Revised Children's Manifest Anxiety Scale Research Articles

Assessment of Physical and Mental Health of Children Living in Orphanages in Islamabad- A Cross-Sectional Survey

Background: Childhood holds immense significance in shaping the physical, mental, and emotional growth of children. Orphaned children face heightened susceptibility to encountering various physical and mental health challenges, thereby depriving them of the opportunity to experience optimal well-being throughout their childhood and beyond. Pakistan is home to an estimated 4.6 million orphaned children, with the majority being under the age of 17. The objective of the study was to assess the mental and physical health of children living in orphanages of Islamabad and Rawalpindi. Methods: A descriptive cross-sectional survey was conducted on a sample of 110 children aged 7 to 18 years, living in orphanages of Rawalpindi and Islamabad to assess their physical and mental health. Anthropometric measurements were taken and the presence or absence of anxiety was determined by using the “Revised Children Manifest Anxiety Scale” (RCMAS) questionnaire. Results: 50% of the study population was underweight based on their BMI, while 46.36% had normal weight and 1.82% were overweight or obese. Out of the 33 male participants, 20 were found to be underweight. The results of the RCMAS scoring revealed that 20.9% of the children had anxiety, with a higher prevalence among females as compared to males. Conclusion: Prevalence of underweight was found to be higher among male orphans. Female orphans were more likely to experience anxiety and depression as compared to males.

School Physical Education Program Impact on Psychological Well-Being and Cognitive Ability of Primary School Children

Study purpose. This study aimed to determine the impact of school Physical Education programs on well-being and cognitive ability (CA), as measured by mathematics achievements, in primary school children. Materials and methods. The study participants selected from three schools were 100 girls and 102 boys aged 9–10 years. According to Kliziene et al. (2022), the CA diagnostic test for mathematics in Grade 4 is grounded in Feuerstein and Lewin-Benham’s (2012) dynamic cognitive modality assessment theory, as well as the General Curriculum for Primary Education approved by the Minister of Education and Science of Lithuania (ISAK-2433, 2008). This test designed for learners in Grade 4 encompasses mathematics. The study aimed to assess the level of enthusiastic well-being by examining three primary dimensions: somatic anxiety, personal anxiety, and social anxiety. To measure anxiety, the Revised Children’s Manifest Anxiety Scale (RCMAS) was used, which consists of 37 items, with 28 of them assessing anxiety and the other 9 measuring the child’s defensiveness. In this study, a pre-/post-test experimental methodology was used to avoid any interruption of educational activities, due to the random selection of children in each group. The methodology depended on dynamic exercise, intense repetition of motor skills, differentiation, seating and parking reduction and physical activity distribution in the classroom model. Results. The CA diagnostic test was analyzed in terms of the learners’ levels of achievement (satisfactory, basic, advanced) and cognitive functions. The systematic exploration function was used to achieve systematic, non-impulsive, planned behavior when collecting data or checking information. There was a strong difference between students at the satisfactory and advanced levels in the ability to orient themselves in space and follow directions (score for boys, Post-test 2.53 (0.25) points; for girls, Post-test 2.91 (0.32) points out of a maximum 4 points; p<0.05). After the school PE program, the personality anxiety results decreased for both boys (2.68 ± 0.98 points) and girls (3.41 ± 0.55 points) (F = 4.98, p < 0.05, P = 0.729). Conclusions. Overall, the physical education program implemented in this study was found to have a positive effect on the psychological well-being of 9–10-year-old children, specifically in reducing somatic anxiety, personality anxiety, and social anxiety. Additionally, it was observed that the program led to statistically significant improvements in the children’s cognitive abilities across nine functions, including spatial orientation, sequencing, recognition of relationships and patterns, and information processing.

