The Influence of Culture on Anxiety in Latino Youth: A Review

This article reviews the literature on how culture influences anxiety in Latino youth. First, a review of cross-cultural variations in prevalence and measurement is presented. Then, the article focuses on how culture impacts the meaning and expression of anxiety. Specifically, we discuss the meaning and expression of anxiety, the impact of culture on anxiety at a societal level and through its effect on family and cognitive processes, and the influence of immigration and acculturation on anxiety. Finally, we propose recommendations on how to advance the literature in this area building on existing knowledge.     

Methodological Issues in Treatment Research for Anxiety Disorders in Youth

This article identifies and addresses three methodological domains relevant to the treatment of anxiety disorders in youth: (a) procedural matters, (b) the assessment of anxious distress, and (c) the analysis of treatment-produced change. Procedural topics include the need to manualize treatment, have diversity among participants and comparability of the duration of treatment and control conditions, and control for medication status. Multiple-method measurement issues include child and parent reports, observations, and structured interviewing. Our examination of change issues considers comorbidity, analyzing the intent-to-treat sample, treatment spillover, and clinical as well as statistical significance. Problems are identified and potential ameliorative strategies are offered.     

Anxiety Symptoms and Fears in Hispanic and European American Children: Cross-Cultural Measurement Equivalence

The cross cultural equivalence of child (n = 217) and parent (n = 283) versions of the revised children’s manifest anxiety scale (RCMAS), multidimensional anxiety scale for children (MASC), and the fear survey schedule for children—revised (FSSC-R) was examined in Mexican youth in Mexico, and Hispanic and white European American youth in the USA. The RCMAS, MASC, and FSSC-R showed cross ethnic measurement equivalence. The Mexican and Hispanic youth reported more worries, and the Mexican youth reported more somatic symptoms than the European American youth. Per mother report, Mexican and Hispanic youth express more somatic symptoms than European American youth who also show the least number of fears of the unknown and fears of danger and death. The results support the validity of commonly used child anxiety measures with these populations and accrue evidence for greater anxiety and fear expression by Hispanic and Mexican youth in certain domains.

Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety

Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.     

Dyadic Anxiety in Youth Sport: The Relationship of Achievement Goals With Anxiety in Young Athletes and Their Parents

The role of achievement motivation on precompetitive anxiety was examined in 73 dyads comprising youth athletes and a parent of each athlete. Participants completed questionnaires assessing achievement goals and anxiety. Actor–partner interdependence models were estimated using Mplus 7.11. Parents’ adoption of performance-approach and performance-avoidance goals predicted athletes’ worry (β_{performance-approach} =.30, p <.01; β_{performance-avoidance} =.25, p <.05). Athletes’ adoption of any goal predicted parents’ concentration disruption (β_{mastery-approach} =.41; β_{mastery-avoidance} =.30, p <.01; β_{performance-approach} =.27; β_{performance-avoidance} =.22, p <.05). Thus, parental definitions of competence held for the child was related to their young athlete's emotional state and vice versa.     

Selective Mutism in Children: Comparison to Youths With and Without Anxiety Disorders

Fifteen children with selective mutism (SM), 15 children with anxiety disorders (AD) without selective mutism, and 15 children without anxiety disorders or selective mutism (CN) were compared to examine the relationship between selective mutism and anxiety. Data were collected from children (age 4–10 years), parents, teachers, and clinicians. Results indicated that children with SM closely resemble children with AD. All children with SM received a diagnosis of social anxiety disorder and 53% received a diagnosis for an additional anxiety disorder. In addition, the SM and AD groups differed substantially from controls with respect to parent- and teacher-rated internalizing behavior problems. No differences among the groups were found with respect to parent-and teacher-reported externalizing behavior problems. The results are consistent with prior research emphasizing the association between selective mutism and anxiety disorders, and suggest that selective mutism may be conceptualized, assessed, and treated as an anxiety-related problem.     

