Structural differences in parent and child reports of children's symptoms of depression and anxiety

Two cohorts of public elementary school children and their parents (assessed 3 years apart) completed child and parent forms of the Children's Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS). Assessments were conducted twice, once during the fall (N = 562) and again during the spring (N = 630) of the 6th grade. Factor analyses revealed 3 factors for each measure. Two of the 3 parent CDI factors manifested some degree of congruence with their counterparts from the child CDI. Similarly, 2 of the 3 RCMAS factors were somewhat congruent across informant types. Differences between parent and child factor structures suggest that parents' and children's reports focus on somewhat different aspects of child psychopathology, and they can make qualitatively different contributions to the multiaxial assessment of children.     

Childhood anxiety sensitivity index factors predict unique variance in DSM-IV anxiety disorder symptoms

Anxiety sensitivity (AS) is an established cognitive risk factor for anxiety disorders. In children and adolescents, AS is usually measured with the Childhood Anxiety Sensitivity Index (CASI). Factor analytic studies suggest that the CASI is comprised of 3 lower-order factors pertaining to Physical, Psychological and Social Concerns. There has been little research on the validity of these lower-order factors. We examined the concurrent and incremental validity of the CASI and its lower-order factors in a non-clinical sample of 349 children and adolescents. CASI scores predicted symptoms of DSM-IV anxiety disorder subtypes as measured by the Spence Children's Anxiety Scale (SCAS) after accounting for variance due to State-Trait Anxiety Inventory scores. CASI Physical Concerns scores incrementally predicted scores on each of the SCAS scales, whereas scores on the Social and Psychological Concerns subscales incrementally predicted scores on conceptually related symptom scales (e.g. CASI Social Concerns scores predicted Social Phobia symptoms). Overall, this study demonstrates that there is added value in measuring AS factors in children and adolescents.     

Assessment of anxiety and depression in young children: support for two separate constructs

Validated the interrelatedness of depression and anxiety in young children by testing four latent factor models: dual construct, unrelated; dual construct, correlated; single construct; and second-order or higher order analysis to test that depression and anxiety are primary constructs under the higher order factor of general affective distress. Children (N = 86) were ages 6 to 11, with mothers who were HIV-symptomatic or diagnosed with AIDS. Depression and anxiety measures included the Children's Depression Inventory (Kovacs, 1992), selected items from the Dominic-R (Valla, Bergeron, Berube, Gaudet, & St-Georges, 1994), and the Revised Children's Manifest Anxiety Scale (Reynolds & Richmond, 1985). Structural equation modeling was used to test the models. Model 2 (dual construct, correlated) fit the data better than did Models 1 and 3; results for the higher order model were identical to Model 2, suggesting the higher order model is equivalent to the dual-construct model.     

Group prevention of depression and anxiety symptoms

To prevent depression and anxiety, we delivered a brief, classroom-based cognitive-behavioral workshop along with ongoing Web-based materials and e-mail coaching to college students at risk for depression. At risk was defined as having mild to moderate depressive symptoms on a self-report measure of depression. Two hundred forty students were randomized into either an eight-week workshop that met in groups of 10, once per week for 2 h or into an assessment-only control group. We plan to track participants for 3 years after the workshop and here we report the 6 month preventive effects on depression and anxiety. The workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, but there was no significant difference between the conditions on depression or anxiety episodes at 6 month follow up. The workshop group had significantly better well being than the control group, and the workshop group had significantly greater improvement in optimistic explanatory style than the control group. Improved explanatory style was a significant mediator of the prevention effects from pre- to post-workshop for depressive and anxiety symptoms, as well as for improved well being.     

Assessment of depression and anxiety in East Asia

This article provides a critical review of the literature on research with self-report measures of depression and anxiety in East Asia. Three trends are noteworthy. First, research on depression and anxiety in East Asia has relied heavily on the use of a limited number of translated instruments. Second, available research suggests that the Asian language versions of these instruments are reliable and valid for use with Asian populations. Third, some subpopulations in East Asia have been studied extensively with respect to depression and anxiety, but there are many regions of Asia where little research literature is available outside of those published in native language journals. The review concludes with recommendations for future research.     

The validity of the hospital anxiety and depression scale and the geriatric depression scale in Parkinson's disease

We assessed the concurrent validity of the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale (GDS) against the Hamilton Rating Scale for Depression (Ham-D) in patients with Parkinson's disease (PD). Forty-six non-demented PD patients were assessed by a neurologist on the Ham-D. Patients also completed four mood rating scales: the HADS, the GDS, the VAS and the Face Scale. For the HADS and the GDS, Receiver Operating Characteristics (ROC) curves were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed PD patients was reached at a cut-off score of 10/11 for both the HADS and the GDS. At the same cut-off score of 10/11 for both the HADS and the GDS, the high sensitivity and NPV make these scales appropriate screening instruments for depression in PD. A high specificity and PPV, which is necessary for a diagnostic test, was reached at a cut-off score of 12/13 for the GDS and at a cut-off score of 11/12 for the HADS. The results indicate the validity of using the HADS and the GDS to screen for depressive symptoms and to diagnose depressive illness in PD.     