Effects of Videogaming on Attention and Conduct in Adolescents with Tourette’s Syndrome (P12-11.010)

<h3>Objective:</h3> To assess the association between time spent playing videogames on attention and behavior in adolescents with Tourette’s Syndrome (TS). <h3>Background:</h3> As adolescents spend more time playing videogames, the effects of gaming on cognitive and behavioral function remain heavily debated. There is literature emphasizing the negative effects of gaming on conduct, but there is also literature showing improvement in attention skills. This may be dependent on the amount of time spent on gaming. The effects of videogaming on attention and conduct in adolescents with TS have not been investigated yet. <h3>Design/Methods:</h3> Patients with TS, age 12–19, seen at the Rush Movement Disorders Clinic were invited to participate in the study. They completed questionnaires including demographics and number of hours spent playing video games per day (0–1, 1–3, more than 3 hours). The primary outcome measures included the Continuous Performance Test, 3rd Edition (CPT-3) and the Behavioral Assessment System for Children, 3rd Edition (BASC). Other assessments included the Yale Global Total Tic Severity Scale (YGTTSS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Revised Children’s Manifest Anxiety Scale (RCMAS). Demographics were summarized with descriptive statistics. CPT-3 (detectability, omissions, commissions, hit reaction, variability) and BASC (externalizing, internalizing, behavioral problems) T-scores were compared between groups of time spent gaming using the ANOVA model. <h3>Results:</h3> 19 subjects were included in the study, 11 male, mean age 14.8 (SD 1.9), mean YGTTSS 53.4 (SD 14.2), median YBOCS 8 (range 0–42), and median RCMAS 14 (range 4–38). 47.4% of subjects carried the diagnosis of ADHD, 5.3% learning disorder, 36.8% obsessive compulsive disorder, 26.3% depression, and 68.4% anxiety. There was no significant association between time spent playing video games and CPT-3 or BASC. <h3>Conclusions:</h3> In this cohort, time spent videogaming did not affect attention or behavior in TS patients. We will continue to recruit patients to adequately characterize this in a larger cohort. <b>Disclosure:</b> Mr. Colgan has nothing to disclose. Bichum Ouyang has nothing to disclose. Dr. Gera has nothing to disclose. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kompoliti has received personal compensation in the range of $0-$499 for serving as a Consultant for Sunovion. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Kompoliti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Scion. Dr. Kompoliti has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Kompoliti has received research support from Emalex. The institution of Dr. Kompoliti has received research support from Aeon. The institution of Dr. Kompoliti has received research support from Sun Pharma. The institution of Dr. Kompoliti has received research support from Revance. The institution of Dr. Kompoliti has received research support from Restore. The institution of Dr. Kompoliti has received research support from Theravance.

Evaluation of the Psychometric Properties of the Persian Version of Spence Children's Anxiety Scale in Iranian Adolescents.

The Spence Children's Anxiety Scale (SCAS) is a tool for measuring anxiety symptoms in children and adolescents. In this study, the psychometric properties of the Persian version of SCAS were investigated in an Iranian adolescents. This study was conducted on a sample of 684 adolescents. For standardization of SCAS, first- and second-order confirmatory factor analyses wereperformed. Also, to evaluate convergent and divergent validity, Fornell and Larcker criteria (1994), along with the Revised Children's Manifest Anxiety Scale (RCMAS)and Children's Depression Inventory (CDI), was used. A receiver operating characteristic (ROC) curve analysis was also performedto determine the cut-off point. The model fit of the correlated six-factor model was good however, a second-order model provided a statistically superior fit to the data. The reliability coefficients for the total scale and its dimensions were satisfactory (α > 0.7). Therefore, it can be concluded that the Persian version of SCAS has acceptable reliability and validity and can be used as a useful tool for early screening of anxiety in Iranian adolescents due to its easy use and specific design for children and adolescents.

The Difference in the Quality of Life of Korean Children With Attention-Deficit/Hyperactivity Disorder Between Before and After COVID-19.

ObjectivesThis study aimed to compare the quality of life (QoL) of children with attention-deficit/hyperactivity disorder (ADHD) before and during coronavirus disease-2019 (COVID-19) and to examine how their QoL is affected by emotional and environmental factors during COVID-19.MethodsParticipants in the pre-COVID-19 (n=43) and COVID-19 (n=36) groups were recruited from the same university hospital. The Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-report, the Children’s Depression Inventory (CDI), the Revised Children’s Manifest Anxiety Scale (RCMAS), the PedsQL 4.0 Parent Proxy Report, and the Conners’ Parent Rating Scale (CPRS) were employed. Independent t-tests, Pearson’s correlation analysis, and multiple regression analysis were conducted.ResultsCaregivers assessed the children’s QoL more negatively than the children themselves in both groups. Children with ADHD evaluated their physical function more negatively and anxiety was significantly higher in the COVID-19 group. In the COVID-19 group, the PedsQL child self-report was significantly predicted by the CPRS, the CDI, and environmental factors (i.e., relation to child and monthly household income).ConclusionChildren with ADHD in the COVID-19 group had a numerically lower QoL and significantly higher anxiety. To improve QoL, it is important to deal with not only depression but also ADHD symptoms and environmental factors.

