Anxiety Scale For Children Research Articles

Time-out under scrutiny: examining the relationships among the discipline strategy time-out, child well-being and attachment and exposure to adversity.

Discipline is a crucial aspect of parenting, shaping child development and behaviour. Time-out, a widely used disciplinary strategy with a strong evidence-base, has recently come under scrutiny with concerns about potential adverse effects on children's emotional development and attachment, particularly for those with a history of adversity. To contribute critical empirical insights to the current controversy surrounding time-out by exploring the associations among time-out implementation, parent-child attachment and child mental health, and whether adversity exposure moderated these associations. This cross-sectional study utilised a nationally representative sample of 474 primary caregivers in Australia, with children aged 6-8 years, who completed an online survey. Measures included the Implementation of Time-out Scale, Adverse Life Experiences Scale, Primary Attachment Style Questionnaire, Strengths and Difficulties Questionnaire and Spence Child Anxiety Scale. Appropriately implemented time-out was associated with enhanced mental health and attachment, while inappropriate time-out correlated with adverse child outcomes. Exposure to adversity moderated the relationship between time-out implementation and child well-being, such that children exposed to adversity were most likely to experience attachment enhancement from appropriately implemented time-out. Despite recent concerns of harm caused by time-out, particularly for children with a history of adversity, findings support the beneficial impact of time-out on child well-being and attachment when implemented in accordance with evidence-based parameters. Combatting misinformation and disseminating evidence-based time-out guidelines is crucial for promoting child well-being and attachment, especially for children who have experienced adversity.

The Efficacy of Brainspotting and Sand Therapy to Reduce Anxiety Symptoms in Children Aged 8-9

This study explored the use of Brainspotting (BSP) in combination with Sand Therapy (ST) for use with 8–to 9-year-old children with anxiety symptoms in a school-based setting. Using the Spence Children's Anxiety Scales (SCAS), The Behavior and Feelings Survey (BFS), and the Top Problems Assessment (TPA), the research project measured anxiety as reported by parents/caregivers and students, internalizing, externalizing, and total concerns as reported by parents/caregivers, teachers, and students, and finally individually identified unique concerns as reported by parents/caregivers, teachers, and students. The researcher collected data from student participants (11) who experienced six sessions of BSP and ST. The quantitative data collected identified project signifiers for future researchers. Outcomes reflected statistical significance of a reduction in anxiety scores for parents in the subscale of generalized anxiety and a significant reduction of scores in children in the subscales of generalized anxiety and separation anxiety. Parents and teachers indicated significantly lower scores in internalizing and total concerns identified across time intervals. All three groups of reporters indicated a significant reduction of top problems identified across time intervals. Outcomes demonstrate the promise of the integrated practice of BSP and ST while laying a framework for future research of this method.

Psychometric properties of the Child Anxiety and Depression Life Interference Scale - Young Adult version.

A life interference measure specifically designed for young adults with anxiety and depressive symptoms does not currently exist. This paper describes the development and psychometric evaluation of a brief self-report measure of life interference associated with young adult anxiety and depression, the Child Anxiety and Depression Life Interference Scale - Young Adult version (CADLIS-YA). Cross-sectional, correlational and exploratory factor analysis (EFA). Five-hundred and thirty-two participants aged 18-24 years recruited from an undergraduate and community sample completed the CADLIS-YA. An EFA supported a three-factor model describing the impact of young adult anxiety and depression on social life, family and daily life interference. Test-retest reliability and internal consistency were good to excellent. Convergent validity was demonstrated, and the scale differentiated between young adults with and without elevated anxiety and depressive symptoms. Support for divergent validity was limited. The CADLIS-YA is a reliable and valid life interference measure for young adults with symptoms of anxiety and depression. It is potentially suitable for administration in low-resource research settings and it has promise for use in clinical settings; however, it needs validation in a clinical sample.

