A psychometric analysis of the Positive and Negative Affect Schedule for Children-Parent Version in a school sample

The current study was the 1st to examine the psychometric properties of the Positive and Negative Affect Schedule for Children-Parent Version (PANAS-C-P) using a large school-based sample of children and adolescents ages 8 to 18 (N = 606). Confirmatory factor analysis supported a 2-factor (correlated) model of positive affect (PA) and negative affect (NA). The PANAS-C-P scale scores also demonstrated acceptable internal consistency and convergent and divergent validity. The PANAS-C-P PA and NA scale scores also related to measures of anxiety and depression in a manner consistent with the tripartite model. Scale means and standard deviations were reported by grade and sex to provide normative data for the PANAS-C-P scales. Results from the present study provide initial support for the PANAS-C-P as a parent-reported perspective of youth PA and NA among school-based youths.     

A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented Scales

The Child Behavior Checklist for Ages 6–18 (CBCL/6-18) possesses newly developed DSM-Oriented Scales, constructed through expert clinical judgment to match selected categories for behavioral/emotional problems as described in the DSM-IV. The present investigation examined the basic psychometric properties for all six DSM-Oriented Scales (i.e., Affective, Anxiety, Somatic, Attention-Deficit/Hyperactivity, Oppositional, and Conduct Scales) in a large clinical sample of children and adolescents (N = 673). Findings from the present study provide strong evidence for the reliability, as well as convergent and discriminative validity, of these scales. It appears that the DSM-Oriented Scales may provide accurate supplementary information that may be considered when formulating clinical diagnoses.

Facilitating Communication of Ideas and Evidence to Enhance Mental Health Service Quality: Coding the Treatment Services Literature Using the Child and Adolescent Needs and Strengths-Mental Health Assessment Scales

The evidence-base services literature is continually growing, providing the field with rich and important sets of information regarding what works for treating different types of youth and families. Given this burgeoning of information, the PracticeWise Evidence-Based Services (PWEBS) Literature Database has been developed to aid in summarizing and delivering aggregated evidence-based treatment information to providers in the field. Meanwhile, the Child and Adolescent Needs and Strengths-Mental Health (CANS-MH) Scale is a youth mental health assessment tool that was developed by a separate team to assist with treatment planning. In the present study, we developed and tested a system for linking these two related ontological systems so that scientific knowledge can be more widely aggregated and made available to a wider set of audiences for enhanced mental health service delivery. Results revealed the following. First, a construct mapping comparison revealed that the CANS-MH and PWEBS ontologies share a strong core of overlapping content, particularly in the areas of Youth Behavioral/Emotional Needs, Youth Risk Behaviors, and Life Domain Functioning. Second, the CANS-MH areas were able to be used to reliably code the following components of published randomized treatment studies: (a) population sample characteristics (e.g., did the characteristics of the treatment study participant population relate to each CANS-MH area?), and (b) outcome measure targets (e.g., did the treatment study outcome measure target areas relate to each CANS-MH area?). The reliability achieved from this coding process supported the linkage between the CANS-MH areas and the PWEBS Literature Database information. Lastly, high agreement was achieved between an automated translation algorithm and the final ratings from the manual coding of published treatment studies using the CANS-MH scale. The importance of such linkages for the communication of ideas, information, and evidence across differing subfields is discussed, as well as examples of achieving enhanced quality of mental health services by linking system ontologies.     

Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale

The practical significance of assessing disorders of emotion in children is well documented, yet few scales exist that possess conceptual if not empirical relevance to dimensions of DSM anxiety or depressive disorders. The current study evaluated an adaptation of a recently developed anxiety measure (Spence Children's Anxiety Scale; [Spence, S. H. (1997). Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology, 106, 280-297; Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545-566]), revised to correspond to dimensions of several DSM-IV anxiety disorders as well as major depression. This investigation involved initial evaluation of the factorial validity of the revised measure in a school sample of 1641 children and adolescents and reliability and validity in an independent sample of 246 children and adolescents. Results yielded an item set and factor definitions that demonstrated structure consistent with DSM-IV anxiety disorders and depression. The revised factor structure and definitions were further supported by the reliability and validity analyses. Some implications for assessment of childhood anxiety and depressive disorders are discussed.     

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety,Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups

Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2 + years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23–1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.     

