Anxiety Symptoms In Children Research Articles

Development and validation of the Modeling of Parental Anxiety Questionnaire

Parental anxious modeling is assumed to be a risk factor for child anxiety. Until now there has been no self-assessment scale available that measures parental modeling of anxiety in a comprehensive way. Our aim with this study was to bridge this gap by developing the Modeling of Parental Anxiety Questionnaire (MPAQ). To do this, we generated an item pool containing 51 statements covering different aspects of parental modeling of anxious and non-anxious behaviors. A sample of Swedish parents (N = 1092) of children aged 4–12, answered an online survey comprising the generated item pool, the Parental Overprotection Scale (OP) and the PROMIS Anxiety short forms (the adult version and the parent proxy report scale). A factor analysis of the items of parental modeling indicated a structure with four separate factors. These factors formed the final four subscales of MPAQ; (1) being curios and content, (2) being on guard, (3) displaying anxiety and avoidance, and (4) displaying stress. The Cronbach’s alpha coefficients of the subscale scores ranged from moderate to good. Linear regression analysis showed that the displaying anxiety and avoidance-subscale had the strongest association with child anxiety symptoms. These findings show that MPAQ demonstrates adequate psychometric properties and has potential for being used in research and clinical settings, for example to identify potential targets for parenting interventions and to measure mediation effects.

COVID-19-Related Stigma and Mental Health of Children and Adolescents During Pandemic.

This cross-sectional study aimed to evaluate depression and anxiety symptoms of the children/grandchildren of COVID-19 patients, children/grandchildren of healthcare workers who have not infected COVID-19, and children/grandchildren of the control group. Parent and children’s perception about COVID-19–related stigma is also investigated and compared between groups. The perception about COVID-19–related stigma between different age and gender groups among children also investigated and compared. The mental health of the 71 participants aged 6–18 years was evaluated via a telemedicine-based semi-structured interview between March and April 2020. Children’s Depression Inventory (CDI), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), and COVID-19–Related Stigma Form were administered to the participants. A significant negative correlation was found between age and separation anxiety disorder (p = .005) and a significant positive correlation was found between age and generalized anxiety disorder (p = .035) in the SCARED-Child report. Generalized anxiety disorder was found to be higher in females compared to males. A significant difference was found between the groups of parents in the COVID-19–Related Stigma Form. Patients infected with COVID-19, healthcare workers, and the control group have different perceptions about COVID-19–related stigma. The age of the children have an impact on stigma perceptions. Anxiety symptoms of children affected by age and gender. Future studies are recommended to determine the other factors associated with perceptions about COVID-19–related stigma among children and parents.

Assessment and treatment of anxiety in children and adolescents with ASD: a systematic review

PurposeThe purpose of this study was to investigate the quality of current studies that assess and treat anxiety symptoms in children with autism spectrum disorder (ASD). More specifically the study aimed to answer the following questions: What are the qualities of the current studies using cognitive behavioral therapies (CBTs) to treat anxiety symptoms in children with ASD? Did studies make necessary modifications and adaptations to CBTs according to the evidence-based strategies and implement these versions of CBTs with precise fidelity? Were the selected measurements appropriate for assessing the anxiety symptoms in children with ASD?Design/methodology/approachA systematic review protocol was developed from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009). A rubric was adapted based on the CEC (Council for Exceptional Children; Cook, 2014) group comparison studies standards and the Evaluative Method for Determining EBP in Autism (Reichow et al., 2007). The 3-point Likert Scale (Chard et al., 2009) was adapted to score each study based on the rubric.FindingsCBT is a first-line treatment with significant mixed results. Current studies use adapted versions of existing CBTs for children with ASD without reporting empirical evidence to these adaptations and changes. Reporting of the implementation fidelity is still an issue in the treatment of anxiety. Anxiety measurements that were designed for typically developing children failure to detect unusual anxiety symptoms in children with ASD.Research limitations/implicationsThe first limitation of this study was including a variety of studies across CBT programs and types of anxiety symptoms. Types of anxiety and CBT treatments may require separate analyses with specific indicators. Due to the limited studies, reviews could not be analyzed across types of CBT programs. The second limitation was the types of studies. Most of the studies were pilot studies. Pilot studies might use various instruments and CBTs components for making selections to produce the best effects and results. The final limitation was the lack of examination of the data analysis process.Originality/valueThese findings are important because due to the variety of changes or adaptation to CBTs, inappropriate implementations and failure to detect unusual anxiety symptoms of children with ASD may cause significant differences in treatment responses and outcomes. The study demonstrated that the majority of the studies used adapted versions of existing CBTs without reporting empirical evidence for these adaptations and changes. The findings have shown that reporting of the implementation fidelity is still an issue. Moreover, the majority of studies had used anxiety measurements that were designed for typically developing children, not for children with ASD.

