Perceived parental rearing behaviour and anxiety disorders symptoms in normal children

The present study examined the relationship between perceptions of parental rearing behaviours and anxiety disorders symptomatology in a sample of normal school children. 45 children, aged 8 to 12 years, completed the EMBU for children, a questionnaire that measures perceptions of parental rearing practices. Additionally, they filled in the Screen of Child Anxiety Related Emotional Disorders (SCARED), an index of DSM-defined anxiety disorders symptoms. Significant and positive relationships were found between anxious rearing behaviours and parental control, on the one hand, and anxiety disorders symptomatology, in particular symptoms of generalized anxiety disorder, separation anxiety disorder and environmental–situational phobia, on the other hand.     

Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample

The current study examined the psychometrics of three traditional [i.e., the trait anxiety version of the State-Trait Anxiety Inventory for Children (STAIC), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Fear Survey Schedule for Children - Revised (FSSC-R)] and three new childhood anxiety scales [the Multidimensional Anxiety Scale for Children (MASC), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Spence Children's Anxiety Scale (SCAS)] in a large sample of normal adolescents (N=521). Childhood anxiety scales were generally found to be reliable in terms of internal consistency. Furthermore, evidence was obtained for the convergent and divergent validity of the various anxiety questionnaires. That is, anxiety questionnaire scores were found to be substantially intercorrelated. Particularly strong associations were found between total scores of the STAIC and the RCMAS, total scores of the SCARED and the SCAS, and between subscales that intend to measure specific categories of anxiety symptoms. Childhood anxiety questionnaires were substantially connected to an index of depression, although correlations among anxiety questionnaires were generally higher than those between anxiety scales and a measure of depression.     

The utility of screen for child anxiety related emotional disorders (scared) as a tool for identifying children at high risk for prevalent anxiety disorders

Abstract

The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used as the diagnostic standard. It was investigated whether SCARED scores are indicative for the presence of generalized anxiety disorder, separation anxiety disorder, and social phobia. Five-hundred-and-thirty-seven children aged 7–14 years completed the SCARED. From this sample, 82 children were selected on the basis of their SCARED scores. A subgroup of these children scored relatively high on the generalized anxiety disorder, separation anxiety disorder, and/or social phobia scale(s) of the SCARED. A comparison group of children scored relatively low on these SCARED scales. Both groups of children then received the semi-structured interview to assess to what extent they fulfilled the DSM-IV criteria for the relevant anxiety disorders. Results provided some support for the predictive validity of the SCARED generalized anxiety disorder and separation anxiety disorder subscales. The implications of these findings for the detection of anxiety disorders in normal children are briefly discussed.     

Comorbidity between SCARED anxiety factors and depressive symptomatology in 8- to 12-year-old children

The aim of this study was to examine the comorbidity between the SCARED anxiety factors and depressive symptoms in 8-12-year-old children. Participants were 792 girls and 715 boys, who completed: the 41-ítem version of the Screen for Child Anxiety Related Emotional Disorder (SCARED), the Children's Depression Inventory (CDI) and a Socio-demographic questionnaire. Of the sample, 47% showed anxiety symptoms and 11.5% showed depressive symptoms. Heterotypic comorbidity was 82% in children at risk of depression and 20% in children at risk of anxiety. Homotypic Comorbidity between anxiety factors was 87%. Homotypic comorbidity and heterotypic comorbidity were high; their early detection will prevent the continuity of an anxious disorder and the development of depression.     

Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions: (1) 3 months before treatment (i.e., baseline), (2) at pretreatment, and (3) at posttreatment. Before and after treatment, scores on traditional childhood anxiety measures (i.e., State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Fear Survey Schedule for Children) were also obtained. Results showed that children's SCARED scores remained relatively stable from baseline to pretreatment. However, from pre- to post-treatment, significant decreases were evident for the SCARED and for all traditional measures. These results suggest that the SCARED reliably taps treatment effects and, thus, provide further support for its utility as a self-report index of childhood anxiety in clinical and research settings.     

Disgust sensitivity, trait anxiety and anxiety disorders symptoms in normal children.