Evaluation of Siddha Samadhi Yoga for anxiety and depression symptoms: a preliminary study

Siddha Samadhi Yoga is a program in which meditation is associated with pranayama (breathing exercises). 22 volunteers with anxiety complaints (M age = 42.8 yr., SD = 10.3) were assigned to two groups: 14 attended the yoga group, and 8 attended a waiting-list or control group. They were evaluated before the intervention and 1 month after it on the State-Trait Anxiety Inventory, the Beck Depression Inventory, Tension Feelings Self-evaluation Scales, and the Well-being Self-evaluation Scales. A significant reduction in scores on anxiety, depression, and tension was found in yoga group, as well as an increase in well-being in comparison with the control group.     

The recognized benefits of negative thinking/affect in depression and anxiety: Developing a scale

Negative thinking/affect (NTA) in depression and anxiety is an important target of clinical intervention. However, individuals recognize the benefit of NTA. There is a need to develop a scale for empirical studies of NTA. Two‐hundred and fifty‐nine Japanese university students were assigned to answer: (a) the state in the past week (positive affect (PA) and Center for Epidemiologic Studies Depression Scale), (b) the current state (PA and State‐Trait Anxiety Inventory‐State (STAI‐S)), and (c) the usual state (PA and STAI‐Trait), after completing the Recognized Benefit of NTA Scale (RBNTA). Another 291 students completed the Rosenberg Self‐Esteem Scale and the Revised Life Orientation Test, after completing the RBNTA. Two weeks later, 76 participants completed the RBNTA. The RBNTA with nine subscales was developed after comparing the indices of fitness from 14 different factor solutions. The internal and test‐retest reliability and content validity were confirmed. Correlation analyses revealed that the recognition of trying to obtain benefits/avoid costs tends to associate with positive/negative affect and that most of such recognitions did not associate with self‐esteem and optimism.     

Prevention of anxiety symptoms in children: results from a universal school-based trial

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and adaptive functioning, coping strategies, social skills, and perfectionism before and after the 10-week FRIENDS program and at two follow-up assessments (6 and 12 months) or wait period. Children who participated in the FRIENDS program exhibited significantly fewer anxiety and depressive symptoms, and lower perfectionism scores than children in the control group at 12-month follow-up. Younger children (9-10-year-olds) displayed treatment gains immediately after the intervention, whereas older children (11-12-year-olds) showed anxiety reduction only at 6- and 12-month follow-up. Perfectionism and avoidant coping acted as mediators of pre- to postintervention changes in anxiety scores. This study provides empirical evidence for the utility of the FRIENDS program in reducing anxiety and depressive symptoms among German children.     

Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.     

Anxiety sensitivity in adolescents: factor structure and relationships to trait anxiety and symptoms of anxiety disorders and depression

The current study examined the anxiety sensitivity construct in a large sample of normal Dutch adolescents aged 13-16 years (n=819). Children completed the Childhood Anxiety Sensitivity Index (CASI; Silverman, W. K., Fleisig, W., Rabian, B. & Peterson, R. A. (1991). Journal of Clinical Child Psychology, 20, 162-168) and measures of trait anxiety, anxiety disorder symptoms and depression. Results showed that (1) anxiety sensitivity as indexed by the CASI seems to be a hierarchically organized construct with one higher-order factor (i.e., anxiety sensitivity) and three or four lower-order factors, (2) anxiety sensitivity and trait anxiety were strongly correlated, (3) anxiety sensitivity was substantially connected to symptoms of anxiety disorders (in particular of panic disorder and agoraphobia) and depression, and (4) anxiety sensitivity and trait anxiety both accounted for unique proportions of the variance in anxiety disorder symptoms. Altogether these findings are in agreement with those of previous research in adult and child populations, and further support the notion that anxiety sensitivity should be viewed as an unique factor of anxiety vulnerability.     

Students under academic stress in a Turkish University: Variables associated with symptoms of depression and anxiety

The present study intended to find out the associated variables of depression and anxiety symptoms for young adults confronted with an academic stress. Ninety-two graduate students, who were actively involved in preparing their thesis, participated in this study. Two regression analyses were conducted to see different variables associated with depression and anxiety symptoms separately. Consistent with the expectations, depression and anxiety had overlapping predictors, such as negative automatic thoughts and hopelessness. However, adequacy of problem-solving abilities seemed to be associated with anxiety symptoms. Findings were discussed in the light of relevant literature. This work has been supported by the Turkish Academy of Sciences in the framework of the Young Scientist Award Program (TG-TUBA-GEBIP/2002-1-11).     

