic Illness

Objective: To develop and evaluate the psychometric propertiesof a scale termed the Maternal Worry Scale (MWS) designed tomeasure maternal worry about children with chronic illnesses. Method: The sample consisted of 140 mothers of young children(mean age 8.2 years, 64% female) with a chronic illness (juvenilerheumatoid arthritis, diabetes, or sickle cell disease). Maternalworry, depression, and anxiety, as well as information aboutthe child's health and behavior, were assessed through structuredinterviews. Results: The MWS had good internal consistency (alpha =.94)and test-retest reliability (r =.84). Analyses indicated a single-factorstructure for the MWS. Estimates of construct validity werequite positive: the MWS was moderately correlated with parentaldepression (r =.34–.39), anxiety (r =.27), and maternalreport of child behavior problems (r =.25 [externalizing], r=.46 [internalizing]). Conclusions: The results suggest that the MWS is a useful, reliable,and valid scale for measuring worry of mothers raising childrenwith chronic health conditions.     

The Structure and Correlates of Perfectionism in African American Children

This study examined the structure and symptom correlates of perfectionism in a sample of 6th-grade, urban, African American children using the Child and Adolescent Perfectionism Scale (CAPS; Flett, Hewitt, Boucher, Davidson, & Munro, 2000). Confirmatory factor analysis showed inadequate fit of the original subscales. Exploratory factor analysis suggested 3 dimensions of perfectionism: A Socially Prescribed and a Self-Oriented–Critical factor were described as maladaptive, whereas a Self-Oriented–Striving factor was proposed as adaptive. Cross-sectional correlations among the perfectionism dimensions and symptoms of psychopathology fit well with the adaptive versus maladaptive model. In addition, Socially Prescribed Perfectionism showed a robust predictive relation to 7th-grade internalizing symptoms, especially depression, in boys. Results are discussed in the context of the cultural and socioeconomic characteristics of this African American sample and suggestions for future research are provided.     

Childhood violence exposure and the development of sexual risk in low-income African American girls

Low-income, urban African American (AA) girls are at heightened risk for sexually transmitted infections (STIs), and violence exposure may be an important risk factor. AA girls (N = 177) from low-income communities in Chicago completed a 2-year longitudinal study of HIV-risk behavior involving five waves of data collection (ages 12–16 at baseline) and a sixth wave (ages 14–22) assessing lifetime trauma and victimization history. Childhood exposure to violence (CEV) represented reports of physical, sexual, or witnessed violence before age 12. Latent growth curve analysis examined CEV as a covariate of sexual experience, number of sexual partners, and inconsistent condom use trajectories. CEV was associated with greater sexual risk, although the pattern differed across the three outcomes. Overall, findings emphasize the need for early interventions to reduce sexual risk among low-income urban girls who have experienced violence. Efforts to address or prevent violence exposure may also reduce rates of STIs in this population.     

Psychometric Properties of a Korean Version of the Pain Anxiety Symptoms Scale-20 in Chronic Pain Patients

Background  

The Pain Anxiety Symptoms Scale (PASS-20) consists of 20 items designed to assess four aspects of pain-related anxiety: cognitive anxiety, escape–avoidance behaviors, fear of pain, and physiological symptoms of anxiety. Although the PASS-20 is a well-established measure of pain-related anxiety in Western samples, different cultures may yield a different factor structure or different associations with pain-related outcome variables.     

Psychometric properties of the Liebowitz Social Anxiety Scale

BACKGROUND: The present study provides data on the reliability, validity and treatment sensitivity of the Liebowitz Social Anxiety Scale (LSAS), one of the most commonly used clinician-administered scales for the assessment of social phobia. METHOD: Three hundred and eighty-two patients from several studies of the treatment of social phobia were evaluated. An independent assessor administered the LSAS to each patient prior to the initiation of treatment. Patients also completed other measures of social anxiety and avoidance, although the specific measures varied across samples. RESULTS: The LSAS and its subscales were normally distributed and demonstrated excellent internal consistency. The convergent validity of the LSAS was demonstrated via significant correlations with other commonly-used measures of social anxiety and avoidance. These correlations also tended to be larger than correlations with measures of depression, especially after treatment. However, the pattern of correlations of LSAS subscales with one another and with the other measures suggest that the fear subscales and the avoidance subscales may not be sufficiently distinct in clinical samples. The LSAS was also demonstrated to be sensitive to the effects of pharmacological treatments of social phobia over time and in comparison to double-blind pill placebo. CONCLUSION: The LSAS appears to be a reliable, valid and treatment sensitive measure of social phobia. Further study of the LSAS, both in samples with severe social phobia and in community samples, is needed.     