There is evidence to suggest that disgust sensitivity plays a role in the development of small animal fears and phobias. Recently, Phillips, Senior, Fahy, and David (1998) [Phillips, M. L., Senior, C., Fahy, T., & David, A. S. (1998). Disgust: the forgotten emotion of psychiatry. British Journal of Psychiatry, 172, 373-375.] suggested that disgust sensitivity is also involved in various other anxiety-based symptoms (e.g. obsessive-compulsive complaints, social phobia). The present study sought to test this suggestion in a large sample of normal school children (N = 189). Children completed a measure of disgust sensitivity, the trait anxiety version of the Spielberger State-Trait Anxiety Inventory for Children and the Screen for Child Anxiety Related Emotional Disorders, an instrument that measures DSM-defined anxiety disorders symptoms. Disgust sensitivity was indeed found to be correlated with a broad range of anxiety disorders symptoms. However, results also indicated that these correlations were predominantly carried by trait anxiety. That is, when controlling for levels of trait anxiety, only specific phobia symptoms (including animal phobia, blood-injection-injury phobia and situational-environmental phobia) and separation anxiety disorder symptoms were significantly related to disgust sensitivity, although correlations were rather modest. Taken together, these findings cast doubts on the claim that disgust sensitivity is an unique and independent factor that contributes to a broad range of anxiety disorders.     

Associations of symptoms of anxiety disorders and self-reported behavior problems in normal children

61 children, aged between 14 and 18 years, completed the Screen for Child Anxiety Related Emotional Disorders, a scale of anxiety disorders symptoms, and the Youth Self-report, a measure of internalizing, i.e., emotional, and externalizing, i.e., behavioral, problems. Analysis showed that, with the exception of the Social Phobia and the Specific Phobia subscales, Screen total and subscale scores were significantly related to Internalizing problems (rs between .40 and .77). Thus, the more frequently children reported Anxiety Disorder symptoms, the more often they reported emotional problems. Furthermore, in particular, anxious-depressed problems as measured by the Youth Self-report were significantly associated with scores on Screen scales. These results further support the concurrent validity of the Screen.     

母亲消极情绪表露与儿童焦虑的关系：有调节的中介模型

本研究以临沂市3所小学1173名一至六年级的学生及其母亲为被试,探讨了母亲消极情绪表露与儿童焦虑的关系,以及母子冲突和母子亲密在这一关系中的作用。采用家庭情绪表露问卷、亲子关系问卷、儿童焦虑性情绪障碍筛查表进行研究。结果表明：(1)母亲消极情绪表露与母子冲突、儿童焦虑两两显著正相关,母子亲密与母亲消极情绪表露、母子冲突、儿童焦虑的相关不显著;(2)母亲消极情绪表露显著正向预测儿童焦虑;(3)母子冲突在母亲消极情绪表露与儿童焦虑间起中介作用,且上述中介效应的后半段路径受到母子亲密的调节。     

The revised version of the screen for child anxiety related emotional disorders (scared-r): Further evidence for its reliability and validity

Abstract The revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-R) is a self-report questionnaire that intends to measure symptoms of childhood anxiety disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1994). The current article presents three studies which examined in more detail the reliability and validity of the SCARED-R. Study 1 (N=101) demonstrated that the SCARED-R possesses satisfactory test-retest stability. Study 2 (N=71) shows that the child-parent agreement of the SCARED-R is rather low. Study 3 (N=88) provides support for the concurrent validity of the SCARED-R. More specifically, SCARED-R scores were correlated in a meaningful way with scores on the Children's Anxiety Scale, a questionnaire that also measures DSM-defined childhood anxiety symptoms.     

Anxiety symptoms in Japanese and in German children

The purpose of this study was to compare the frequency of anxiety symptoms and their association with gender and age in Japanese and German children using the Spence Children's Anxiety Scale (SCAS). A total of 1837 children (862 from Germany and 975 from Japan) between the age of 8 and 12 years were investigated. Results revealed that German children reported significantly higher symptoms of separation anxiety, social phobia, obsessive compulsive disorder, and generalized anxiety disorder than Japanese children. Conversely, Japanese children reported significantly higher scores on symptoms related to physical injury fear. In both countries, girls scored higher than boys on all the scales of the SCAS. Symptoms of separation anxiety and panic decreased with age, whereas social phobia increased with age. The findings underscore the impact of culture on children's anxiety.     

