Child Self-report Measures Research Articles

Prevention of internalizing difficulties in the middle years: Protocol for a noninferiority randomized trial of Mindfulness-Based Cognitive Therapy for Children and Cognitive Behavioural Therapy.

Mindfulness-based interventions have been tested as preventive programs for childhood internalizing difficulties, but most research has been at a 'universal' level with small to null effects. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has similar effects to Cognitive Behaviour Therapy (CBT) when used as a small-group, targeted preventive program. Knowledge gaps include the longer-term effectiveness of MBCT-C relative to CBT and the benefits of adding a parent module. This trial aims to compare MCBT-C to traditional CBT, including a parent module, to 15-months post-intervention and to test the feasibility and acceptability of adding a parent module. Participants will be recruited from primary schools in areas of socio-economic disadvantage in South Australia (n = 194). Children (aged 9-12) years with signs of internalizing difficulties (e.g., shy, withdrawn, worried), and their parents, will be eligible for this two-armed randomized controlled non-inferiority trial (RCT). Children will participate in 10 group sessions of MBCT-C or CBT, facilitated by psychologists, and parents from both conditions will participate in two parent-only group sessions. Child self-report measures include depression and anxiety, as well as attention, mindfulness and self-compassion. Parent measures include symptoms of depression and anxiety, mindfulness, and parent-child relationship strength. The primary outcome will be child anxiety and depression (Revised Child Anxiety and Depression Scale-25). Measures will be collected pre and post intervention, and at 3, 6, 12 and 15-month follow up. Schools will be recruited from October 2022. Nomination of children will commence from February 2023. Program implementation will begin May 2023. This trial will have implications for the feasibility of involving parents in preventative programs, as well as whether mindfulness-based interventions prevent internalizing difficulties over time.

Friendship interventions for children with neurodevelopmental needs: A systematic review and meta-analysis

Rationale Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. Objective To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. Method Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. Results Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). Conclusion Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.

Exploring listening-related fatigue in children with and without hearing loss using self-report and parent-proxy measures.

Children with hearing loss appear to experience greater fatigue than children with normal hearing (CNH). Listening-related fatigue is often associated with an increase in effortful listening or difficulty in listening situations. This has been observed in children with bilateral hearing loss (CBHL) and, more recently, in children with unilateral hearing loss (CUHL). Available tools for measuring fatigue in children include general fatigue questionnaires such as the child self-report and parent-proxy versions of the PedsQLTM-Multidimensional Fatigue Scale (MFS) and the PROMIS Fatigue Scale. Recently, the Vanderbilt Fatigue Scale (VFS-C: child self-report; VFS-P: parent-proxy report) was introduced with a specific focus on listening-related fatigue. The aims of this study were to compare fatigue levels experienced by CNH, CUHL and CBHL using both generic and listening-specific fatigue measures and compare outcomes from the child self-report and parent-proxy reports. Eighty children aged 6-16 years (32 CNH, 19 CUHL, 29 CBHL), and ninety-nine parents/guardians (39 parents to CNH, 23 parents to CUHL, 37 parents to CBHL), completed the above fatigue questionnaires online. Kruskal-Wallis H tests were performed to compare fatigue levels between the CNH, CUHL and CBHL. To determine the agreement between parent-proxy and child self-report measures, Bland-Altman 95% limits of agreement were performed. All child self-report fatigue measures indicated that CBHL experience greater fatigue than CNH. Only the listening-specific tool (VFS-C) was sufficiently able to show greater fatigue in CUHL than in CNH. Similarly, all parent-proxy measures of fatigue indicated that CBHL experience significantly greater fatigue than CNH. The VFS-P and the PROMIS Fatigue Parent-Proxy also showed greater fatigue in CUHL than in CNH. Agreement between the parent-proxy and child self-report measures were found within the PedsQL-MFS and the PROMIS Fatigue Scale. Our results suggest that CBHL experience greater levels of daily-life fatigue compared to CNH. CUHL also appear to experience more fatigue than CNH, and listening-specific measures of fatigue may be better able to detect this effect. Further research is needed to understand the bases of fatigue in these populations and to clarify whether fatigue experienced by CBHL and CUHL is comparable in nature and degree.