Personalized Assessment of Anxiety and Avoidance in Children and Their Parents-Development and Evaluation of the Anxiety and Avoidance Scale for Children.

In treating childhood anxiety disorders, therapists use highly individualized anxiety hierarchies to assess anxiety-eliciting situations and to personalize treatment. In contrast, psychometric assessment of anxiety symptoms in children usually consists of standardized questionnaires, assessing either total anxiety or disorder-specific symptom scores, prioritizing comparability over individual information. To account for interindividual differences, the Anxiety and Avoidance Scale for Children (AVAC) was developed, following a precise, personalized, assessment approach. In responding to the questionnaire, children and parents identify the most anxiety-eliciting situations before starting treatment, and rate them for anxiety and avoidance. Ratings are repeated over the course of treatment. The aim of this study is to introduce the new questionnaire and present first data on psychometric properties. The AVAC was administered to 389 children with separation anxiety disorder (N = 148), social anxiety disorder (N = 110) or specific phobia (N = 131) aged 8 to 16 and their parents, along with other measures of anxiety and psychopathology before and after cognitive behavioral treatment. Results showed adequate to good test-retest reliability. The AVAC items correlated significantly with established anxiety questionnaires, indicating convergent construct validity. Regarding divergent construct validity, the AVAC showed only small correlations with externalizing symptoms, demonstrating its precision in measuring anxiety and avoidance. The questionnaire was also sensitive to change after treatment, with medium to large effects in the reduction of anxiety and avoidance. The present analyses suggest that the new personalized assessment approach with the AVAC is a reliable and valid assessment of individualized anxiety and avoidance, as well as change in those constructs over the course of CBT treatment.

Relationships between local school closures due to the COVID-19 and mental health problems of children, adolescents, and parents in Japan

The widespread impacts of COVID-19 have affected both child and parent mental health worldwide. This study aimed to investigate the relationship between school closures due to COVID-19 and child and parent mental health in Japan. A sample of 1,984 Japanese parents with children and adolescents aged 6–15 years participated. The parents responded to online questionnaires about their own mental health and that of their children cross-sectionally. Participants were divided into three school situations based on the past week: full school closure, partial school closure, and full school open. Results indicated that 2.02% (n = 40) of the participants were in full school closure and 5.95% (n = 118) of the participants were in partial school closure. The results indicated that, after controlling for other variables regarding the pandemic, full school closure was associated with much higher scores in both child and parent mental health problems compared to full school open. Moderately higher scores were found only for anxiety symptoms in both children and parents under partial school closure compared to where schools were fully open. Consideration of the needs of families is necessary in the context of both full and partial school closures to prevent deteriorating mental health.

Gestalt Interventions Benefitting Children and Adolescents: A Literature Review

ABSTRACTGestalt therapy is a therapeutic approach used by many groups. Quite often, qualitative and quantitative research for Gestalt has focused on adult populations. This literature review has explored research on the benefits of a Gestalt approach with children and adolescents. Gestalt research has benefited children and adolescents in the following areas: emotional self-expression, conflict resolution, contact with therapists, well-being, self-esteem, communication skills, decreased depression, child anxiety, parent anxiety, and trauma symptoms. The findings suggest that evidence of effective Gestalt interventions with children and adolescents is still developing. Eight studies after the year 2000 have reported effectiveness with this population. Implications for Gestalt practice and research with children and adolescents are explored.

Clinical Case of a Child with Algoneurodystrophy

A clinical case of a 12-year-old female child with anxiety symptoms and a diagnosis of Algoneurodystrophy in the left hand is presented. The psychological assessment was carried out using the following instruments: observation, psychological interview, Wechsler Intelligence Scale for Children (WISC-III), State/Trait Anxiety Questionnaire for children, and Conners Scales for parents and teachers. The intervention aimed to reduce anxiety levels, promote self-esteem, and alleviate the child's grief. For this purpose, a cognitive-behavioral intervention was carried out with the child and their parents. Through education, the child's parents were alerted to the need to express the feeling of loss, providing an environment for the resolution of the grieving process of all family members. Furthermore, they were also warned about the maintenance factors of the child's anxiety symptoms, such as the issue of high parental demand. As a result, it can be concluded that good therapeutic gains were seen, translating into the resolution of the child's problems and, consequently, increasing their psychological well-being.

