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Child Anxiety Sensitivity Index
Abstract
Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Anxiety sensitivity was assessed using the Children's Anxiety Sensitivity Index (CASI; Silverman et al., 1991). Prior studies have demonstrated that the CASI has good internal consistency and test-retest reliability in non-clinical samples of youth (Rabian et al., 1999). ...
... In this study, the CASI was scored by averaging the 18 items. Some studies presented averaged scores (e.g., Hernandez Rodriguez et al., 2020), whereas other studies have presented sum scores (e.g., Silverman et al., 1991). Past research indicates sum CASI scores of about 26 (SD = ~6) in clinical samples (Silverman et al., 1991) and 11 (SD = ~7) in non-clinical samples (Hernandez Rodriguez et al., 2020). ...
... Some studies presented averaged scores (e.g., Hernandez Rodriguez et al., 2020), whereas other studies have presented sum scores (e.g., Silverman et al., 1991). Past research indicates sum CASI scores of about 26 (SD = ~6) in clinical samples (Silverman et al., 1991) and 11 (SD = ~7) in non-clinical samples (Hernandez Rodriguez et al., 2020). In this study, sum scores of the CASI were similar to those with non-clinical samples (M = 11.88, ...
Objective:
Current antibullying programs can reduce overall rates of victimization but appear to overlook processes that give rise to persistent peer victimization. Needed are studies that delineate the interplay between social contextual and individual difference variables that contribute to persistent peer victimization. We examined the extent to which two individual-difference variables - internalizing symptoms (IS) and anxiety sensitivity (AS) - moderated the link between children's average social preference score across the school year and their status as persistent victims.
Method:
Participants included 659 4th-grade students (Mage = 9.31 years, SD = 0.50, 51.8% girls; 42.3% Latinx, 28.9% non-Hispanic White, 10.2% Pacific Islander, 7.7% Bi/Multiracial, 1.9% Black, 1.7% Asian, 1.7% Native American, and 3.4% unreported) from 10 public elementary schools in the U.S.
Results:
As expected, higher social preference scores predicted a decreased likelihood of being persistently victimized. Conversely, IS and AS were positively linked to persistent victim status. AS significantly moderated the link between social preference and persistent victim status such that for children with high AS, compared to those with AS scores at or below the mean, the negative association between social preference and persistent victim status was attenuated.
Conclusions:
Findings provide evidence that children who experience high levels of IS and AS are at risk for being persistently victimized by peers and that high AS could signal increased risk for persistent victimization even when children are generally liked by peers. We discuss the implications of these findings for efforts to develop focused interventions for chronically bullied children.
... These investigators examined predictors of panic attacks in a large sample (N ϭ 2,365) of adolescents (Grades 9 through 12, mean age at study entry ϭ 15.4 years) who were followed over a 4-year period. Results indicated that anxiety sensitivity, assessed with the Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1987), predicted the onset of panic attacks during the course of the study period. Given the accumulating evidence for a role of anxiety sensitivity in the etiology of panic, it is important to better understand the developmental phenomenology of anxiety sensitivity (see Taylor, 1999). ...
... The ASI (Peterson & Reiss, 1987;Reiss, Peterson, Gursky, & McNally, 1986) was used to assess anxiety sensitivity. The ASI assesses the extent to which participants agree with certain statements about the frightening nature of anxiety sensations and behavior. ...
... The range of the total score is 0 to 64. The ASI has sound psychometric properties (Peterson & Reiss, 1987) and extensive validity estimates (Taylor, 1999). Test-retest reliability has been reported at .75, and various studies have estimated Cronbach's alpha coefficient of internal reliability at between .82 and .91 (see Reiss, Silverman, & Weems, 2001, for a review). ...
This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups of adolescents with stable low, stable high, and escalating anxiety sensitivity levels were identified. Adolescents with stable high or escalating anxiety sensitivity were significantly more likely to report experiencing a panic attack than individuals with stable low anxiety sensitivity. Results also indicated that Asian and Hispanic adolescents tended to report higher anxiety sensitivity but that their anxiety sensitivity was less strongly associated with panic than that of Caucasian adolescents.
... A person with high levels of AS may interpret anxious thoughts or sensations as threat-related, which induces a fear or anxious reaction (Silverman et al., 1991). Unlike trait anxiety, which is a general tendency to respond fearfully to a stressor, AS is described as responding fearfully to anxiety symptoms (McNally, 1989). ...
... Multilevel models examined (1) change in anxiety from pre to posttreatment with time being modeled as a fixed effect and (2) whether each variable (AFQ-Y and CASI) predicted change in anxiety symptoms across treatment. Thus, models included the predictor variables of AS (CASI) and EA (AFQ-Y), as well as the interaction between each predictor scores indicating higher levels of AS. Silverman et al. (1991) reported Cronbach's alpha of 0.87 and a test-retest reliability correlation of 0.79 in a sample of emotionally disturbed youth. In the present sample, Cronbach's alpha was 0.89. ...
... In understanding why differences between child, parent, and independent evaluator reported outcome measures may have occurred, it is important to note that both AS and EA are child-reported measures. Further, the measure of EA (AFQ-Y) asks and relates to the internal experience of the youth (Greco et al., 2008), whereas the measure of AS (CASI) asks and relates to more physical symptoms of anxiety, which may be more outwardly expressed or visible to a parent (Silverman et al., 1991). This distinction ...
Purpose
Anxiety sensitivity (AS) and experiential avoidance (EA) are associated with anxiety in both adults and youths. This study examined the separate contributions of AS and EA in predicting (a) anxiety (symptom severity) and (b) differential treatment outcomes in anxious youth receiving cognitive behavioral therapy (CBT).
Methods
Participants (N = 89; age 10–17 years; 37% male; 78% white) met diagnostic criteria for an anxiety disorder and received CBT (Coping Cat). AS and EA were child-report measures collected at baseline. The outcome variables were anxiety symptom severity (Multidimensional Anxiety Scale for Children; child- and parent-reported) and Independent Evaluator-rated anxiety severity (Child Global Impression-Severity) collected at baseline and posttreatment. Multilevel models (MLM) examined independent and relative contributions of AS and EA to the outcome variables as a secondary analysis.
Results
Both AS and EA were associated with levels of anxiety symptom severity at pretreatment and at posttreatment, varying by reporter. Neither AS nor EA predicted differential treatment outcomes: youth at varying levels had comparably favorable outcomes.
Conclusions
Findings suggest similarity in AS and EA, and that both constructs may be adequately and equally addressed in CBT. Future research could consider examining change in AS and EA and anxiety across treatment in diverse populations.
... Conceptual models posit that children with high AS are concerned with several anxiety-related sensations, including physical, emotional, and social (Silverman et al., 1991). In fact, items on the Child Anxiety Sensitivity Index (CASI; Silverman et al., 1991) specifically reference concerns about the social impact of these sensations (e.g., "I don't want other people to know when I'm afraid," "Other kids can tell when I feel shaky"). ...
... Conceptual models posit that children with high AS are concerned with several anxiety-related sensations, including physical, emotional, and social (Silverman et al., 1991). In fact, items on the Child Anxiety Sensitivity Index (CASI; Silverman et al., 1991) specifically reference concerns about the social impact of these sensations (e.g., "I don't want other people to know when I'm afraid," "Other kids can tell when I feel shaky"). Weems et al. (2010) speculated that children whose AS involves social concerns might worry that others will view them negatively, which could potentially lead to ridicule or social exclusion, and, over time, to avoiding places or activities (e.g., playing at recess) associated with social concerns. ...
... The Children's Anxiety Sensitivity Index (CASI; Silverman et al., 1991) was used to assess children's self-reports of AS at T1. The CASI is a psychometrically sound, 18-item measure designed to assess AS in children ages 7 to 16. Sample items include "It scares me when my heart beats fast" and "It scares me when I have trouble getting my breath." ...
Previous research suggests both social contextual and individual difference variables contribute to chronic peer victimization. We tested whether two individual difference variables – anxiety sensitivity (AS) and internalizing symptoms (IS) – predicted persistent peer victimization in elementary school children. Participants were 677 fourth-grade students (51.8% girls) from 10 public elementary schools. We hypothesized that persistent victims would report the highest levels of AS and IS. We also expected that IS would mediate the link between AS and persistent peer victimization. Results indicated that persistent victims reported significantly higher levels of AS and IS than transient or limited victims, and we found evidence that IS functioned as an intermediate variable between AS and persistent peer victimization status. Implications and directions for research are discussed.