Self-Reported Communication Attitudes of Children With Childhood Apraxia of Speech: An Exploratory Study.

Much of the research literature on childhood apraxia of speech (CAS) has focused on understanding, diagnosing, and treating the impairment, rather than examining its functional effect on children's daily lives. This study focuses on the Personal Factors component of the World Health Organization International Classification of Functioning, Disability and Health-Children and Youth Version Framework. Specifically, the purpose was to examine the self-reported communication attitudes of children with CAS. Two validated communication attitude questionnaires were administered to 12 children with CAS enrolled in an intensive speech-focused intervention (age range: 4-10 years old). Children's scores were compared to the questionnaires' typically developing norms. Descriptive analyses explored relationships between communication attitude and CAS severity, caregiver perceptions of communicative participation, frustration ratings during therapy, and change in communication attitude over a brief time. Older (ages 6-10 years) but not younger (ages 4-5;11 [years;months]) children with CAS were more likely to have negative attitudes about their speech. No clear relationships were observed between communication attitudes and caregiver perceptions of communicative participation; small positive relationships were observed between communication attitude and frustration during therapy. For the younger children, there was also a relationship with CAS severity. For most children, no change in communication attitude was observed over a brief period, though one child appeared to develop more negative and one appeared to develop more positive attitudes. These initial findings suggest that older children with CAS may be at greater risk for negative communication attitudes than their peers without CAS. The findings also highlight the need to include more child self-report measures in research. Further implications for CAS assessment and intervention are discussed. https://doi.org/10.23641/asha.21834432.

A systematic literature review of child self-report measures of emotional wellbeing during primary to secondary school transitions

A systematic literature review of child self-report measures of emotional wellbeing during primary to secondary school transitions

Measuring child coping in times of societal crises: Pilot development, reliability, as well as mental health and meaning mindset convergent validity of the children's crisis coping scale (3Cs).

To date, there are no brief child self-report coping measures for the pandemic and other major societal events resulting in social or learning disruptions for children. Ignoring the voice of children can ultimately result in programs or services that fail to meet their needs. Thus, a child self-report measure called the 3Cs (Children's Crisis Coping) was developed and underwent pilot evaluation. This measure was designed in collaboration with key stakeholders using a Knowledge Translation-Integrated development framework. Some of the primary concerns that were relevant in the literature for the development of a pandemic coping measure included stress, worries, loneliness, and unpredictable school changes. The completed 4-item measure, grounded in these concerns, demonstrated good internal consistency reliability, as well as convergent validity with mental health and meaning mindset. A Second Wave Positive Psychology framework is presented concerning a spiritual concept called "meaning mindset" and it's association with positive societal crisis coping (i.e., pandemic coping in the present study).

Children's disaster trauma in Haiti: Configurations of similarities and dissimilarities in experiences.

The 2010 earthquake in Haiti, an urgent crisis, occurred in the context of persistent social dysfunctions, amplifying both the chronic poor living conditions and adversities for children and families. The present study sought to gain better understanding of the ways Haitian children respond during times of adversity. The House-Tree-Person (HTP) drawing test, culturally adapted for Haitians (Roysircar et al., 2017, 2019a, 2019b), was used to assess Resilience and Vulnerability in 75 Haitian children's 225 drawings to map the spatial configurations of their trauma experiences in the aftermath of the 2010 earthquake and continuous trauma. Assessment data also included interviews with child self-report measures of self-esteem perceived by self, peers, and family; posttraumatic symptoms; and self-concept. Data analyses involved standardization of sample scores and reliability tests. Classical multidimensional scaling (MDS) examined relationships among variables of resilience, vulnerability, self-esteem, posttraumatic symptoms, and self-concept. MDS stress was reduced considerably with two dimensions, and there was minimal further reduction in stress with three or more dimensions. Furthermore, the two latent dimensions in Haitian children's mental health, called Feeling Unloved and Balance of Good and Evil, were interpretable within the conceptualization of the study and the literature on Haitians' and other disaster survivors' adaptive worldview. The authors' long-term investment in the people of Haiti increased trust, participation, research rigor, and cultural alignment of interventions, including the adaption of the HTP as a culturally sensitive and clinically useful instrument. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The development of empathy in child maltreatment contexts