Establishing Measurement Equivalence and Invariance in Longitudinal Data With Item Response Theory

If measurement invariance does not hold over 2 or more measurement occasions, differences in observed scores are not directly interpretable. Golembiewski, Billingsley, and Yeager (1976) identified 2 types of psychometric differences over time as beta change and gamma change. Gamma change is a fundamental change in thinking about the nature of a construct over time. Beta change can be described as respondents' change in calibration of the response scale over time. Recently, researchers have had considerable success establishing measurement invariance using confirmatory factor analytic (CFA) techniques. However, the use of item response theory (IRT) techniques for assessing item parameter drift can provide additional useful information regarding the psychometric equivalence of a measure over time that is not attainable with traditional CFA techniques. This article marries the terminology commonly used in CFA and IRT techniques and illustrates real advantages for identifying beta change over time with IRT methods rather than typical CFA methods, utilizing a longitudinal assessment of job satisfaction as an example.     

Exploring Relationships Between Negative Cognitions and Anxiety Symptoms in Youth With Autism Spectrum Disorder

Although cognitions are central to the conceptualization and treatment of anxiety in typically developing (TD) youth, there is scant research investigating automatic thoughts and their relationship with anxiety in youth with autism spectrum disorder (ASD). We sought to examine the types of automatic thoughts experienced by youth with ASD and co-occurring anxiety as well as the predictive relationship of anxiety to different types of automatic thoughts in 97 children, ages 8-14 years. We also explored the relationship of automatic thoughts and intolerance of uncertainty. Consistent with prior data, there was a strong relationship between anxiety and automatic thoughts pertaining to social and physical threat. Anxiety and IU were independently associated with thoughts pertaining to personal failure which raises the hypothesis that personal failure may serve as a common pathway between anxiety, IU, and depression in ASD youth. These findings highlight the importance of assessing and treating negative cognitions in youth with ASD and anxiety.     

Meta‐Analysis of Counseling Outcomes for Youth With Conduct Disorders

Twenty‐one clinical trials were synthesized using a random‐effects model, which substantiated that counseling generally produces a medium effect in treating conduct disorder in youth at termination (d + = 0.30 to 0.57; k = 28). However, the lasting effects at follow‐up were unclear because few follow‐up studies (k = 13) have been conducted (d + = ?0.53 to 0.58), and only 2 randomized controlled follow‐up studies were located. No effects of moderating variables were evident. Implications for counseling practice and outcome research are addressed.     

Language Measurement Equivalence of the Ethnic Identity Scale With Mexican American Early Adolescents

The current study considers methodological challenges in developmental research with linguistically diverse samples of young adolescents. By empirically examining the cross-language measurement equivalence of a measure assessing three components of ethnic identity development (i.e., exploration, resolution, and affirmation) among Mexican American adolescents, the study both assesses the cross-language measurement equivalence of a common measure of ethnic identity and provides an appropriate conceptual and analytical model for researchers needing to evaluate measurement scales translated into multiple languages. Participants are 678 Mexican-origin early adolescents and their mothers. Measures of exploration and resolution achieve the highest levels of equivalence across language versions. The measure of affirmation achieves high levels of equivalence. Results highlight potential ways to correct for any problems of nonequivalence across language versions of the affirmation measure. Suggestions are made for how researchers working with linguistically diverse samples can use the highlighted techniques to evaluate their own translated measures.     

Fear and Anxiety in COVID-19: Preexisting Anxiety Disorders

The general population has experienced a significant elevation in fear and anxiety during COVID-19 both as a direct result of the virus but also due to measures taken to prevent it spreading, such as the need to stay inside and increase hand-washing. Lockdown has been used in many/most countries to prevent widespread infection. The advice and imposed actions are necessary to prevent the virus from spreading, but they might exacerbate the problems experienced by people with a preexisting anxiety-related disorder. The treatment of anxiety-related disorders can be provided while in quarantine. Staying at home in self-isolation does not preclude obtaining psychological treatment for anxiety-related disorders. Dealing with cognitive biases, over-estimations of threat, intolerance of uncertainty, inflated responsibility and excessive safety behavior, are useful clinical directions.     