The diagnostic utility of the Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71)

Objective

This study investigated the diagnostic utility of the 71-item Screen for Child Anxiety Related Emotional Disorders (SCARED-71), as a screening tool for identifying anxiety disorders in youth aged 8-18 years.

Method

The SCARED-71 and the Anxiety Disorder Interview Schedule (ADIS) were administered to clinically referred anxious children (n = 138) and control children (n = 38) as well as their parents.

Results

Results showed that the SCARED-71 differentiated clinically anxious from control children on the total score and on all subscales. Girls generally reported higher levels of anxiety symptoms and there were also significant age effects for various anxiety subscales. Further, reliable cut-off scores were established for the child and parent version of the SCARED-71. The parent version displayed better sensitivity and specificity, and therefore seems to be a more optimal screen for anxiety problems in children and adolescents. Finally, evidence for the predictive validity across anxiety disorders was found.

Conclusion

The SCARED-71 can be used as a screening tool to detect clinically significant anxiety problems in children and adolescents and discriminates reasonably well among specific anxiety disorders.     

Emotion-focused cognitive-behavioral therapy for anxious youth: A multiple-baseline evaluation

Examined the efficacy of an Emotion-focused Cognitive-Behavioral Therapy (ECBT) for six anxious youths ages 7–13 years. All participants had a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia) based on the Anxiety Disorder Interview Schedule for Children—Child and Parent versions. Children and parents reported on anxious symptomatology using the Multidimensional Anxiety Scale for Children (MASC). To assess emotion-related competencies, children were administered the Kusche Affective Interview—Revised and children and parents completed the Emotion Expression Scale for Children (EESC) and Emotion Regulation Checklist (ERC), respectively. Cases began treatment after baselines of 0, 2, or 3 weeks. At posttreatment, the majority of children demonstrated improvements in anxious symptomatology, emotion understanding and regulation skills, and overall functioning. Such improvements in emotion-related skills, in addition to anxiety, are significant given that emotional competence is a crucial component in children's adaptive social functioning and psychological adjustment. These findings provide initial support for ECBT.     

The Role of Anger in the Relationship Between Internalising Symptoms and Aggression in Adolescents

The purpose of this study was to examine the role of anger in the relationships between various internalising symptoms and direct and indirect aggression. A sample of 241 adolescents aged 12–17 years completed the Screen for Child Anxiety Related Emotional Disorders, Centre for Epidemiological Studies Depression scale (CES-D) and the Buss–Warren Aggression Questionnaire (AQ-15). Symptoms of panic disorder, generalised anxiety disorder and depression, but not social phobia, were positively correlated with anger, direct aggression and indirect aggression. When considered simultaneously in regression analyses, only symptoms of depression contributed to variance in the anger and aggression variables. However, using indirect effect modelling, no direct relationships were found between the internalising symptom variables and the aggression variables. Instead, the data suggested that the relationship between internalising symptoms and aggression is mediated by the emotion of anger. These findings suggest that the degree to which anger co-occurs with internalising symptoms may play an important role in an individual’s propensity to engage in aggressive behaviour.     

Children with social phobia have lower quality friendships than children with other anxiety disorders

Background and Objective: Whilst shy, socially anxious or socially withdrawn children in nonclinical community samples report lower friendship quality (FQ) than nonanxious children, no study has examined the FQ of clinically anxious children. The aim of the study was to examine the FQ of children with anxiety disorders; and whether it differs for clinical children with or without a diagnosis of social phobia (SP). Design: The study design was cross-sectional self-report. Methods: Clinical children – 39 anxiety-disordered children with SP and 28 anxiety-disordered children without SP (No-SP) – presented for psychological treatment, and 29 nonclinical children were recruited from the community. Same-sex close friends were invited to participate using an unrestricted nomination procedure. All children were aged between 7 and 13 years. Both target child and friend completed the Friendship Quality Questionnaire and the Spence Children's Anxiety Scale. Results: Using multilevel modeling within the framework of the Actor–Partner Interdependence Model, SP dyads were found to report lower overall FQ than No-SP dyads. SP dyads did not report lower overall FQ than nonclinical dyads. Conclusion: Children with SP in their diagnostic profile may be unique in their friendship experiences relative to children with other anxiety disorders.     