BackgroundDespite robust associations between child maltreatment experiences and emotional development, a paucity of research examines the influence of child maltreatment on empathy development, and still fewer studies differentiate these effects across maltreatment subtypes. ObjectiveThe present study examined the development of children's empathy from ages six to eight, as predicted by maltreatment, and as moderated by children's attachment representations. Participants and settingParticipants were a community sample of 250 children followed longitudinally and assessed in a laboratory setting with their primary caregivers. MethodChild maltreatment experiences from birth to age six were assessed by semi-structured interviews with caregivers, which were rated according to widely-used child maltreatment coding protocols, and by caregiver and child self-report measures. Child empathy was assessed at ages six and eight by caregiver-report. Attachment representations were observed in children using the MacArthur Story Stem Battery. ResultsChild emotional abuse (β = −0.150, p = .012) and child neglect (β = −0.137, p = .016) predicted decreased empathy at age eight, whereas child physical abuse (β = 0.132, p = .027) and child exposure to domestic violence (β = 0.164, p = .004) predicted increased empathy at age eight. Further, children's negative representations of mother figures moderated the positive association between child physical abuse and empathy (β = −0.177, p = .005), such that the association became weaker as negative representations increased. ConclusionsThese results highlight the nuanced ways in which child maltreatment experiences of different subtypes contribute to the development of empathy in school-aged children.

Measuring Violence Against Children: A COSMIN Systematic Review of the Psychometric Properties of Child and Adolescent Self-Report Measures

Research on violence against children (VAC) requires meaningful, valid, and reliable self-report by children. Many instruments have been used globally and decisions to select suitable measures are complex. This review identifies child and adolescent self-report measures that are most likely to yield valid, reliable, and comparable data in this field. A systematic review (PROSPERO: CRD4201706) was conducted using the 2018 Consensus-based Standards for the selection of health Measurement Instrument (COSMIN) criteria. Six electronic databases and gray literature were searched. Manuscripts published in English and describing the development and psychometric qualities of child/adolescent self-report instruments were included. Thirty-nine original instruments and 13 adaptations were identified in 124 studies. The quality of evidence ranged from “very low” to “high” depending on the measure and the psychometric properties assessed. Most measures were not widely used, and some have been applied in many settings despite limited evidence of their psychometric rigor. Few studies assessed content validity, particularly with children. The ACE, CTQ, CTS-PC, CECA, ICAST, and JVQ have the best psychometric properties. An overview of items measuring frequency, onset, duration, perpetrators, and locations is provided as well as an assessment of the practicalities for administration to help researchers select the instrument best suited for their research questions. This comprehensive review shows the strengths and weaknesses of VAC research instruments. Six measures that have sufficient psychometric properties are recommended for use in research, with the caveat that extensive piloting is carried out to ensure sufficient content validity for the local context and population.

Measuring self-efficacy in defecation: Validation and utilization of a Chinese version of the self-efficacy for functional constipation questionnaire (SEFCQ) in a pediatric population.

