Revised Child Anxiety and Depression Scale: a Psychometric Examination in Chinese Youth

There remains a need for a disorder-specific inventory of children’s depression and anxiety that can reliably screen anxious and depressive disorder symptomatology in Chinese children. The Revised Child and Anxiety Depression Scale (RCADS) is a self-report questionnaire assessing anxiety and depression in children (Chorpita et al., 2000; Piqueras et al., 2017). This study sought to evaluate its psychometric properties in a Mainland Chinese sample. Students from the 4th to 11th grades (N?=?1001) participated in this study. Each of the RCADS subscales, by age and sex, possessed reliability coefficients ranging between .63 and .81. Means and standard deviations for RCADS subscales calculated for the age and sex sub-samples were reported. Participants reported slightly lower levels on five subscales than for Chorpita et al. (2000) normative sample. The scales were significantly and strongly correlated with the Child Behavior Checklist (CBCL) subscales (somatic, withdrawal, anxiety) as well as CBCL internalizing scores. Fit statistics suggested marginal to adequate fit for the six-factor model for the Chinese youth. The present study provides foundational support for the psychometric properties of the RCADS in a large sample of Chinese youth yet indicates that factor structure might be improved through enhanced sampling of culturally relevant symptom expressions.

     

Self-Report Differentiation of Anxiety and Depression in a Mood Disorders Sample

Several lines of research suggest there is considerable overlap between anxiety and depression and that it is difficult to distinguish between these two constructs. However, a few studies utilizing factor analytic procedures have provided evidence that anxiety and depression can be differentiated when measures of these constructs are considered at the item level. In addition, there is some evidence that differentiation can be accomplished in samples experiencing high levels of anxiety (i.e., a clinically anxious sample; B. J. Cox, R. P. Swinson, L. Kuch, & J. Reichman, 1993). In the present study, this research strategy was extended to a sample of patients with high levels of depressed mood (i.e., a mood disorders sample; N = 378). Their responses to widely used measures of depression (i.e., Beck Depression Inventory; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) and anxiety (i.e., Spielberger State-Trait Anxiety Inventory—State subscale; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) were entered into a principal-components analysis with oblique rotation. A 4-factor solution was retained. This solution was comprised of factors representing anxiety, anxiety absent (a reverse scored factor), cognitive symptoms of depression, and somatic/vegetative symptoms of depression. These findings indicated that anxiety and depression, as emotional states, can be differentiated within a mood disorders sample, using existing popular self-report measures. The clinical and research implications of these findings are briefly discussed.     

Cognitive factors associated with depression and anxiety in adolescents: A two-year longitudinal study

Background/Objective: To examine the roles of anxiety sensitivity and attentional bias in the development of anxiety and depression symptoms among adolescents. Method: 214 grade 7 to grade 10 Hong Kong Chinese students completed a package of psychometric inventories to measure levels of anxiety sensitivity, selective attentional processing, and anxiety and depressive symptoms in 2016 and then again in 2017. Results: Girls, when compared with boys, exhibited more anxiety symptoms and anxiety sensitivity in 2016. They also reported a significant increase in mean depression level from 2016 to 2017. Regression analyses revealed that the physical-concerns dimension of anxiety sensitivity, positive attentional bias, and to a lesser extent negative attentional bias were related to the development of both anxiety and depression symptoms one year later. Fear of mental incapacity could predict depression one year later but not anxiety symptoms. Conclusions: Intervention through anxiety sensitivity training to reduce somatic concerns and attentional bias modification to increase habitual attention to positive stimuli and to disengage from negative stimuli can reduce anxiety and depression symptoms among high school students.     