Cross-sectional and longitudinal associations of park coverage, greenness exposure and neighbourhood median household income with children's depressive and anxiety symptoms.

Internalising symptoms and disorders often emerge in childhood and are associated with negative health outcomes into adulthood. Studies have shown neighbourhood characteristics (e.g. socio-economic composition, greenspace exposure) to be associated with depression and anxiety symptoms in adults; however, research that explores these relationships longitudinally in children is lacking. This study examined cross-sectional and longitudinal associations of neighbourhood characteristics with developmental trajectories of internalising symptoms in 202 children (ages 8-12) from the Mothers' and Their Children's Health (MATCH) Study. The MATCH Study is a Los Angeles-based longitudinal observational investigation of children's health outcomes with six semi-annual assessment waves across 3 years. Latent growth curve modelling was used to examine cross-sectional and longitudinal associations between child's self-reported anxiety or depressive symptoms and their neighbourhood's park coverage, greenness exposure and median household income. All models included the following as covariates: child's age, sex, ethnicity, family household income and mother's mental health measures. Cross-sectionally, results indicated that neighbourhood median household income was negatively associated with children's depressive symptoms at baseline. Longitudinally, neighbourhood median household income was associated with steeper increases in children's depressive symptoms. Neither greenness exposure nor park coverage was associated with children's depressive or anxiety symptoms cross-sectionally or longitudinally. Childhood plays a key factor in setting the foundations for healthy mental, social, physical and cognitive growth. Our study suggests future mental health prevention programmes in youth should cater to a multilevel approach that integrates individual, familial and neighbourhood interventions and pay special attention to their neighbourhood SES levels.

Children's appraisals of threat in pediatric cancer

PurposeAlthough many children with cancer cope well with challenges, some experience distress that results in poor adjustment. Children's perceptions of threat may be one explanation for heterogeneity in outcomes, but relatively little is known about what children find threatening. This study aimed to describe the threats that children report. MethodYouth (4–18 years old) newly diagnosed with cancer and their primary/parent caregivers (PC) participated in a multi-method study. Appraisals of threat were assessed via self-report and a narrative technique at two weeks post-diagnosis. PCs reported children's anxiety and depressive symptoms three months post-diagnosis and children reported their quality of life (QOL) six months post-diagnosis. ResultsYouth reported various types of threatening events (e.g., receiving the cancer diagnosis, fear or pain of procedures) across multiple domains (e.g., threat to self, physical threat, threat of loss). Adolescents tended to report threat to life (e.g., the seriousness of the diagnosis itself) whereas younger children reported other threats (e.g., procedural pain). Children with high perceived threat to self had higher subsequent anxiety symptoms and lower QOL compared to those with low appraisals of threat to self. There was also a significant mean difference between high and low appraisals of threat of loss in child reported QOL. ConclusionsYouths’ reported threats, as well as how threat appraisals related to adjustment outcomes in distinct ways, underscores the developmental nature of how youth interpret medically stressful events and the utility of developmentally sensitive assessment. Understanding perceived threat could ultimately inform efforts to foster positive long-term adaptation for youth with cancer.

Examining Associations Between Amygdala Volumes and Anxiety Symptoms in Autism Spectrum Disorder

BackgroundAnxiety is one of the most common co-occurring conditions in people with autism spectrum disorder. The amygdala has been identified as being associated with anxiety in populations with and without autism, yet associations in autism were based on relatively small or developmentally constrained samples, leaving questions as to whether these results hold at different developmental ages and in a larger, more robust sample. MethodsStructural neuroimaging and parent report of anxiety symptoms of children ages 5–13 years with (n = 123) and without (n = 171) a diagnosis of autism were collected from the University of Maryland and three sites from the Autism Brain Imaging Data Exchange. Standardized residuals for bilateral amygdala volumes were computed adjusting for site, hemispheric volumes, and covariates (age, sex, Full Scale IQ). ResultsClinically significant anxiety symptoms did not differentiate amygdala volumes between groups (i.e., autism and anxiety, autism without anxiety, without autism or anxiety). No significant association between left or right amygdala volumes and anxiety scores was observed among the sample of individuals with autism. Meta-analytic and Bayes factor estimations provided additional support for the null hypothesis. Age, sex, and autism severity did not moderate associations between anxiety and amygdala volumes. ConclusionsNo relation between amygdala volumes and anxiety symptoms in children with autism was observed in the largest sample to investigate this question. We discuss directions for future research to determine whether additional factors including age or method of assessment may contribute to this lack of association.

