Relationships among depression,anxiety, anxiety sensitivity,and perceived social support in adolescents with conversion disorder

Objective: This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Methods: Fifty outpatients, aged 8–18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Results: Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. Conclusions: This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.     

Factors that assist and hinder efforts towards recovery from eating disorders: A comparison of collegiate female athletes and non-athletes

ABSTRACT

This study compared female intercollegiate athletes’ and non-athletes’ experiences of working towards recovery from an eating disorder. Participants (55 athletes, 99 non-athletes) responded to open-ended questions about factors that influenced their progress towards recovery. Both subgroups reported that Supportive Relationships and Cognitive/Emotional Shifts were most helpful. The third most frequent helpful factor for athletes was Sport Performance Concerns, for non-athletes it was Treatment. Athletes’ most frequent hindering factors were Negative Emotions/Cognitions, Sport Pressures, and Hurtful Modelling, while non-athletes reported Negative Emotions/Cognitions, Lack of Support, and Hurtful Modelling. Sport-specific factors were among the most common themes in athletes’ responses; therefore, athletes’ recovery experiences and treatment needs appear unique.     

Assessing Defense Structure in School-Age Children Using the Response Evaluation Measure-71-Youth Version (REM-Y-71)

This study used the Response Evaluation Measure-Youth (REM-Y-71), a self-report measure of 21 defense reactions, among school-age children. Participants were elementary and middle school students (n=290; grades 3–8; age range: 8–15; mean=11.73). Factor analysis revealed a 2-factor defense structure consistent with structure among high school and adult samples. The composite REM-Y defense scores for each factor were significant predictors of social desirability, using the Children’s Defensiveness Scale (CDS); anxiety, using the State-Trait Anxiety Inventory for Children (STAIC); and psychosocial functioning. This study represents the first cross-sectional empirical analysis of overall defense structure and use among children and early adolescents.     

Is there a relationship between attention deficit/hyperactivity disorder and manic symptoms among children with mental retardation of unknown etiology?

Mental retardation (MR) is common and lifelong. In children and adolescents with MR, the rate of attention deficit/hyperactivity disorder (ADHD) and bipolar disorder is higher than that in the general population. However, there are no previous sufficient data that exist in establishing a relationship between ADHD and manic symptoms. The aim of the present study was to examine the relationship between manic symptoms and ADHD as well as oppositional-defiant disorder (ODD) and conduct disorder (CD) in children with MR of unknown etiology (MR-UE).A total of 167 children with MR-UE attending a rehabilitation and training school in Erzurum, Turkey, were included in the study. We administered the Child Disruptive Behavior Screening and Rating Scale related to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the Young Mania Rating Scale–Parent Version (P-YMRS) to parents.The age range of children and adolescents with MR-UE was between 5 and 21 years, with a mean age of 11.13 ± 3.75 years. In total, 5.8% of children and adolescents with MR-UE showed a border intelligence quotient (IQ), with 58.4% having a mild IQ, 29.2% having a moderate IQ, and 6.6% having severe IQ. According to the Child Disruptive Behavior Screening and Rating Scale related to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 40.1% of children and adolescents with MR-UE had inattention, 19.9% had hyperactivity, 28.7% had ODD, and 13.3% had CD.A total of 7.2% of the children and adolescents with MR-UE had probable mania, and 1.8% had mania according to Young Mania Rating Scale–Parent Version. A positive correlation existed between the mean scores of Young Mania Rating Scale–Parent Version and the mean scores of inattention, hyperactivity, ODD, and CD (P = .000). Hyperactivity and ODD were predictors of being manic/probably manic.Diagnosing psychiatric disorders in children and adolescents with MR-UE is difficult but essential for better functioning. Manic symptoms and disruptive behaviors as well as ADHD symptoms were prevalent among children and adolescents with MR-UE and hyperactivity, and oppositional-defiant symptoms were predictors of manic symptoms in these patients.     