Social support and mental health outcomes in palestinian children victims of bullying and cyberbullying during the covid-19 pandemic: an exploratory investigation

BackgroundStudies have shown that COVID-19 negatively impacted mental health by increasing depression and anxiety. Additionally, bullying might deteriorate children's psychological functioning. Nevertheless, social support has been studied as a positive buffer for mental well-being.ObjectivesThus, our study aimed to examine the consequences of the COVID-19 outbreak on children’s mental health when they are a victim of bullying and cyberbullying. Moreover, we tested the effect of social support as a mediating variable. A sample of 141 children (63 boys and 78 girls) 9 to 13 years old (M = 10.31, SD = 2.26) who reported having experienced bullying participated in the research. All were Palestinians living in Israel, attending primary schools.MethodsData was collected using the following measures, the Multidimensional Bullying Victimization Scale (MBVS), the Adolescents Cyber-Victimization Scale (CYBVICS), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire measuring the effect of COVID-19 on mental health outcomes, the Revised Child Anxiety and Depression Scale (RCADS), and the Multidimensional Scale of Perceived Social Support (MSPSS). Structural equation modelling was applied to test the association between variables and mediating effects.FindingsA positive correlation between Fear of COVID-19 and traditional bullying, cyberbullying, depression, and anxiety were found. Moreover, social support was negatively correlated with traditional forms of bullying and cyberbullying. Also, statistically significant differences between traditional bullying, cyberbullying, depression, and parents' difficulties emerged from parental marital status.Conclusionsfindings might help victims of bullying by training teachers and guiding parents to construct intervention plans to empower the social networks of children victims.

Evaluation of the Effect of Surgery on Psychosocial Function and Quality of Life in Children with Simple Congenital Ptosis and Their Parents.

Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery. Materials and. A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and parents answered the Spence Children's Anxiety Scale (SCAS) - Social Anxiety Domain, and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and three months after ptosis surgery. This study involved 45 children. Females comprised 57.8% (n=26). At enrolment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean MRD1 and mean inter-eye MRD1 difference of 4.070.62 mm and 0.290.46 mm respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p<0.001). A decrease in inter-eye MRD1 difference post-operatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p<0.001). Together with the presence of amblyopia (p<0.001), the inter-eye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p=0.021). Age, gender and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p<0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p<0.001). Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

Assessment of anxiety symptoms in children and adolescents: Italian validation of the short version of the spence children's anxiety scale for parents.

The assessment of anxiety symptoms in children and adolescents requires a valid and reliable single instrument able to detect various anxiety symptoms early and systematically collect data from other informant such as parents. The present study aimed to test the one-factor structure of the SCAS-P-8 and to examine its psychometric properties and invariance across sex and age in an Italian sample of 769 parents of children and adolescents aged 3-18years (50.8% females). Confirmatory factor analysis confirmed the one-factor structure of the SCAS-P-8, which showed good reliability and invariance by sex and age. When examining mean differences by sex and age, results showed that female schoolchildren had higher anxiety scores than males and other age groups. A strong correlation with emotional problems demonstrated convergent validity, while discriminant validity resulted from the weak correlations with externalizing symptoms and relationship problems with peers. Overall, findings support the SCAS-P-8 as a valid brief instrument to assess anxiety symptoms in children and adolescents for clinical and research purposes and demonstrate its invariance across sex and age.

Psychometric Validation of the Slovenian Version of the Revised Child Anxiety and Depression Scale - Child and Parent Versions (RCADS and RCADS-P)

Abstract Objective Anxiety and depression are common disorders in children and adolescents and can have a negative impact on their lives. The Revised Child Anxiety and Depression Scale – Child and Parent versions (RCADS and RCADS-P) are widely used standardized measurement tools, but the Slovenian versions have not yet been validated. The aim of the present study was to examine the psychometric properties of the Slovenian version of RCADS and RCADS-P in a representative Slovenian school sample. Methods We examined the psychometric properties (factor structure, internal reliability, short-term stability, inter-rater agreement and convergent validity) of the Slovenian version of the RCADS and the RCADS-P in 754 primary and secondary school students and parents of 485 students. The short-term stability of anxiety and depressive symptoms in youth was assessed in a subsample of 117 children and adolescents. Results Confirmatory factor analysis showed an acceptable fit of the 6-factor model with CFI=0.92, TLI=0.92 and RMSEA=0.056 for RCADS and with CFI=0.93, TLI=0.92 and RMSEA=0.047 for RCADS-P. Cronbach's α and McDonald's ω ranged from 0.70 to 0.95 for the total scale and the six subscales. The subscales correlated significantly positively with the total Child Anxiety Life Interference Scale score. Conclusion The results affirm the good psychometric properties of the Slovenian versions of RCADS and RCADS-P within a school-based sample. There is a need in the future to examine psychometric properties in clinical samples and to provide normative data.

