Multidimensional Anxiety Scale For Children Scores Research Articles

Impact of Biofeedback in the Treatment of Nonspecific Persistent Wrist and Forearm Pain in Adolescents

Biofeedback is a self-regulation technique in which patients learn to control what were once thought to be involuntary bodily processes. The goal of this study was to examine a sample of adolescents with persistent, nonspecific wrist and forearm pain to assess whether biofeedback can improve symptoms. A secondary goal was to identify any shared characteristics. This is a retrospective case series of patients seen by an upper-extremity surgeon and a biofeedback expert at a pediatric hospital from 2011 through 2017. Data collected included Multidimensional Anxiety Scale for Children (MASC) and Children's Depression Inventory (CDI) scores, pain intensity, frequency, and duration; as well as self-report of depression, anxiety, self-harm, and/or suicidal ideation. Additional data included biological sex, brace or orthosis wear, history of injury, prior medical or surgical treatments, and the presence of paresthesias. Biofeedback sessions were held every 1 to 2 weeks, for typically 5 sessions. Sixteen patients met inclusion criteria; 9 completed biofeedback. Eight patients were female (88%) and 1 was male (11%). The dominant extremity was affected in 8 patients (89%). Seven of the 9 patients who completed biofeedback had improvement or resolution of symptoms (78%). Both patients who completed biofeedback but did not have improvement in pain underwent surgery before biofeedback referral. Three patients reported paresthesias; each had an elevated CDI and MASC score (33%). Six patients did not report paresthesias, and one patient had similar elevated CDI and MASC scores CONCLUSIONS: More females than males were seen and referred to biofeedback in this study group. There appears to be an association between underlying anxiety or depression and the report of paresthesias. Biofeedback is an available nonsurgical treatment modality for persistent wrist and forearm pain that should be considered in appropriate patients. Therapeutic V.

Anxiety Symptoms Differ in Youth With and Without Tic Disorders.

We compared anxiety symptoms in youth with and without tic disorders by comparing scores on the Multidimensional Anxiety Scale for Children (MASC) in youth with tic disorders to those in a concurrent community control group and in a group of treatment-seeking anxious youth from the Child/Adolescent Anxiety Multimodal Study (CAMS). Data from 176 youth with tic disorders, 93 control subjects, and 488 CAMS participants were included. Compared to youth with tic disorders, controls had lower total MASC scores (p < 0.0001) and CAMS participants had similar total MASC scores (p = 0.13). Separation Anxiety (p = 0.0003) and Physical Symptom (p < 0.0001) subscale scores were higher in youth with tic disorders than in CAMS participants. We conclude that the anxiety symptom profile differs in youth with and without tic disorders, which may have important implications for targeting treatment of anxiety in youth with tic disorders.

Physical Therapy Outcome Measures for Assessment of Lower Extremity Chronic Pain-Related Function in Pediatrics

To assess the clinical utility of 5 physical therapy (PT) outcome measures in quantifying functional changes in pediatric lower extremity chronic pain treated at a hospital-based interdisciplinary rehabilitation center. This was a cross-sectional study with retrospective review of 173 individuals, 8 to 18 years old, treated from June 2008 to 2013. The measures used were the Timed Up and Go, Timed Up and Down Stairs, Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, 6-minute walk test, and Lower Extremity Functional Scale. Participant performance was correlated with demographic characteristics, the Functional Disability Index, Multidimensional Anxiety Scale for Children, Child Depression Inventory, and Canadian Occupational Performance Measure. Scores from all 5 PT measures showed significant improvement following treatment. Functional Disability Index correlated to every PT measure except the 6-minute walk test. This study supports the clinical use of these PT measures to track functional progress after rehabilitative treatment of lower extremity chronic pain-related disability.

Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program.