Examining the Role of Anxiety Sensitivity in Sleep Dysfunction Across Anxiety Disorders

Anxiety Sensitivity (AS) has been associated with sleep difficulties in certain anxiety disorder populations, but no studies have examined cross-diagnostically the role of anxiety sensitivity in sleep dysfunction. Three hundred one participants with generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD) completed an ancillary questionnaire-based study. Linear regression was used to examine AS and sleep dysfunction, and mediation analyses were used to examine whether AS was a mediator of the effect of primary diagnosis on sleep. AS was associated with increased sleep dysfunction across anxiety disorders, and primary anxiety disorder diagnosis was significantly associated with sleep dysfunction. However, after controlling for AS, primary diagnosis was no longer significant. AS significantly mediated the effects of PD versus SAD and of PD versus GAD on sleep dysfunction, but did not significantly mediate the effect of GAD versus SAD on sleep dysfunction. Taken together, AS appears to be a more important predictor of sleep dysfunction overall, emphasizing the cross-diagnostic nature of AS and bolstering the RDoC initiative approach for treating psychological dysfunction.     

Parenting Styles and Child Behavior in African American Families of Preschool Children

Examined the relations between parenting styles and child behavior problems in African American preschool children. Participants were 108 African American female caregivers of 3- to 6-year-old children. Correlational analysis showed that parent-reported child behavior problems were associated with maternal education, family income, and parents' endorsement of authoritative parenting, authoritarian parenting, and permissive parenting. Hierarchical regression analysis showed that the authoritative parenting style was most predictive of fewer child behavior problems. These results are consistent with previous findings with European American families and provide strong support for the cross-cultural validity of the authoritative parenting style.     

学前儿童焦虑量表中文版的测量学分析

目的:考察Spence学前儿童焦虑量表在中国的适用性.方法:以学前儿童焦虑量表和儿童行为量表为评估工具,让607名母亲报告3-6岁儿童的焦虑与行为问题.结果:各项目与分量表的相关为0.50-0.78.总量表的Cronbach's α系数为0.87,分半信度和重测信度分别为0.83、0.70.各分量表得分和总分与CBCL中的内化和外化问题得分均呈显著正相关,且与内化问题的相关程度高于与外化问题的相关程度.综合探索性和验证性因素分析的结果发现,我国学前儿童的焦虑结构包括广泛性焦虑、躯体伤害恐惧、社交恐惧、强迫一冲动障碍和分离焦虑5个因子,解释总方差的45.81%,各题项在所属因子的因素负荷为0.35～0.86,五因子对焦虑数据的拟合指数均大于0.90.结论:Spence学前儿童焦虑量表可用于评估我国学前儿童的焦虑症状.     

The Korean Version of the Trauma Symptom Checklist for Children: Psychometric Properties and the Connection to Trauma among Korean Children and Adolescents

The purpose of the present study was to develop a Korean version of the trauma symptom checklist for children (TSCC) and to examine its reliability and validity for screening posttraumatic stress symptoms. A normative group of 405 children and adolescents aged 8 to 16 yr participated in the study. A test-retest procedure was conducted with 76 participants from the normative group after 4 weeks. In the traumatized group, 73 children and adolescents of the same age from the Child Sexual Abuse Treatment Center were included. Good internal consistency (Cronbach''s alpha) for the total scale (0.95, ranging 0.79-0.85 on the clinical scales) and test-retest reliability for the total scale (r=0.91, ranging 0.71-0.87 on the clinical scales) were found. Confirmatory 6-factor analysis explained 51.1% of the variance. Other measures such as concurrent or discriminative validity were also shown to be satisfactory. In conclusion, the Korean version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable of identifying trauma symptoms among children and adolescents who have self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.     

In Search of an ADHD Screening Tool for African American Children

PurposeBehavior rating scales have often been used to evaluate home and classroom behavior for children suspected of attention-deficit/hyperactivity disorder (ADHD). However, there is concern related to the use of behavior rating scales because African American boys and girls are twice as likely to be identified with ADHD behaviors by some of these instruments. This article serves as a brief reference for effectively evaluating African American children for ADHD.MethodsA MEDLINE search of peer reviewed literature published from 1970 to 2009 was conducted concerning the diagnosis of ADHD in African American children.ResultsThe majority of ADHD-specific behavior rating scales have face validity based on the Diagnosfic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic criteria. However, with few exceptions, developers of these instruments have failed to use national samples with significant numbers of ethnic minorities to ascertain that screening questions are in fact detecting equivalent behavioral abnormalities across cultures. Fortunately, efforts have been undertaken to validate and improve effectiveness of ADHD-specific behavior rating scales in ethnically diverse populations.ConclusionThere are data supporting the use of the Terry and Vanderbilt Attention-Deficit/Hyperactivity Disorder scales for diagnosing ADHD in African American children. Further studies to develop and validate ADHD-specific behavior rating scales for African American children are needed.     

The Pain Anxiety Symptoms Scale: Psychometric properties in a community sample

This study investigated the factor structure and psychometric properties of the Pain Anxiety Symptoms Scale (PASS). The PASS assesses four components of pain-related anxiety: cognitive, fear, escapelavoidance, and physiological. Confirmatory factor analyses provided support for both the one-factor and the four-factor structures reported for samples of clinic-referred pain patients. The alpha coefficients were high for the PASS subscales. Significant gender differences were obtained on the PASS total and subscale scores. Convergent and divergent validity estimates of the PASS were also assessed. Results may be used to evaluate the responses of clinic-referred pain patients.