Spence Children's Anxiety Research Articles

Validation of the parent report version of the Spence Children's Anxiety Scale (SCAS-P) for Spanish children.

Although Spence Children's Anxiety Scale (SCAS) is a widely used anxiety measure in many countries around the world, until now, research has barely focused on the usefulness of the parent version (SCAS-P) in young children. This study examines the psychometric properties and the factor structure of the SCAS-P in a Spanish community sample of 181 children aged 6-8 years (M = 6.87, SD = 0.78). Confirmatory factor analysis showed a good fit of the original six-factor model to the Spanish sample. The internal consistency and the test-retest reliability of the scale were high. Regarding the validity of this measure, higher and significant correlations between the SCAS-P and internalizing problems and lower correlations with externalizing problems were obtained, as found in the original version. Girls seemed to show more anxiety problems than boys, but no significant differences were found. The results suggest that the SCAS-P is an adequate measure to assess anxious symptomatology in young children. The availability of measures with good psychometric properties allows psychologists to assess and carry out a correct and early diagnosis of anxiety disorders in children, making possible an early clinical intervention.

Lifetime exposure to traffic-related air pollution and symptoms of depression and anxiety at age 12 years

BackgroundWhile air pollution has been associated with depression and anxiety in adults, its impact on childhood mental health is understudied. ObjectiveWe examined lifetime exposure to traffic-related air pollution (TRAP) and symptoms of depression and anxiety at age 12 years in the Cincinnati Childhood Allergy and Air Pollution Study cohort. MethodsWe estimated exposure to elemental carbon attributable to traffic (ECAT), a surrogate of diesel exhaust, at birth, age 12 years, and average exposure throughout childhood, using a validated land use regression model. We assessed depression and anxiety at age 12 years by parent report with the Behavior Assessment System for Children-2, and by child report with the Child Depression Inventory-2 (CDI-2) and the Spence Children's Anxiety Scale (SCAS). Associations between TRAP at birth, age 12 years, and childhood average and mental health outcomes were estimated using linear regression models adjusting for covariates including parent depression, secondhand smoke exposure, race, household income, and others. ResultsExposure to ECAT was not significantly associated with parent-reported depression or anxiety. However, exposure to ECAT at birth was associated with increased child-reported depression and anxiety. Each 0.25 µg/m3 increase in ECAT was associated with a 3.5 point increase (95% CI 1.6–5.5) in CDI-2 scores and 2.3 point increase (95% CI 0.8–3.9) in SCAS total anxiety scores. We observed similar associations between average childhood ECAT exposures but not for concurrent exposures at age 12. ConclusionsTRAP exposure during early life and across childhood was significantly associated with self-reported depression and anxiety symptoms in children. The negative impact of air pollution on mental health previously reported among adults may also be present during childhood.

Dimension-specific symptom patterns in trajectories of broad anxiety: A longitudinal prospective study in school-aged children.

Theories of maladaptive anxiety in children have suggested different developmental trajectories across age. Weems (2008) suggested that one subgroup of children demonstrates high and stable levels of broad anxiety, but shifting levels of dimension-specific symptoms in part due to related normative challenges. In a prospective longitudinal design, the current study examined patterns of dimension-specific anxiety symptoms in subgroups of children following different developmental trajectories of broad anxiety. A total of 300 children (150 girls, 150 boys) ages 8-11 at baseline, completed the Spence Children's Anxiety Scale four times over 3 years. Using latent class growth mixture modeling, we found evidence of three subgroups of children following different trajectories of broad anxiety across age: low-stable, moderate-increasing, and high-decreasing. Compared with other children, the subgroup with moderate and increasing levels of broad anxiety demonstrated an initially higher level of separation anxiety with larger improvement across time but, initially, similar levels of generalized and social anxiety with a larger increase across age. High broad anxiety was partly carried by different sets of dimension-specific symptoms at different ages, which suggests that children with high levels of broad anxiety across time may be more sensitive to normative challenges that happen in typical child development.

Anxiety, depression, self-esteem among children of alcoholic and nonalcoholic parents.