BackgroundThere are no approved medications for juvenile fibromyalgia (JFM), a disorder that is often under-diagnosed. The effects of milnacipran, a drug approved for the management of fibromyalgia (FM) in adults, was assessed in a clinical trial program for JFM.MethodsPatients, ages 13–17 years who met the Yunus and Masi criteria for JFM and/or 1990 American College of Rheumatology criteria for FM, were enrolled in a responder-enriched, randomized withdrawal trial. After receiving open-label milnacipran (8 weeks), patients with ≥50 % improvement in pain underwent double-blind randomization (1:2) to either placebo or continuing treatment with milnacipran (8 weeks). All patients, including those who did not meet the randomization criteria for double-blind withdrawal, were allowed to enter an extension study with open-label milnacipran (up to 52 weeks). The primary endpoint was loss of therapeutic response (LTR) during the double-blind period. Additional outcome measures included the Patient Global Impression of Severity (PGIS), Pediatric Quality of Life Inventory (PedsQL: Generic Core Scales, Multidimensional Fatigue Scale), and Multidimensional Anxiety Scale for Children (MASC). Safety assessments included adverse events (AEs), vital signs, electrocardiograms, and laboratory tests.ResultsThe milnacipran program was terminated early due to low enrollment. Because only 20 patients were randomized into the double-blind withdrawal period, statistical analyses were not conducted for the LTR endpoint. However, 116 patients entered the open-label period of the initial study and 57 participated in the open-label extension study. Their experience provides preliminary information about the use of milnacipran in JFM patients. During both open-label periods, there were mean improvements in pain severity, PGIC, PedsQL, and MASC scores. No unexpected safety issues were detected. The most commonly reported treatment-emergent AEs were nausea, headache, vomiting, and dizziness. Mean increases in heart rate and blood pressure were observed, and were consistent with the AE profile in adults with FM.ConclusionsThe open-label findings provide preliminary evidence that milnacipran may improve symptoms of JFM, with a safety and tolerability profile that is consistent with the experience in adult FM patients. Future trial designs for JFM should consider the relatively low recognition of this condition compared to adult FM and the difficulties with enrollment.Trial registrationNCT01328002; NCT01331109Electronic supplementary materialThe online version of this article (doi:10.1186/s12969-015-0025-9) contains supplementary material, which is available to authorized users.

Normative data for female adolescents with eating disorders on the multidimensional anxiety scale for children

To provide normative data on the Multidimensional Anxiety Scale for Children (MASC) for female adolescents presenting for eating disorder (ED) treatment. This study is part of the Helping to Outline Paediatric Eating Disorders Project registry (N ∼ 1,000), a prospective ongoing registry study comprising consecutive pediatric tertiary ED referrals. Female adolescents (N = 278; 13-17 years) with EDs completed the MASC at intake. Summary data including percentiles are given for the MASC total and subscales. MASC scores were higher than community norms as expected and increased with age (p <.001) and an anorexic spectrum diagnosis (p < .001). The norms reported will aid clinicians in the understanding and interpretation of individual MASC scores among female adolescents with EDs and could assist future research to better understand the role of anxiety in the onset and maintenance of EDs.

The Impact of a 1-Week Residential Program on Anxiety in Adolescents With Incontinence

To determine the effect of a 1-week residential program on anxiety in adolescents with bowel and/or bladder dysfunction. Participants were 89 adolescents (mean age = 14.56 years, range 11-18 years) attending a 1-week residential program for individuals with bowel and/or bladder dysfunction. The program is both educational and social in nature and is held at 1 of 3 rotating university campuses. A quasi-experimental study design that included 3 administrations of the Multi-dimensional Anxiety Scale for Children (MASC) was employed for data collection. The MASC was administered immediately before the program, immediately after the program, and 2 to 4 months after conclusion of the program. The 1-week program includes structured and unstructured sessions facilitated by young adults with these conditions and/or WOC nurses. Topics are physiological and psychological in nature, focusing on strategies for home, school, and medical settings. There are also social activities designed to facilitate development of social relationships among peers. : A positive, statistically significant impact on total MASC scores was found (F1.679, 80.587 = 3.587; P = .404) as well as on the Social Anxiety scale (F2,96 = 5.299; P = .007) and its 2 subscales, Humiliation/Rejection Fears (F2,96 = 3.876; P = .024) and Performance Fears (F2,96 = 6.453; P = .002). This 1-week residential summer program was found to exert a positive impact on anxiety symptoms, particularly social anxiety, and benefits persisted for 2 to 4 months. This suggests the psychological benefits of even relatively brief experiences for individuals with bowel and/or bladder dysfunction.

