Non-clinical Children Research Articles

Sleep Problems and Daily Functioning in Children With ADHD: An Investigation of the Role of Impairment, ADHD Presentations, and Psychiatric Comorbidity

Objective: Little systematic information is available regarding how sleep problems influence daytime functioning in children with ADHD, as the role of ADHD presentations and comorbidity is unclear. Method: In total, 397 children were assessed with the Children’s Sleep Habits Questionnaire, the Weiss Functional Impairment Rating Scale, and the ADHD Rating Scale. Results: We found a moderate, positive correlation between sleep problems and impaired functioning in both children with ADHD and in typically developed children. ADHD presentations did not differ significantly with respect to sleep problem profile, but having a comorbid internalizing or autistic disorder lead to higher sleep problem score. Conclusion: Sleep problems and impaired daily functioning were more common in children with ADHD, but the overall association between sleep problems and impaired daily functioning was similar in clinical and nonclinical children. Internalizing or autistic comorbid disorders added significantly to the sleep problems.

A Study on the Psychometric Properties of the Fairy Tale Test (FTT)

The Fairy Tale Test (FTT) is a projective personality measure that provides a comprehensive evaluation of the child’s personality. The test consists of 21 cards that depict popular fairy tale characters that are administered in sets of three. Having three versions of the same character allows the child to project different aspects of self and activates the emergence of several defense mechanisms such as undoing, reaction formation, and splitting. The test is administered in the form of a semi-structured interview. Children’s responses are interpreted in a quantitative and qualitative way. Quantitative interpretation includes the rating of 30 personality variables on a 1–3 scale, while qualitative evaluation consists of the analysis of ego functions and the nature of anxiety. The FTT was standardized in Greece on a sample of 873 nonclinical children. The construct validity was examined through the application of factor analyses that led to the formation of 13 first-order and 5 second-order factors. Criterion validity included the comparison of the FTT factors with those derived from the AQ, the BYI, and the CBCL. The results confirmed the dichotomy of reactive and proactive aggression and disclosed their association with victims and bullies.

A French Translation of the Childhood Anxiety Sensitivity Index (CASI): Factor Structure, Reliability and Validity of This Scale in a Nonclinical Sample of Children

<strong>Introduction: </strong>Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations due to beliefs that these sensations will lead to catastrophic outcomes. AS plays a central role in the etiology and maintenance of anxiety disorders. From a clinical perspective, it therefore seems important to possess a valid scale to assess AS in children. <strong>Objective, Method: </strong>This study examines the factor structure, reliability, and validity of the French translation of the Childhood Anxiety Sensitivity Index (CASI) in 353 Belgian children (9 to 13 years). <strong>Result: </strong>Results show that AS can be adequately measured using the French version of the CASI and conceptualized as a hierarchical factor structure with four lower-order factors – Physical Concerns, Mental Incapacity Concerns, Social Concerns, and Losing Control Concerns – loading on a single higher-order factor, Anxiety Sensitivity. The reliability was acceptable for the total scale. Hierarchical multiple regressions show that the CASI makes a significant contribution in predicting anxiety. <strong>Conclusion: </strong>The data support the relevance of the French CASI in the assessment of AS in nonclinical children.

Relations Among Behavioral Inhibition, Shame- and Guilt-Proneness, and Anxiety Disorders Symptoms in Non-clinical Children

This study examined relationships between the self-conscious emotions of shame and guilt, behavioral inhibition (as an index of anxiety proneness), and anxiety disorder symptoms in non-clinical children aged 8-13years (N=126), using children's self-report data. Results showed that there were positive and significant correlations between shame and guilt, behavioral inhibition, and anxiety disorders symptoms. When controlling for the overlap between shame and guilt, it was found that shame (but not guilt) remained significantly associated with higher levels of anxiety proneness and anxiety symptoms. Further, when controlling for the effect of behavioral inhibition, shame still accounted for a significant proportion of the variance of total anxiety and generalized anxiety scores. For these anxiety problems, support emerged for a model in which shame acted as a partial mediator in the relation between behavioral inhibition and anxiety. These results indicate that the self-conscious emotion of shame is a robust correlate of anxiety pathology in children.

Outcomes Associated with Psychopathic Traits in a Non-Clinical Sample of Children Aged 6-13

Childhood psychopathy is a construct that remains contentious for many researchers, as questions still arise about the merit of assessing these traits in younger individuals, particularly in non-clinical children.