Context:Children of alcoholics (COAs) face risks of behavioral problems during childhood and mental health problems in adult life. Identifying these problems at the earliest can significantly reduce the problems in future.Aims:To compare the anxiety, depression, and self-esteem between COA and non-COA parents.Settings and Design:A cross-sectional comparative survey research design was adopted for the present study. The study was conducted at selected government high school located in Bangalore urban.Subjects and Methods:The simple random sampling technique was used. A total of 200 children comprising 100 children of each alcoholic parents and nonalcoholic were recruited for the study. A screening test (modified) was used for identifying COA. Spence Children's Anxiety Scale, Center for Epidemiological Studies Depression Scale for Children (CES-DC), and Rosenberg Self-Esteem Scale were used to assess anxiety, depression, and self-esteem, respectively.Statistical Analysis Used:Data were analyzed using Statistical Package for the Social Sciences software package (version 23).Results:The results show that there is statistically significant difference between COA and non-COA group with regard to anxiety, depression, self-esteem, separation anxiety, social phobia, obsessive compulsive problems, and physical injury.Conclusion:The study concludes that COAs are having higher rate of anxiety, depression, and low self-esteem compared with children of nonalcoholics.

Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?

The aim was to investigate whether clinical experience, formal cognitive behavioural therapy (CBT) training, adherence, and competence predict outcome in CBT for anxiety disorders in youth. Videotapes (N=181) from the sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014, Behaviour Research and Therapy, 57, 1-12) comprising youth (N=182, M age=11.5years) with mixed anxiety disorders were assessed for treatment adherence and competence using the Competence and Adherence Scale for CBT for anxiety disorders in youth (Bjaastad et al., 2016, Psychological Assessment, 28, 908-916). Therapists' (N=17) clinical experience and educational background were assessed. Participants completed a diagnostic interview (Anxiety Disorders Interview Schedule, child and parent versions) and an anxiety symptom measure (Spence Children's Anxiety Scale, child and parent versions) at pretreatment, posttreatment, and 1-year follow-up. Higher therapist adherence was related to better treatment outcomes, whereas number of years of clinical experience and competence was related to worse outcomes. However, these findings were not consistent across informants and the time points for the assessments. Interaction effects suggested that competence among therapists with formal CBT training was related to better patient outcomes. Therapist adherence, competence, and clinical experience are associated with outcomes of manualized CBT for youth anxiety disorders, but mixed findings indicate the need for more research in this area.

Cognitive biases predict symptoms of depression, anxiety and wellbeing above and beyond neuroticism in adolescence

BackgroundAdolescence represents a period of vulnerability to affective disorders. Neuroticism is considered a heritable risk factor for depression, but is not directly amenable to intervention. Therefore, it is important to identify the contributions of modifiable risk factors. Negative cognitive biases are implicated in the onset and maintenance of affective disorders in adults, and may represent modifiable risk factors in adolescence. Aim(s)This study sought to assess to what extent cognitive biases are able to predict depression, anxiety and wellbeing beyond that of neuroticism in adolescents. MethodsAdolescents (N = 99), recruited from Scottish secondary schools (54.5% female; mean age = 14.7), ensured a sample representing the breadth of the mental health spectrum. In line with prevalence estimates, 18% of this sample demonstrated clinical levels of depression symptoms. Cognitive biases of autobiographical memory, self-referential memory, ambiguous scenarios interpretation, facial expression recognition, rumination and dysfunctional attitudes were assessed. Depression, anxiety, and wellbeing were indexed using the Mood and Feelings Questionnaire, Spence Children's Anxiety Scale and the BBC Subjective Wellbeing Scale. ResultsRegression analyses demonstrated neuroticism to significantly predict depression, anxiety and wellbeing. The addition of cognitive biases resulted in a significant increase of explained variance with final models explaining just over 50% of variances of depression, anxiety and wellbeing. ConclusionThese findings demonstrate that cognitive biases explain mental health symptoms over and above that of neuroticism. Depressive symptomology was particularly related to self-referential memory bias, while anxiety was predicted by interpretive bias. The key clinical implication is that targeting specific biases based on diagnostic features may be of particular benefit in alleviating distress and promoting wellbeing.