Self-efficacy in defecation plays an important role on behavioral therapy for functional constipation (FC). There is an unmet need for valid child self-report measures of task-specific self-efficacy for pediatric FC. Our aim was to cross-culturally validate the Self-Efficacy for Functional Constipation Questionnaire (SEFCQ) and to explore the salient factor(s) of self-efficacy in defecation that correlate with anxiety and constipation symptom severity among Chinese children. The SEFCQ was adapted to Chinese version following the Rome Foundation guidelines for the translation of questionnaires. Two hundred and three children with FC were involved in psychometric testing. Confirmatory factor analysis was conducted to determine the structure of the SEFCQ. Construct validity was evaluated by testing the relationship between the SEFCQ and both anxiety and the Patient Assessment of Constipation Symptoms (PAC-SYM). Test-retest reliability, internal consistency, and interfactor correlation were used to evaluate reliability. Hierarchical multiple regression was used to identify salient self-efficacy for FC that correlates with anxiety and constipation symptom severity. Confirmatory factor analysis supports the two-factor structure of the SEFCQ. Adequate test-retest reliability (r=0.973, p<0.001) and internal consistency (Cronbach's α=0.871) were obtained. Both self-efficacy factors were significantly associated with anxiety (r=-0.227 to -0.350, p<0.001) and PAC-SYM (r=-0.495 to -0.602, p<0.001), with emotional self-efficacy being the most salient factor for predicting the symptom severity of constipation after controlling for sex, age, quality of parents' marriage, and family history. The SEFCQ showed satisfactory psychometric properties. Low self-efficacy in defecation correlates with anxiety and may contribute to poor adherence to behavior change, which exacerbates the symptoms of constipation. Further study is needed to apply social cognitive intervention to increase children's self-efficacy in defecation and assess its effect on treatment outcomes.

How do children and youth with autism spectrum disorder self-report on behavior? A study of the validity indexes on the Behavior Assessment System for Children, Second Edition, self-report of personality.

Using self-report questionnaires is an important method in the assessment and treatment of children with autism. Self-reports can provide unique information about children's feelings and thoughts that is not available through other methods such as parent-reports. However, many clinicians are not sure whether children with autism can provide accurate self-reports. To study this, we examined 139 children and youth with and without autism aged 8-17 years. We looked at the effect of having autism, as well as other factors such as age, intelligence quotient, and attention problems on the validity of self-reports in these children. We examined if the children gave overly negative or positive answers and if they responded to the questions randomly or without paying attention. We found that children with autism can provide acceptable self-reports. However, they have more validity problems compared to their peers without autism. Our findings showed that this difference might be related to having attention problems in addition to autism, rather than having autism by itself. Children, with and without autism spectrum disorder, with fewer attention problems and higher intelligence quotient scores and those in the older age group, showed better validity. This article suggests that clinicians can use self-report measures for children with autism, but they should pay attention to important factors such as children's intelligence quotient and attention problems.

Assessing whether child and parent reports of the KINDL questionnaire measure the same constructs of quality of life in children with attention-deficit hyperactivity disorder

BackgroundDiscrepancy between child self-report and parent proxy-report has long been documented in the health-related quality of life (HRQoL) measurement of children with chronic health conditions. This study aims to assess whether child and parent reports of the Kinder Lebensqualität fragebogen (KINDL) questionnaire measure the same construct of HRQoL in children with attention-deficit hyperactivity disorders (ADHD).MethodsParticipants were 122 Iranian children with ADHD and 127 of their parents, who completed the child and parent reports of the KINDL, respectively. Internal consistency of the child and parent reports were assessed by Cronbach's alpha. The intra-class correlation (ICC) coefficient and factor analysis were applied to assess whether the child self-report and the parent proxy-report measured the same construct of HRQoL. Additionally, convergent and discriminant validity were assessed using the Spearman correlation.ResultsThe results of factor analysis revealed that the child self-report and parent proxy-report measure two different aspects of HRQoL. Moreover, both versions of the KINDL instrument showed excellent convergent and discriminant validity. The internal consistency was close to or greater than 0.7 for all domains of both child and parent reports.ConclusionsAlthough the child self-report and the parent proxy-report of the Persian version of the KINDL have good psychometric properties, they are not interchangeable. This finding indicates that Iranian children with ADHD and their parents evaluate children's HRQoL from their own viewpoints.