Parent and Teacher Agreement of Behavior Problems in Youth Diagnosed With and Without Autism Spectrum Disorders

The prevalence and severity of behavioral problems in youth with autism spectrum disorders (ASD) may be context dependent leading to discrepant informants’ reports and complicating case conceptualizations and treatment goals. This study examines the inter-rater agreement of parents and teachers on behavioral problems of 58 youth with ASD and 42 youth without an ASD diagnosis. Parents and teachers of 26 youth with ASD (M?=?4.08, SD?=?1.02) and 21 youth with non-ASD diagnoses (M?=?4.38, SD?=?0.80), ages 2–5 years, and 32 youth with ASD (M?=?7.47, SD?=?1.44), and 21 youth with non-ASD diagnoses (M?=?7.71, SD?=?1.23), ages 6–10, completed the Child Behavior Checklist and Teacher Report Form. Compared to youth with a non-ASD diagnosis (ages 2–5 years), youth with ASD also had poor to moderate agreement across subscales with the exception of comparable substantial agreement on Externalizing Behavior (ICC?=?0.73 and ICC?=?0.63, respectively) and Aggressive Behavior subscales (ICC?=?0.72 and ICC?=?0.69, respectively). Compared to youth with a non-ASD diagnosis (ages 6–10 years), youth with ASD similarly had poor agreement across subscales with the exception of moderate agreement on Anxious/Depressed subscale (ICC?=?0.41 and ICC?=?0.06, respectively). These results suggest that the severity and prevalence of behavior problems in youth may depend on the context and reporter of the symptoms.     

Using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders With Youth Exhibiting Anger and Irritability

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A) are evidence-based treatment programs with cognitive-behavioral and third-wave behavior therapy elements, aimed at extinguishing distress to intense emotion states and reducing unhelpful action tendencies in such states among youth with emotional disorders. A growing body of literature demonstrates the high prevalence of problematic anger and irritability among youth with emotional disorders, yet evidence-based treatments to address anger and irritability are typically developed more exclusively for youth with externalizing disorders. Given this need, a clinical case example of the UP-C applied to a child with anger and irritability is presented. Application of transdiagnostic theory to both conventional anxiety concerns and to irritability concerns is discussed. We demonstrate the flexibility and utility of a transdiagnostic approach like the UP-A and UP-C for addressing concerns across a range of emotions.     

Perfectionism in Pediatric Anxiety and Depressive Disorders

Although perfectionism has been identified as a factor in many psychiatric disorders across the life span, it is relatively understudied in pediatric anxiety and depressive disorders. Furthermore, there exists little cohesion among previous research, restricting the conclusions that can be made across studies. In this review, research associating perfectionism with pediatric anxiety and depression is examined and a framework is presented synthesizing research to date. We focus on detailing the current understanding of how perfectionism develops and interacts with other developmental features characteristic of anxiety and depression in children and potential pathways that result in anxiety and depressive disorders. This includes: how perfectionism is measured in children, comparisons with relevant adult literature, the development of perfectionism in children and adolescents, mediators and moderators of the link between perfectionism and anxiety and depression, and the role of perfectionism in treatment and prevention of these disorders. We also present research detailing perfectionism across cultures. Findings from these studies are beginning to implicate perfectionism as an underlying process that may contribute broadly to the development of anxiety and depression in a pediatric population. Throughout the review, difficulties, limitations, and gaps in the current understanding are presented while offering suggestions for future research.     

Assessing At‐Risk Youth Using the Reynolds Adolescent Adjustment Screening Inventory With a Latino Population

Factor analyses were conducted on scores from the Reynolds Adolescent Adjustment Screening Inventory (RAASI; Reynolds, 2001 ) representing at‐risk Latino youth. The 4‐factor model of the RAASI did not exhibit a good fit. However, evidence of generalizability for Latino youth was noted.