Examination of Spatial Working Memory Performance in Children and Adolescents with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT) and Anxiety

Spatial working memory (SWM) is known to be impaired in children with ADHD-CT, whether anxiety is present or not. Yet, it remains unclear whether anxiety disorders add to the SWM impairments evident in ADHD-CT and whether these findings extend into adolescents with ADHD-CT and anxiety. Further, it is not yet known whether children and adolescents with carefully defined anxiety disorders alone, demonstrate SWM deficits. This study explored the association of SWM and its strategy and spatial span components in carefully defined children and adolescents (age 6–16 years) with ADHD-CT alone (N?=?163; 14 % female), ADHD-CT and anxiety (N?=?243; 23 % female), anxiety disorders alone (N?=?69; 25 % female) compared to age- and gender-matched healthy control participants (N?=?116; 19 % female). The relationship between SWM and its strategy and span components and core ADHD-CT symptoms and anxiety symptoms were also examined. There was no evidence of an additive effect of ADHD and anxiety on SWM, strategy and spatial span deficits. But, anxiety disorders alone were associated with impaired SWM and span performance compared to healthy control participants. In contrast, strategy did not differ between children and adolescents with anxiety disorders alone and healthy control participants, suggesting that with anxiety span is the most affected component. Further, these findings were age-independent. This study concurs with and extends current influential models about the cognitive effects of anxiety on performance in the setting of ADHD-CT. Clinical implications and future research directions are discussed.     

A preliminary investigation of cognitive and relaxation treatment of panic disorder: effects on intense anxiety vs 'background' anxiety

In this study, three adult males complaining of Panic Disorders were treated with cognitive therapy followed by relaxation training combined with cognitive therapy in a multiple-baseline across Ss design. All Ss demonstrated a decrease in the number and duration of episodes of heightened or intense anxiety, which was maintained at 3-month follow-up. Daily time-sampled ratings of ‘background’ anxiety, not necessarily associated with periods of intense anxiety, showed a substantial decrease for S2, which was maintained at 3-month follow-up. However, S 1 and S 3 evidenced an increase in background anxiety during the combined treatment phase in contrast to the effects of treatment on periods of ‘intense’ anxiety. These results suggest that psychological treatments for patients classified as suffering from Panic Disorder are effective and lend some support to the differentiation of panic from ‘general’ anxiety. Recent observations of relaxation-induced anxiety were also replicated in this clinical setting. These data also illustrate the advantages and difficulties of self-monitoring anxiety over a period of time.     

Evaluation apprehension and response withholding in solution of anagrams

Sixty male Ss who were classified as high or low scorers on the Sarason Test Anxiety Scale performed a difficult anagrams task either alone, before a passively observing experimenter or in the presence of an experimenter who both observed and evaluated the S's performance. Ss who were high in test anxiety attempted fewer anagrams and had fewer correct solutions in the Evaluated condition than in the Alone condition, but also had a higher proportion of correct solutions out of total attempts. Low test-anxiety Ss did not show variable performance across conditions for any measure. Follow-up studies showed that when Ss were encouraged to attempt partial solutions neither test anxiety nor experimental treatment influenced any of the measures of performance. State anxiety change scores from baseline to post-treatment assessment showed a generally negative correlation between anxiety and number of anagrams attempted. The results indicate that fear of failure engendered by test anxiety and experimenter evaluation caused Ss to withhold responding.     

Trait anxiety,stress, and learning a test of Saltz's hypothesis

Behavioral predictions from Saltz's, Spence's, and Spielberger's interpretations of trait anxiety were tested in a complex verbal learning task. Fifty-three high-anxious and 52 low-anxious male college students were randomly distributed to test conditions of failure-stress, pain-stress, or neutral instructions. The learning data revealed that high-anxious-failure and low-anxious-pain Ss were disrupted and supported Saltz's hypothesis; self-reported anxiety (A-State scale, STAI) was observed only in high-anxious-failure Ss and supported Spielberger's theory of the arousal of state anxiety as a function of trait anxiety. However, the contradiction between self-reported anxiety and learning behavior in low-anxious-pain Ss indicated that the verbal report of these Ss was an inaccurate or insensitive index of arousal.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