فعالية برنامج قائم على الإثراء النفسي في تخفيف اضطراب القلق ونقص تقدير الذات لدي ضحايا التنمر من أطفال الروضة The effectiveness of a psychological enrichment program in reducing Anxiety and self-esteem among the victims of bullying in kindergarten children

يهدف البحث الحالي إلى الکشف عن فعالية برنامج قائم على الإثراء النفسي في تخفيف اضطراب القلق ونقص تقدير الذات لدي ضحايا التنمر من أطفال الروضة ، وکذلک الکشف عما إذا کانت هناک فروق دالة إحصائيا بين متوسطي درجات المجموعة الضابطة والمجموعة التجريبية في التطبيق البعدى لمقياس کلا من ( القلق - تقدير الذات) لصالح المجموعة التجريبية لدى أطفال الروضة ضحايا والکشف عما إذا کان هناک فرق دال إحصائيا بين متوسطي درجات المجموعة التجريبية في التطبيق البعدى والتطبيق التتبعى لمقياس کلا من (القلق- تقدير الذات) لدى أطفال الروضة ضحايا التنمر. وقد تم استخدام مقياس ضحايا التنمر لأطفال الروضة (إعداد: الباحثة)، ومقياس سبنس إعداد (Spence Children's Anxiety Scale) ترجمة وتقنين: عبد العزيز موسى محمد ثابت،2010 ) واستخدام قائمة تقدير الذات إعداد کوبر سميث، Cooper Smith ترجمة خليفة وآخرون،2007) بالإضافة إلي برنامج الإثراء النفسي المقترح.(إعداد الباحثة)، وتکونت عينة البحث من(60) طفل وطفلة من أطفال الروضة بمدرسة الرملة الابتدائية المشترکة رقم (1) من الذين تتراوح أعمارهم ما بين(4-7) سنوات تم تقسميهم إلى (30) طفلا من الجنسين مجموعة تجريبية و(30) طفلا من الجنسين مجموعة ضابطة. واستخدمت الباحثة المنهج شبه التجريبي. وتم التوصل إلى النتائج التالية : أنه يوجد فرق دال إحصائيا بين متوسطي درجات المجموعة الضابطة والمجموعة التجريبية في التطبيق البعدى في التخفيف من حدة القلق لصالح المجموعة التجريبية لدى أطفال الروضة ضحايا التنمر، کما أنه يوجد فرق دال إحصائيا بين متوسطي درجات المجموعة الضابطة والمجموعة التجريبية في التطبيق البعدى في الرفع من مستوي تقدير الذات المنخفض لصالح المجموعة التجريبية لدى أطفال الروضة ضحايا التنمر، مما يعني فعالية البرنامج المقترح القائم على الإثراء النفسي، في حين لم توجد تلک الفروق بين القياسين البعدي والتتبعي؛ مما يعني استمرارية فعالية البرنامج المقترح بعد شهرين من تطبيقه. وجود فرق دال إحصائيا بين متوسطي رتب درجات ذکور وإناث المجموعة التجريبية في التطبيق البعدى لأبعاد مقياس قلق الأطفال (الجسدي، اللفظي، الاجتماعي) للأبعاد الثلاثة الأولى على التوالي، ولکن غير دالة في البعد الرابع(النفسي) وقامت الباحثة بتقديم عدة توصيات ومنها ضرورة إجراء المزيد من الدراسات والبحوث التي تهتم بمعالجة ظاهرة التنمر عند مراحل عمرية مختلفة، والاهتمام بالمزيد من البرامج التي من شأنها علاج أثر ما ترکه التنمر على کلا من المتنمر والضحية، وعمل برامج للمعلمات والآباء والأمهات للتوعية بخطورة تلک الظاهرة وکيفية التعامل معها. The current research aims at uncovering the effectiveness of a psychotherapy program in alleviating anxiety disorder and self-esteem among the victims of bullying in kindergarten children. As well as Identify if there are statistically significant differences between the mean scores of the control group and the experimental in a pre/post/follow-up tests after performing the sessions on the self-esteem scale and anxiety scale.The study tools wereThe scale of the victims of bullying (the researcher), the Spence scale for anxiety for childrer (Thabit, 2010) and the self-esteem list (by Cooper Smith) (Khalife et al., 2007). The research utilizes the quasi-experimental method.the final study sample included (30) children in Al-RamlaElementary School No. (1), aged (4-7) years. They were divided randomly into two groups; an experimental (intervention) group (n = 14), and a control group 16). the results show that there was a statistically significant difference between the mean scores of the control group and the experimental group in the post-application of the (anxiety-self-esteem) scale for the experimental group.While there were no differences between the two dimensions and the dependency, which means the continued effectiveness of the proposed program two months after its application There was a statistically significant difference between the mean scores of males and females of the experimental group in the remote application of dimensions of the children's anxiety scale (physical, verbal and social dimention) for the first three dimensions respectively, but not significant in the fourth dimension. The study recommended that to perform more studies and research that address the phenomenon of bullying at different stages of age, and attention to more programs that will address the impact of bullying left on both the bullying and the victim, work programs for teachers and parents to raise awareness of the seriousness of this phenomenon and how to deal with it .