Relations between anxiety sensitivity and panic symptoms in nonreferred children and adolescents

Anxiety sensitivity (AS), the fear of anxiety-related sensations, has been posited to be a cognitive risk factor for the development of anxiety disorders but has been understudied in youth. The purpose of the present investigations was to evaluate relations between AS and panic symptoms in nonreferred children and adolescents. In Study 1, (N = 113, mean age, 13.98). scores on the Childhood Anxiety Sensitivity Index (CASI) predicted the experience of uncued panic attacks after controlling for general anxiety and depression, although the total variance accounted for was small. In Study 2 (N = 52; mean age, 9.48), the Panic/ Agoraphobia subscale of the Spence Children's Anxiety Scale was used as the criterion variable. CASI score again predicted panic symptoms after controlling for trait anxiety and depression. Identification of a risk factor for panic attacks and panic disorder in youth will have important implications for etiologic theory, intervention, and prevention.     

Validation of the Mood and Anxiety Symptom Questionnaire in Korean Adolescents

ObjectiveThe tripartite model categorizes symptoms of depression and anxiety into three groups: 1) non-specific general distress that is shared between depression and anxiety, 2) depression-specific symptoms that include low positive affect and loss of interest, and 3) anxiety-specific symptoms that include somatic arousal. The Mood and Anxiety Symptoms Questionnaire (MASQ) was developed to measure these three factors of depression and anxiety. The purpose of the present study was to test the psychometric properties of the Korean version of the MASQ (K-MASQ) in adolescents.MethodsCommunity-dwelling adolescents (n=933) were randomly assigned to two groups. Exploratory factor analysis and confirmatory factor analysis were conducted in each group to identify the factor structure of the K-MASQ. The reliability and validity of the K-MASQ were also evaluated.ResultsOur results support the three-factor structure of the K-MASQ in adolescents. However, we found that the specific items of each factor differed from those of the original MASQ. That is, the depression-specific factor was only related to low positive affect and not loss of interest, and the anxiety-specific factor included more items related to general somatic symptoms of anxiety. The reliability and validity of the K-MASQ were found to be satisfactory.ConclusionThe K-MASQ supports the tripartite model of depression and anxiety and has satisfactory reliability and validity among Korean adolescents. The K-MASQ can be used to distinguish unique symptoms of depression and anxiety in Korean adolescents.     

Sleep quantity and quality as predictors of behavior and mental health issues for children and adolescents with autism

BackgroundResearch has supported a relationship between sleep problems and day-time behavior and mental health for young children with autism. Fewer studies have investigated these relationships across young children to adolescents.MethodThis study analyzed data retrieved from a sleep and behavior data base constructed from information obtained from patient charts and psychological assessments at a developmental pediatric clinic. The study evaluated the relationships among sleep quality and quantity (measured by the Behavioral Evaluation of Disorders of Sleep), age, and mental health and behavior problems (measured by the Child Behavior Checklist) for children and adolescents with autism (N = 446) from 16 months to 18 years old.ResultsResults indicated that despite age, children and adolescents with autism who experienced sleep quantity and quality problems were more likely to experience internalizing (e.g., anxiety/depression), and externalizing (aggression, destructiveness, delinquency) behavior problems. Internalizing and externalizing behavior problems were associated with sleep behavior, such as sensitivity to environmental stimuli, waking during the night, disoriented waking, and fewer hours of sleep (last 24 h for externalizing and total).ConclusionsThe results of this study replicate and extend previous research on daytime behavior, mental health, and sleep quality and quantity relationships. Indications of sensitivity to the environment to these daytime issues indicates the need for subsequent research delineating the influence of variables within the biopsychosocial model (e.g., sensory hyperarousal) of the inter-relatedness of sleep, daytime behaviors, and mental health for individuals with autism across the lifespan.     