Diagnostic Efficiency of the Child and Parent Versions of the Multidimensional Anxiety Scale for Children

The objective of this study is to evaluate the psychometrics and clinical efficiency of the Multidimensional Anxiety Scale for Children (MASC), which measures physical symptoms, harm avoidance, social anxiety, and separation/panic. Using a sample of 190 treatment-seeking Norwegian youth (aged 7–13 years, M age = 10.3 years, 62.1% male), the internal stability and ability to predict to disorder were examined for child, mother, and father reports on the MASC. Moderate to strong internal reliability was exhibited across all MASC subscales. Parent–child agreement was low, but mother–father agreement was high. MASC scores successfully distinguished between children with and without anxiety disorders and identified youth with separation anxiety disorder and social phobia, but less accurately generalized anxiety disorders. The MASC has favorable psychometric properties and is a useful screening instrument for identifying youth with anxiety disorders.

Group Cognitive-Behavioral Therapy for Anxiety in a Clinic Setting: Does Child Involvement Predict Outcome?

The current study examined the relationship between child involvement and treatment outcome in a group cognitive–behavioral treatment (GCBT) program for children with anxiety, using an adapted version of the Child Involvement Rating Scale (CIRS). Thirty-four children with a primary diagnosis of an anxiety disorder, referred for outpatient treatment at a hospital, and their parents participated in a manualized 12-session GCBT program. The Multidimensional Anxiety Scale for Children (MASC), administered at pretreatment, posttreatment, and at 4-month follow-up, served as the outcome measure. The psychometric properties of the adapted CIRS were good. Early involvement (EI) was calculated as the average score from Sessions 1 to 6 and late involvement (LI), the average score from Sessions 7 to 12. EI predicted lower MASC scores at posttreatment, after controlling for pretreatment MASC scores and for LI, B = – 1.05, t(3) = – 2.34, p < .05. EI did not predict outcomes at follow-up. Results were replicated using the original CIRS measure. Exploratory analyses suggested that the relationship between LI and treatment outcomes was moderated by medication. Involvement in therapy prior to exposures might be an important predictor of posttreatment outcomes in GCBT in a community setting.

Patterns and Predictors of Subjective Units of Distress in Anxious Youth

Subjective Units of Distress Scale (SUDS) ratings are commonly used during exposure tasks in cognitive behavioral treatment (CBT) for anxiety. The present study examined patterns and predictors of SUDS in a sample of anxiety-disordered youth. Youth (N = 99) aged 7 to 14 (M = 10.4, SD = 1.8) were treated with CBT for social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Analyses were conducted using hierarchical linear modeling. Child's peak SUDS and magnitude of change in SUDS significantly increased between sessions. Higher child self-reported pretreatment total Multidimensional Anxiety Scale for Children (MASC) score predicted greater change in SUDS within the first exposure session. Primary GAD diagnosis predicted less increase in change in SUDS between sessions. Results suggest that higher pretreatment total MASC scores are associated with increased first exposure within-session habituation. Additionally, youth with a principal diagnosis of GAD experienced less between-session habituation, perhaps because they may have required more imaginal than in-vivo exposures.

Psychological assessment in children and adolescents with Benign Paroxysmal Vertigo

Migraine in childhood and adolescence has been associated with the presence of behavioural and emotional difficulties, but only few data are available with respect to unusual types of headache syndromes such as Benign Paroxysmal Vertigo of Childhood (BPVC). Aim of the present study was to evaluate the behavioural and emotional profiles of clinically referred children and adolescents suffering from BPVC and migraine, as compared to normal controls. According to the revised International Classification of Headache Disorders (ICHD-2) the BPVC belongs to the category of “primary headache”, as a migraine equivalent, in a subset that is called “periodic syndromes of childhood”. A total of 60 clinically referred children and adolescents (4–15 years) 21 suffering from BPVC and 20 from migraine, according to the diagnostic criteria of the ICHD-2, and 19 normal control (NC) were recruited in this study. Psychological assessment were performed using the Child Behaviour Checklist (CBCL), the Children’s Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC). Although most of the patients suffering from headache had scores within the normative non-pathological range, both BPVC and migraine patients had significantly higher CBCL total, internalizing, and externalizing scores, as compared to NC. Furthermore, both BPVC and migraine groups displayed significantly higher CDI and MASC scores than NC group. No differences were found between the two types of headache. In conclusion, clinically referred children and adolescents with BPVC and migraine showed higher indices of behavioural and emotional symptoms, both internalizing and externalizing, as compared to normal peers.