Prevalence and determinants of psychosocial disorders in children and adolescents with asthma in Enugu, Nigeria: a comparative cross-sectional study

Objective Like most chronic illnesses, childhood asthma has a significant impact on the child’s overall psychosocial well-being. Psychosocial disorders occur in children with uncontrolled asthma making their asthma control more difficult. We aimed to determine the prevalence and determinants of psychosocial disorders in children and adolescents with asthma. Methods A comparative cross-sectional study of children and adolescents (aged 6 to 17 years with and without asthma) was conducted in a Nigerian tertiary health facility. The Revised Children Manifest Anxiety Scale (RCMAS) and Center for Epidemiological Studies-Depression Scale for Children (CES-DC) were used to screen for anxiety and depression respectively. Results A total of 190 (95 asthma and 95 non-asthma) children were studied. Anxiety occurred in 15 (15.8%) of asthma and four (4.2%) of non-asthma children, OR 95% CI =4.3 (1.4-13.4). Forty-five (47.4%) of asthma and 32 (33.7%) of non-asthma children had depression (OR 95% CI =1.8 (0.9-3.2). Asthma was significantly associated with social problems such as difficulty in making friends (OR 95% CI = 58.5 (3.5-979.9); restriction from daily activities (OR 95% CI =34.0 (2.0-578.5); stigma from peers (OR 95% CI = 18.6 (1.1-326.2); and strengthened and overprotective relationship with parents, (OR 95% CI = 26.0 (1.5-447.8). Poor asthma control was significantly associated with restriction from play, OR (95%CI) = 0.12 (0.04-0.32); anxiety, OR 95%CI = 18.26 (3.80-87.76) and depression, OR 95%CI = 4.57 (1.85-11.33). Conclusions Children with asthma are more prone to psychosocial disorders than their non-asthma counterparts. Poor asthma control influenced the psychosocial well-being of children with asthma negatively.

Sleep and Avoidant Restrictive Food Intake Disorder (ARFID): Correlation With Psychopathology, Gender, and Academic Performance.

ObjectiveNo studies have investigated sleep disturbance in avoidant/restrictive food intake disorder (ARFID). We examined sleep disturbance in ARFID and its association with eating problems, body mass index (BMI), gender, internalizing and externalizing symptoms, cognitive performance, and academic difficulties.MethodsData from 71 ARFID patients from our partial hospitalization program (PHP) for children and adolescents were examined. Sleep data were extracted from measures administered at admission including Achenbach Child Behavior Checklist (CBCL), Children's Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Correlational analyses were conducted to evaluate the convergent validity of parent-reported and participant-reported sleep problems. Association with the severity of eating problems, BMI, percentage of median body weight (% MBW), age, gender, psychotropic medication, psychopathology, and academic difficulties was examined using analysis of variance (ANOVA) and Pearson’s correlation. ResultsFifty-two percent of parents and 74% of participants reported two or more sleep symptoms. Trouble sleeping was reported by 46.48% and nightmares by 35.21% of parents. Parent-reported trouble sleeping highly correlated with internalizing disorders. Parent-reported trouble sleeping and participant-reported difficulty sleeping positively correlated with attention and attention-deficit/hyperactivity disorder (ADHD) problems. Parent-reported less sleep and feeling tired correlated with sluggish cognitive tempo, while walking/talking in sleep negatively correlated with school performance. Gender differences were noted in parent-reported sleep problems. Sleep disturbances were not associated with lower BMI or median body weight at intake. Parent-reported talking/walking in sleep and participant-reported bad dreams and bedtime worries positively correlated with Children's Eating Attitudes Test (ChEAT) scores at intake and discharge.DiscussionOur results provide compelling evidence to screen for sleep disturbance in ARFID patients regardless of median body weight and BMI. Exploration of sleep disturbances in ARFID using objective measures is warranted.