... Further, in a longitudinal study of 117 adolescent boys and girls, Felton et al. (2019) found that DI, as measured by a behavioral persistence task (the Behavioral Indicator of Resiliency to Distress; Lejuez et al., 2006), moderated the effects of stress, such that negative life events were associated with greater increases in depressive symptoms over time only for adolescents with higher levels of DI (Felton et al., 2019). A selfreport measure of DI (the Child Anxiety Sensitivity Index; Silverman et al., 1991) has also been found to prospectively predict depression in adolescents. In addition, a recent study found that Black and Hispanic adults reported significantly higher DI, more stressful life events, and higher levels of depression and anxiety than non-Hispanic Whites (McIntosh et al., 2021). ...
... Despite these high scores, we did not find a significant association between the frequency of stressful life events and depressed mood (p = .69). In our cross-sectional study, there was a significant main effect of self-reported DI on depression with higher levels of DI associated with higher self-reported depressive symptoms, consistent with the longitudinal prediction of depression reported by Zavos et al. (2012) using the Child Anxiety Sensitivity Index (Silverman et al., 1991). We did not find a similar main effect association for the behavioral persistence measure of DI (MTPT-C), and contrary to our hypothesis, neither measure of DI moderated the relation between frequency of stressful life events and depression. ...
Background
Lower socio-economic status (SES) is associated with experiencing a greater number of life stressors and increased risk for depression. This study investigated two factors for adaptive coping—working memory capacity (WMC) and distress intolerance (DI)—as moderators of the association between frequency of stressful life events and depressed mood, controlling for age and gender. We hypothesized that lower WMC and greater DI, alone and in interaction with each other, would moderate the association between the frequency of stressful life events and depression.
Methods
Our sample included 82 adolescents (M = 14 years) recruited from youth mentorship programs, charter schools, and youth community centers. A majority being female (54.9%) and reported their race and/or ethnicity as Other race/Hispanic (43.9%), and Black/non-Hispanic (30.5%). Participants completed self-report measures of stressful life events, depression, DI, and a behavioral measure of WMC.
Results
Results showed a statistically significant main effect of self-reported DI predicting depression (p < .001), such that higher DI scores were associated with higher levels of depression.
Conclusions
Our findings join broader literature indicating that DI is an important regulatory process that may be a useful mechanistic target to enhance emotional functioning, especially among racially/ethnically diverse adolescents from low SES neighborhoods, a relatively understudied population.
... scale (0 = very little, 4 = very much) according to how much the item reflects their usual way of thinking or feeling. The ASI (Peterson & Reiss, 1987) has shown good psychometric properties, with internal consistency coefficients ranging from .82 to .91 (Peterson & Reiss, 1992), good predictive validity (Reiss, 1991), and test-retest reliability of r = .71 over a three-year period (Mailer & Reiss, 1992). ...
... The ASI (Peterson & Reiss, 1987) is a 16-item instrument composed of items that investigate fears and thoughts about symptoms of anxiety and panic and their negative consequences (e.g., "It scares me when my heart beats rapidly," "When T cannot keep my mind on a task, I worry that I might be going crazy"). Respondents rate each item on a 0-4 JLikert-type ...
Anxiety sensitivity (AS) has been defined as the fear of symptoms of anxiety and panic, and is most frequently assessed with the Anxiety Sensitivity Index (Peterson & Reiss, 1987). To investigate the nature and structure of AS in an older sample, data were collected from a sample of 322 adults aged 65 to 97, with mean age 75. Confirmatory factor analysis indicated a hierarchical structure with three group factors (physical concerns, mental incapacitation concerns, and social concerns), as well as a general factor, consistent with previous investigations. Results suggest that the nature and structure of the AS trait in older adults are highly similar to those of younger adults.
... The CASI (Silverman et al., 1991) is an 18-item measure of anxiety sensitivity in children and adolescents aged 8-16, for both clinical and non-clinical populations. The CASI assesses self-reported anxiety sensitivity, which is the belief that anxiety symptoms cause negative effects. ...
... The CASI uses a 3-point Likert scale [ (1) none, (2) some, and (3) a lot)], where adolescents selected the option that best described themselves for given statements (e.g., I don't want other people to know when I feel afraid, It scares me when my heart beats fast). Per Silverman et al., (1991), anxiety sensitivity was calculated as the sum total of all items. Four subscales were also computed (Silverman et al., 1999) as follows: physical concerns (7 items), mental incapacitation concerns (4 items), social concerns (2 items), and control concerns (5 items). ...
Social anxiety disorder is among the most common forms of pediatric psychopathology. Social anxiety symptoms peak in adolescence and are associated with significant impairment encompassing familial, social, and academic domains. Considerable heterogeneity in symptomatology, risk factors, and biological underpinnings exists across anxious adolescents, which has implications for (1) understanding the developmental etiology of who is at highest risk, (2) identifying individual patterns of symptom course. In particular, fearful temperament is the best early-emerging predictor of the development of anxiety symptoms, and attention bias to threat and other neurobiological processes have been implicated as mechanisms but it is unknown for whom and to what degree these factors impair functioning and what the developmental course looks like across adolescence. The current study employs a longitudinal design capturing a wide range of anxiety symptom presentation (i.e., low risk, temperamental risk, and clinical anxiety). We follow adolescents (N = 195) annually across the transitions to middle- and high-school – ages 13, 14, 15, & 16 years. We implement a rich assessment of anxiety symptoms, temperament, attention bias, endocrine (cortisol), physiological (RSA) and neurobiological (EEG, ERP) processes. We aim to (1) characterize a biobehavioral (i.e., biased attention, neuroendocrine, physiological, and neural processes) pattern associated with fearful temperament and social anxiety in adolescence, (2) characterize trajectories of social anxiety in adolescence, with an emphasis on linking fearful temperament and anxiety across development, and (3) examine how social contextual factors, sex, and pubertal development shape social anxiety trajectories and moderated links between temperament and SA.
... Anxiety sensitivity was measured using the Children's Anxiety Sensitivity Index (CASI) (Silverman et al., 1991). This questionnaire has 18 items (theoretical range 0-36) referring to fear of the physical symptoms of anxiety. ...
... This questionnaire has 18 items (theoretical range 0-36) referring to fear of the physical symptoms of anxiety. The CASI has good validity and internal consistency (Muris et al., 2001;Silverman et al., 1991). In this sample the Cronbach's alpha was .86. ...
Background
Insomnia with short sleep duration has been postulated as more severe than that accompanied by normal/long sleep length. While the short duration subtype is considered to have greater genetic influence than the other subtype, no studies have addressed this question. This study aimed to compare these subtypes in terms of: (1) the heritability of insomnia symptoms; (2) polygenic scores (PGS) for insomnia symptoms and sleep duration; (3) the associations between insomnia symptoms and a wide variety of traits/disorders.
Methods
The sample comprised 4000 pairs of twins aged 16 from the Twins Early Development Study. Twin models were fitted to estimate the heritability of insomnia in both groups. PGS were calculated for self‐reported insomnia and sleep duration and compared among participants with short and normal/long sleep duration.
Results
Heritability was not significantly different in the short sleep duration group (A = 0.13 [95%CI = 0.01, 0.32]) and the normal/long sleep duration group (A = 0.35 [95%CI = 0.29, 0.40]). Shared environmental factors accounted for a substantial proportion of the variance in the short sleep duration group (C = 0.19 [95%CI = 0.05, 0.32]) but not in the normal/long sleep duration group (C = 0.00 [95%CI = 0.00, 0.04]). PGS did not differ significantly between groups although results were in the direction expected by the theory. Our results also showed that insomnia with short (as compared to normal/long) sleep duration had a stronger association with anxiety and depression (p < .05)—although not once adjusting for multiple testing.
Conclusions
We found mixed results in relation to the expected differences between the insomnia subtypes in adolescents. Future research needs to further establish cut‐offs for ‘short’ sleep at different developmental stages and employ objective measures of sleep.
... Anxiety and depression: ADIS-C (Silverman & Albano, 1996) PANAS (Joiner et al., 1996) CASI (Silverman et al., 1991) RCADS (Chorpita et al., 2000) Pre, post, follow-up 2 weeks and 1 month Youth in the intervention condition showed significantly lower levels of anxiety sensitivity (23% reduction) at the onemonth follow-up period when compared to youth in the control group (14% reduction). EG: It includes elements of psychoeducation, functional analysis, identification of warning signs, and the planning of alternative responses. ...