Lower serum selenium concentration associated with anxiety in children

PurposeFew studies have examined the role of selenium in anxiety. This study aimed to evaluate the association between serum selenium concentrations and anxiety disorders and symptoms in children. Design and methodsThis study utilized data from 831 children participating in the China Jintan Child Cohort Study (mean age = 12.67 years; 46.1% female). Serum selenium samples were collected and anxiety was assessed using the Chinese version of the Screen for Child Anxiety Related Disorders. Six types of anxiety scores were calculated, including total anxiety, panic/somatic, generalized anxiety, separation anxiety, social anxiety, and school phobia. ResultsControlling for covariates, children with lower serum selenium concentrations were more likely to meet clinical cutoffs for total anxiety (OR = 0.992, p < 0.01), panic/somatic disorder (OR = 0.993, p < 0.05), generalized anxiety disorder (OR = 0.990, p < 0.05), social anxiety disorder (OR = 0.991, p < 0.01), and school phobia (OR = 0.989, p < 0.01), but not separation anxiety (OR = 1.000, p > 0.05). Controlling for covariates, lower serum selenium concentrations were also associated with higher continuous total anxiety, generalized anxiety, and school phobia scores (p < 0.05). ConclusionsLower serum selenium concentrations were associated with higher anxiety. To our knowledge, this was the first study to examine the relationship between serum selenium and anxiety disorders in a sample of children. Results indicate an association between children's micronutrient levels and anxiety disorders. Practice implicationsImproving child nutrition may be a promising strategy to help reduce childhood anxiety.

Prevalence and Risk Factors of Post-traumatic Stress Disorder Symptoms in Students Aged 8-18 in Wuhan, China 6 Months After the Control of COVID-19.

Objectives: To explore the prevalence of post-traumatic stress disorder (PTSD) symptoms and the factors influencing mental health symptoms in students aged 8–18 in Wuhan, China at 6 months after the COVID-19 pandemic was controlled.Methods: Questionnaires were distributed to students aged 8–18 in Wuhan through an online platform from September to October 2020, and 15,993 valid surveys were returned, resulting in a response rate of 75.4%. The data related to symptoms of PTSD, anxiety, depression, stress and psychological inflexibility levels, as well as demographic information about the population. Hierarchical multiple regression analyses were performed to examine the predictive effects.Results: In total, 11.5% of the students met the criteria for clinically concerning PTSD symptoms. Psychological inflexibility was associated with PTSD symptoms, depression, anxiety, and stress symptoms (β = 0.45, 0.63, 0.65 and 0.69, respectively, with ΔR2 = 0.16, 0.32, 0.34 and 0.39, respectively, p < 0.001) in children and adolescents.Conclusion: This study investigated the impacts of COVID-19 on the mental health status among students aged 8–18 in Wuhan. Even at 6 months after the outbreak was brought under control, some students were still affected. Psychological inflexibility was correlated with psychological symptoms in students. Therefore, methods to reduce psychological inflexibility may help improve the mental health states of students as part of psychological interventions.

Targeting risk factors for inhibited preschool children: An anxiety prevention program

ObjectiveChildren with a behaviorally inhibited temperament during early childhood have been shown to have an increased risk for developing anxiety disorders. This study evaluated the efficacy of an anxiety prevention program aimed at reducing the risk of anxiety in behaviorally inhibited preschool children. MethodParticipants were 86 children aged 41–57 months and their mothers. Children were selected if their mothers reported high levels of child behavioral inhibition on a screening measure. Participants were randomly allocated to a nine-session intervention or a waitlist control condition. Mothers and children both participated in the intervention. Results. At follow-up, the intervention group had significantly fewer clinician-rated child anxiety disorders and fewer mother-reported child anxiety symptoms than at baseline but this change was not significantly different to the change seen in the waitlist control group. ConclusionsOn average, across the course of the study, anxiety decreased in all children irrespective of group. A number of potential reasons for this are discussed along with implications for research and clinical practice.

Exploring risk factors of food and alcohol disturbance (FAD) in U.S. college students.