Self-confidence and anxiety interpretation: A qualitative investigation

Objectives: To examine performers’ retrospective explanations for the relationship between self-confidence, competitive anxiety intensity, and symptom interpretation toward performance.Method: Semi-structured interviews were conducted with 10 elite performers to determine how self-confidence levels influenced the perceived effects of pre-competitive anxiety intensity and identify the confidence management strategies used to protect symptom interpretation.Results: Two causal networks were identified, showing self-confidence to influence the relationship between competitive anxiety intensity and symptom interpretation. In the absence of self-confidence, increases in competitive anxiety intensity were perceived as outside of the performers’ control and debilitating to performance. Under conditions of high self-confidence, increases in symptoms were reported to lead to positive perceptions of control and facilitative interpretations. To protect against debilitating interpretations of competitive anxiety, performers reported the use of cognitive confidence management strategies including mental rehearsal, thought stopping, and positive self-talk.Conclusions: The findings highlight self-confidence as an essential quality for elite athletes to possess in order to protect against potentially debilitating thoughts and feelings experienced in competitive situations.     

Self-Help for Social Anxiety: Randomized Controlled Trial Comparing a Mindfulness and Acceptance-Based Approach With a Control Group

There are many barriers to the delivery of evidence-based treatment, including geographical location, cost, and stigma. Self-help may address some of these factors but there is a paucity of research on the efficacy of self-help for many problems, including social anxiety. The present research evaluated the efficacy of a mindfulness and acceptance-based self-help approach for the treatment of social anxiety. Individuals seeking help for social anxiety or shyness were recruited from the community. Participants (N = 117) were randomly assigned to a book (n = 58) or wait-list control condition (n = 59) on a 1:1 ratio. Hierarchical linear modelling results supported the efficacy of the self-help condition with between-group effect sizes on social anxiety outcomes ranging from .74 to .79. Significant change was also observed on self-compassion, mindfulness, acceptance, and depression. Some variables, including social anxiety and acceptance, were assessed weekly for those in the book condition. Additional participants (n = 35) were recruited for the book condition increasing the sample size to 93 for the latent change score modelling analyses. A unidirectional model was supported: increases in acceptance were associated with subsequent decreases in social anxiety. Overall these results support the use of a mindfulness and acceptance-based self-help approach for social anxiety.     

Effect of Direct-to-Consumer Genetic Tests on Health Behaviour and Anxiety: A Survey of Consumers and Potential Consumers

Direct-to-consumer (DTC) genetic tests can be purchased over the internet. Some companies claim to provide relative genetic risks for various diseases and thus encourage healthy behaviour. There are concerns that exposure to such information may actually discourage healthy behaviour or increase health anxiety. An online survey was conducted (n?=?275). Respondents were composed of individuals who had purchased a DTC genetic test and received their results (consumers, n?=?189), as well as individuals who were either awaiting test results or considering purchasing a test (potential consumers, n?=?86). Consumers were asked if their health behaviour or health anxiety had changed after receiving their results. Respondents’ current health behaviour and health anxiety were queried and compared. In total, 27.3 % of consumers claimed a change in health behaviour, all either positive or neutral, with no reported cessation of any existing health behaviour. A change in health anxiety was claimed by 24.6 % of consumers, 85.3 % of which were a reduction. Consumers had significantly better health behaviour scores than potential consumers (p?=?0.02), with no significant difference in health anxiety. This study points towards an association between receipt of DTC genetic test results and increased adoption of healthy behaviours for a minority of consumers based on self-report, with more mixed results in relation to health anxiety.     