... Childhood Anxiety Sensitivity Index (CASI; Silverman et al., 1991). The Spanish version of Sandín (1997) adapted by Chorot et al. (2023) and Sandín et al. (2002) was used. ...
Objective: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is awell-established transdiagnostic cognitive-behavioral therapy (T-CBT) intervention. The aim of the present studywas to examine the efficacy of the program Learn to Manage your Emotions [Aprende a Manejar tus Emociones](AMtE), a self-applied transdiagnostic internet-delivered program based on the Spanish version of the UP-A. Thisis the first transdiagnostic internet-based program designed for the treatment of emotional disorders inadolescents.Method: A sample of Spanish adolescents with a primary diagnosis of an anxiety and/or depressive disorder (n =58; age range = 12–18 years; 78.3% girls; 90% Caucasian) were randomly allocated to receive AMtE (n = 28) orthe UP-A via videocall (n = 30). Pre-treatment, post-treatment and 3-month follow-up data were collected usingself-reports and clinician-rated measures of anxiety, depression, positive and negative affect, anxiety sensitivityand emotional avoidance.Results: Based on generalized estimating equations (GEE) models, both intervention programs were effective insignificantly reducing self-reported anxiety and depressive disorder symptoms and clinician-rated severity ofanxiety and depression, as well as self-reported transdiagnostic outcome variables.Conclusions: Data provide empirical support for the efficacy of AMtE as a transdiagnostic online CBT treatmentfor anxiety and depressive disorders in adolescents. No marked nor consistent differences were observed betweenthe UP-A and AMtE, highlighting the potential usefulness of the online self-administered AMtE program.
... Studies have found that the CASI has high internal consistency (α=.87) and good test-retest reliability in both clinical (r=0.79) and nonclinical (r=0.76) samples [44]. Patients in our study who were missing 1 of the 18 items had their total CASI sum imputed by adding the mean of their 17 complete items to their 17-item sum. ...
Background
Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics and VR immersion level on the effectiveness of VR for managing pediatric pain and anxiety during venipuncture.
Objective
The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures.
Methods
This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children’s Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention.
Results
Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain.
Conclusions
VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR’s success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population.
Trial Registration
ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901
... Two sensitivity analyses were run. In the first, the parent-report measure of anxiety in models 1 and 2 was replaced with a self-report measure, the Childhood Anxiety Sensitivity Index CASI; [40]. This measure mainly captures adolescents' awareness of, and tendency to negatively interpret, symptoms of anxiety [41]. ...
Greater environmental sensitivity has been associated with increased risk of mental health problems, especially in response to stressors, and lower levels of subjective wellbeing. Conversely, sensitivity also correlates with lower risk of emotional problems in the absence of adversity, and in response to positive environmental influences. Additionally, sensitivity has been found to correlate positively with autistic traits. Individual differences in environmental sensitivity are partly heritable, but it is unknown to what extent the aetiological factors underlying sensitivity overlap with those on emotional problems (anxiety and depressive symptoms), autistic traits and wellbeing. The current study used multivariate twin models and data on sensitivity, emotional problems, autistic traits, and several indices of psychological and subjective wellbeing, from over 2800 adolescent twins in England and Wales. We found that greater overall sensitivity correlated with greater emotional problems, autistic traits, and lower subjective wellbeing. A similar pattern of correlations was found for the Excitation and Sensory factors of sensitivity, but, in contrast, the Aesthetic factor was positively correlated with psychological wellbeing, though not with emotional problems nor autistic traits. The observed correlations were largely due to overlapping genetic influences. Importantly, genetic influences underlying sensitivity explained between 2 and 12% of the variations in emotional problems, autistic traits, and subjective wellbeing, independent of trait-specific or overlapping genetic influences. These findings encourage incorporating the genetics of environmental sensitivity in future genomic studies aiming to delineate the heterogeneity in emotional problems, autistic traits, and wellbeing.
... Without treatment (Sabourin et al., 2016), AS remains stable over time, resembling a trait (Hovenkamp-Hermelink et al., 2019). Psychometric studies suggest AS, measured by the Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992) or the ASI-3 (Taylor et al., 2007), has a global and three lower-order dimensions: cognitive concerns (fear of cognitive dysfunction sensations given beliefs they will result in loss of control), physical concerns (fear of autonomic arousal sensations given beliefs they will result in physical catastrophe), and social concerns (fear of publiclyobservable arousal sensations given beliefs they will result in social censure). These dimensions show distinct associations with different forms of psychopathology (e.g., cognitive concerns with depression, physical concerns with panic, social concerns with social anxiety; Allan et al., 2014;Olthuis et al., 2014;Saulnier et al., 2018). ...
Anxiety sensitivity (AS) – characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences – is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.
... CSCY (Brodzinsky et al., 1992), CASI (Silverman et al., 1991), MASC (March et al., 1997), FSSC-R (Ollendick, 1983) and PSTPS developed for this study. ...
Accessible Summary
What is known on the subject?
Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily.
Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours.
What this paper adds to existing knowledge?
The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children.
It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies.
The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience.
What are the implications for practice?
Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults.
Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience.
This holds particular importance for low‐ and middle‐income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting.
Abstract
Introduction
Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences.
Aim
The aim of this review is to synthesize peer‐reviewed studies on the impact of storytelling interventions in developing resilience in children.
Method
The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children.
Results
The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children.
Discussion
Storytelling‐based interventions in school settings with participatory approaches using cultural stories, and positive psychology‐based interventions were effective and feasible.
Implications for Practice
This review has scope for informing future interventions with children, especially those who live in marginalized communities in low‐ and middle‐income countries (LMICs).
... The Childhood Anxiety Sensitivity Index (CASI) is a 18-item self-report measure that can be used to assess the fear of anxious arousal [40]. It comprises three subscales, including physical concerns (e.g., "It scares me when I feel like I am going to faint"), cognitive concerns (e.g., "It scares me when I am unable to keep my mind on a task") and social concerns (e.g., "It scares me when I blush in front of other people"). ...
Background
Irritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia.
Methods
Participants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations.
Results
Anxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation.
Conclusions
Anxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.
... The ASI is a 16-item questionnaire measuring an individual's concerns about the emotional and physical consequences of experiencing anxiety symptoms. Participants rate each item on a 4-point Likert scale, with total scores ranging from 0 to 64 (Peterson & Reiss, 1992). Construct validity of the ASI has been supported by several lines of research (Peterson & Heilbronner, 1987). ...
Eighty-six asthmatics completed measures of illness-specific panic-fear (i.e., panic-fear in response to symptoms of asthma) and of generalized panic-fear, dyspnea frequency, and catastrophic cognitions about bodily symptoms (the Anxiety Sensitivity Index [ASI] and Agoraphobic Cognitions Questionnaire [ACQ]). Asthma variables (self-report and pulmonary function tests) and cognitive variables (ASI and ACQ) were independently related to illness-specific panic-fear. Regression analyses showed that the cognitive variables predicted significant variance in both panic-fear scales after controlling for the effects of demographic and asthma variables. By contrast, the asthma variables were not associated with generalized panic-fear when the cognitive measures were controlled. In light of the adverse effects of panic-fear on asthma, the authors’ results suggest that researchers may fruitfully explore the use of cognitive techniques as an adjunctive treatment for improving asthma outcome.
... "It scares me when I can't keep my mind on my schoolwork"), was found to be present among children and young people and was hence incorporated in the child adapted version of ASI, i.e. the Childhood Anxiety Sensitivity Index (CASI; Silverman et al., 1991). ...
Introduction
Given the high rate of trauma exposure among children and adolescents, it is important to understand the risk factors for post-traumatic stress disorder (PTSD). Anxiety sensitivity has been implicated in multiple anxiety disorders, and an emerging evidence base has explored the relationship between this construct and PTSD. The present review investigated the size of the relationship between anxiety sensitivity and PTSD symptoms among children and adolescents exposed to trauma.
Method
A systematic search on multiple electronic databases (MEDLINE, PsycINFO, CINAHL and PTSDpubs) returned a total of 2916 records, among which six (n = 1331) met study inclusion criteria and were included in our random effects meta-analysis.