Differential Effects of Anxiety on Internet Gaming Disorder: A Large-Scale Cross-Sectional Survey.

BackgroundInternet gaming disorder (IGD) has become a serious public health problem in East Asia, and studies have reported IGD to be significantly associated with anxiety, but no causal relationship between the two has yet been demonstrated. Children are at high risk of developing IGD, however, previous studies have principally focused on the condition in adults and adolescents and reported non-clinical samples. A large-scale survey is needed to research and evaluate IGD and anxiety in children and adolescents to understand the current situation of IGD in children and explore the impact of IGD on anxiety.MethodsA cross-sectional study using an online questionnaire was conducted between March 1 and July 31, 2021. A total of 10,479 school children and adolescents in the western provinces of China were selected by convenience sampling. A questionnaire was used to collect data anonymously. The questionnaire covered IGD and the Revised Children's Manifest Anxiety Scale (RCMAS). Welch's ANOVA Test and Games-Howell test were used to test for differences in anxiety levels between IGD groups. Poisson regression analysis was used to further investigate the key predictors of IGD.Results3.2% of participants (n = 334) (95% CI: 2.9–3.2%) were classified as at high risk of presenting with IGD, 71.1% (n = 7,454) (95% CI: 70.3–72.0%) were classified as low-risk players, and 25.7% (n = 2,691) (95% CI: 24.9–26.5%) were classified as non-gaming. The average RCMAS score was (7.18 ± 7.534). The high-risk group had a higher total score RCMAS, as well as scoring higher in its three dimensions. Regression analysis using gender, age, and total RCMAS score as independent variables, and risk of IGD as a dependent variable showed that the odds ratio (OR) for gender was 2.864 (95% CI: 2.267–3.618), and the OR for total RCMAS score was 1.101 (95% CI: 1.087–1.114). The OR for age was not statistically significant.ConclusionAnxiety was a predictor of IGD, with statistically significant group differences in total anxiety, as well as the dimensions of physiological anxiety, social correlation, and sensitivity. The timely assessment of anxiety in children and adolescents, training social skills, and facilitating effective integration into society could be effective ways of reducing the incidence and impact of IGD.

Child and adolescent anxiety in relation to the type of foster family

The aim of the study was to determine whether there are differences in the manifestation of anxiety between children and adolescents in foster families with a long history of foster care and foster families with no experience in foster care. The sample consisted of 87 respondents, 48 from foster families with a long history of foster care and 39 respondents from foster families who have just entered the foster care system. Anxiety levels were examined using the Revised Children’s Manifest Anxiety Scale (RCMAS). The results showed statistically significant differences in the manifestation of anxiety between respondents from the two types of foster families. The Kruskal-Wallis test indicated statistically significant differences between respondents from foster families with a long history of foster care compared to respondents from families with no foster care experience in terms of expressing anxiety in all four subtests: a) Psychological Anxiety; b) Worry/ Hypersensitivity c) Social Anxiety and d) lie control subscale. The results of this study indicate that there are significant statistical differences between respondents living in different types of foster families. The conclusion points to the need for planned interventions that would improve the functionality of inexperienced foster families in their multidimensional influence on the development of children and adolescents

Psychometric Properties of the Obsessive-compulsive Inventory: The Persian Child Version; a Preliminary Study