Attachment anxiety and implicit self-concept of neuroticism: Associations in women but not men

Previous research has shown that adult attachment-related anxiety is associated with the explicit self-concept of neuroticism. It remains to be clarified whether attachment anxiety is related to the implicit self-concept of neuroticism. There is evidence that gender can moderate the strength of correlation between implicit and explicit measures. The Experiences in Close Relationships scale and the NEO Five-Factor Inventory (NEO-FFI) were administered to 106 healthy adults along with an Implicit Association Test assessing neuroticism. Attachment anxiety correlated with NEO-FFI neuroticism, regardless of gender. Attachment anxiety was correlated with neuroticism as measured by the IAT in women but not men. Results from multiple regression analysis showed that gender was a moderator of the relationship between attachment anxiety and implicit neuroticism. Our data suggest that in the associative network of women with high attachment anxiety associative representations of the self are more strongly linked to attributes of neuroticism compared to women with low attachment anxiety.     

Prognostic value of implicit and explicit self-associations for the course of depressive and anxiety disorders

Dysfunctional self-beliefs are assumed to play an important role in maintaining depression and anxiety. Current dual-process models emphasize the relevance of differentiating between implicit and explicit self-beliefs. Therefore, this study tested the prognostic value of automatic and explicit self-associations for the naturalistic course of depressive and anxiety disorders over two years follow-up. Both self-depressed and self-anxious associations were measured in unipolar depressed patients (n = 313), anxious patients (n = 566), and patients with comorbid depressive and anxiety disorders (n = 577) as part of the Netherlands Study of Depression and Anxiety. Outcomes showed that in single predictor models specifically automatic self-anxious associations were related to a reduced chance of remission from anxiety, whereas automatic self-depressed associations were related to a reduced chance of remission from depression. Explicit self-anxious associations and fearful avoidance behaviour showed independent predictive validity for remission from anxiety, whereas explicit self-depressed associations and having both major depressive disorder and dysthymia showed independent predictive validity for remission from depression. These findings are not only consistent with the view that both implicit and explicit dysfunctional self-associations are related to the course of anxiety and unipolar depressive disorders, but also suggest that both types of self-beliefs are proper targets for therapeutic interventions.     

Sattva, Rajas and Tamas Factors and Quality of Life in Patients with Anxiety Disorders: A Preliminary Investigation

The most common approach to define personality has been in terms of characteristics or qualities within a person. A three-dimensional personality theory based on the Sankhya school of Hindu philosophy postulates human personality in terms of three gunas or factors namely sattva, rajas and tamas (SRT). Disequilibrium in any one of these factors has an adverse effect on one??s health and psychological well-being. This preliminary exploratory study assessed SRT factors and quality of life in persons with anxiety disorders. Thirty persons with anxiety disorders were compared with a community sample of 30 participants on measures of anxiety, SRT and quality of life. Results indicated higher scores on rajas and tamas factors in the clinical sample and scores on sattva factor were found to be higher in the community sample. Quality of life was found to be significantly better in the community sample in comparison to clinical sample. Rajasic and tamasic factors were associated with impaired quality of life in the persons with anxiety disorder.     

Anxiety and Depression During Childhood and Adolescence: Testing Theoretical Models of Continuity and Discontinuity

The present study sought to clarify the trajectory (i.e., continuous vs. discontinuous) and expression (i.e., homotypic vs. heterotypic) of anxiety and depressive symptoms across childhood and adolescence. We utilized a state-of-the-science analytic approach to simultaneously test theoretical models that describe the development of internalizing symptoms in youth. In a sample of 636 children (53% female; M _age = 7.04; SD _age = 0.35) self-report measures of anxiety and depression were completed annually by youth through their freshman year of high school. For both anxiety and depression, a piecewise growth curve model provided the best fit for the data, with symptoms decreasing until age 12 (the “developmental knot”) and then increasing into early adolescence. The trajectory of anxiety symptoms was best described by a discontinuous homotypic pattern in which childhood anxiety predicted adolescent anxiety. For depression, two distinct pathways were discovered: A discontinuous homotypic pathway in which childhood depression predicted adolescent depression and a discontinuous heterotypic pathway in which childhood anxiety predicted adolescent depression. Analytical, methodological, and clinical implications of these findings are discussed.     