Results
Our results indicated a large effect size (r = .56, 95% CI = 0.47 − 0.64) for the relationship between anxiety sensitivity and PTSD symptoms; there was significant between-study heterogeneity.
Conclusion
This supported current cognitive models of anxiety and PTSD. Clinical implications, strengths and limitations of the review were discussed.
... Esta versión para niños conocida como Índice de Sensibilidad a la Ansiedad para Niños (Childhood Anxiety Sensitiviy Index -CASI) fue desarrollada por Silverman et al. (36) , y ha sido validada en España por Sandín et al. (34) , quienes la aplicaron a 151 niños de entre 9 y 11 años de edad. Esta versión del índice de Sensibilidad a la Ansiedad cuenta con 18 ítems distribuidos en dos factores: somático y mental, que aluden a las dimensiones de la Sensibilidad a la ansiedad somática y la Sensibilidad a la ansiedad cognitiva. ...
Introducción:
La sensibilidad a la ansiedad es un constructo poco conocido, y que sin embargo tiene un importante valor clínico, por ser un potente predictor de los trastornos de ansiedad, tanto en niños, como adolescentes y adultos. En Perú existen pocas pruebas psicométricas que evalúan la ansiedad en niños, y menos aún sobre sensibilidad a la ansiedad.
Objetivo:
En esta investigación se realiza un análisis psicométrico del Índice de Sensibilidad para Niños con la finalidad de estimar la validez y la confiabilidad de esta prueba que no ha sido aplicada en población peruana.
Método:
Se tomó una muestra no probabilística de 568 escolares de entre 8 y 12 años de cinco instituciones educativas de la ciudad de Arequipa, en Perú. Los datos se procesaron mediante el Análisis Factorial Confirmatorio de Grupo Múltiple utilizando el programa R.
Resultados:
Los resultados confirmaron una estructura de dos factores: Miedo a las sensaciones corporales y Miedo a síntomas mentales y sociales, con índices de confiabilidad aceptables calculados mediante la prueba Omega de McDonald.
Conclusión:
Se concluye que la prueba es válida y confiable, pero se sugiere profundizar en el análisis psicométrico de este instrumento.
... ACT-related Skills. The Child Anxiety Sensitivity Index (CASI) measured sensitivity to internal stimuli at baseline, post, and 1-month follow-up 36 . The measure has 18 items and examines how much a child views internal stimuli of anxiety as negative 37 . ...
Youth with chronic medical conditions need accessible and effective mental health interventions to address high levels of disruption in their psychological, social, and emotional development. Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy based on behavioral interventions that combines the principles of Relational Frame Theory and Mindfulness. ACT has been shown to be effective in populations of youth with various chronic conditions. As telehealth use has increased, ACT has been administered virtually on an individual level to adults and adolescents with chronic conditions, including chronic pain and Type II diabetes. However, few studies have incorporated a group-based element to the virtual delivery of ACT, which may be more accessible, cost-effective and may have additional therapeutic value in the form of peer connection and cohesion. To investigate the potential benefits of a virtual group model, we developed a web-based virtual ACT (vACT) group intervention for youth with chronic illness aged 14-21. The 6-week virtual group consisted of 1.5-hour sessions that each focused on a unique ACT concept: acceptance, values, mindfulness, cognitive defusion, experiential avoidance, and willingness/commitment. Additionally, the sessions included exercises to engage group members and teach skills. Baseline, post-, and follow-up data were collected on stress, mental health, functional outcomes, and satisfaction from one participant, “Kasey”, a 14-year-old Latina adolescent with comorbid Type I diabetes, depression, and anxiety. This case report details the procedures for the vACT group, discusses the barriers, and provides examples and recommendations for future administration of the group model. The report also describes Kasey’s experience during the group and presents quantitative/qualitative data supporting her improvement. Kasey’s perceived stress declined across sessions, while her anxiety sensitivity and depressive symptoms improved from the moderate range to the mild range, with sustained improvements at follow-up. Additionally, Kasey reported improvements in her peer relations with sustained improvements at follow-up, which was initially a significant concern. This case report provides promising preliminary data for the virtual administration of a group-based ACT intervention. We hope that clinicians can use this approach to provide evidence-based services that can reach a wider range of youth with chronic illnesses who may not otherwise have access to care and/or are estranged from their peers.
... Childhood Anxiety Sensitivity Index (CASI). The CASI (Rabian et al., 1999;Silverman et al., 1991) is a reliable and valid 18-item questionnaire measuring anxiety sensitivity in both clinical and nonclinical samples. Questions relate to interpretating anxiety-related bodily sensations as physically, socially, or psychologically harmful, such as "It scares me when I feel shaky" or "When my stomach hurts, I worry that I might be really sick." ...
Two experiments investigated perceived and physiological changes in anxiety in children (7–11 years; N = 222; 98 female) in a performance situation after they observed another child in a similar situation with a negative or neutral outcome. The sample's London, United Kingdom, school catchment areas ranged from low to high socioeconomic statuses with 31% to 49% of children from ethnic minority backgrounds. In Study 1, participants watched one of two films of a child playing a simple musical instrument (a kazoo). In one film, an audience of peers responds negatively to the performance. In the other film, the audience response was neutral. Participants were then filmed playing the instrument themselves and measures of perceived and actual heart rate were taken along with individual differences in trait social anxiety, anxiety sensitivity, and effortful control. To better understand findings from Study 1, Study 2 replicated Study 1 but added a manipulation check and measures of effortful control and self-reported anxiety. Multiple regression analyses found watching a negative performance film, compared with a neutral one, was associated with a blunted heart rate response for children with low effortful control (Study 1 and 2). These findings suggest that children who are low in effortful control may disengage during performance tasks if the situation's social threat is elevated. Hierarchical regression analyses found that, compared to the neutral film, the negative performance film elevated children's self-report anxiety (Study 2). Overall, the findings indicated that anxiety in performance situations can be elevated after observing peers’ negative experiences.
... The Childhood Anxiety Sensitivity Index (CASI) (Silverman et al., 1991) measures anxiety sensitivity in children. It contains 18 items and responses are given in three-point Likert-type questions with responses ranging from 0 "not at all" to 2 "a lot. ...
A number of studies to date examine dimensions of social phobia and anxiety in adolescents. A variety of tools has been developed, along with their abbreviated versions, that are used to assess Social Anxiety (SA) but little research has been devoted to the types of fears they each assess. Due to differences in the content of the multitude of instruments, different aspects of SA are addressed and this leads to confusion when the relationship between SA and other constructs is being investigated. The aim of the present study was to examine the psychometric properties of the abbreviated Social Phobia and Anxiety Inventory SPAI-23 in Greek-Cypriot community adolescents and describe dimensions of social fears at that age. Seven hundred twenty-one adolescent students from Cyprus, (Mean Age: 15.5, Range: 13–19, SD: 1.12, 64% female) participated in the study. Participants completed, among others, an abbreviated version of the Social Phobia and Anxiety Inventory (SPAI-23). Exploratory Factor Analysis on the SPAI-23 revealed a quite similar structure to the original questionnaire (SPAI). Three Social Phobia factors, describing distinct socially fearful situations, were identified (Performance, Interaction, and Presence in a social context) and one Agoraphobia factor after the evaluation of alternative solutions. Findings were verified by means of Confirmatory Factor Analysis, testing alternative models. Overall, findings were in line with recent evidence on youth samples, and contribute to significant insights towards more sophisticated and personalized assessments.
... Anxiety sensitivity. Anxiety sensitivity was assessed using the Children's Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991). The CASI is an 18-item self-report questionnaire that asks participants whether statements capturing fear of anxiety sensations are Not true (0), Quite true (1) or Very true (2) over the last 6 months ( Table S2). ...
Background
Despite being considered a measure of environmental risk, reported life events are partly heritable. One mechanism that may contribute to this heritability is genetic influences on sensitivity, relating to how individuals process and interpret internal and external signals. The aim of this study was to explore the genetic and environmental overlap between self‐reported life events and measures of sensitivity.
Methods
At age 17, 2,939 individuals from the Twins Early Development Study (TEDS) completed measures of anxiety sensitivity (Children's Anxiety Sensitivity Index), environmental sensitivity (Highly Sensitive Child Scale) and reported their experience of 20 recent life events. Using multivariate Cholesky decomposition models, we investigated the shared genetic and environmental influences on the associations between these measures of sensitivity and the number of reported life events, as well as both negative and positive ratings of life events.