Trajectories of Social Anxiety in Children: Influence of Child Cortisol Reactivity and Parental Social Anxiety

Few studies have examined the interactive effect of intra- and extra-individual vulnerability factors on the trajectory of social anxiety in children. In this study, we examined the joint influence of familial vulnerability (i.e., parental social anxiety) and child biological stress vulnerability (i.e., cortisol reactivity) on trajectories of social anxiety. Children (N?=?112 (57 males), M _age?=?8.14 years, S.D. = 2.25) were followed over three visits spanning approximately three years. Parental social anxiety was assessed using the Social Phobia and Anxiety Inventory, children’s behavior and salivary cortisol reactivity were measured in response to a speech task, and children’s social anxiety was assessed at all three visits using the Screen for Child Related Emotional Disorders (SCARED; Parent-report). A growth curve analysis was used to examine trajectories of child social anxiety as predicted by children’s cortisol reactivity and parental social anxiety, adjusting for covariates. We found a significant interaction between parental social anxiety and child cortisol reactivity in predicting child social anxiety across time. Having a socially anxious parent coupled with heightened cortisol reactivity predicted the highest levels of child social anxiety, with scores that remained above clinically significant levels for social anxiety across all visits. Children with familial risk for social anxiety and who also exhibit high stress-reactivity appear to be at risk for persistent, clinically significant social anxiety. This highlights the importance of considering the interaction between both biological and contextual factors when considering the development, maintenance, and treatment of social anxiety in children across time.     

A Genetically Informed Study of the Covariation Between Childhood Anxiety Dimensions and Social Competence

We investigated the nature of latent shared etiological elements in 398 Italian twin pairs aged 8–17, explaining covariation between high levels of anxiety symptoms and low social competence. We found significant negative correlations between Child Behaviour Checklist/6–18 Social Competence Scale and three (Panic Anxiety, Separation Anxiety, Social Anxiety) out of five Screen for Child Anxiety Related Disorders anxiety subscales. Results from causal analysis seem to exclude the hypothesis that co-occurrence between Anxiety Symptoms and Social Competence could be due to a direct phenotypic effect of one trait upon the other. Multivariate analysis suggested that both genetic and shared environmental components contribute to the phenotypic correlation between Social Competence and Anxiety Subscales, whereas unique environmental factors have a negligible influence. This means that both common genetic and shared environmental causal factors contribute simultaneously to increase risk of having low Social Competence and high Anxiety scores. In particular, covariation with Social Competence seems to be influenced by both genetic and shared environmental causal components in Separation Anxiety and Social Anxiety, whereas environmental factors have an irrelevant influence for covariation with Panic/Somatic Anxiety Subscale. Our results support the adoption of a broader view of the relationships between psychopathology and diminished social competences in childhood for both clinicians and educators.     

Prolonged institutional rearing is associated with atypically large amygdala volume and difficulties in emotion regulation

Early adversity, for example poor caregiving, can have profound effects on emotional development. Orphanage rearing, even in the best circumstances, lies outside of the bounds of a species-typical caregiving environment. The long-term effects of this early adversity on the neurobiological development associated with socio-emotional behaviors are not well understood. Seventy-eight children, who include those who have experienced orphanage care and a comparison group, were assessed. Magnetic resonance imaging (MRI) was used to measure volumes of whole brain and limbic structures (e.g. amygdala, hippocampus). Emotion regulation was assessed with an emotional go-nogo paradigm, and anxiety and internalizing behaviors were assessed using the Screen for Child Anxiety Related Emotional Disorders, the Child Behavior Checklist, and a structured clinical interview. Late adoption was associated with larger corrected amygdala volumes, poorer emotion regulation, and increased anxiety. Although more than 50% of the children who experienced orphanage rearing met criteria for a psychiatric disorder, with a third having an anxiety disorder, the group differences observed in amygdala volume were not driven by the presence of an anxiety disorder. The findings are consistent with previous reports describing negative effects of prolonged orphanage care on emotional behavior and with animal models that show long-term changes in the amygdala and emotional behavior following early postnatal stress. These changes in limbic circuitry may underlie residual emotional and social problems experienced by children who have been internationally adopted.     