Students under academic stress in a Turkish University: Variables associated with symptoms of depression and anxiety

The present study intended to find out the associated variables of depression and anxiety symptoms for young adults confronted with an academic stress. Ninety-two graduate students, who were actively involved in preparing their thesis, participated in this study. Two regression analyses were conducted to see different variables associated with depression and anxiety symptoms separately. Consistent with the expectations, depression and anxiety had overlapping predictors, such as negative automatic thoughts and hopelessness. However, adequacy of problem-solving abilities seemed to be associated with anxiety symptoms. Findings were discussed in the light of relevant literature. This work has been supported by the Turkish Academy of Sciences in the framework of the Young Scientist Award Program (TG-TUBA-GEBIP/2002-1-11).     

Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents

Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents’ symptom reporting. Participants (N = 33; 9–18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children – C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents’ reports of anxiety and depression symptoms and considering potential discrepancies between informants’ answers.     

Measurement tool for preoperative anxiety in young children: The yale preoperative anxiety scale

To develop a preoperative anxiety scale (YPAS) for children undergoing surgery, 21 specific behaviors indicating anxiety were defined within five domains (activity, emotional expressivity, state of arousal, vocalization, and use of adults). A reliability Kappa analysis revealed that inter-observer agreement ranged from .66 to .94, while intra-observer Kappa ranged from .66 to .91. Validity analysis between a Visual Analog Scale and the YPAS revealed an r of .59 for entering the operating room. Multiserial analysis comparing the YPAS to the Vernon Anxiety Scale ranged from .61 to .64. Showing good to excellent observer reliability and validity, the YPAS proves to be an appropriate tool for studying children's responses in preoperative settings. As such, the new assessment instrument should be of interest to clinical and research neuropsychologists who need to assess a child's anxiety level prior to the undertaking of a given surgical procedure.     

The tripartite model for assessing symptoms of anxiety and depression: psychometrics of the Dutch version of the mood and anxiety symptoms questionnaire

AIM: The tripartite model conceptualizes symptoms of depression and anxiety in three groups: low positive affect and anhedonia, which is specific to depression, somatic arousal, which is unique to anxiety, and nonspecific general distress. The Mood and Anxiety Symptoms Questionnaire (MASQ) was developed to measure these symptom domains. This study reports on the psychometric properties of the Dutch translation of the MASQ. METHOD: The questionnaire was completed by a population-based sample and by patients with anxiety and/or mood disorders. Scores of these respondent groups were compared to assess the discriminant validity of the MASQ and evaluate the appropriateness of the tripartite model. RESULTS: The psychometric properties of the translated MASQ were highly satisfactory. In accordance with the model, we found the MASQ to comprise three main scales, which discriminate well between subgroups of patients with mood and anxiety disorders. DISCUSSION: Overall, like the English version the Dutch translation of the instrument appears to be a reliable and valid measure of symptoms of depression and anxiety, conceptualized as comprising three groups of symptoms. The Dutch MASQ is better able to distinguish unique aspects of mood and anxiety disorders than other self-report instruments.     

Comorbidity of anxiety and depression in children and adolescents.

Anxiety and depression in children and adolescents are reviewed, including differential diagnosis, assessment of symptoms, family history data, developmental features, and clinical correlates. Findings indicate that 15.9% to 61.9% of children identified as anxious or depressed have comorbid anxiety and depressive disorders and that measures of anxiety and depression are highly correlated. Family history data are inconclusive. Differences emerged among children with anxiety, depression, or both disorders. Anxious children were distinguishable from the other 2 groups in that they showed less depressive symptomatology and tended to be younger. The concurrently depressed and anxious group tended to be older and more symptomatic. In this group, the anxiety symptoms tended to predate the depressive symptoms. Findings are discussed in the context of a proposed developmental sequence.     

Aging and symptoms of anxiety and depression: structural invariance of the tripartite model

Negative affect measures were evaluated in a cross-sectional community sample of adults aged 18-93 (N = 335) to examine the structure of neuroticism, anxiety, and depressive symptoms in young, middle, and older adult cohorts. Structural equation modeling was used to contrast 3 nested models: a 1-factor general distress model; a 2-factor high negative-low positive affect model; and a 3-factor "tripartite model" reflecting a higher order Negative Affect factor that is common to depression and anxiety problems and 2 lower order factors, Low Positive Affect (mostly specific to depression) and Arousal (specific to anxiety/panic). As expected, the tripartite model fit best for all age groups. Further, multigroup analyses indicated age invariance for the tripartite model, suggesting the model can be effectively applied with older populations.     

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.