Measuring Anxiety in Autistic Children: Assessing the Validity of the Anxiety Scale for Children with Autism Spectrum Disorder.

The present study assessed the validity of one of the first autism-specific anxiety measures, the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD), and compared its ability to predict parent-reported clinical anxiety to a 'traditional' anxiety measure, the Spence Children's Anxiety Scale (SCAS). Whether the inclusion of the child form for each measure improved the predictive ability of the parent forms was also examined. Eighty-seven parents of autistic children, aged 8-12 years, completed the ASC-ASD, the SCAS, and the Social Communication Questionnaire (SCQ), a screener for autism characteristics. Of these parents, 56 had their child complete the ASC-ASD and SCAS. The children with a reported anxiety diagnosis were rated significantly higher by their parents on both the SCAS and the ASC-ASD compared to the non-anxious children. Pearson's correlation coefficients indicated that the ASC-ASD had good divergent and convergent validity, as demonstrated by a poor, non-significant correlation with the SCQ and a strong, significant correlation with the SCAS. Regression analyses indicated that while the ASC-ASD was a significant predictor of parent-reported clinical anxiety in autistic children, the SCAS was not. Neither model was improved with the inclusion of the respective child form. This study is the first to demonstrate the ability of the ASC-ASD to predict child clinical anxiety disorder status and adds to the growing body of evidence for the validity of this measure. The findings also suggest that parent reports of anxiety may be sufficient to identify autistic children warranting further clinical investigation of anxiety in this age group.

Effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children: a parallel group randomised controlled trial

Children whose parents have anxiety problems are at increased risk of developing anxiety themselves. Parenting behaviors are a contributing factor to intergenerational transmission. Interventions which seek to limit anxiogenic parenting behaviors have shown potential in reducing anxiety in offspring but are not widely accessible. This prevention trial aimed to establish the effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children. A parallel group, block-randomised controlled trial of unblinded participants in a 1:1 ratio was conducted to compare efficacy of the online course compared to a no-intervention control. The intervention comprised 8 modules, of approximately 20min each, and participants progressed through the course at their own pace. The study was conducted entirely online with a self-referred UK-based community sample of parents (child 2-11 years) with substantial anxiety. The primary outcome measure was change in parent-reported child anxiety, as measured by the Spence Children's Anxiety Scale-Parent Report (SCAS-P) or Spence Pre-School Anxiety Scale-Parent Report (Preschool SCAS). Secondary outcomes were child internalising, externalising, and attentional symptoms (Pediatric Symptom Checklist), and parent anxiety (SCARED-Adult). Analyses using complete case analysis following intention to treat principles investigated intervention effects at 6 months (primary analysis) and additionally at 9 to 25-months' follow-up. Trial registration: ClinicalTrials.GovNCT04755933, https://clinicaltrials.gov/ct2/show/NCT04755933. 1811 participants (intervention=900; control=911; 92.7% (1677/1810) female; 85.3% (1535/1800) White-British; 66.8% (1201/1799) university educated). Participant retention (based on primary outcome completion) at T2 (6-months post consent) was 67.6% overall (n=1224) and substantially lower in the intervention arm 57.3% ((516/900) control=77.8% (708/910)). Child anxiety was lower in the intervention group compared to control at 6-month follow-up (adjusted effect size estimate-0.15 (95% CI:-0.23 to-0.08, p<0.001). There was very strong evidence that those in the intervention arm had lowered child anxiety (standardised SCAS score) compared to the control arm, with an effect size (Cohen's d) of-0.16 (95% CI:-0.23 to-0.08, p<0.001). The difference in standardised Spence Child Anxiety Scale score between the arms was-0.15 standard deviations. On the original scales for SCAS-P (0-114) and Preschool SCAS (0-112), this corresponds to a reduction of-2.38 (95% CI:-3.59 to-1.16) and-2.68 (95% CI:-4.05 to-1.31), respectively. No reported harms. A clinically unsupported online intervention designed for parents with high levels of anxiety is effective in reducing anxiety and internalising symptoms in their children, and also anxiety in parents. Given the low resource intensity of this intervention, and the positive effects reported here, these findings suggest it has promise in limiting the intergenerational transmission of severe anxiety. This work was supported by Kavli Trust (grant 38/19).