Factor structure and psychometric properties of the Pittsburgh Sleep Quality Index in community-based adolescents.

The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses general sleep quality. This study aimed to validate the single-factor scoring structure and related psychometric properties in the English language version of the PSQI in community-based adolescents. Participants were 889 (352 males, 39.6%) students (age M = 15.71 ± 1.57; 12.08-18.92 years) recruited from 14 Australian secondary schools. Participants completed the PSQI, Center for Epidemiological Studies-Depression (CES-D) scale, and Spence Children's Anxiety Scale (SCAS). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of PSQI component scores were performed on two independent random half-samples (i.e. cross-validation approach). The internal consistency of PSQI components and convergent validity of the PSQI global score with CES-D and SCAS total scores were also assessed. EFA yielded a single-factor model. CFA of the single-factor model in a separate sample yielded acceptable model fit to the data after important relationships were modeled. Namely, modification indices suggested improved model fit by correlating residual scores of PSQI components of sleep duration and sleep efficiency, and sleep efficiency and sleep latency. Internal consistency was acceptable (Cronbach's α = 0.73). The PSQI global score had moderate-to-large positive correlations with CES-D (r = 0.58) and SCAS (r = 0.45) total scores, demonstrating good convergent validity with emotional problems as predicted. The findings validate the single-factor scoring structure of the PSQI in an adolescent sample and highlight important covariation between poor sleep duration, efficiency, and latency in this age group. Further validation studies are required to determine an appropriate PSQI clinical cut-off score for adolescents.

A Tailored Web-Based Intervention to Improve Parenting Risk and Protective Factors for Adolescent Depression and Anxiety Problems: Postintervention Findings From a Randomized Controlled Trial.

BackgroundDepression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking.ObjectiveThis study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms.MethodsA two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents’ risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent’s strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children’s Anxiety Scale (anxiety symptoms).ResultsParents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions.ConclusionsThe fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents’ risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents’ mental health.Trial RegistrationAustralia New Zealand Clinical Trials Registry: ACTRN12615000328572; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx? id=368274 (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj)

Anxiety symptoms in regular school students in Mumbai City, India.

Aim:Anxiety disorders usually remain undiagnosed in school students owing to the internalized nature of their symptoms. The present study was conducted with the primary objective of evaluating the prevalence of anxiety symptoms in school students in Mumbai. A secondary objective was to assess the impact of variables (age, gender, presence of sibling, and type of school curriculum or school) on anxiety symptoms.Materials and Methods:Study cases (8–15 year olds) were recruited by nonprobability sampling from four English-medium schools. Anxiety was measured using Spence Children's Anxiety Scale (SCAS)-child self-report questionnaire. T-scores (total and subscales) were calculated and cut-off scores of >60 were considered as significant.Results:Symptoms of overall anxiety were present in 10.8% (53/493) of the students. Older students (12–15 year olds) had greater odds of having overall anxiety symptoms (crude OR = 4.36, 95% CI 2.27 to 8.39, P < 0.0001). Symptoms of all anxiety disorders were present in the 493 participants, with obsessions/compulsions and fears of physical injury being the most common (in 29.6% and 27.2%, respectively). Older students and boys had greater odds of having obsessions/compulsions (crude OR = 2.32, 95% CI 1.56 to 3.44, P < 0.0001; and crude OR = 1.54, 95% CI 1.04 to 2.27, P = 0.035, respectively]. Students with sibling (s) had greater odds of having fears of physical injury (crude OR = 0.48, 95% CI 0.30 to 0.78, P = 0.003).Conclusions:There is an urgent need to screen school students in our city for anxiety disorders.