Symptom differentiation of anxiety and depression across youth development and clinic-referred/nonreferred samples: An examination of competing factor structures of the Child Behavior Checklist DSM-oriented scales

This study examined the psychometric properties of the DSM-oriented scales of the Child Behavior Checklist (Achenbach, Dumenci, & Rescorla, 2003) using confirmatory factor analysis to compare the six-factor structure of the DSM-oriented scales to competing models consistent with developmental theories of symptom differentiation. We tested these models on both clinic-referred (N = 757) and school-based, nonreferred (N = 713) samples of youths in order to assess the generalizability of the factorial structures. Although previous research has supported the fit of the six-factor DSM-oriented structure in a normative sample of youths ages 7 to 18 (Achenbach & Rescorla, 2001), tripartite model research indicates that anxiety and depressive symptomology are less differentiated among children compared to adolescents (Jacques & Mash, 2004). We thus examined the relative fit of a six- and a five-factor model (collapsing anxiety and depression) with younger (ages 7-10) and older (ages 11-18) youth subsamples. The results revealed that the six-factor model fit the best in all samples except among younger nonclinical children. The results extended the generalizability of the rationally derived six-factor structure of the DSM-oriented scales to clinic-referred youths and provided further support to the notion that younger children in nonclinical samples exhibit less differentiated symptoms of anxiety and depression.

Maternal expectancy versus objective measures of child skill: evidence for absence of positive bias in mothers' expectations of children with internalizing disorders.

Parents of anxious children are thought to be more attuned to threat, which might translate into less positive bias in parental report of child coping and ability, unlike parents of non-anxious children. Maternal expectancy bias was examined in a sample of 43 clinically anxious (51 % female), 30 clinically anxious/depressed (50 % female), and 44 non-clinical control children (46 % female), 8–14 years of age. When compared to an objective observer’s ratings of the children, mothers of non-clinical children demonstrated a positive bias (i.e., over-rated their children’s performance) for both ratings of expected speech performance in absolute terms and relative to peers. Mothers in the clinical groups did not exhibit this positive expectancy bias. Moreover, mothers of clinical children reported lower expectations in absolute terms and relative to peers than mothers of non-clinical children. The data suggest that mothers of clinical children held accurate expectations for child performance when compared to the gold standard of an objective observer.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-013-9793-1) contains supplementary material, which is available to authorized users.

Bound to Feel Bad About Oneself: Relations Between Attachment and the Self-conscious Emotions of Guilt and Shame in Children and Adolescents

Two cross-sectional studies were conducted to explore the relationship between attachment and the self-conscious emotions of guilt and shame in childhood. Study 1 was performed in non-clinical children aged 9–13 years (N = 688) who completed a single-item measure of attachment style and a vignette-based instrument for assessing guilt and shame. Results showed that children who classified themselves as insecurely attached displayed higher levels of shame and maladaptive types of guilt as compared to securely attached children. Study 2 was conducted in adolescents aged 12–18 years (N = 135), of whom the majority was referred to a clinical setting because of externalizing problems. Adolescents filled in a dimensional scale for measuring attachment quality to parents and peers and the above mentioned vignette-based instrument of guilt and shame. It was found that the clinical adolescents generally exhibited lower levels of self-conscious emotions as compared to non-clinical adolescents. Within this clinical group, communication to parents and peers was associated with higher levels of self-conscious emotions, and alienation was accompanied by higher levels of maladaptive forms of guilt and shame. Altogether, these results fit with the theory that attachment (in)security is involved in people’s proneness to experience self-conscious emotions.

Étude exploratoire de la stabilité à long terme des indices standard du WISC-IV

By a Test–Retest procedure, this study explores the long-term stability of the French WISC-IV index scores. The average Test–Retest interval was 2.33years. The sample consisted of 96 non-clinical children aged between 8 and 12years. Mean difference between the two testings was not statistically significant for VCI, PRI, WMI, GAI and FSIQ. Test–Retest reliability correlations between the two assessments are high for VCI, GAI and FSIQ (ranging from .81 to .82). An analysis of the performance differences between two assessments indicates intra-individual stability for WMI and GAI. In sum, only GAI demonstrates reliable long-term stability at an inter-and intra-individual level.

Friendship Quality and Social Information Processing in Clinically Anxious Children

The association between perceived friendship quality (FQ) and social information processing (SIP) was examined in three groups of children and their close friends aged 7-12 years: 16 anxiety disordered children with social phobia (SP); 12 anxiety disordered children without SP (No-SP); and 32 nonclinical children. Positive and negative FQ positively associated with target children's positive and negative responding on a vignette measure of SIP. SP children reported lower positive SIP than No-SP but not nonclinical children; and this was the only group difference in SIP. Target children and their friends were similar in negative but not positive SIP. Following discussion about the vignette with a close friend, all target children increased in positive SIP; negative SIP did not change. Lower FQ and a more socially anxious friend predicted higher negative target child SIP postdiscussion. Close friendships play an important role in the SIP of both clinical and nonclinical children.