Child mental health: Early detection and interventions in anxiety disorders and depression

Introduction: Child mental health is a critical public health issue, with disorders such as anxiety and depression affecting up to 20% of children worldwide. Early detection and effective interventions are essential to mitigate the effects of these disorders and improve the quality of life of affected children. This study conducted a systematic review to identify the most effective strategies for early detection and interventions in childhood anxiety disorders and depression. Methods: The systematic review was conducted in the PubMed, Scopus, PsycINFO, and Web of Science databases, using descriptors such as “Child Mental Health,” “Early Detection,” “Anxiety Disorders in Children,” and “Childhood Depression.” Empirical studies published between 2010 and 2024 were included. Study selection was performed by two independent reviewers, and methodological quality was assessed using the AMSTAR tool and the Newcastle-Ottawa Scale. Results: Thirteen studies were included that indicate the effectiveness of instruments such as the "Spence Children's Anxiety Scale" (SCAS) and the "Child Depression Inventory" (CDI) in the early detection of anxiety and depression in children. Interventions based on Cognitive-Behavioral Therapy (CBT) and multidisciplinary approaches were effective in reducing symptoms and improving the quality of life of children. However, the implementation of these strategies faces significant challenges, such as lack of resources and the need for cultural adaptations. Conclusion: Early detection and timely interventions are essential for the effective management of anxiety disorders and depression in children. The importance of public policies for training professionals and intersectoral collaboration to ensure quality mental health care is reinforced. Future research should focus on culturally adapted interventions and evaluate their long-term effectiveness.

A Review of the Child Anxiety Questionnaire Based on the Left-behind Children

Left-behind children are a special group in the process of urban development. They lack parental care, which affects the development of mental health. Anxiety is one of the most common psychological problems in children around the world. It has an important impact on children’s emotions and social interaction, lasting until adulthood. To study the anxiety of left-behind children, this study summarized the screening tools for children’s anxiety in this review and found that there is no anxiety questionnaire for left-behind children at present and most of the existing anxiety questionnaires for children are not completely based on the existing diagnostic criteria. As a result, these scales are not able to accurately measure all contents covered by the concept of children’s anxiety. The study summarized the left-behind anxiety questionnaire to provide some ideas for choosing a questionnaire for researchers studying left-behind children. In addition, the study believes that the development of anxiety scales for left-behind children as soon as possible and the use of multiple measurement methods should be the direction of future researchers.

Stability and Validity of Self-Reported Depression and Anxiety in Autistic Youth.

The aim of this study was to assess test-retest reliability and diagnostic validity of self-report instruments of depression and anxiety in autistic youth. Participants were 55 autistic youth aged 8-17 years presenting with depressive or anxiety symptoms. They were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and completed the Children's Depression Inventory, Second Edition - Self Report Short (CDI 2:SR[S]) and the Revised Child Anxiety and Depression Scale (RCADS) twice, separated by a two-week interval. Test-retest reliability was measured with intraclass correlation coefficients (ICCs), and diagnostic validity was assessed using receiver operating characteristic (ROC) curves with the summary ratings on the K-SADS-PL as the criterion. The effect of participant characteristics was analyzed through a moderation analysis. Generalized anxiety (GAD) and social anxiety disorder (SOC) were the two most prevalent disorders in the sample. Test-retest reliability for most of the subscales was good (ICC = 0.74 - 0.87), with the exception of the RCADS obsessive-compulsive disorder (OCD) and GAD. The Adaptive Behavior conceptual score was a significant moderator of the reliability of the CDI 2:SR[S]. The ROC analysis suggested the RCADS SOC and the CDI 2:SR[S] to be good screening tools with inadequate specificity when appropriately sensitive cutoff scores are used. Optimal cutoff scores in this sample were lower than originally published. The findings suggest that autistic youth can provide stable reports of anxiety and depressive symptoms over time. Diagnostic validity varied according to the construct and instrument.

Assessing Psychological Disorders in Turkish Adolescents with Transfusion-Dependent Thalassemia.

We investigated depression and anxiety levels and related psychological disorders in adolescents with transfusion-dependent thalassemia (TDT) in this study. The study was conducted in two pediatric hematology outpatient clinics and included adolescents with TDT (14.8 ± 2.4 years, n = 40) in the study and compared them with the healthy age-matched control group (14.3 ± 2.3 years, n = 62). The Turkish version of the Revised Child Anxiety and Depression Scale (RCADS) was used to determine depression, anxiety, and related psychologic disorders (obsession, panic disorder, social phobia). Depression, anxiety, obsession, panic disorder, and social phobia scores were significantly higher in the patient group compared with the control (all p < 0.05). Ferritin levels were positively correlated with total depression, general anxiety, separation anxiety, and social phobia scores, but transfusion frequency and young age were the confounding factors. Patients in early adolescence and those who require more frequent blood transfusions are at higher risk of developing psychological disorders; routine screening for mood disorders should be warranted. Serum ferritin level may be a good warning indicator for early recognition of psychologic disorders in TDT patients.