Current research examining mental health and history of childhood trauma as risk factors of food and alcohol disturbance (FAD) is limited. College students may be at greater risk to engage in FAD behaviors because of the common co-occurrence of alcohol misuse and disordered eating behaviors within college populations. Therefore, the current study examined anxiety, depression, and adverse childhood experiences as possible risk factors of FAD behaviors in a college student sample. Two-hundred and seven undergraduate students from a large Midwest university completed a cross-sectional survey assessing history of adverse childhood experiences, depressive symptoms, anxiety symptoms, FAD behaviors, and frequency of alcohol use. Current symptoms of generalized anxiety were significantly associated with engagement in FAD behaviors (Alcohol Effects subscale,β = 0.13,F(1, 204) = 4.10,p = 0.04; Bulimia subscale,β = 0.17,F(1, 204) = 6.19,p = 0.01; Diet and Exercise subscale,β = 0.19,F(1, 204) = 9.05,p < 0.01).Adverse childhood experiences were associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.14, F(1, 204) = 4.27, p = 0.04). Current depressive symptoms were not significantly associated with FAD behaviors. Study findings suggest that students who experience greater current symptoms of anxiety are at a greater risk to engage in FAD behaviors. Further understanding the role of anxiety in the development and maintenance of FAD behaviors may provide clinically useful information for the prevention and treatment of FAD behaviors. These findings highlight the need for further research to examine psychological distress as a risk factor for engagement in FAD behaviors longitudinally, in a larger, more diverse study sample. Level V, cross-sectional descriptive study.

Frequency of Anxiety, Depression, and Irritability Symptoms in Children During the COVID-19 Outbreak and Potential Risk Factors Associated With These Symptoms.

The aim of this study was to determine the frequency of anxiety, depression, and irritability symptoms in children during the COVID-19 outbreak and to investigate the associated factors of these symptoms. This study was conducted with 1071 children aged 6 to 17. Results showed that 49.9% of the participants had anxiety symptoms, 29.5% had depression symptoms, and 51.4% had irritability symptoms. Low age was a potential risk factor for anxiety symptoms. Female sex was a potential risk factor for anxiety and depression symptoms. A COVID-19 death in the family or environment was a potential risk factor for depression and irritability symptoms. Exposure to COVID-19 information on television and on the internet was a potential risk factor for anxiety, depression, and irritability symptoms. In conclusion, this study revealed that the COVID-19 outbreak may have serious effects on the mental health of children, and the study highlighted potential risk factors.

Combined Emotional Socialization Training and Family Accommodation Modification: Impact on Emotional Regulation and Anxiety Symptoms in Anxious Children

Past studies show that emotional socialization and family accommodation are involved in children's anxiety, but research has yet to investigate whether targeting emotional socialization training (EST), family accommodation modification (FAM), or EST and FAM in tandem can reduce anxiety in children. The purpose of this study was to evaluate the efficacy of a combination of EST and FAM on improving emotion regulation (ER) and reducing anxiety symptoms in anxious children. The sample consisted of 80 children with an anxiety disorder (Mage = 6.7, SD = 0.1) and their mothers. Mothers were randomly assigned to an EST (n = 17), FAM (n = 16), Combined (n = 17), or a waitlist control (WLC) (n = 16) groups. Mothers completed The Emotion Regulation Checklist (ERC) and Spence Children’s Anxiety Scale (SCAS) at pre-test, post-test, and at 6-month of follow-up. The results showed that the EST, FAM, and Combined groups were more effective than WLC in improving ER and reducing anxiety severity at post-test and follow-up. Among the intervention groups, children in the combined group showed greater reductions in the severity of anxiety symptoms and emotion dysregulation than the other two groups. Assisting parents to use strategies that encourage healthy emotion regulation and decrease family accommodation might help reduce the severity of children's anxiety symptoms.

Health anxiety symptoms in Danish children during the first lockdown period of the COVID-19 pandemic: an Odense Child Cohort study