Examining Student–Teacher Relationship and Callous–Unemotional Traits in Children with Adverse Childhood Experiences

Aggression in childhood has been linked to short- and long-term negative outcomes. One area of aggression that has gained attention in the literature is the construct of callous/unemotional (C/U) traits, which have also been associated with deleterious outcomes. Theoretical support for associations between C/U traits and adverse childhood experiences (ACEs) is largely based on retrospective research conducted in adult populations, while there remains a dearth of research examining these relations in children. This study aimed to evaluate associations between ACEs and C/U traits and the student–teacher relationship (STR) as a moderator of these associations. Participants included male students between the ages of 6 and 14 attending school in a residential treatment setting (N = 86) and their teachers. Cross-sectional data were collected from educational files, child self-report measures, and teacher-report measures. Main and interaction effects were estimated within path models that included callous, uncaring, and unemotional traits as multiple outcomes. Significant interaction effects of both STR conflict and closeness emerged on the association between ACEs and callous traits (β = .12; p = .03 and β = − .10; p = .04, respectively). At high levels of STR conflict and low levels of STR closeness, there was a significant positive association between ACEs and callous traits. This association was only marginally significant at low levels of conflict and high levels of closeness. Findings highlight how the STR might exacerbate or mitigate callousness in children with a history of ACEs and thereby help to inform clinical and educational practices for high-risk youth.

Sleep in New Zealand children aged 7-9: associations with ethnicity, socioeconomic status, and achievement in reading and mathematics.

The aims were (1) to investigate differences by ethnicity and socioeconomic status (SES) in objective measures of sleep in children aged 7-9 years and (2) determine whether measures of sleep predict child achievement in reading or mathematics after controlling for ethnicity and SES. Four groups of parent-child dyads were recruited: Māori, low-SES schools (n = 18); Māori, high-SES schools (n = 17); New Zealand European, low-SES schools (n = 18); New Zealand European, high-SES schools (n = 17). Child sleep was measured by actigraphy. Parents and teachers reported child daytime sleepiness and behavior, and children completed a self-report of anxiety symptoms. Teachers also reported on child achievement in reading and mathematics. Children from low-SES schools went to bed later on school nights (F[1,68] = 12.150, P = .001) and woke later (F[1,68] = 15.978, P < .001) than children from high-SES schools but had similar sleep duration. There were no differences related to ethnicity. Children from low-SES schools were almost 3 times more likely to be below national standards for mathematics. Children not meeting academic standards in mathematics had a later sleep start time, lower sleep period efficiency, and a decreased total sleep time. However, when SES and sleep period efficiency were modeled together neither were found to significantly influence achievement in mathematics. In this study, SES influenced sleep timing but not the quality and quantity of sleep in 7- to 9-year-old children, and a significant independent effect of sleep efficiency on learning could not be demonstrated.

Convergent and Ecological Validity of Mother and Child Reports of Children’s Depressive Symptoms: Evidence from a Diverse Sample of Mother–Child Dyads

This study investigated the convergent and ecological validity of a multi-informant approach through retrospective measures and ecological momentary assessment (EMA) from mother–child dyads. In 202 mother–child dyads, mothers completed parent-proxy retrospective measures of their child’s depressive symptoms and their own depressive symptoms. Children completed self-report retrospective measures of their own depressive symptoms, self-esteem, and sleep quality; and self-report EMA of affect across 8 days. Results showed that parent-proxy and child self-report retrospective measures of depressive symptoms were weakly positively correlated (r = 0.23); this association was stronger for non-Hispanic mothers compared to Hispanic mothers (p = 0.048). Parent-proxy retrospective measures were moderately positively associated with the mothers’ own retrospectively reported level of depressive symptoms (r = 0.33). Parent-proxy and child self-report retrospective measures were negatively associated with the children’s average EMA happiness (p = 0.001 and p = 0.003, respectively), but only the children’s retrospective measures were positively associated with EMA sadness (p = 0.001). In multivariable models, the children’s retrospectively reported depressive symptoms were significantly associated with lower self-esteem and reduced sleep quality, while parent-proxy retrospective reports were only associated with the mother’s own depressive symptoms. Overall, the current study provides evidence for the convergent and ecological validity of children’s self-reports of depressive symptoms. However, there was limited validity for parent-proxy reports, and parent-proxy reports may be highly influenced by the mothers’ depression.