Enhancing children's well‐being using Malaysian‐adapted version Super Skills for life (M‐SSL) among primary school children in Malaysia

AbstractWith the increasing prevalence of mental health issues among children, there is a growing need to implement school‐based preventive programs for emotional well‐being in Malaysia. Super Skills for Life (SSL) is a transdiagnostic preventive program designed based on the cognitive‐behavioral therapy concept to address emotional problems among children. This study examined the effectiveness of the M‐SSL program in reducing depressive and anxiety symptoms as well as other psychological issues such as social competency, worries, cognitive and emotional regulation in a sample of Malaysian children between the ages of 10 and 12. A quasi‐experimental preintervention and postintervention research design was conducted. A total of 165 primary school children (M = 10.9, SD = 0.72) were recruited with 88 of them randomly assigned to the intervention group. All of them were asked to complete a questionnaire consisting of demographic data, the Centre for Epidemiologic Studies Depression Scale Revised, Spencer Children's Anxiety Scale, Strength and Difficulties Questionnaires, Social Skills Questionnaires and Cognitive Emotional Regulation Questionnaires. Children in the M‐SSL group significantly reported lower levels of depressive scores during follow‐up assessment compared to the children in the control group. They also showed significant improvement in their depressive subscale scores, social worries scores, and the way they perceived an event as compared to the control group. These findings provide initial support for the effects of M‐SSL, suggesting that it is a valuable resource for the prevention of depressive symptoms and for improving social worries among children.

Social Anxiety in Students with Specific Learning Disorders Based on Emotion Regulation and Emotional Intelligence: The Mediating Role of Perceived Self-Efficacy

Background: One of the basic challenges faced by children with specific learning disorders (SLD) is social-emotional problems. Objectives: Considering the importance of social anxiety in interacting with others and its negative consequences in the family, society, and academic life of students with specific learning disabilities, the present study aims to develop a causal model of social anxiety in these students based on emotion regulation and emotional intelligence, taking into account the mediating role of perceived self-efficacy. Methods: The research employed a descriptive approach and utilized path analysis. The statistical population of this research comprised all the students with SLD who were referred to the student counseling centers and LD centers affiliated with the education organization of Sanandaj city in the academic year 2022 - 2023. The research sample consisted of 360 students aged between 8 and 12 years old with SLD, selected from the statistical population through purposeful sampling. In this research, the self-report version of Leibovitz's Social Anxiety Scale for children and adolescents by Masia-Warner et al., Shields and Cicchetti's emotion regulation inventory, Trait Emotional Intelligence Questionnaire by Mavroveli et al., and Muris' Children's Self-Efficacy Questionnaire were utilized. The fit indices of the model were also confirmed. Results: The variables of emotion regulation, perceived self-efficacy, and emotional intelligence directly affected the social anxiety of students with SLD. Additionally, the social anxiety of students with SLD was significantly related to the mediation of perceived self-efficacy with emotion regulation and emotional intelligence (P &lt; 0.01). Conclusions: Therefore, to reduce the social anxiety of students with SLD, it is recommended that educators and experts develop educational programs to increase adaptive emotion regulation strategies, enhance perceived self-efficacy, and strengthen emotional intelligence.

Similarities and differences of neuropsychological functions, metacognitive abilities and resilience in Cognitive Disengagement Syndrome (CDS) and Attention Deficit/Hyperactivity Disorder (ADHD)