Results
The majority of the associations between anxiety sensitivity, environmental sensitivity and reported life events were explained by shared genetic influences (60%–75%), with the remainder explained by nonshared environmental influences (25%–40%). Environmental sensitivity showed comparable genetic correlations with both negative and positive ratings of life events (rA = .21 and .15), anxiety sensitivity only showed a significant genetic correlation with negative ratings of life events (rA = .33). Approximately 10% of the genetic influences on reported life events were accounted for by influences shared with anxiety sensitivity and environmental sensitivity.
Conclusion
Differences in how individuals process the contextual aspects of the environment or interpret their own physical and emotional response to environmental stimuli may be one mechanism through which genetic liability influences the subjective experience of life events.
... These frameworks may provide information on emotions' (a) typical course (e.g., duration), (b) causes and consequences (e.g., validity, effects on relationships), (c) implications for self-concept (e.g., shamefulness), (d) normality, (e) comprehensibility, and (f) means of regulation (e.g., controllability), thereby shaping the ways in which an individual processes, interprets, and responds to emotions, emotional experiences, and emotional information Leahy, 2002Leahy, , 2014Leahy, , 2015. As such, assessment of emotional schemas most often includes self-report measures that evaluate overall endorsement of or agreement with common emotional schemas [e.g., "Some feelings are wrong to have" (Leahy Emotional Schema Scale;Leahy, 2012); "It is important not to appear nervous" (Anxiety Sensitivity Index; Peterson & Reiss, 1992); "Emotions help people get along in life" (Need for Affect Scale; Maio & Esses, 2001)]. Consistent with theories of PD development, growing research suggests a strong association between endorsement of common maladaptive emotional schemas and PD psychopathology. ...
Emotional schemas—cognitive frameworks that organize and guide beliefs, values, interpretations of, and reactions to emotions and emotional experiences—appear to underlie many clinically-relevant constructs, including self-validation, emotion and behavior regulation, and psychopathology. Although growing research suggests emotional schemas may also be related to personality disorders, this research is often fragmented by idiosyncratic conceptualizations of emotional schemas and under-evaluation of cluster A and cluster C personality disorders. The current study contributed to this growing literature by exploring associations between emotional schemas and personality disorder symptoms in a large sample of 1125 individuals seeking outpatient mental health care. Results suggested endorsement of maladaptive emotional schemas were generally associated with greater symptom severity for most personality disorders, and patterns of emotional schema endorsement were generally consistent with personality disorder clinical presentations. However, narcissistic, histrionic, and obsessive–compulsive personality disorders were characterized by under-endorsement of common maladaptive emotional schemas. Further, whereas some emotional schemas appeared pervasive across personality disorders (i.e., invalidation, incomprehensibility), others were closely associated with only one or a few personality disorders (e.g., only individuals with schizoid personality disorder showed exaggerated endorsement of low expression schemas). Results broadly attest to the potential importance of emotional schemas as underlying clinical presentations of personality disorders.
... This measure uses a 5-point Likert scale to assess exposure to physical, emotional, and sexual abuse, as well as physical and emotional neglect, with a higher sum score (ranging from 25 to 125) indicative of more severe CT experience (Bernstein and Fink 1998). A composite AP score was generated from the Childhood Anxiety Sensitivity Index, an 18-item questionnaire designed to measure the fear of experiencing symptoms of anxiety in children and adolescents, and the State-Trait Anxiety Inventory-Trait measure, which includes 20 items that assess the tendency to present with anxiety (Spielberger 1983;Silverman et al. 1991;Viljoen et al. 2020). ...
Dysregulation of stress response systems may mediate the detrimental effects of childhood trauma (CT) on mental health. FKBP5 regulates glucocorticoid receptor sensitivity and exerts pleiotropic effects on intracellular signaling, neurobiology and behavior. We investigated whether CT, alone and in combination with rs1360780 genotype, is associated with altered FKBP5 methylation and whether CT-associated methylation profiles are associated with anxiety proneness (AP) and structural brain volumes. Ninety-four adolescents completed the Childhood Trauma Questionnaire, and a composite AP score was generated from the Childhood Anxiety Sensitivity Index and the State-Trait Anxiety Inventory—Trait measure. Mean methylation values for 12 regulatory regions and 25 individual CpG sites were determined using high-accuracy measurement via targeted bisulfite sequencing. FKBP5 rs1360780 genotype and structural MRI data were available for a subset of participants (n = 71 and n = 75, respectively). Regression models revealed an inverse association between methylation of three intron 7 CpG sites (35558438, 35558566 and 35558710) and right thalamus volume. CpG35558438 methylation was positively associated with AP scores. Our data indicate that an intron 7 methylation profile, consistent with lower FKBP5 expression and elevated high sensitivity glucocorticoid receptor levels, is associated with higher AP and smaller right thalamus volume. Research into the mechanisms underlying the intron 7 methylation–thalamus volume relationship, and whether it confers increased risk for long-term psychopathology by altering the regulatory threshold of stress responding, is required.
... Data were imputed using package "mice" (van Buuren & Groothuis-Oudshoorn, 2011) with 20 imputations and 20 iterations for each imputation. The predictors of the imputation included demographic variables at intake, dropout status, PDSS-IE before therapy, PDSS-SR and Anxiety Sensitivity Index (Peterson & Reiss, 1987) ratings prior to the third session. The predictors of the imputation also included patient intake scores of adult separation anxiety checklist (ASA-CL), work and social adjustment scale-self report version (WSAS-SR) and aggression scale of the inventory of interpersonal problems (IIP-aggression) -all of which were found to be related to therapy outcome in this sample (Aaronson et al., 2008;Lutz et al., 2014). ...
Objective The therapeutic alliance is related to treatment outcome but less is known about the agreement on alliance between patients and therapists and its relationship to outcomes. We examined the association of patient-therapist congruence of alliance perceptions, early and late in cognitive behavioral therapy for panic disorder in relation to symptom reduction and dropout. Method: Patients (n = 181) and their therapists provided alliance ratings early and late during 11-session treatment. Independent evaluators rated patients' symptomatic levels post-treatment. Polynomial regression and response surface analysis were used to examine congruence as a predictor of outcome. Results: Early in therapy, stronger combined patient-therapist alliances, regardless of agreement, predicted lower symptom severity at the end of therapy and a lower likelihood of dropout. Late in treatment, the outcome was worse when therapist ratings of the alliance were higher than those of the patient. Conclusions: Therapist-patient agreement on the strength of the alliance is important for symptom improvement and dropout. The study highlights the importance of understanding the dyadic nature of the alliance and its impact on therapeutic change.
... Despite the discomfort of anxiety, there is variability in an individual's ability to tolerate the experience of anxiety, a phenomenon known as distress tolerance (Simons and Gaher, 2005). A related validated construct that has been measured and studied in children is anxiety sensitivity, which is the extent to which an individual views symptoms associated with anxiety as aversive, particularly the physical symptoms (Reiss et al., 1986;Silverman et al., 1991). Youth with non-clinical anxiety are likely to have high levels of distress tolerance and low levels of anxiety sensitivity compared to youth with clinical anxiety. ...
Anxiety is common and is a typical aspect of development in children and adolescents (referred to as youth). In contrast, anxiety disorders, or clinical anxiety, are psychological disorders that are distressing and impairing. In this chapter we discuss the differences between non-clinical and clinical anxiety and describe the anxiety disorders listed in the Diagnostic Statistical Manual Version 5 (DSM-5; American Psychiatric Association, 2013). We also summarize biopsychosocial factors that contribute to youth anxiety including those relating to individual differences, parenting, learning, biology, social interaction, culture, and the sociopolitical environment. These interacting factors inform the science underlying the development of evidence-based treatments (EBTs), as well as novel treatments with emerging evidence. The existence of a range of EBTs provides hope to the large proportion of youth with anxiety disorders and their families. An important challenge is to ensure that all segments of the population have access to these treatments.