Pathways From Early Family Violence to Adolescent Reactive Aggression and Violence Victimization.

The current study examined how early childhood (EC) family violence and risk (i.e., maternal aggression, sibling aggression, environmental risk) predicted early adolescent (EA) reactive physical and relational aggression and violence victimization through middle childhood (MC) parenting (i.e., guilt induction, power assertive discipline). Mother-infant dyads (N = 216; 72% African American) were recruited as part of a larger longitudinal study on prenatal cocaine and other substance exposure. Observations, interviews, and maternal and child self-report measures were collected from dyads in early childhood (1 to 36 months), middle childhood (84 months), and early adolescence (12 to 15 years). A cascading path model was specified where current variables were regressed on variables from the preceding time point. Primary results showed that environmental risk and EC child physical aggression predicted higher levels of MC caregiver power assertive discipline, which subsequently predicted lower levels of EA reactive relational aggression. Maternal substance use in pregnancy and the child's continuous placement with biological caregivers predicted higher levels of reactive physical aggression in EA. Finally, MC physical aggression and EA reactive relational aggression predicted higher levels of EA violence victimization. There were a series of direct paths from early childhood family violence and demographic factors to reactive aggression and violence victimization. The current study underscores the importance of evaluating multiple facets of family violence and risk when evaluating aggressive behavior and victimization.

How the Affective Reactivity Index (ARI) works for teachers as informants

BackgroundThe Affective Reactivity Index (ARI) is a brief instrument originally designed as a self- and parent report. However, the view of teachers, who can observe social situations that may give rise to irritability, is relevant. The goal is to provide the measurement qualities of the ARI score as reported by teachers. MethodChildren formed part of a longitudinal study on behavior problems in Barcelona (Spain) and they were assessed when they were 7 (N = 471) and 11 years old (N = 454) with questionnaires about psychopathology, anger and aggressive behavior, and a diagnostic interview answered by the parents, youths and teachers. Confirmatory factor analysis, measurement invariance, reliability and validity were studied for the ARI answered by teachers. ResultsThe 6-item, 1-factor model fitted well. Almost full metric invariance and partial scalar invariance was obtained across sex and over age. The ARI scores largely converged with other teacher-reported measures of anger and irritability, and with other measures of psychopathology, aggressive behavior, and callous-unemotional traits at a medium level. The associations with parent's measures were medium to low, and very low for child self-reported measures. The ARI scores significantly differentiated children with and without psychopathology and functional impairment, both cross-sectionally and longitudinally. LimitationsOnly one child self-report measure of irritability included. Limited internal consistency of some scale scores. Findings are mostly generalizable to Spanish children. ConclusionsARI could be a suitable instrument for measuring irritability as reported by teachers. The teacher's view can be useful when planning treatment by helping to identify treatment targets.

Fatigue in young people with Duchenne muscular dystrophy.