Purpose The coronavirus disease 2019 (COVID-19) pandemic has a severe impact on the general population. During the pandemic, children may develop emotional and psychological symptoms, including increased worries about health and illness, known as health anxiety symptoms (HASs). We aimed to explore HAS in 7–9-year-old children from the Danish Odense Child Cohort (OCC) during the first COVID-19 lockdown period in Denmark, and to examine associations with potential risk factors. Material and methods OCC is a cohort of children born between 2010 and 2012, which originally recruited 2874 of 6707 pregnancies (43%). Among the current OCC population of 2430 singleton children, 994 participated in this study (response rate 40%). Children and their parents filled out questionnaires about child HAS, family exposure to COVID-19 infection and parental HAS. Adjusted odds ratios (aORs) were calculated between high score child HAS (≥90th percentile) and covariates by use of logistic regression. Results Most children (n = 686, 69%) reported few worries about their health. Children reporting high score HAS also had higher levels of internalizing symptoms at age 5; aOR 2.15 (1.20;3.85), p = .010, and higher levels of maternal and paternal HAS; aOR 2.40 (1.44;3.97), p = .001, and 2.00 (1.10;3.65), p = .023, whereas no association with child sex or familial exposure to COVID-19 was detected (n = 65, 6.5%). Conclusions High score child HAS during the first lockdown period of the COVID-19 pandemic was not associated with family exposure to COVID-19 infection, but to being a more anxious child a priori and to HAS in parents.

The psychological impact of COVID-19 quarantine on children, and the role of parental support and physical environment design

Coronavirus disease 2019 is a contagious infection that caused a global lockdown and affected children who needed to stay home. There is a lack of knowledge about the role of parental stress and physical environment design on children’s mental wellbeing in quarantine. We hypothesis that COVID-19 quarantine affected child mental health, and that paternal stress or support, and child physical environment including household space, colors, sunlight exposure, and natural views, impacted child mental wellbeing in the quarantine. To assess the effect of quarantine on a child’s mental health, an online survey was administered globally through scientific organizations and social media. Those over 18 years old, and guardians of children were asked to participate in the survey. The survey was filled by 114 guardians from 31 countries. Descriptive statistics were used to summarize the data. Most participants experienced stress in the quarantine and reported child anxiety symptoms including focus reduction, sleeping difficulties, and appetite changes. Family fun activities and encouraging words, were mostly successful in reducing child anxiety. Reporting anxiety symptoms in children were more common in parents who had mental hardships compared to those who did not experience mental problems or had an improved mental status. Physical environment assessment showed that households with bright walls associated with fewer reports of child mental problems compared to households with neutral wall colors, and that most guardians thought that their children’s living space was not sufficient to play and study. Architects can provide evidence-based recommendations for customers to support children’s mental health.

Developmental associations between risk-taking and anxiety symptoms across ages 8-12years.

This study explored the transactional association between anxiety symptoms and risk‐avoidance in Dutch elementary schoolchildren (N = 1200; 50% girls) across ages 8–12. Anxiety symptoms were obtained using self‐, peer‐, and teacher‐reports. Risk‐avoidance was measured using the Balloon Analogue Risk Task—Youth Version. Random‐intercept cross‐lagged panel models showed that, across informants, increases in anxiety symptoms predicted decreases in risk‐taking. Apart from minor exceptions, this effect was similar across sexes. For peer‐reports, the reverse path from decreases in risk‐taking to increased anxiety was also found. Overall, this study gives insight into the developmental link between symptoms of anxiety and risk‐avoidance which is important for early signaling and prevention as well as for our understanding of the consequences of childhood anxiety symptoms.

Differences in Patient and Parent Informant Reports of Depression and Anxiety Symptoms in a Clinical Sample of Transgender and Gender Diverse Youth.

Purpose: We assessed characteristics of patients at a pediatric gender clinic and investigated if reports of mental health concerns provided by transgender and gender diverse (TGD) youth patients differed from reports provided by a parent informant on their behalf. Methods: This cross-sectional study included 259 TGD patients 8 to 22 years of age attending a pediatric gender clinic in the southeast United States from 2015 to 2020. Pearson correlations and paired sample t-tests compared patient-reported mental health concerns at patient intake with those provided by a parent informant. Clinical symptom severity was assessed with standardized T-scores. Level 2 Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress-Depression Scale and Level 2 PROMIS Emotional Distress-Anxiety Scale assessed depression and anxiety symptoms of patients. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure was used with parents. Results: Patients had a mean age of 14.9 at first visit, with most identifying as White (85.5%), non-Hispanic (91.1%), and as a boy or man (63.6%). Half had moderate-to-severe depression (51.2%) or anxiety (47.9%) symptoms. There was a moderate, positive correlation between patient-reported and parent-reported depression symptoms, with no correlation for anxiety symptoms. Informant type differences were statistically significant (patients reporting greater depression and anxiety symptoms). Conclusions: TGD youth patients reported more severe depression and anxiety symptoms compared with parent informants. Despite moderate agreement on depression symptoms, parents did not accurately detect their child's anxiety symptoms. These discrepancies highlight a need for interventions which increase parental recognition of child mental health status.