Background: The Obsessive-Compulsive Inventory-Child Version (OCI-CV) is an approved self-report assessment tool that includes various domains of Obsessive-Compulsive Disorder (OCD). Objectives: This study was done to evaluate the psychometric properties of the OCI-CV in a sample of youth with OCD. Materials &amp; Methods: This was a descriptive-analytic study. The subjects were 107 children and adolescents, 7 to 17 years old admitted to the Shafa hospital and Gill psychiatric center in the north of Iran in 2017-2018. The subjects with the diagnosis of OCD based on a diagnostic interview by a youth psychiatrist based on the DSM-5 were included in the study. They were assessed by the OCI-CV, Revised Children’s Manifest Anxiety Scale (RCMAS), and children depression inventory (CDI). Data were analyzed by SPSS v. 22, using Cronbach alpha, Pearson correlation coefficient, and exploratory factor analysis. Results: Youth with the Mean±SD age 11.18±3.1 years participated in the study. Results showed that 51% of the samples were girls. The internal consistency assessed by the Cronbach alpha for the total scale was 0.75, indicating good reliability. The Pearson correlation coefficient between OCI-CV and RCMAS was 0.584 (P=0.01), and between OCI-CV and CDI was 0.232 (P=0.05), showing an excellent concurrent validity. Construct validity showed that all subscales had a high correlation with the total score of the questionnaire and the correlation coefficient was significant (P&lt;0.05). Conclusion: The Persian version of the OCI-CV has good psychometric characteristics in the clinical sample of youth with OCD.

Impact of Disclosure over Time on the Emotional Well-Being of Children with Perinatally Acquired HIV Infection in South Africa.

The aim of this study was to describe the disclosure process in children with perinatally acquired HIV infection (PHIV+) and its impact on their emotional well-being and adherence to antiretroviral therapy (ART) in South Africa. This prospective cohort study followed PHIV+ children aged 7 to 13 years attending counseling over 18 months. Standardized disclosure tools were used by a counselor with both child and caregiver present. Assessments included the Child Behavior Checklist (CBCL), Vineland Adaptive Behavior Scale (VABS), Child Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Adherence to ART was recorded through pharmacy pill returns. Changes over time and their differences from baseline were assessed by linear mixed models. Thirty children with median age 10 years (interquartile range [IQR]: 9.0-11.0) were enrolled. The median time to disclosure was 48 weeks (IQR: 48.0-54.6). There was a significant decrease from baseline (p < 0.0001) and over time (p = 0.0037) in the total CDI score. A positive trend in the changes from baseline and over time was observed for internalizing (p values < 0.0001) and externalizing (p values < 0.0001) CBCL scales and Total Anxiety score of the RCMAS (p < 0.0001 and p < 0.0002, respectively). Only the Defensiveness median T-score increased during the follow-up (p = 0.004) and in the change from baseline (p = 0.0005). The adaptive (p = 0.0092) and maladaptive (p < 0.0001) scores of the VABS showed a decrease from baseline. ART adherence remained high throughout this study. Disclosure does not worsen the child's emotional well-being and adherence to ART over time. This study adds to research from low- and middle-income countries to alleviate fears that disclosure may have an adverse outcome on children with PHIV+.

EFFECT OF SAVASANAAS AN ADJUNCT TO CONVENTIONAL SENSORY INTEGRATION THERAPY ON ANXIETY LEVEL OF CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER.

Attention Decit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder characterized by either signicant difculties of inattention or/ and impulsiveness or a combination of two. This results in hyperactivity.The Children with ADHD often have problems with working memory, organization and time management that make it hard to follow daily routines, It is accompanied by heightened anxiety levels. Savasana has been found to be effective in reducing stress in cardiac conditions. The Savasana may help to reduce anxiety in children with ADHD.The study was conducted to study the effect of Savasana along with conventional sensory integration therapy on anxiety levels of Chidren with ADHD &amp; compare the anxiety level in children with ADHD receiving conventional Sensory integrative therapy. Children meeting inclusion criterion were allocated in two groups and were evaluated on Revised Children`s Manifest Anxiety Scale (RCMAS) at the baseline,at 4 weeks &amp; at 8th week. There was signicant difference in improvement at 8th week follow-up between the groups with p&lt; 0.001. The Savasana being integral part of Yoga, Savasana can help in reducing the anxiety.The parents expressed satisfaction, as they noted reduction in hyperactivity of their child &amp; improved attention during short term activities. They have also reported improvement in their behavior at school.The study on larger population is recommended.

Effects of a Physical Education Program on Physical Activity and Emotional Well-Being among Primary School Children.