The Obsessive-Compulsive Inventory-Child Version (OCI-CV), which was developed to assess OCD symptoms in children and adolescents, was recently revised (OCI-CV-R) after hoarding was removed as an OCD symptom dimension in the DSM-5. The study aimed to examine the validity of the OCI-CV-R for assessing OCD symptoms in Turkish culture. A total of 1,062 youths, aged 9 to 18 years, participated in this study to assess the OCI-CV-R's psychometric properties in the Turkish culture. Analysis included factor analyses and assessments of validity and reliability. Results demonstrated that the Turkish version of the OCI-CV-R had good model fit values for the five-factor structure of the scale. The revised scale also revealed measurement invariance between two age groups: children (ages 9-11) and adolescents (ages 12-18). The findings indicate that the OCI-CV-R is a valid and reliable instrument for assessing OCD symptoms among Turkish-speaking populations and thus can replace the previous version.
Associations among scores on scales of anxiety sensitivity and trait anxiety and a fear of pain questionnaire were examined for 118 children. Analysis showed that anxiety sensitivity was positively and substantially related to fear of pain in the children. Furthermore, the data suggested anxiety sensitivity to be a better predictor of fear of pain than trait anxiety.
Obsessive-compulsive symptoms (OCS) increase with age during childhood and adolescence, and subthreshold OCS in childhood associate with a higher probability of obsessive-compulsive disorder (OCD) diagnosis in adulthood. Additionally, average age of onset for OCD is in adolescence, with the majority of OCD cases emerging by early adulthood. Despite these trends, the specific course of OCS development in adolescence is relatively unknown. To this end, the present prospective longitudinal study used latent growth mixture modeling and a diverse community sample of 3,335 high schoolers to identify and characterize growth trajectories of OCS across middle to late adolescence. Results identified three trajectories: High-but-Remitting, Moderate-but-Escalating, and Low-and-Stable. Results also indicated age, gender, anxiety sensitivity, and distress tolerance as significant predictors of trajectory group membership, such that younger age and being female predicted classification in the High-but Remitting group, greater anxiety sensitivity predicted classification in both the Highbut-Remitting and Moderate-but Escalating groups, and greater distress tolerance predicted a lower likelihood of classification in the High-but-Remitting and Moderate-but-Escalating groups. Taken together, these trajectories have illustrated the temporal course and development of OCS across key developmental years. Moreover, the trajectories and their corresponding predictors may help identify adolescents who are particularly vulnerable to developing OCD.
Biological mechanisms underlying anxiety proneness (AP), the tendency to react fearfully to stressors due to the belief that experiencing anxiety has harmful consequences, remain unclear. Epigenetic mechanisms, such as microRNAs (small, non‐coding RNAs 19–20 nucleotides long), may be contributory. This study investigated AP‐associated differences in microRNA expression among South African adolescents with variable exposure to childhood trauma (CT). AP was assessed using a composite score reflecting trait anxiety and anxiety sensitivity, while CT exposure was assessed with the Childhood Trauma Questionnaire. High‐quality total RNA ( n = 88) extracted from whole blood underwent microRNA‐sequencing. Differential microRNA expression analysis was conducted with DESeq2 in R, messenger RNA target prediction analysis was performed using TargetScan and DIANA‐microT, and the DIANA mirPATH tool was used for KEGG pathway analysis. The majority of participants were female (75.86%) with an average age of 15 (±1.19) years. MicroRNA expression analysis identified upregulation of hsa‐miR‐28‐5p and downregulation of hsa‐miR‐502‐3p and hsa‐miR‐500a‐3p in high‐AP individuals, irrespective of CT. Four KEGG pathways, each with ≥10% of their constituent genes predicted to be targets of the differentially expressed microRNAs, were identified and were enriched for genes involved in calcineurin and glutamate signalling. These findings suggest that epigenetically mediated effects on neuronal function contribute to the molecular aetiology of AP.
Background: Anxiety disorders (AD) being the most prevalent psychological problem among children and adolescents remain largely unrecognized due to their nature. If untreated, AD could lead to many adverse outcomes. The aim of this study was to assess the prevalence and correlates of anxiety disorders among children aged 13-15 years attending government Sinhala medium schools in Colombo district, Sri LankaMethods: A school based cross-sectional study was conducted among 1524 children in Sinhala-medium government schools aged 13-15 years old selected by stratified cluster sampling. The presence of “any anxiety disorder” and its correlates were assessed using a pre-tested self-administered questionnaire that included validated Screen for Child Anxiety Related Disorders (SCARED). Multivariable analysis with binary logistic regression was carried out using backward elimination method to determine the association between anxiety disorders and selected correlates identified at bivariate analysis at p<0.05 level.Results: The adjusted prevalence of anxiety disorders was 12.3% (95% CI: 9.8% to 14.9%) Factors significantly associated with having any anxiety disorders at the multivariable analysis included being female (OR=3.0, 95% CI:2.0-4.4,p<0.001), residing away from the family (OR= 4.6, 95%:1.2-17.8, p=0.027), low to moderate self-esteem (OR=1.6, 95% CI: 1.1-2.5, p=0.022), having Stress (OR=2.3, 95%, CI: 1.5-3.6, p= <0.001), having Depression (OR= 2.5, 95% CI: 1.4-4.5, p<0.001), attending tuition classes for 5-7 days per week (OR=2.9, 95% CI: 1.9-4.3, p<0.001), non-engagement in sports activities (OR=1.6, 95%CI: 1.1-2.6, p=0.028), having a sibling/s less than one year of age ( OR=2.9, 95% CI: 1.2-6.6, p=0.015), father’s low level of education (OR=2.0, 95% CI: 1.1-3.8 p=0.044) and mother engaged in foreign employment (OR=5.3 , 95% CI: 2.0-13.9,p= 0.001), having an insecure attachment style (OR=2.7, 95% CI: 1.8-4.0, p<0.001).Conclusions: The prevalence of AD is high in this community and is associated with multiple personal, family, and educational factors. Screening for ADs need to be considered at routine mental health services.
Objective
There is debate surrounding how to differentiate between anorexia nervosa (AN) and atypical AN (atypAN) as diagnostic entities, and whether a distinction based on BMI is warranted. Better understanding eating disorder (ED) and emotional symptoms across atypAN and AN subtypes [AN‐restricting (AN‐R), AN‐binge/purge (AN‐BP)], with and without controlling for BMI, can elucidate how atypAN differs from AN subtypes and whether there is a basis for a BMI cut‐off.
Methods
1810 female patients at an ED treatment centre completed intake surveys. ANCOVAs assessed differences across AN‐R ( n = 853), AN‐BP ( n = 726), and atypAN ( n = 231) groups on ED, depressive, and anxiety symptoms, anxiety sensitivity, experiential avoidance, and mindfulness, with and without controlling for BMI.
Results
Relative to AN‐R, atypAN and AN‐BP groups endorsed significantly higher ED and depressive symptoms, anxiety sensitivity, experiential avoidance, and significantly lower mindfulness (all p < 0.001), but atypAN and AN‐BP groups did not differ from one another. When controlling for BMI, all previously significant differences between atypAN and AN‐R did not remain significant.
Conclusion
Individuals with atypAN who have a higher BMI experience more pronounced ED and emotional symptoms, suggesting that relying solely on BMI as a marker of illness severity may be problematic.
Background:
Sensitivity to pain traumatization is defined as the propensity to develop cognitive, affective, and behavioral responses to pain that resemble a traumatic stress reaction. To date, sensitivity to pain traumatization has been assessed in adults (Sensitivity to Pain Traumatization Scale [SPTS-12]) and parents of youth with chronic pain (Sensitivity to Pain Traumatization Scale-Parent version [SPTS-P]). SPT may be relevant in the context of pediatric chronic pain given the substantial comorbidity between posttraumatic stress symptoms and pain.
Aims:
This prospective study aimed to adapt the SPTS-12 for use in youth and to evaluate the psychometric properties of the new scale.
Methods:
Participants included 175 youth with chronic pain (Mage = 14.31 years, 73% girls) referred to outpatient chronic pain programs. At baseline, youth self-reported the levels of their sensitivity to pain traumatization (Sensitivity to Pain Traumatization Scale-Child version [SPTS-C]), as well as their pain symptoms, pain-related anxiety, posttraumatic stress symptoms, and attentional control. Three months later, youth self-reported their pain symptoms and completed the SPTS-C.
Results:
The SPTS-C had a one-factor structure that explained 48% of variance and demonstrated good reliability and construct validity. SPTS-C baseline scores predicted follow-up levels of pain interference but not pain intensity or pain unpleasantness.