Predictors of competitive anxiety direction in male Tae Kwon Do practitioners: a multilevel mixed idiographic/nomothetic interactional approach

Objectives: To examine (a) affective states, proximity of competition and personality traits as predictors of anxiety direction and (b) investigate the role of personality characteristics in moderating the relationship between anxiety direction and proximity of competition and affective states.Method: A multilevel mixed idiographic/nomothetic approach. Intensity and direction of competitive anxiety and positive (PA) and negative affect (NA) were monitored in 22 male Tae Kwon Do practitioners across a week preceding a major competition using the experience sampling method (ESM). The participants were assessed on neuroticism and extraversion. Negative and positive affect and anxiety intensity and direction were measured at three random times a day across 1 week before the competition and 1 hour pre-competition.Results: Multilevel regression analyses revealed that cognitive anxiety intensity, positive affect, proximity to competition and extraversion were significant predictors of cognitive anxiety direction. Significant interaction effects of proximity to competition and neuroticism, and neuroticism and negative affect on cognitive anxiety direction were also observed. Somatic anxiety direction was a function of positive affect, somatic anxiety intensity, proximity to competition and the interaction effects of neuroticism and somatic anxiety intensity and neuroticism and proximity to competition.Conclusions: A multilevel mixed idiographic/nomothetic interactional approach may substantially assist in the explanation of intra- and inter-individual differences in anxiety direction.     

A cross-cultural study of the test anxiety levels in Iranian and Indian students

This study compared the test anxiety levels of Iranian (N = 160) and Indian (N = 160) school and college students. Significant main effects of Culture, Educational Level and Sex indicated that the Iranian students had higher Test Anxiety scores than their Indian counterparts, and females reported higher test anxiety than males. A significant Culture x Educational Level x Sex interaction revealed, however, that level of education had opposite effects within the Indian culture: Indian school females reported more test anxiety than their college counterparts; Indian college males had higher test anxiety than their school counterparts. Iranian school males and females both reported higher test anxiety than their college counterparts. Tricultural differences in the test anxiety levels of comparable student groups in Iran, India and the U.S. were interpreted as reflecting East-West cultural factors that influenced reactions to objective examinations, resulting in greater test anxiety in Eastern cultures.     

Human genetic markers associated with variation in intellectual abilities and personality

Eight commonly-used genetic markers were correlated with the Verbal Reasoning (VR), Space Relations (SR) and Clerical Speed and Accuracy (CSA) tests of the Differential Aptitude Tests (DAT) and the Psychoticism (P), Extraversion (E), Neuroticism (N) and Lie (L), scales of the Eysenck Personality Questionnaire (EPQ). In a sample of 122 undergraduate students tongue-curling ability, light eye color and inability to taste PTC were related to high intelligence, with dominant right eye, disconnected ear lobes and near-sightedness being associated with specific DAT scales. P showed a male-female sex difference. Dark eyes were related to E and N.     

Maternal prenatal anxiety trajectories and infant developmental outcomes in one-year-old offspring

A longitudinal study of a sample of women and their offspring from two urban areas (N = 233) was conducted to test whether maternal prenatal anxiety trajectories from early to late pregnancy are associated with 12-month infant developmental outcomes, independent of maternal postpartum anxiety symptoms, prenatal and postpartum depressive symptoms, parity, birth outcomes and maternal education. Three types of maternal anxiety trajectories over the course of pregnancy were identified and labeled increasing, decreasing, and stable-low. Only increasing maternal prenatal anxiety was associated with 12-month infant outcomes, specifically lower Bayley-III scores on receptive language and gross motor skills. Maternal anxiety measured at each individual timepoint in pregnancy was not associated with infant Bayley-III outcomes, highlighting the importance of examining trajectories of maternal affect.