Feasibility of a Simplified and Dynamic Bayesian System for Use in Structured Diagnostic Interviews

An important goal of clinical assessment is to balance cost-effectiveness, administration demands, and accuracy (G. Young, J. O'Brien, E. Gutterman, & P. Cohen, 1987). The incorporation of Bayesian logic into diagnostic interviewing may assist with this goal, but in previous examinations, such methods have been prohibitively complex. In this study, analysis of a simplified Bayesian system showed overall classification error rates as good or better than traditional structured interviewing, and reduction in error was positively related to the psychometric properties of the predictor used in the actuarial functions. A dynamic system using simplified Bayesian logic appears to function well in the context of a structured interview and requires comparatively less data than previously tested Bayesian approaches. This type of system appears suitable for further research with clinical populations to determine its performance in applied settings.     

Examining Youth Anxiety Symptoms and Suicidal Ideation in the Context of the Tripartite Model of Emotion

This study sought to clarify the relation of anxiety symptoms and suicidal ideation in children and adolescents by examining these variables in the context of depression and negative affect. As outlined in the tripartite model of anxiety and depression, negative affectivity is common to both emotional constructs; therefore negative affectivity may best explain the relation of each to suicidal ideation. Self report measures of generalized anxiety, depression, negative affectivity, and suicidal ideation were assessed in a primarily externalizing sample of children ages 7–18. Results suggested that the relation between anxiety and suicidal ideation was best accounted for by depression, not negative affectivity. Results also suggested that negative affectivity was associated with suicidal ideation but did not account for the relations among anxiety, depression, and suicidal ideation. Further, depression, negative affect, and anxiety all significantly contributed to the prediction of suicidal ideation scores (r ²  = .307, p < .01).     

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.     

Psychometric Properties of a Spanish Translation of the Revised Child Anxiety and Depression Scale – Parent Version

The Revised Child Anxiety and Depression Scale – Parent Version (RCADS-P) is a parent-report questionnaire that assesses dimensions of DSM anxiety and depressive disorders in youths. Previous studies have found that the RCADS-P possesses clinical utility and strong psychometric properties in both clinic- and school-based populations. To increase applicability of the measure to a greater proportion of the individuals accessing mental health services, the present study sought to develop and examine the psychometric properties of a Spanish version of the RCADS-P. As completed by parents of 85 publicly referred children and adolescents, the RCADS-P demonstrated good internal consistency and convergent, discriminant, and divergent validity. Confirmatory factor analysis also supported a six-factor model consistent with the measure’s six subscales: separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and major depressive disorder. A secondary aim of this study was to evaluate the validity and reliability of a shortened, 25-item version of the Spanish translation of the RCADS-P, which also evidenced favorable psychometric properties. Findings provide support for the Spanish version of the RCADS-P as an efficient and informative parent-report measure of youths' internalizing behaviors.     

Differences in Internalizing Symptoms Across Specific Ethnic Minority Groups: An Analysis Across Chinese American,Filipino American,Japanese American,Native Hawaiian,and White Youth

Research to date on child and adolescent anxiety and depression have focused predominantly on major ethnic groups. Very few studies to date have been conducted on specific ethnic minority groups and the relatively few studies on these ethnic minority samples have produced mixed findings. The following question therefore still remains: Do specific ethnic subgroups differ with respect to their expression of anxiety and depression? And do these differences differ as a function of reporter type (i.e., youth versus parent)? If the expression of internalizing symptoms differs across specific ethnic subgroups, these differences could inform approaches to assessing and treating these populations. In the current study, we therefore examined ethnic differences in anxiety and depression symptoms in ethnic subgroups. A total of 629 children and adolescents from various public and private schools, aged 8–18 years (M = 12.37, SD = 2.8) and their caregivers completed anxiety and depression scales. Multiple indicators, multiple causes confirmatory factor analysis revealed that the following specific ethic subgroups were associated with significantly greater anxiety and depression relative to Caucasian youth: Chinese American, Filipino American, Japanese American, and Native Hawaiian. These results were found only among parent (but not youth) reports. Age and low SES status was also associated with more internalizing problems among Chinese, Filipino, and Japanese American youth. Implications related to ethnic minority subgroup differences and the role of multi-informant reports in understanding the relationship between anxiety, depression and ethnic minority subgroups are discussed.     

Vicarious Improvement Among Parents Participating in Child-Focused Cognitive-Behavioral Therapy for Anxiety

Parental variables likely have important and bidirectional influences on the etiology of child anxiety. Although some child-focused cognitive-behavioral therapy (CCBT) anxiety trials have found vicarious improvements among parents who participated in their children’s treatment, this is an understudied area. We hypothesized that parental variables (psychopathology, stress, and burden) will significantly decrease from pre- to post-CCBT and will be associated with child treatment response. We explored whether intervention delivery method—in-person CCBT versus parent-mediated bibliotherapy—influenced vicarious parental improvements. Parental variables decreased from pre- to post-CCBT and were associated with child treatment response. Effects did not interact with delivery method. Parent participation in anxiety CCBT may result in vicarious improvements for parents.