Conclusions:
The results provide preliminary evidence for the psychometric properties of the SPTS-C and the potential role of SPT in pediatric chronic pain outcomes.
Youth with anxiety disorders report difficulty falling asleep and returning to sleep after sleep onset (i.e., poor sleep efficiency). Anxiety sensitivity, the excessive attention to physical symptoms of anxiety and their threatening interpretations, has been linked to poor sleep efficiency. We tested a conceptual model wherein attentional control, attentional focusing and attentional shifting would account for the relationship between anxiety sensitivity and poor sleep efficiency. 255 youths (6–17 years old, 78% Hispanic/Latino) who presented to a university-based research clinic completed measures on anxiety sensitivity, sleep, and attentional control. Poorer sleep efficiency was significantly correlated with higher anxiety sensitivity and lower attentional control, attentional focusing, and attentional shifting. Higher anxiety sensitivity was significantly correlated with lower attentional control and attentional focusing. Attentional control and attentional focusing, not attentional shifting, accounted for the relationship between anxiety sensitivity and poor sleep efficiency. These findings identify attentional control and attentional focusing as variables that may explain the association between anxiety sensitivity and sleep efficiency in youth.
Objective
Bodily threat monitoring is a core clinical feature of Fear of cancer recurrence (FCR) and is targeted in psycho‐oncology treatments, yet no comprehensive self‐report measure exists. The aim of this study was the theory‐informed development and initial validation of the Bodily Threat Monitoring Scale (BTMS).
Methods
Adult survivors of breast and gynaecological cancers (Study 1: N = 306, age = 37–81 years) and childhood cancer survivors (Study 2: N = 126, age = 10–25 years) completed the BTMS, designed to assess how individuals monitor for and interpret uncertain symptoms as indicating that something is wrong with their body. Participants completed measures to assess construct and criterion validity of the BTMS, and childhood cancer survivors (Study 2) completed the BTMS again 2 weeks later to assess test‐retest reliability.
Results
The 19‐item BTMS demonstrated excellent internal consistency across adult and childhood cancer samples ( α = 0.90–0.96). Factor analyses indicated two subscales capturing 1. Monitoring of bodily sensations and 2. Threatening interpretations of bodily sensations. Two‐week stability estimates were acceptable. For construct validity, the BTMS correlated with body vigilance and anxiety sensitivity. The BTMS also demonstrated criterion validity, yielding significant associations with FCR, intolerance of uncertainty, help‐seeking behaviours, and quality of life. The BTMS was associated with FCR while controlling for body vigilance and anxiety sensitivity, indicating a unique contribution of this theory‐informed measure.
Conclusions
The BTMS shows evidence of sound psychometric properties and could be used to elucidate the role of bodily threat monitoring in the maintenance and management of FCR.
Sixty children, ages 7–17 years, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis for various specific phobias were randomized to (a) 1-session exposure treatment alone, (b) 1-session treatment with a parent present, or (c) wait-list control group for 4 weeks. After the waiting period, the wait-list patients were rerandomized to the active treatments. The patients' phobias were assessed with behavioral approach tests (approach behavior, experienced anxiety, and physiological reactions), whereas general anxiety, depression, phobic tendencies, and anxiety sensitivity were assessed with self-report inventories. Assessments were done pre-, post-, and 1-year following treatment. Results showed that both treatment conditions did significantly better than the control condition, whereas the treatment groups did equally well on most measures, and the effects were maintained at follow-up. The implications of these results are discussed.
We tested the hypothesis that anxiety sensitivity enhances responses to biological challenge by exposing college students who scored either high or low on the Anxiety Sensitivity Index (ASI) to 5 min of voluntary hyperventilation. The ASI is a validated self-report instrument that measures the fear of anxiety symptoms. Following hyperventilation, high-anxiety-sensitivity (HAS) subjects reported more frequent and more intense hyperventilation sensations and a higher level of subjective anxiety than did low-anxiety-sensitivity (LAS) subjects. Analyses of covariance controlling for baseline differences indicated that the magnitude of increase (i.e., reactivity) in hyperventilation symptoms remained greater in the HAS than in the LAS group, whereas the magnitude of increase in anxiety did not. HAS subjects also exhibited a bias for reporting bodily sensations in general. These findings parallel those obtained when panic patients and normal controls are biologically challenged with hyperventilation, lactate infusion, and other anxiogenic agents. Taken together, these results suggest that anxiety sensitivity may also enhance the anxiety responses of panic patients during biological challenge tests.
The Cambridge Handbook of International Prevention Science offers a comprehensive global overview on prevention science with the most up-to-date research from around the world. Over 100 scholars from 27 different countries (including Australia, Bhutan, Botswana, India, Israel, Mexico, Singapore, South Korea, Spain and Thailand) contributed to this volume, which covers a wide range of topics important to prevention science. It includes major sections on the foundations of prevention as well as examples of new initiatives in the field, detailing current prevention efforts across the five continents. A unique and innovative volume, The Cambridge Handbook of International Prevention Science is a valuable resource for established scholars, early professionals, students, practitioners and policy-makers.
Though anxiety sensitivity (AS)—fear of anxiety-related experiences—is primarily tied to anxiety vulnerability, AS has also been prospectively associated with general negative affect and depression. Furthermore, depression has been longitudinally associated with different forms of substance use, and some AS subfactors (e.g., cognitive concerns) have been associated more consistently with depression and substance use than others. However, no previous study has investigated if longitudinal associations of AS with substance use may be mediated by depression or whether aspects of AS may be prospectively associated with substance use among adolescents. Hence, the present study tested depressive affect (the negative affective aspect of depression) as a prospective mediator of AS associations with substance use and examined longitudinal AS subfactor associations with substance use and problems. High school 9th graders (N = 2,877; Mage = 14.1 years; 55.3% female) completed self-report measures at baseline and at 6 months and 1 year later. Depressive affect mediated AS associations with subsequent alcohol, cigarette, electronic cigarette, cannabis, benzodiazepine, and opioid use. Also, AS cognitive and social concerns (vs. physical concerns) were more consistently associated with later depressive affect and substance use and problems. Current findings suggest that adolescents high in anxiety sensitivity tend to prospectively experience greater depressive affect, which in turn is related to a higher likelihood of engaging in several different forms of substance use. Thus, it is possible that interventions which target AS (particularly AS cognitive concerns) may help to treat or prevent depression and substance use among adolescents.
The present study examined the impact of separation anxiety on the vulnerability of children without parental care. Parenting is no doubt one of the most tedious, diverse, and complex jobs to execute, and when it goes wrong, it affects society deeply. Parents are the first form of protection for their children, and when the roles are not executed, it tends to affect the child’s moral and psychological abilities. Separating children from their loved ones and/or familiar environments has a great impact on the developmental milestones of such children. Separation anxiety is a required distress-response to being separated from one’s caregivers during infancy, which is critical to the child’s emotional or psychological development. Regardless of the fact that some children develop coping strategies to regulate how they react to this distress, others hardly handle it, and it affects their behaviors and how they react to things. The United Nations Convention on the Rights of the Child (UNCRC) suggests that bringing up a child under the care of a parent or close relative is of great help to the child. However, children who are not privileged to have such opportunities are subjected to negligence and severe vulnerability. Some of the factors that contribute to child vulnerability include, but are not limited to, disability, parents’ educational level, and mental health status. Therefore, this commentary aims to investigate the previous empirical studies and other psychological implications and triggers of vulnerability in children without parents. It suggests that, apart from the physical and socio-economic challenges faced by children without parents, some psychological challenges (e.g., separation anxiety) predispose them to being vulnerable.
Introduction:
Developmentally appropriate pre-surgical educational programs can help alleviate the anxiety of both children and parents. As one of the most common pediatric surgical procedures is circumcision; and they may experience anxiety and fear before and after this surgical procedure, this study is considered to make an important contribution to the literature.
Objective:
This study aimed to examine the effect of therapeutic play based training program on pre- and post-operative anxiety and fear levels of children aged 8-11 years who would undergo circumcision.
Study design:
This was a quasi-experimental study that consisted of a pre- and post-intervention and control groups; and concluded with 60 children aged 8-11 years (intervention group: 30 and no intervention/control group: 30). Child and Parent Information Form, Childhood Anxiety Sensitivity Index (CASI) and Fear for Medical Procedures Scale (FMPS) were used as data collection tools. Children in the intervention group applied a "therapeutic play-based training program" 2 h before they underwent circumcision surgery. Therapeutic toys used in the educational program has designed by researchers.