Development and validation of a brief screening procedure for pediatric obsessive-compulsive disorder derived from the Spence Children's Anxiety Scale

Evidence-based assessment (EBA) is essential to accurate measurement of psychiatric disorders, including pediatric obsessive-compulsive disorder (OCD). There are, unfortunately, barriers to using these techniques in clinical settings, primary among which is the time entailed in instrument administration. The current study applied decision-tree statistics to parent and child forms of the OCD subscale contained within a commonly used pediatric anxiety assessment tool (the Spence Children's Anxiety Scale) with an emphasis on abbreviating the measure. The end product of this examination was a pair of algorithms derived from analysis of a sample containing both clinical cases who presented for treatment and community controls (n = 1094 parent/children dyads in total). These were noted to be either statistically significantly superior to or not different from the lengthier SCAS/P OCD subscales in terms of common metrics of clinical utility (i.e., sensitivity, specificity, positive predictive value, and negative predictive value) despite containing only 1 – 2 items each. The results demonstrate feasibility of data reduction strategies to improve clinical implementation of EBA, particularly decision-tree models. The fit of this instrument into a clinical setting is discussed, as are future extensions of these methods to diverse problem sets in the context of integrated healthcare services.

Understanding the Impact of Paediatric Asthma on Families: Development of a Theoretical Model

The experience of paediatric asthma is associated with increased stress and emotional difficulties for both the child and family. The current study aimed to qualitatively explore parents’ views of their child's asthma experience, from initial diagnosis onwards, to enhance our understanding of how families emotionally adjust and adapt to the diagnosis and management of asthma. Semi-structured interviews were conducted with 17 parents of children (&lt;18 years) with physician-diagnosed asthma. Questionnaires were used to capture demographic information and anxiety symptom status of parents (State Trait Anxiety Inventory — Form Y [STAI-Y1/Y2]) and children (Spence Children's Anxiety Scale — Parent reported [SCAS-P]). Grounded theory was used to analyse the results. Analysis saw three themes emerge as important in understanding the impact of asthma on the family: (1) the experience of obtaining an asthma diagnosis, (2) parents’ belief in their competence to manage asthma, and (3) parents’ behaviour in response to the asthma. A model was developed that posits adaptive parental adjustment to asthma is determined in part by the circumstances around the time of diagnosis, the level of knowledge and skills, and the controllability of the asthma. This model can guide medical and allied health professionals to specific areas where intervention may reduce stress and emotional difficulties associated with asthma and its management for affected families.

Who benefits from adolescent sleep interventions? Moderators of treatment efficacy in a randomized controlled trial of a cognitive-behavioral and mindfulness-based group sleep intervention for at-risk adolescents.

The aim of this study was to test moderators of therapeutic improvement in an adolescent cognitive-behavioral and mindfulness-based group sleep intervention. Specifically, we examined whether the effects of the program on postintervention sleep outcomes were dependent on participant gender and/or measures of sleep duration, anxiety, depression, and self-efficacy prior to the interventions. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female=59.34%; mean age=14.48years, range 12.04-16.31years) who had elevated levels of sleep problems and anxiety symptoms. Participants were randomized into either a group sleep improvement intervention (n=63) or group active control 'study skills' intervention (n=60). The sleep intervention ('Sleep SENSE') was cognitive behavioral in approach, incorporating sleep education, sleep hygiene, stimulus control, and cognitive restructuring, but also had added anxiety-reducing, mindfulness, and motivational interviewing elements. Components of the active control intervention ('Study SENSE') included personal organization, persuasive writing, critical reading, referencing, memorization, and note taking. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Center for Epidemiologic Studies Depression Scale (CES-D), and General Self-Efficacy Scale (GSE) and wore an actigraph and completed a sleep diary for five school nights prior to the interventions. Sleep assessments were repeated at postintervention. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True). The results showed that compared with the active control intervention, the effect of the sleep intervention on self-reported sleep quality (PSQI global score) at postintervention was statistically significant among adolescents with relatively moderate to high SCAS, CES-D, and GSE prior to the intervention, but not among adolescents with relatively low SCAS, CES-D, and GSE prior to the intervention. The results were consistent across genders. However, the effects of the sleep intervention on actigraphy-measured sleep onset latency and sleep diary-measured sleep efficiency at postintervention were not dependent on actigraphy-measured total sleep time, SCAS, CES-D, or GSE prior to the intervention. This study provides evidence that some sleep benefits of adolescent cognitive-behavioral sleep interventions are greatest among those with higher levels of anxiety and depressive symptoms, suggesting that this may be an especially propitious group to whom intervention efforts could be targeted. Furthermore, adolescents with lower levels of self-efficacy may need further targeted support (e.g. additional motivational interviewing) to help them reach treatment goals.