To describe fatigue in Duchenne muscular dystrophy (DMD) from patients' and parents' perspectives and to explore risk factors for fatigue in children and adolescents with DMD. A multicentre, cross-sectional study design was used. Seventy-one patients (all males; median age 12y, age range 5-17y) identified via the Canadian Neuromuscular Disease Registry, and their parents completed questionnaires. Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale by child self-report and parent proxy-report. Patients with DMD across ages and disease stages experienced greater fatigue compared to typically developing controls from published data. Sleep disturbance symptoms were associated with greater fatigue by child self-report (ρ=-0.42; p=0.003) and parent proxy-report (ρ=-0.51; p<0.001). Depressive symptoms were associated with greater fatigue by child self-report (ρ=-0.46; p<0.001) and parent proxy-report (ρ=-0.45; p<0.001). Lower functional ability was associated with greater fatigue by parent proxy-report (ρ=0.26; p=0.03). Physical activity level, and musculoskeletal, respiratory, and cardiac function were not associated with fatigue. In paediatric DMD, sleep disturbance symptoms and depressive symptoms are potentially modifiable factors associated with fatigue, warranting additional investigation to facilitate the development of therapeutic strategies to reduce fatigue. Fatigue is a major issue in paediatric Duchenne muscular dystrophy (DMD) across ages and disease stages. Sleep disturbance and depressive symptoms are significantly associated with fatigue in paediatric DMD.

Haitian Children’s Disaster Trauma: Validation of Pictorial Assessment of Resilience and Vulnerability

The House-Tree-Person (HTP) drawing test has been culturally adapted for Haitian children and objectively scored for resilience and vulnerability (Roysircar, Colvin, Afolayan, Thompson, &amp; Robertson, 2017). The HTP was used to assess 88 Haitian children’s adjustment to the 2010 earthquake and the continuous trauma of societal inequalities. The study examined the validity of the adapted HTP test and its dimensionality. The study included participant interviews with child self-report measures of self-esteem, as perceived by self, peers, and family; posttraumatic symptoms; and self-concept. All measures were translated and administered in Créole. Analyses included standardized sample scores; descriptive statistics; internal consistency reliability; interscale correlations; a generalizability study showing that there were no differences in HTP scores due to novice or expert raters; and an exploratory factor analysis of HTP scores indicating three factors and accounting for just under 50% of the variance. The three dimensions, HTP Resilience-Vulnerability Integrated, House Feeling Safe, and Person Feeling Unloved, are discussed within the international literature on child disaster trauma assessed pictorially, and within Haitians’ spiritual worldview of suffering and endurance.

A double-blind, randomized, placebo-controlled trial of a computer-based Interpretation Bias Training for youth with severe irritability: a study protocol

BackgroundSevere, chronic, and impairing irritability is a common presenting clinical problem in youth. Indeed, it was recently operationalized as disruptive mood dysregulation disorder (DMDD) in the DSM-5. However, to date, there are no evidence-based treatments that were specifically developed for DMDD. The current randomized controlled trial assesses the efficacy of a computer-based cognitive training intervention (Interpretation Bias Training; IBT) in youth with DMDD. IBT aims to reduce irritability by altering judgments of ambiguous face-emotions through computerized feedback. IBT is based on previous findings that youth with irritability-related psychopathology rate ambiguous faces as more hostile and fear producing.Methods/designThis is a double-blind, randomized controlled trial of IBT in 40 youth with DMDD. Participants will be randomized to receive four IBT sessions (Active vs. Sham training) over 4 days. Active IBT provides computerized feedback to change ambiguous face-emotion interpretations towards happy interpretations. Face-emotion judgments are performed pre and post training, and for 2 weeks following training. Blinded clinicians will conduct weekly clinical ratings. Primary outcome measures assess changes in irritability using the clinician-rated Affective Reactivity Index (ARI) and Clinical Global Impressions-Improvement (CGI-I) scale for DMDD, as well as parent and child reports of irritability using the ARI. Secondary outcome measures include clinician ratings of depression, anxiety, and overall impairment. In addition, parent and child self-report measures of depression, anxiety, anger, social status, and aggression will be collected.DiscussionThe study described in this protocol will perform the first RCT testing the efficacy of IBT in reducing irritability in youth with DMDD. Developing non-pharmacological treatment options for youth suffering from severe, chronic irritability is important to potentially augment existing treatments.Trial registrationClinicalTrials.gov, ID: NCT02531893. Registered on 25 August 2015.