It was aimed to evaluate the relationships between neuropsychological functions, self-reported metacognitive abilities, and resilience levels among children with Attention Deficit Hyperactivity Disorder (ADHD) and those with Cognitive Disengagement Syndrome (CDS) compared to healthy controls. This cross-sectional, case-control study was consisted of 36 children with CDS only, 36 with ADHD only, 33 with CDS and ADHD and 39 control children were enrolled for a total sample of 144 children. The intellectual and neuropsychological functioning of the participating children was evaluated using the WISC-IV. Metacognitive Awareness Inventory for Children(MAI-C), Emotional Resilience Scale(ERS), and Revised Child Anxiety and Depression Scale(RCADS) were used. In both Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI), children with CDS had significantly lower scores compared to those with ADHD, while those with ADHD and ADHD + CDS were similar to each other and controls. Children with CDS had greater metacognitive awareness than those with ADHD only and those with ADHD + CDS, whereas controls had the greatest level of metacognitive awareness. The emotional sensitivity of children with CDS was similar to that of children with ADHD + CDS and significantly greater than that of children with ADHD and controls, while control children had the lowest levels. The results of this study suggest that metacognitive abilities and emotional resilience may be targeted in rehabilitation/therapy of children with CDS ± ADHD and that interventions targeting processing speed and perceptual reasoning in younger children with CDS symptoms may be beneficial.

Association of problems, coping styles, and preferred online activity with depression, anxiety, and other psychological disorders in Turkish adolescents diagnosed with chronic kidney disease

BackgroundTo assess depression, anxiety, and other psychological disorders in adolescents with chronic kidney disease (CKD) and determine the significant factors and the effect of digital media use on its scores among these patient groups.MethodsThe study was conducted as a cross-sectional study and included 84 adolescents with CKD and 68 healthy controls. The participants completed the Revised Child Anxiety and Depression Scale (RCADS). We recorded their age, gender, the most problematic issue in their lives, coping methods with problems, and online applications they prefer in their leisure time.ResultsElevated rates (scores > 70) of separation anxiety, panic disorder, obsession, depression, total anxiety, and total depression scales were statistically higher in the CKD group. Separation anxiety, panic disorder, obsession, total anxiety, and total depression scales were higher in girls, and panic disorder, obsession, depression, total anxiety, and total depression scores were higher in younger ages in multivariate analysis. In the CKD group, family issues/problems increased panic disorder, obsession, depression, total anxiety, and total depression scales. Crying in tears/yelling response in children while facing a problem was associated with increased separation anxiety and social phobia rates. Also, preferring video applications was associated with separation anxiety and messaging applications with depression, total anxiety, and total depression.ConclusionsAdolescents with CKD are at risk for depression, anxiety, obsession, and panic disorders. Also, crying in tears/yelling response may be at greater risk for anxiety among CKD adolescents. Early psychiatric evaluation and routine psychiatric follow-ups initiated early may improve the mental health of this vulnerable population.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information

Assessment of anxiety in children with neurodevelopment disorders: Rasch analysis of the Spence Children's Anxiety Scale.

Anxiety is common in neurodevelopmental disorders (NDD). The parent version of the Spence Children's Anxiety Scale (SCAS-P) is a widely used measure to assess anxiety across a broad range of childhood populations. However, assessment of the measurement properties of the SCAS-P in NDDs have been limited. The present study aimed to assess the psychometric properties of the SCAS-P in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) using Rasch Measurement Theory. Data from the Province of Ontario Neurodevelopmental Disorders Network Registry were used in the analysis. Children (ages 6-13 years old) with a primary diagnosis of ADHD (n=146) or ASD (n=104) were administered the SCAS-P. Rasch Measurement Theory was used to assess measurement properties of the SCAS-P, including unidimensionality and item-level fit, category ordering, item targeting, person separation index and reliability and differential item functioning. The SCAS-P fit well to the Rasch model in both ADHD and ASD, including unidimensionality, satisfactory category ordering and goodness-of-fit. However, item-person measures showed poor precision at lower levels of anxiety. Some items showed differential item functioning, including items within the obsessive-compulsive, panic/agoraphobia and physical injury fears domains, suggesting that the presentation of anxiety may differ between ADHD and ASD. Overall, the results generally support the use of the SCAS-P to screen and monitor anxiety symptoms in children with ADHD and ASD. Future studies would benefit from examination of more severely anxious NDD cohort, including those with clinically diagnosed anxiety.