A pilot study on the effectiveness of a school-based cognitive-behavioral anxiety intervention for 8- and 9-year-old children: A controlled trial in Japan

IntroductionMany universal school-based preventative intervention trials for anxiety have been conducted in Western countries. This pilot study examined the efficacy and acceptability of a school-based, universal preventative program for anxiety among children aged 8–9 years in Japan. The program was based on cognitive-behavioral therapy (CBT) and was informed by similar universal programs (i.e., the Fun FRIENDS program; Barrett, 2007a, 2007b). MethodsSeventy-four children from a single school were allocated to an intervention or control group. The intervention comprised 10 CBT sessions, and assessments were conducted before and after the program. The primary outcome measure was the Spence Children's Anxiety Scale (SCAS) as children's self-report. Secondary outcome measures were the Depression Self-Rating Scale for Children (DSRS-C), Children's Hope Scale (Hope), Spence Children's Anxiety Scale-Parent Version (SCAS-P), and Strengths and Difficulties Questionnaire-Parent Version (SDQ-P). ResultsThe SCAS as the primary outcome showed no significant differences between the two groups. In addition, DSRS-C, Hope and SDQ-P also showed no significant differences. SCAS-P in the intervention group showed significant decrease compared to those in the control group. ConclusionThe results of this trial study suggest that a school-based universal preventative program for anxiety may have no significant effects on 8–9-year-old children. Trial registrationUMIN-CTR Identifier UMIN000008798.

Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME).

Little is known about the type and severity of sleep disturbances in the pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) population, compared with healthy adolescents. Using a range of objective and subjective measures, the aim of this study was to investigate sleep quality, the relationship between objective and subjective measures of sleep quality, and their associations with anxiety in adolescents with CFS/ME compared with healthy controls. Twenty-one adolescents with CFS/ME aged 13 to 18 years (mean age 15.57 ± 1.40), and 145 healthy adolescents aged 13 to 18 years (mean age 16.2 ± 1.00) wore actigraphy watches continuously for 2 weeks to collect a number of objective sleep variables. The Pittsburgh Sleep Quality Index was used to obtain a subjective measure of sleep quality. Anxiety was measured by the Spence Children's Anxiety scale. On average over the 2-week period, adolescents with CFS/ME were found to have (1) significantly longer objective sleep onset latency, time in bed, total sleep time, and a later rise time (all P < .005), and (2) significantly poorer subjective sleep quality (P < .001), compared with healthy adolescents. The CFS/ME patient group displayed higher levels of anxiety (P < .05), and in both groups, higher levels of anxiety were significantly related to poorer subjective sleep quality (P < .001). This study provides objective and subjective evidence of sleep disturbance in adolescents with CFS/ME compared with healthy adolescent controls.

The measurement properties of the spence children's anxiety scale-parent version in a large international pooled sample of young people with autism spectrum disorder.

Anxiety-related difficulties are common in ASD, but measuring anxiety reliably and validly is challenging. Despite an increasing number of studies, there is no clear agreement on which existing anxiety measure is more psychometrically sound and what is the factor structure of anxiety in ASD. The present study examined the internal consistency, convergent, divergent, and discriminant validity, as well as the factor structure of the Spence Children's Anxiety Scale-Parent Version (SCAS-P), in a large international pooled sample of 870 caregivers of youth with ASD from 12 studies in the United Kingdom, United States, and Singapore who completed the SCAS-P. Most were community recruited, while the majority had at least one measure of ASD symptomatology and either cognitive or adaptive functioning measures completed. Existing SCAS-P total scale and subscales had excellent internal consistency and good convergent, divergent and discriminant validity similar to or better than SCAS-P properties reported in typically developing children, except for the poorer internal consistency of the physical injury subscale. Confirmatory Factor Analysis (CFA) of the existing SCAS-P six-correlated factor structure was a poor fit for this pooled database. Principal component analysis using half of the pooled sample identified a 30-item five correlated factor structure, but a CFA of this PCA-derived structure in the second half of this pooled sample revealed a poor fit, although the PCA-derived SCAS-P scale and subscales had stronger validity and better internal consistency than the original SCAS-P. The study's limitations, the use of the SCAS-P to screen for DSM-derived anxiety problems in ASD and future research directions are discussed. Autism Res 2017, 10: 1629-1652. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents.