Searching for Danger: On the Link Between Worry and Threat-Related Confirmation Bias in Children

The present study examined the relationship between worry and threat-related confirmation bias in children. Forty non-clinical children aged 10–12 years completed the child version of the Penn State Worry Questionnaire as a cognitive index of anxiety proneness, and then were administered a modified version of the Wason Selection Task to assess verifying and falsifying reasoning strategies in response to conditional danger rules. Results demonstrated that children with high levels of worry displayed a stronger tendency towards verification and a weaker inclination towards falsification than children with low levels of worry. This finding indicates that confirmation bias occurs in individuals with a general vulnerability to anxiety, and fits well with current theoretical models in which cognitive distortions are viewed as risk factors predisposing to the development of fear and anxiety problems.

Metacognitive Beliefs and Processes in Clinical Anxiety in Children

Recent research has explored the role of metacognitive beliefs and processes in clinical anxiety in youth. The aim of this study was to examine the relationship between metacognitions and anxiety in 7- to 12-year-old children with and without clinical anxiety disorders. A secondary aim of the study was to investigate the psychometric properties of the recently developed Metacognitions Questionnaire for Children (MCQ-C). The sample consisted of 83 children (60.2% female; Oceanian 71.1%), comprising 49 children with anxiety disorders and 34 nonclinical children. All children completed self-report measures of anxiety, emotional difficulties, and metacognitions. A subsample of 7- to 8-year-old participants was used to explore whether young children could wholly comprehend all items on the MCQ-C. Positive and negative metacognitive beliefs and cognitive monitoring were significantly correlated with anxiety and emotional difficulties. Clinical children endorsed significantly more negative and more positive metacognitive beliefs than nonclinical children. Each subscale of the MCQ-C had poor internal consistency. Support for the criterion and convergent validity of the MCQ-C was found. The results suggest that certain metacognitions play a role in clinical anxiety in children but that psychometrically and developmentally validated measures of these concepts in younger individuals are needed.

Don’t be afraid of the General Factor of Personality (GFP): Its relationship with behavioral inhibition and anxiety symptoms in children

Two studies examined the relationship between the General Factor of Personality (GFP) and behavioral inhibition and anxiety symptoms in primary school children. The GFP is assumed to reflect effectiveness in interaction with others. In Study 1, using self-reports and parent ratings of 226 non-clinical children, we found GFP scores to be negatively related to behavioral inhibition and anxiety symptoms. In Study 2 we compared non-clinical children (N=81) with children with anxiety disorders (N=45). In both groups we obtained child and parent ratings. The clinically referred children scored significantly lower on the GFP than the non-clinical children. Moreover, as in Study 1, higher GFP scores were associated with lower levels of behavioral inhibition and anxiety symptoms. The two studies support the view that the GFP is a relevant construct in anxiety proneness and anxiety problems.

Parental and children's report of emotional problems: agreement, explanatory factors and event-emotion correlation.

As often only parents are addressed, studying parent-child agreement and its explanatory factors is crucial in gaining accurate information on young children's emotional problems. Parental and children's reports of children's emotional problems (anger, anxiety, sadness) and children's reports of life events were gathered between February and June, 2010 from 464 Belgian nonclinical children 5-10years old. Children reported more emotional problems than their parents. Parental underestimation was higher in the case of girls, older children, nontraditional family structures and authoritative parenting style. Furthermore, life events and emotional problems were significantly correlated only when using children's reported emotions. In our nonclinical children, interviewing both parents and children on children's emotional problems is necessary and parent-child disagreement can partially be explained by child or family characteristics.

Relations Between Behavioral Inhibition, Big Five Personality Factors, and Anxiety Disorder Symptoms in Non-Clinical and Clinically Anxious Children

This study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6–13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form, the Big Five Questionnaire for Children, and the Screen for Child Anxiety Related Emotional Disorders-Revised. Results indicated that, compared to parents of non-clinical children, parents of clinically anxious children rated their offspring higher on neuroticism and behavioral inhibition, but lower on extraversion, conscientiousness, and intellect/openness. Further, extraversion emerged as the strongest correlate of an inhibited temperament, and this appeared true for the clinically anxious as well as the non-clinical children. Finally, in both the clinical and non-clinical samples, higher levels of behavioral inhibition and neuroticism were unique and significant predictors of anxiety disorders symptoms.