(1) Background: It has been identified that schools that adopt at least two hours a week of physical education and plan specific contents and activities can achieve development goals related to physical level, such as promoting health, well-being, and healthy lifestyles, on a personal level, including bodily awareness and confidence in physical skills, as well as a general sense of well-being, greater security and self-esteem, sense of responsibility, patience, courage, and mental balance. The purpose of this study was to establish the effect of physical education programs on the physical activity and emotional well-being of primary school children. (2) Methods: The experimental group comprised 45 girls and 44 boys aged 6–7 years (First Grade) and 48 girls and 46 boys aged 8–9 years (Second Grade), while the control group comprised 43 girls and 46 boys aged 6–7 years (First Grade) and 47 girls and 45 boys aged 8–9 years (Second Grade). All children attended the same school. The Children’s Physical Activity Questionnaire was used, which is based on the Children’s Leisure Activities Study Survey questionnaire, which includes activities specific to young children (e.g., “playing in a playhouse”). Emotional well-being status was explored by estimating three main dimensions: somatic anxiety, personality anxiety, and social anxiety. The Revised Children’s Manifest Anxiety Scale (RCMAS) was used. (3) Results: When analysing the pre-test results of physical activity of the 6–7- and 8–9-year-old children, it turned out that both the First Grade (92.15 MET, min/week) and Second Grade (97.50 MET, min/week) participants in the experimental group were physically active during physical education lessons. When exploring the results of somatic anxiety in EG (4.95 ± 1.10 points), both before and after the experiment, we established that somatic anxiety in EG was 4.55 ± 1.00 points after the intervention program, demonstrating lower levels of depression, seclusion, somatic complaints, aggression, and delinquent behaviours (F = 4.785, p < 0.05, P = 0.540). (4) Conclusions: We established that the properly constructed and purposefully applied eight-month physical education program had positive effects on the physical activity and emotional well-being of primary school children (6–7 and 8–9 years) in three main dimensions: somatic anxiety, personality anxiety, and social anxiety. Our findings suggest that the eight-month physical education program intervention was effective at increasing levels of physical activity. Changes in these activities may require more intensive behavioural interventions with children or upstream interventions at the family and societal levels, as well as at the school environment level. These findings have relevance for researchers, policy makers, public health practitioners, and doctors who are involved in health promotion, policy making, and commissioning services.

Efektivitas Penerapan Telemental Konseling terhadap Penurunan Kecemasan Remaja Akibat Paparan Informasi Covid 19 di Kota Padang

The Coronavirus disease 2019 (COVID-19) epidemic in China is a global health threat, which causes fear, anxiety in receiving the right information according to the mental health needs of society. Teenagers are included in the group who experience the psychological impact of Covid 19 who experience anxiety. Adolescents are more receptive to the use of smartphone applications, health authorities may consider providing psychoeducation and online or smartphone-based psychological interventions. This study aims to determine the effectiveness of implementing Telemental Counseling in Padang city adolescents in 2020. The design used in this study was a Quasi experimental design with a pre and post control group design approach. The sampling technique was Simple Random Sampling with a total sample of 44 people, 22 people in the intervention group and 22 from the control group. This study used the Revised Children's Manifest Anxiety Scale (RCMS) questionnaire. Data analysis was performed using Paired T-Test. The results of this study showed a decrease in the level of anxiety in adolescents in the intervention group, namely the average score of anxiety before being given the application of Telemental counseling in the experimental group was 21.18 and 17.32 afterwards. The results of this statistical test show that there is an effect of providing telemental counseling in the intervention group on reducing anxiety in adolescents in Padang City. The statistical test results obtained p-value = 0.000 (p &lt;0.05).

Effects of Hospital Clowning on Anxiety and Fatigue in Children with Cancer undergoing Chemotherapy