Reliability and Validity of the Chinese Version of the Multidimensional Anxiety Scale for Children Among Chinese Secondary School Students

The objective of the current study was to develop a Chinese translation of the Multidimensional Anxiety Scale for Children (MASC) [March (1997) Multidimensional anxiety scale for children: Technical manual, Multi health systems, Toronto, ON], and to evaluate its reliability and validity. The original version of the MASC was translated into Chinese (MASC-C) and administered to 1,538 Chinese adolescents between the ages of 14 and 19. In comparison to the American normative sample [March (1997) Multidimensional anxiety scale for children: Technical manual, Multi health systems, Toronto, ON], Chinese adolescents reported significantly higher scores on the subscales of social anxiety and separation anxiety. Girls reported higher levels of anxiety on all subscales than males. Participants between the ages of 16 and 19 reported higher scores on the physical symptoms and harm avoidance subscales. The MASC-C exhibited strong internal consistency (Cronbach's alpha coefficient was 0.91 and the mean inter-item correlation coefficient was 0.20) and moderate test-retest reliability (intra-class correlation coefficient was 0.84 over a one-month interval). MASC scores inter-correlated a small to moderate degree with measures assessing negative life events and depressive symptoms indicating acceptable convergent validity. The results of confirmatory factor analyses indicated that the four-factor structure of the MASC was suitable for the Chinese sample. The four factor structure was also invariant across sex and age. As the Chinese translation of the MASC indicated high levels of reliability and validity, the MASC-C is appropriate for assessing anxiety in Chinese adolescents.

Behavioural and Temperamental Characteristics of Children and Adolescents Suffering from Primary Headache

To examine indices of behavioural and emotional problems and temperamental traits in clinically referred children and adolescents suffering from tension headache or migraine. Headache in childhood and adolescence (<18 years) has been associated with the presence of behavioural and emotional difficulties, but limited data are available on the relationship between these problems and different types of headache. Clinically referred children and adolescents (N=114), 6-16 years of age, suffering from primary headache according to the diagnostic criteria of the International Headache Society, 47 with tension-type headache (TH) and 67 with migraine (M), and 36 normal controls without headache (NC) were assessed using the Parent Child Behaviour Checklist (CBCL), Children's Depression Inventory (CDI), Multidimensional Anxiety Scale for Children (MASC), Conner's Parent Rating Scale (CPRS), and Emotionality-Activity-Sociability-Shyness Scale (EAS). Psychological and personality self-rating assessments were obtained also on the children's parents and siblings. Although most headache patients had scores within the normative non-pathological range, both TH and M patients had higher CBCL total, internalizing, and externalizing scores than NC (P<0.001), and TH patients had higher scores than M patients. TH and M had higher CDI and MASC scores than NC (P<0.05), with no difference between the headache groups. TH patients had higher Emotionality and Shyness scores, and lower Sociability scores than M patients. Clinically referred children and adolescents with TH and M had higher scores of behavioural and emotional symptoms, both of internalizing and externalizing type, than normal peers. The TH group had greater psychological and temperamental difficulties than the M group.

Screening for Anxiety and Depression in Early Adolescence

To examine the level of diagnostic and discriminative accuracy of three dimensional rating scales for detecting anxiety and depressive disorders in a school-based survey of 9th grade youths. Classroom screening instruments, the Center for Epidemiologic Studies-Depression Scale (CES-D), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Multidimensional Anxiety Scale for Children (MASC) were administered to 632 youths from three sites in 1998. On the basis of rating scale results, samples of high-scoring and non-high-scoring youths were invited to participate in a diagnostic interview conducted within 2 months of the screening sessions. MASC scores were most strongly associated with individual anxiety disorders, particularly among females, whereas the CES-D composite score was associated with a diagnosis of major depression, after controlling for comorbid disorders. The RCMAS was least successful in discriminating anxiety and depression. When receiver operator characteristic curves were examined, diagnostic accuracy was moderate. The ability of the MASC and CES-D to discriminate within and between categorically defined diagnostic groups has important implications for the accurate identification of youths in need of services.