Content Specificity of Threat Interpretation in Anxious and Non-Clinical Children

This study investigated content specificity of children’s threat interpretations in a group of 40 clinically anxious (18 boys, 22 girls; ages 7–14 years) and a group of 40 non-clinical children (19 boys, 21 girls; ages 8–14 years). Associations between disorder-specific threat interpretations (in response to situations selected by each child) and each of six DSM-IV anxiety and depressive disorder symptom domains were examined for each group of children through multivariate regression analyses. Supporting theories of cognitive content specificity, results showed that for clinically anxious children, symptoms of social phobia and panic disorder were significantly and specifically predicted by threat interpretation in response to situations that corresponded to each disorder, while symptoms of separation anxiety were predicted by threat perception in situations relevant to separation anxiety and panic disorder. There was little evidence of cognitive content specificity within the non-clinical group of children. Implications for theories of development of interpretation biases associated with child anxiety disorders are discussed.

Research on the use of the Hand Test in clinical assessment of children and adolescents

The research study discussed here was meant to test the clinic validity and usefulness of the Hand Test (HT) widely used as a diagnostic instrument in the assessment of children and adolescents with psychological disorders. The test was administered to 131 non-clinical children and adolescents with ages between 7 and 17 and to 160 clinical subjects of the same age. For this study, we included the analysis of the Interpersonal, Environmental, Maladjustive, Withdrawal, AOS, and Pathological scores as well as qualitative Hand Test variables. The investigation showed significant differences between the variables of the Hand Test for each clinical category: epilepsy, internalizing disorders and externalizing disorders.

Comparação entre comportamentos apresentados por mães de pré-escolares clínicos e não clínicos em uma situação lúdica

Analisar padrões de interação que mães estabelecem com filhos que não apresentam problemas comportamentais permitirá verificar se as habilidades ensinadas nos programas de orientação para estes pais correspondem às habilidades que pais e mães com filhos sem problemas usam no manejo da vida diária. O objetivo do presente estudo foi verificar a existência de diferenças no responder das mães com filhos pré-escolares clínicos e não clínicos em uma situação de interação lúdica semi-estruturada. Foram medidas e comparadas a frequência de emissão de elogios descritivos e genéricos, ordens e críticas por parte da mãe, e obediência e não obediência por parte da criança. As mães de crianças não clínicas fizeram menos uso de críticas ao comportamento das crianças do que as mães de crianças clínicas, sendo que os grupos não diferiram significativamente quanto ao uso de elogios e de ordens. As crianças diferiram apenas quanto ao comportamento de não obediência. Ensinar às mães de crianças com problemas, a punirem menos os comportamentos inapropriados destas, talvez seja tão importante para a melhora clínica quanto ensiná-las a elogiarem os comportamentos apropriados de seus filhos.

Processing Biases for Emotional Faces in 4- to 12-Year-Old Non-Clinical Children: An Exploratory Study of Developmental Patterns and Relationships with Social Anxiety and Behavioral Inhibition

The present study examined (a) processing biases for emotional facial stimuli in a sample of 355 4- to 12-year-old non-clinical children, (b) developmental patterns of such biases, and (c) to what extent biases were related to social anxiety and the temperamental trait of behavioral inhibition in children of various ages. Processing biases were assessed with a dot probe task and a dynamic emotion recognition paradigm (i.e., morph task), whereas children's levels of social anxiety and behavioral inhibition were measured by means of parent-report. Results showed that on the morph task children were generally faster in detecting happy faces compared to angry faces, and this effect was not qualified by age, social anxiety, or behavioral inhibition. Further analyses revealed no significant effect of age on bias scores. However, analyses did reveal two classes in the data with one class mainly consisting of younger children and the other class predominantly composed of older children: Younger children were in general slower, less accurate, and displayed more variance in their scores on the processing biases tasks than older children. Results of this study underline the need of the development and use of more age-appropriate, non-reaction time-based tasks for measuring processing bias in younger children.

Social Anxiety and Content Specificity of Interpretation and Judgemental Bias in Children

Previous research with adult samples has demonstrated that social anxiety disorder is associated with content‐specific interpretation and judgemental biases. The present study extends our understanding of the specificity of cognitive biases in childhood social anxiety. A sample of non‐clinical children aged 11–12 years completed social anxiety and depression scales and was presented with scenarios depicting hypothetical events varying along two dimensions: relevance to self (event occurs to self or to other) and domain of activity (event is social or non‐social). Partial support for the content‐specificity hypothesis was found. Children's social anxiety symptoms were positively associated with negative interpretation ratings for ambiguous self‐referent and other‐referent events, but only when these events were in the social domain. Further, children's social anxiety symptoms were positively associated with emotional cost judgements for ambiguous social and non‐social events, but only when these events referred to the self. Both patterns of results remained significant even after controlling for concurrent depressive symptoms. Implications of the results for our understanding of maintaining factors in childhood social anxiety are discussed. Copyright © 2011 John Wiley &amp; Sons, Ltd.