Psychometric properties of the Brazilian-Portuguese version of the Spence Children's Anxiety Scale (SCAS): Self- and parent-report versions

This study examined the psychometric properties of the Spence Children's Anxiety Scale (SCAS) self- and parent-report versions in a community (n = 712) and a clinical (n = 70) sample of Brazilian children and adolescents. Confirmatory factor analysis conducted in the community sample provided support to the original six correlated factors model of the SCAS. Moreover, the SCAS demonstrated good internal consistency, convergent and divergent validity, and a significant informant effect on the total score with higher anxiety levels in the self-report than in the parent-report version. Considering the clinical sample, we could demonstrate that the SCAS total scores have good discriminant validity differentiating: (a) anxious, community, and negative screening groups; and (b) children diagnosed with different severity levels of anxiety disorders. Our findings suggest that the SCAS (self- and parent-report versions) is suitable for assessing anxiety symptoms in Brazilian children and adolescents in community and clinical settings.     

Child Behavior Checklist item scores in Norwegian children

In an epidemiological study of children aged four to 16, 1170 parents responded to the Child Behavior Checklist (CBCL). Similar effects of age and socio-economic status (SES) on item scores as those reported in several international studies with the CBCL were found in the total sample. Contrary to the results of other studies, differences related to gender were found for only a few items. A subgroup of 41 children and 36 adolescents and their parents were interviewed with psychiatric interviews. Several CBCL problem items were good predictors of psychiatric disorder in the interviewed children and adolescents. High positive and negative predictive values were found for the items clumsy and the item unhappy, sad or depressed in this sample. Accepted: 7 May 1999     

Gender differences in Childhood Anxiety Sensitivity Index (CASI) dimensions

We examined the hierarchical structure of the Childhood Anxiety Sensitivity Index (CASI) as a function of gender and examined the occurrence of gender differences in anxiety sensitivity (AS) dimensions in a large nonclinical sample of children and adolescents (N = 1698). Separate principal components analyses (PCAs) on the 18 CASI items for the total sample, boys, and girls revealed similar lower-order three-factor structures for all groups. The three factors reflected Physical, Social/Control, and Psychological Concerns. PCAs on the lower-order factor scores revealed similar unidimensional higher-order solutions for all groups. Girls scored higher than boys on the Physical and, to a lesser extent, Social/Control Concerns factors; girls scored higher on the Physical Concerns factor relative to their scores on the Social/Control and Psychological Concerns factors; and boys scored higher on the Social/Control and Psychological Concerns factors relative to their scores on the Physical Concerns factor. Girls also scored higher than boys on the higher-order factor representing the Global AS construct. The present study provides additional support for the theoretical hierarchical structure of AS and suggests that there is a difference in the manifestation of AS between girls and boys.     

Psychometric Properties of the Norwegian Aberrant Behavior Checklist and Diagnostic Relationships in a Neuro-Pediatric Sample

ABSTRACT

Introduction: Although the Aberrant Behavior Checklist (ABC) is one of the most widely used behavioral rating scales among people with developmental disabilities, very few studies have examined the factor structure of the non-English versions.Methods: The construct validity of the Norwegian ABC was examined in a clinical sample of children and adolescents with neurological and neurodevelopmental disorders (N = 339). Diagnoses were obtained from direct interdisciplinary assessments in our neuro-pediatric clinics. Results: In an exploratory factor analysis, 46 of the 58 items (79%) loaded most heavily on four of the five original factors in the English version. Confirmatory factor analysis revealed less-than-optimal fit indices for the five-factor solution. Internal consistency was adequate to excellent for all subscales (α range = .76–.95). The ABC showed meaningful overlap and differentiation with the Strengths and Difficulties Questionnaire, the Behavior Rating Inventory of Executive Function, the Vineland Adaptive Behavior Scales, and full scale IQ. There were positive correlations between several of the ABC subscales and diagnoses of attention deficit/hyperactivity disorder, autism spectrum disorder, oppositional defiant disorder, and emotional disorder Conclusion: Satisfactory psychometric properties were found for the ABC, with the exception of the Inappropriate Speech factor, in a mixed sample of higher functioning children and adolescents with neurodevelopmental and neurological disorders.     