The Impact of Latino Caregiver Acculturation on Treatment Engagement in Children’s Community Mental Health Services

Ongoing treatment engagement is low in children’s community mental health. Although concerns are more pronounced for racial/ethnic minorities, findings have been mixed when comparing racial/ethnic minorities with Non-Hispanic Whites. Within-group variability, such as level of acculturation, may be a more proximal predictor of treatment engagement. The current study aimed to examine the effect of Latino caregivers’ acculturation on ongoing treatment engagement indicators, specifically session attendance, premature treatment termination, and treatment satisfaction. Participants were families of youth, ages 5–15, with a Latino primary caregiver (N = 93) receiving treatment for anxiety/trauma, depression, or disruptive behavior problems in community-based mental health agencies. Caregivers were classified into low and high acculturation groups using latent class analysis based on demographic indicators, such as nativity status and primary language spoken. Groups significantly differed in terms of caregivers’ nativity status, age at immigration, primary language spoken, language of study assessment completion, and language spoken in the home. Families of low acculturation caregivers no showed to significantly fewer planned treatment sessions than families of highly acculturated caregivers. Treatment satisfaction did not differ between groups. Low acculturation families also had lower odds of prematurely withdrawing from treatment. Results of this study highlight the importance of considering family characteristics such as acculturation when engaging families in treatment.     

Implementation in a Changing Landscape: Provider Experiences During Rapid Scaling of Use of Evidence-Based Treatments

This study examined 133 service providers’ perspectives on a rapid shift to mandated evidence-based treatment delivery, utilizing an inductive coding process to capture themes present in their qualitative feedback. The majority of provider comments were negatively valenced, but attitudes varied considerably across response categories: comments regarding practice context and support were nearly uniformly negative, while comments regarding treatment fit and therapeutic consequences were more balanced. Treatment fit was the most commonly cited category; the fit to therapist (e.g., ease of use) subcategory was predominantly positive in contrast with the fit to client (e.g., flexibility) subcategory, which was predominantly negative. Results illustrate the intended and unintended consequences of large-scale implementation efforts on community providers, and may aid implementation researchers and system decision makers optimize the conditions under which community providers are asked to implement evidence-based treatment.     

Sudden gains as a long-term predictor of treatment improvement among children in community mental health organizations

ObjectiveSudden gains have been described as rapid, sizeable changes observed between treatment sessions and have been associated with improved treatment outcome in adults. The current study examined weekly sudden gains among children seeking treatment in the community mental health setting.MethodParticipants were 161 children (age M = 10.58, SD = 1.73; 69.6% male; 47.8% Caucasian) and their parents who were randomized to one of three treatment modalities and were administered weekly and quarterly assessments throughout treatment.ResultsWhen idiographic (youth- and parent-identified “top problems”) and nomothetic measures (standardized checklists) were used to calculate sudden gains (i.e., gain must be large: in absolute terms, relative to prior session, and relative to changes in prior and subsequent sessions), 20–42% of participants experienced at least one sudden gain during treatment. Most sudden gains occurred early in treatment, and session content of relaxation was associated with sudden gain presence. Using a modified Bonferonni correction, sudden gains predicted overall symptom levels at final assessment (i.e., last assessment obtained following post-treatment) even after controlling for pre-treatment symptom levels and magnitude of the overall gain from pre- to post-treatment.ConclusionsSuddenness of gains may have a direct effect on long-term treatment outcome among children in the community.     

Concurrent Validity of the Child Behavior Checklist DSM-Oriented Scales: Correspondence with DSM Diagnoses and Comparison to Syndrome Scales

This study used receiver operating characteristic (ROC) methodology and discriminative analyses to examine the correspondence of the Child Behavior Checklist (CBCL) rationally-derived DSM-oriented scales and empirically-derived syndrome scales with clinical diagnoses in a clinic-referred sample of children and adolescents (N = 476). Although results demonstrated that the CBCL Anxiety, Affective, Attention Deficit/Hyperactivity, Oppositional and Conduct Problems DSM-oriented scales corresponded significantly with related clinical diagnoses derived from parent-based structured interviews, these DSM-oriented scales did not evidence significantly greater correspondence with clinical diagnoses than the syndrome scales in all cases but one. The DSM-oriented Anxiety Problems scale was the only scale that evidenced significantly greater correspondence with diagnoses above its syndrome scale counterpart —the Anxious/Depressed scale. The recently developed and rationally-derived DSM-oriented scales thus generally do not add incremental clinical utility above that already afforded by the syndrome scales with respect to corresponding with diagnoses. Implications of these findings are discussed.