The psychosocial outcomes of advanced hybrid closed-loop system in children and adolescents with type 1 diabetes

The study was carried out to determine the psychosocial outcomes of advanced hybrid closed-loop (AHCL) systems in children and adolescents with type 1 diabetes (T1D). Single-center and cohort study with a duration 6 months consisted of 60 children and adolescents with T1D. Standard clinical procedures, including both glycemic indicators, e.g., sensor-measured time within the 70–180 mg/dL range and glycated hemoglobin (HbA1c) levels, and psychosocial metrics were used for data collection. The psychosocial metrics included the Pediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module for both children (8–12 years) and parents; the Quality of Life for Youth scale for adolescents (13–18 years); the Strengths and Difficulties Questionnaire (SDQ); the Hypoglycemia Fear Survey for Children (HFS-C); the Revised Child Anxiety and Depression Scale (R-CADS); and AHCLS-specific DTSEQ satisfaction and expectation survey. These metrics were evaluated at the baseline and after 6 months of AHCL use. Of the 60 children and adolescents with T1D for whom the AHCL system was utilized, 41 of them, 23 female and 18 male, completed the surveys. The mean age of the 41 children and adolescents was 12.5 ± 3.2 (min. 6.7, max. 18) years. The time spent within the target glycemic range, i.e., time-in-range (TIR), improved from 76.9 ± 9% at the baseline to 80.4 ± 5% after 6 months of AHCL system use (p = 0.03). Additionally, HbA1c levels reduced from 7.1% ± 0.7% at the baseline to 6.8% ± 0.8% after 6 months of AHCL system use (p = 0.03). The most notable decline in HbA1c was observed in participants with higher baseline HbA1c levels. All patients’ HFS-C and AHCL system-specific DTSEQ satisfaction and expectation survey scores were within the normal range at the baseline and remained unchanged during the follow-up period. No significant difference was found in the R-CADS scores of children and adolescents between baseline and after 6 months of AHCL system use. However, there was a significant decrease in the R-CADS scores of the parents. Patients’ PedsQL scores were high both at the baseline and after 6 months. The SDQ scores were high at baseline, and there was no significant improvement at the end of 6 months. Conclusion: This is the first study to investigate in detail the psychosocial outcomes of AHCL system use in T1D patients and their parents. Although state-of-the-art technologies such as AHCL provide patients with more flexibility in their daily lives and information about glucose fluctuations, the AHCL resulted in a TIR above the recommended target range without a change in QOL, HFS-C, SDQ, and R-CADS scores. The scores obtained from the R-CADS conducted by the parents of the children indicated that the use of pumps caused a psychological improvement in the long term, with a significant decrease in the R-CADS scores of the children and adolescents with T1D.What is Known:• Previous studies focused on clinical outcomes of AHCL systems in pediatric T1D patients, showing glycemic control improvements.• Limited attention given to psychosocial outcomes of AHCL systems in children and adolescents with T1D.• Crucial psychosocial factors like quality of life, emotional well-being, and fear of hypoglycemia underexplored in AHCL system context.What is New:• First study to comprehensively examine psychosocial outcomes of AHCL systems in pediatric T1D patients.• Study's robust methodology sets new standard for diabetes technology research and its impact on qualiy of life.

How much do adverse childhood experiences contribute to adolescent anxiety and depression symptoms? Evidence from the longitudinal study of Australian children.

This study aims to: (i) examine the association between adverse childhood experiences (ACEs) and elevated anxiety and depressive symptoms in adolescents; and (ii) estimate the burden of anxiety and depressive symptoms attributable to ACEs.Data were analyzed from 3089 children followed between Waves 1 (age 4-5 years) and 7 (16-17 years) of the Longitudinal Study of Australian Children. Logistic regression was used to estimate the associations between ACEs and child-reported elevated anxiety and depressive symptoms at age 16-17. Anxiety and depressive symptoms were measured using the Children's Anxiety Scale and Short Mood and Feelings Questionnaire, respectively. The punaf command available in STATA 14 was used to calculate the population attributable fraction (PAF).Before the age of 18 years, 68.8% of the children had experienced two or more ACEs. In the analysis adjusted for confounding factors, including co-occurring ACEs, both history and current exposure to bullying victimisation and parental psychological distress were associated with a statistically significant increased likelihood of elevated anxiety and depressive symptoms at age 16-17. Overall, 47% of anxiety symptoms (95% CI for PAF: 35-56) and 21% of depressive symptoms (95% CI: 12-29) were attributable to a history of bullying victimisation. Similarly, 17% (95% CI: 11-25%) of anxiety and 15% (95% CI: 4-25%) of depressive symptoms at age 16-17 years were attributable to parental psychological distress experienced between the ages of 4-15 years.The findings demonstrate that intervention to reduce ACEs, especially parental psychological distress and bullying victimisation, may reduce the substantial burden of mental disorders in the population.