Background: Chemotherapy is associated with various physical and psychological complications such as fatigue and anxiety in children. Although hospital clowning completely affects health care in pediatric patients, it is a little-known distraction approach in children undergoing chemotherapy in Iran. Aim: This study aimed to investigate the effect of hospital clowning on anxiety and fatigue in children with cancer undergoing chemotherapy. Method: The participants in this clinical trial were 7-15-year-old children (n = 18) with cancer undergoing chemotherapy in a hospital in southeastern Iran, 2019. Participants were selected using convenience sampling and randomly assigned to the intervention (n=40) and control groups (n=40). The intervention group and clown participated in different games for two weeks, 3 sessions per week, and each session lasted 2 to 3 hours in the playroom of the oncology ward. The control group received routine care. A demographic survey, the Revised Children's Manifest Anxiety Scale (RCMAS), and the Visual Analog Fatigue Scale (VAFS) were completed before and immediately after the intervention by interviewing the two groups. Data were analyzed by IBM SPSS v.21 using the Independent t-test, Paired t-test, and Chi-square. Results: The mean and standard deviation of the age in the intervention and control groups were 9.61±2.84 and 9.65±2.28 years old, respectively. The mean difference between anxiety and fatigue in the two groups was significantly different after hospital clowning (p <0.001). Implications for Practice: The present study indicated that hospital clowning reduced anxiety and fatigue in children with cancer undergoing chemotherapy. Using hospital clowning is recommended in clinical wards due to the negative effects of anxiety and fatigue on the treatment of children with cancer.

The effect of prayer painting on spiritual life and anxiety in 7–11-year-old children with immunodeficiency

ABSTRACT One of the recommended treatments for reducing anxiety is spiritual care. This study surveys the effect of prayer painting on spiritual life and anxiety in 7–11-year-old children with immunodeficiency diseases. This experimental research used convenience sampling. Data were collected through the Children’s Spirituality Lives (CSL) and the Revised Children’s Manifest Anxiety Scale (RCMAS) which were filled before, one week after and one month after the intervention. Samples were asked to paint their prayers to God over six sessions. Mean score for CSL was 105.85 ± 8.6 before intervention, 108.45 ± 10.22 one week after and 107 ± 8.2 one month after intervention. Anxiety was 10.24 ± 6.33, 7.76 ± 5.36, and 6.52 ± 4.88 respectively with a significant difference (P < 0.001). The results show that prayer painting can be recommended as an anxiety-reducing practice and that the effect of painting on children’s spiritual life requires more studies.

The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes.

Background Given the importance of anxiety and quality of life for the mental health of children with type 1 diabetes (T1D), exercise prescription can be of crucial significance. The present study aims to explore the effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life among pediatric T1D. Methods Forty children (aged 8-14 years) were randomly assigned to experimental (n = 20) and control groups (n = 20) for 16 weeks. The exercise training program was composed of 16 weeks of interval concurrent resistance-aerobic training with a duration of 60 min performed three times a week. The subjects first performed the resistance training (20 min of Pilates exercises and 20 min of body weight-bearing exercises). Then, the aerobic exercises were performed with an intensity of 50-75% of maximum heart rate. Before and after the training, blood tests including cortisol were carried out on the subjects by RIA kit. Anxiety and quality of life were measured by the Revised Children's Manifest Anxiety Scale (RCMAS) and Pediatric Quality of Life (PedsQL), respectively. Body composition was measured by InBody. Data were analyzed by paired and independent t-test at p < 0.05 significance level. Results Sixteen weeks of concurrent resistance-aerobic exercise significantly reduced the anxiety index (p = 0.001) and increased the quality of life (p = 0.003). Although the cortisol index was increased, it did not reveal any significant differences between the experimental and control groups (p = 0.781). No significant differences were observed in the indices of quality of life, anxiety, and cortisol in the control group. Conclusions A 16-week program of concurrent resistance-aerobic training can improve the quality of life and anxiety among children suffering from T1D, but it may not influence the cortisol level (p > 0.05).

Validation of the French version of the « Meta-Cognition Questionnaire » for adolescents (MCQ-Af): Evolution of metacognitive beliefs with age and their links with anxiety during adolescence.