Screening for trauma in children and adolescents: the validity of the Traumatic Stress Disorder Scale of the screen for child anxiety related emotional disorders

Examined the validity of the Traumatic Stress Disorder scale of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a recently developed self-report questionnaire measuring Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) defined anxiety disorders symptoms in children. A large sample of normal schoolchildren (N = 996) ages 7 to 19 years completed the SCARED. Children who scored high on the SCARED Traumatic Stress Disorder scale (i.e., trauma group; n = 43) and children who scored low on this scale (i.e., control group; n = 43) were then interviewed about their most aversive life event. In addition, children completed self-report questionnaires of traumatic experiences and posttraumatic stress disorder (PTSD) symptomatology. Results showed that children in the trauma group more frequently reported life events that independent judges considered to be 'potentially traumatic' than did control children. Furthermore, children in the trauma group reported having experienced more traumatic incidents and had higher scores on PTSD-related questionnaires compared with control children. Moreover, trauma group children more frequently fulfilled DSM-IV criteria for PTSD than did control children. The results of this study support the validity of the Traumatic Stress Disorder scale of the SCARED.     

Anxiety and Stress in Children Following an Earthquake: Clinically Beneficial Effects of Treatment with Micronutrients

This study examined the effects of micronutrients on children with clinically elevated stress and anxiety 23–36 months after experiencing a natural disaster (a major earthquake). A single-case multiple-baseline design allocated 14 children (7 males, 7 females; aged 8–11 years; 10 with formal anxiety-disorder diagnoses) randomly to 1, 2 or 3 week baselines. Participants then took eight capsules/day of a micronutrient formula (EMPowerplus) during an 8-week open-label trial. Assessment instruments were the Children’s Global Assessment Scale (CGAS), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Pediatric Emotional Distress Scale (PEDS), and the Revised Children’s Manifest Anxiety Scale (RCMAS). Symptom severity declined slightly in baseline for some children and declined much more during intervention for all children. Effect sizes at end of treatment were ?1.40 (RCMAS), ?1.92 (SCARED), +1.96 (CGAS), and ?2.13 (PEDS). Modified Brinley plots revealed decreases in anxiety and improvements in overall functioning for 10 out of 11 completing participants. Side effects were mild and transient. The study provided evidence that treatment with a dietary supplement containing micronutrients reduced children’s post-disaster anxiety to a clinically significant degree. Future placebo-controlled randomized-controlled trials and treatment-comparison research is recommended to determine if this is true of anxiety in general.     

A parent-report measure of children's anxiety: psychometric properties and comparison with child-report in a clinic and normal sample

This study examined the psychometric properties of the parent version of the Spence Children's Anxiety Scale (SCAS-P); 484 parents of anxiety disordered children and 261 parents in a normal control group participated in the study. Results of confirmatory factor analysis provided support for six intercorrelated factors, that corresponded with the child self-report as well as with the classification of anxiety disorders by DSM-IV (namely separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, obsessive-compulsive disorder, and fear of physical injuries). A post-hoc model in which generalized anxiety functioned as the higher order factor for the other five factors described the data equally well. The reliability of the subscales was satisfactory to excellent. Evidence was found for both convergent and divergent validity: the measure correlated well with the parent report for internalizing symptoms, and lower with externalizing symptoms. Parent-child agreement ranged from 0.41 to 0.66 in the anxiety-disordered group, and from 0.23 to 0.60 in the control group. The measure differentiated significantly between anxiety-disordered children versus controls, and also between the different anxiety disorders except GAD. The SCAS-P is recommended as a screening instrument for normal children and as a diagnostic instrument in clinical settings.