The aim of this study was to test whether a cognitive behavioral and mindfulness-based group sleep intervention would improve sleep and anxiety on school nights in a sample of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and presleep hyperarousal. Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n = 63) or active control "study skills" intervention (n = 60). Preintervention and postintervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Presleep Hyperarousal Scale (PSAS) and wore an actiwatch and completed a sleep diary for five school nights. The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOLobj), sleep diary measured sleep efficiency (SEsubj), PSQI, SCAS, SBS, and PSAS, with medium to large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in the PSAS that resulted from the intervention. Improvements in SOLobj and SEsubj were not specifically related to improvements in any of the putative treatment mechanisms. This study provides evidence that presleep arousal but not sleep hygiene awareness is important for adolescents' perceived sleep quality and could be a target for new treatments of adolescent sleep problems.

Psychometric Properties of the Spence Children's Anxiety Scale: Parent Report in Children with Autism Spectrum Disorder.

Although anxiety is frequently reported in children with autism spectrum disorder (ASD), existing anxiety scales are often psychometrically inappropriate for this population. This study examined the internal structure, reliability, convergent and discriminant validity of the Spence Children's Anxiety Scale-Parent Report (SCAS-P; Spence 1999) in 238 school-aged children with ASD. While confirmatory factor analysis did not support the original six-correlated-factor structure, structural support as well as acceptable internal consistency and convergent validity was found for Generalized Anxiety, Separation Anxiety, Panic, and Agoraphobia subscales. Use of the SCAS-P in its original form for assessment in children with ASD was not supported. However, four subscales showed viability, and may benefit re-analyses of existing SCAS-P data and future scale adaptations for research and clinical purposes.

Parenting styles and anxiety disorders in children – A study in an Albanian clinical population

IntroductionAbout 20% of children suffer from an anxiety disorder and symptoms may persist in adulthood. About 13 in every 100 children from 9 to 17 years old experience anxiety disorders, girls seem more vulnerable than boys. Theoretical models of anxiety emphasize the effect of parenting on development and maintenance of child anxiety.ObjectivesThis research aims to study the nature of correlation between parenting styles and anxiety in children who attend Tirana Child &amp; Adolescent Psychiatric Service.MethodsOne hundred and seventy-five children and 175 their parents filled Spence Children Anxiety Scale (SCAS) and Parenting Styles &amp; Dimensions Questionnaire (PSDQ) was found a significant correlation between parenting styles and anxiety in children.ConclusionsParental overprotection produces vulnerable children who become adults ready to give up in front of life difficulties therefore; it is necessary parents’ awareness in practicing a balance in their parenting styles, in order to reduce children's anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Negative Life Events, Social Support, and Self-Efficacy in Anxious Adolescents.

To examine the prevalence and correlates of anxiety in a community sample of adolescents. Knowing the prevalence and characteristics of anxious adolescents is valuable to improve anxiety prevention strategies and interventions. Cross-sectional data about anxiety were collected via a school survey from a community sample of Norwegian adolescents aged 12-17 (N = 1719). Based on scores from the Spence Children's Anxiety Scale, the adolescents were categorized as not anxious or anxious. Logistic regression analysis was performed to access the impact of each factor on the likelihood that participants would report an elevated level of anxiety. A total of 22% of the adolescents were categorized as anxious. Female gender, experienced negative life events, low social support, and low self-efficacy were associated with elevated level of anxiety. The high prevalence of anxiety in adolescents demonstrates the importance of improved prevention interventions targeting anxious adolescents. We argue that addressing is the responsibility of not only the individual adolescents and their families but also schools, school health services, and policy makers. School-based interventions that increase social support and self-efficacy would probably be particularly beneficial for anxious adolescents.