The facets of anxiety sensitivity in adolescents

This study examined the factor structure, reliability, and validity of the German translation of the Childhood Anxiety Sensitivity Index (CASI). A total of 1292 adolescents participated in the study. Analyses using the Schmid-Leiman solution showed the CASI to have one higher order factor and three orthogonal lower order factors. CASI scores correlated significantly with anxiety symptoms and with general difficulties. Hierarchical multiple regression showed CASI to make a significant contribution in predicting anxiety even after controlling for variance due to general difficulties, thus giving further support to the incremental validity of the CASI. The CASI is a potentially useful measure to include in longitudinal studies that examine the development of childhood and adolescent anxiety disorders.     

Metodikk ved tilretteleggelse av behandlingsforsök med nye medikamenter i psykiatrien

Background: Obsessive–compulsive disorder (OCD) is a frequent and clinically heterogeneous disorder. The complex clinical presentation can be summarized using a few consistent and temporally stable symptom dimensions. Only few studies in children and adolescents have examined the importance of symptom dimensions. Aims: This retrospective study was undertaken to describe the relation between symptom dimensions, pattern of comorbidity and family disposition, in a sample of Danish children and adolescents with OCD assessed in a naturalistic setting. Methods: A retrospective study of children and adolescents (n=83) diagnosed with OCD in the period 1998–2004, at the Psychiatric Hospital for Children and Adolescents, Risskov, Denmark. Information from clinical records was systematically collected and Children's Yale–Brown Obsessive–compulsive Scale (CY-BOCS) scores and symptom checklists were obtained. Results: High scores on the symmetry/ordering dimension were related to OCD in first-degree relatives and high scores on the aggressive/checking dimension were associated to comorbidity with tic disorders. We showed a correlation between limited insight and younger age. Conclusion: This is one of the first studies to examine symptom dimensions in children and adolescents in naturalistic settings. The results were comparable with those in adult studies, showing an association between the occurrence of the symmetry/ordering dimension and family OCD and the occurrence of the aggressive/checking dimension and comorbid tic disorders. In small children, insight into symptoms may be limited.     

Ataques de Nervios and Somatic Complaints Among Island and Mainland Puerto Rican Children

Previous research has documented the association between the Latino cultural idiom of distress, ataques de nervios (i.e., “attacks of nerves”), and unexplained neurological symptoms among adults. However, the associations between ataques and somatic complaints in children have not been sufficiently explored. Aims: In this study, we assessed the relation between this anxiety‐related experience, henceforth ataques, and somatic complaints in a probability sample of Puerto Rican youth, ages 5–13 years, living in San Juan, Puerto Rico (N = 1353) and in the South Bronx, New York (N = 1138). When both sites were combined, children with ataques were significantly more likely to have either a lifetime prevalence of asthma or headaches, and tended to have more stomach aches and a history of epilepsy or seizure than children without ataques. Further within site analyses showed a similar patterning of complaints for the South Bronx sample as for the combined sample. However, children in San Juan with ataques were only slightly more likely to experience headaches, and at risk for injury, than those without ataques. In addition, comparisons between ataque sufferers across sites indicated that children in San Juan with ataques were at elevated risk for serious illness or injury in comparison to those in the South Bronx with ataques. Ataques are significantly associated with a wide range of physical complaints in Puerto Rican youth. However, their pattern of associations differs by context.     

Pre-treatment child and family characteristics as predictors of outcome in cognitive behavioural therapy for youth anxiety disorders

Abstract

Background: Cognitive behavioural therapy (CBT) has been found to be effective for children and adolescents (6–18 years) with anxiety disorders, but the non-response rate is high—a fact that may argue for the importance of studies on pre-treatment characteristics of children and their families that predict treatment outcome. Aims: To provide a systematic review of clinical and demographic pre-treatment child and family predictors of treatment outcome in CBT for anxiety disorders in youth. Method: A systematic literature search was conducted based on electronic databases (PsycINFO, Embase and PubMed), and retrieved studies were analysed according to the box-score method of counting significant findings. Results: 24 studies with a sample size ≥ 60 were located. Most studies dealt with the following predictors: child age, gender, comorbidity, symptom severity and parental psychopathology. There was some evidence that a higher degree of pre-treatment symptomatic severity and non-anxiety comorbidity predicted higher end-state severity, but not a lesser degree of improvement. There was some but inconsistent support for a negative influence of parental psychopathology. Conclusion: Studies on pre-treatment child and family predictors of outcome in CBT for youth anxiety disorders have until now resulted in few findings of clinical or theoretical significance.     