IntroductionThe Meta-Cognitions Questionnaire for Adolescents (MCQ-A) measures individual differences of metacognitive beliefs and monitoring thought to be involved in the onset and maintenance of psychological disorders, especially in those involving anxiety. This assessment tool has been employed in research and clinical settings involving French-speaking adolescents, but appropriate validation has yet to be conducted. This article aims to first validate the francophone version of the MCQ-Af using measures sensitive to the expression of anxiety, and secondly, to examine the influence of age and gender on metacognitive beliefs, anxiety and their links.Method214 adolescents (114 females) between 13 and 17 completed the MCQ-Af (French version) as well as the Revised-Children's Manifest Anxiety Scale (R-CMAS), French version, to assess anxiety manifestations. Structural validity was examined with confirmatory factor analyses. Three models were compared to the higher order five factor model proposed in the original validation study. Internal consistency and test-retest reliability were also performed. Student’s t tests as well as simple and stepwise regressions were conducted to assess for age and gender.ResultsThe five correlated factors retained in the original version of the MCQ were replicated, and confirmatory factor analyses yielded comparable fit indices for a covariate factor model, as well as for a bifactor model. The bifactor model was privileged for theoretical reasons. Analyses were performed on a shortened questionnaire of 27 items as 3 items (2, 12 and 14) had non-significant loadings in prior path analyses. Age and gender differences were found in specific sub-factors of the MCQ-Af; positive and negative metacognitive beliefs seem to increase with age; girls seem to score higher on the negative metacognitive beliefs and thought control dimensions. The study further reports specific links between anxiety manifestation and negative and positive metacognitive beliefs, as well as confidence in one’s memory. A modest influence of age and gender on this link was also highlighted.ConclusionThe present research provides the first evidence that the MCQ-Af is a valid and reliable instrument to assess individual differences of metacognitive beliefs in French-speaking adolescents. Nevertheless, it highlights that caution should be taken in regards of 3 items in particular (items 2, 12 and 14). Furthermore, age and gender in assessed samples of adolescents might influence the scores of the different dimensions of the questionnaire.

Association of Upper Quarter Posture with Depression, Anxiety, and Level of Physical Activity in Sixth Grade Elementary School Students of Karaj City, Iran

Background: Postural abnormalities are prevalent among elementary school students. The aim of this study was to investigate the association of the upper quarter posture with depression, anxiety and level of physical activity in elementary school students of Karaj. Methods: In this cross-sectional study, 346 sixth grade students were randomly selected from 10 elementary schools. Levels of physical activity, anxiety, and depression were measured and the data were collected employing International Physical Activity Questionnaire-Short form (IPAQ-SF), Revised Children’s Manifest Anxiety Scale (RCMAS), and Children’s Depression Inventory (CDI), respectively. Photogrammetric method and a flexible ruler were used to assess the students’ posture. Pearson correlation test and linear regression model at the confidence level of 95% (P<0.05) was utilized to analyze the data. Results: There was a significant relation between depression and the craniovertebral angle (P=0.003); physical activity levels were also correlated with the sagittal head angle (P=0.012), and kyphosis (P=0.012). Conclusions: Certain postural abnormalities were associated with physical activity and psychological problems. Therefore, preventive actions are of great necessity to decrease postural and psychological problems.

Exploratory Factor Analysis of the Adolescent Version of the General Behavior Inventory in Korean Youth

Objectives:We examined the factor structure of the Adolescent version of the General Behavior Inventory (A-GBI) for Koreans.Methods:We retrospectively reviewed the medical records of 220 adolescents (age, 12–18 years) who completed the A-GBI through the Department of Psychiatry at Asan Medical Center, Seoul, Korea, from October 2011 to December 2018. Caregivers of the study participants completed the Parent version of the GBI (P-GBI) 10-item Mania Scale. The adolescents were evaluated based on the A-GBI, Children’s Depression Inventory (CDI), and Revised-Children’s Manifest Anxiety Scale (RCMAS). Subsequently, an exploratory factor analysis (EFA) using the maximum likelihood method with direct oblimin rotation and correlation analyses with other scales were performed.Results:The EFA identified a two-factor structure as having the best fit: factor I included depressive symptoms and factor II included hypomanic/biphasic symptoms. Factor I was very strongly correlated with the A-GBI depressive subscale (r=0.990, p<0.001) and strongly correlated with CDI (r=0.764, p<0.001) and RCMAS (r=0.666, p<0.001). Factor II was also very strongly correlated with the A-GBI hypomanic/biphasic subscale (r=0.877, p<0.001) and weakly correlated with CDI (r=0.274, p<0.001) and RCMAS (r=0.332, p<0.001).Conclusion:The above findings support a two-dimensional model of mood symptoms in Korean youth.