The Reliability and Validity of the Korean Version of the Mood and Feelings Questionnaire for Depression in Youth: A Cross-Cultural Perspective

We aimed to assess cross-cultural differences in depressive symptoms and the validity of the Korean version of the Mood and Feelings Questionnaire (MFQ). Four hundred and sixty-four children and adolescents (aged 7–19, 278 girls) with any psychiatric diagnosis, 290 of whom had major depressive disorder, were included. The levels of depressive symptoms in children and adolescents were evaluated by children/adolescents and their parents. We conducted Pearson’s r and Cronbach’s α, confirmative factor analysis and item response theory tests. The Korean version of the MFQ demonstrated excellent criterion validity and discriminant validity. There were no cultural differences in the clinical manifestations of depression in youth from Western countries and Korea. Korean youths with depression were more likely to complain of cognitive and emotional symptoms than somatic symptoms. The Korean version of the MFQ demonstrated promising psychometric properties in a clinical sample of children and adolescents.

     

A biomarker of anxiety in children and adolescents: A review focusing on the error-related negativity (ERN) and anxiety across development

BackgroundAnxiety disorders are the most common form of psychopathology and often begin early in development. Therefore, there is interest in identifying neural biomarkers that characterize pathways leading to anxiety disorders early in the course of development. A substantial amount of work focuses on the error-related negativity (ERN) as a biomarker of anxiety. While two previous reviews have focused on the relationship of the ERN and anxiety in adults, no previous review has focused on this issue in children and adolescents.Results and conclusionsOverall, 22 studies were included in the current review. A number of patterns emerged, including: 1.) The ERN is enhanced in clinically anxious children at all ages (6–18 years old), regardless of the task used to measure the ERN. 2.) Studies focusing on anxiety symptoms and temperamental fear suggest that the relationship between the ERN and normative anxiety may change across development. 3.) The ERN can predict the onset of anxiety disorders across different developmental periods. 4.) The ERN relates to other markers of risk for anxiety (e.g., aversive startle potentiation) in children and adolescents.     

Obesity in children and adolescents with acquired brain injury

Objectives: To measure the prevalence of obesity and to assess associated clinical factors in children and adolescents with acquired brain injury (ABI).

Study design: This cross-sectional study included 88 subjects aged between 2.4–17.7 years attending the Brain Injury Clinic at a tertiary paediatric hospital. Body mass index (BMI) and BMI z-scores were calculated. Obesity and overweight were defined using the International Obesity Taskforce cut-points. Associations were examined between BMI z-scores and the following: ABI severity, mobility level, duration from injury and presence of radiological injury.

Results: The prevalence of obesity in this population (obese?=?15%) was higher than those in Australian children and adolescents (1995 National Nutrition Survey) while the prevalence of overweight (19.3%) was comparable. There was a linear trend for the participants to have a higher BMI z-score with increasing level of mobility (F?=?6.91, df 1.70, p?=?0.011).

Conclusion: There is no data about obesity in children and adolescents with ABI. The study with limited statistical power suggests that obesity is prevalent in this population and increases with increasing level of mobility. Further studies are required to address the issue of obesity and related complications in this population.     

Exploring Factors Related to Problematic Internet Use in Childhood and Adolescence

This study used data from a Korean national survey to identify the relationships between problematic Internet use (PIU) and Internet use and psychological functioning variables in children (n = 1221) and adolescents (n = 3671). Data analysis revealed that the rate of PIU is higher in adolescents than in children and that compared to children, adolescents with PIU use the Internet for longer periods than do those without PIU. Moreover, compared to adolescents, children with PIU have a higher tendency to use the Internet for information, entertainment, and communication than do those without PIU. The degree of depression is higher in individuals with PIU than in those without. Therefore, it was concluded that the moderating effect of age cohorts was only found in the relationships between PIU and Internet use time and purpose. Parental education guidelines for each age group and counseling programs for individuals with PIU are suggested.