Results:
After the training program, children in the intervention group obtained lower CASI (preop t = 6.383, p < .001; postop t = 8.763, p < .001) and FMPS (preop t = 6.331, p < .001; postop t = 9.366, p < .001) total mean scores than those in the control group.
Discussion:
This study was concluded that the therapeutic play based training program used to prepare children for circumcision surgery was effective in reducing their pre- and post-operative anxiety and medical fears. Considering that male circumcision is a religious and cultural necessity in Turkey, further studies can also examine whether the anxiety and medical fear scores differ in study groups that include children who are not Muslim or live in a different country, and whether the training program will be effective in reducing their anxiety and medical fears.
Conclusions:
A therapeutic play based training program can be used to prepare children for circumcision in the preoperative period.
A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being. However, only a few brief psychological interventions target distress or subclinical symptoms. This systematic review aimed to identify and describe brief psychological interventions to reduce distress or subclinical symptoms in survivors of disasters, pandemics, and other severe stressors. Based on a systematic literature search (MEDLINE, PsycINFO, PSYNDEX, PTSDpubs, and Web of Science), we reviewed published studies and study protocols on self-help, psychosocial support, or brief psychotherapeutic interventions to reduce distress and/or subclinical symptoms following natural hazards and man-made disasters, pandemics, or other traumatic events. We included 27 published studies or study protocols (n = 15 RCTs, n = 3 controlled pre–post studies, and n = 9 uncontrolled pre–post studies) describing 22 interventions. We found evidence for reducing psychological distress and/or subclinical symptoms in 9 out of 15 RCTs, 2 out of 3 controlled pre–post studies, and 9 out of 9 uncontrolled pre–post studies. One RCT provided evidence of increasing well-being. Innovative brief interventions have been developed to reduce distress and/or subclinical symptoms that have an emerging evidence base.
Anxiety disorders are one of the most common psychiatric conditions in youth and can contribute to impairment in social, academic, and family functioning. Cognitive-behavioral therapy (CBT) has been shown to be efficacious in treating youth anxiety disorders; however, for a multitude of reasons, fewer than 20% of adolescents with anxiety disorders receive services for anxiety-related problems. Intensive treatments, which rely on the same traditional components of CBT but are delivered over a shorter period of time or in a fewer number of sessions, may be particularly helpful for anxiety disorders and can offer a number of advantages over standard CBT. Despite emerging evidence supporting the advantages of the intensive approach, there are few established intensive treatment programs for youth with anxiety disorders. Further, no treatment to date has comprehensively targeted the entire spectrum of comorbid adolescent anxiety disorders in a combined intensive and transdiagnostic format, even though non-intensive (i.e., weekly delivered) CBT has been tested using a transdiagnostic approach. We developed an intensive, six-session intervention based on Angelosante and colleagues’ 2009 The Adolescent Panic Control Treatment with In-Vivo Exposures (Angelosante et al., 2009) and other empirically-supported treatments for youth to target all anxiety disorders in adolescents. We present a case study on an adolescent with multiple comorbid anxiety and related disorders who received intensive CBT treatment as a way to illustrate the clinical benefit and utility of an intensive, transdiagnostic approach. Findings support the acceptability and feasibility of transdiagnostic treatment of youth anxiety.
Anxiety sensitivity is a transdiagnostic construct that has been associated with the etiology of emotional disorders, especially panic and other anxiety disorders. Although it is well known that, for the adult population, the factor structure of anxiety sensitivity includes three separate facets (physical, cognitive, and social concerns), the facets of anxiety sensitivity for adolescents have not yet been established. The main goal of the present study was to examine the factor structure of the Spanish version of the Childhood Anxiety Sensitivity Index (CASI). A large sample of nonclinical adolescents completed the Spanish version of the CASI in school settings (N = 1655; aged 11–17 years; 800 boys and 855 girls). Exploratory and confirmatory factor analyses of the full scale (CASI-18) indicate that a three first-order factor solution represents appropriately the three anxiety sensitivity facets previously defined for the adult population. The 3-factor structure had a better fit and was more parsimonious than a 4-factor solution. Results also indicate that the 3-factor structure remains invariant across genders. Girls scored significantly higher than boys on the total scale and on all three dimensions of anxiety sensitivity. In addition, the present study provides information concerning normative data for the scale. The CASI holds promise as a useful tool for assessing general and specific facets of anxiety sensitivity. It could be helpful for the assessment of this construct in clinical and preventive settings. The limitations of the study and suggestions for further research are outlined.
Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.
There needs to be serious transformation of evidence-based interventions (EBIs) into real-world solutions; otherwise, EBIs will never achieve the intended public health impact. In a randomized trial, we reported effects of a re-designed anxiety program. Herein, we described the re-design process that led to the program. Survey data revealed provider preferences for school mental health anxiety services. Focus groups and prototype feedback sessions revealed service barriers to uptake, implementation, and sustainability along with corresponding enabling strategies. Prototype feedback sessions also focused on refinement and fine-tuning of the redesign. In the end, traditional EBI strategies were transformed and packaged into six lessons, lasting 20 to 30 minutes each, and amenable to delivery in small-group format. The redesign achieved the intended purpose of retaining elements from cognitive and behavior therapy and social skills training for the target population of the intervention (e.g., 3rd to 5th graders with heterogeneous anxiety problems - identified and referred). The streamlined EBI is accessible from PBS LearningMedia™ - a service that hosts public, research-based, and school-ready materials.
• We investigated the prevalence of DSM-III disorders in 792 children aged 11 years from the general population and found an overall prevalence of disorder of 17.6% with a sex ratio (boys-girls) of 1.7:1. The most prevalent disorders were attention deficit, oppositional, and separation anxiety disorders, and the least prevalent were depression and social phobia. Conduct disorder, overanxious disorder, and simple phobia had intermediate prevalences. Pervasive disorders, reported by more than one source, had an overall prevalence of 7.3%. Examination of background behavioral data disclosed that children identified at 11 years as having multiple disorders had a history of behavior problems since 5 years of age on parent and teacher reports. Fifty-five percent of the disorders occurred in combination with one or more other disorders, and 45% as a single disorder.
In this study, the validation of a Revised Fear Survey Schedule for Children (FSSC-R) is detailed. Psychometric properties of the scale are reported for two normal samples and one clinical sample of school-phobic children. Initial analyses indicate that the FSSC-R possesses high internal consistency, high test-retest reliability and acceptable stability over time. Further, it adequately discriminates between normal and clinical samples, has acceptable convergent and discriminant validity and possesses a meaningful factor structure. The potential clinical utility of the scale is discussed, and important social and developmental issues affecting the development and expression of fear in children are addressed.
Reliability, factor structure, and factor independence from other anxiety measures for the Anxiety Sensitivity Index (ASI) was assessed. One hundred and twenty-two anxious college students were administered the ASI, Cognitive-Somatic Anxiety Questionnaire, and the Reactions to Relaxation and Arousal Questionnaire. The results suggest that the ASI is a reliable measure which is factorially independent of other anxiety measures. Further, the ASI was supported as a measure of the variable anxiety sensitivity which has been suggested as an important personality variable in fear behavior.
The effect of the comorbidity of overanxious disorder (ANX) in attention deficit hyperactivity disorder (ADHD) on laboratory measures of behavior, cognition, and stimulant response was examined. Seventy-nine children who met DSM-III-R criteria for ADHD were tested further for an oppositional defiant disorder (ODD), conduct disorder (CD), or ANX. Subjects with comorbid ANX showed less impulsiveness on a laboratory measure of behavior and had longer, sluggish reaction times on the Memory Scanning Test than those without ANX. ADHD subjects with comorbid ANX were less frequently diagnosed as CD. Forty-three of the subjects completed a double-blind trial of methylphenidate; subjects with comorbid anxiety had a significantly poorer response to the stimulant than those without anxiety, while the comorbidity of ODD or CD did not affect stimulant response. The results suggest that ADHD with comorbid ANX may represent children with primary anxiety who develop secondary inattentiveness, or they may represent a different subtype of ADHD, perhaps similar to the condition of attention deficit disorder without hyperactivity under DSM-III.
The reliability of DSM-III/DSM-III-R childhood anxiety disorder diagnoses was determined using a new semistructured interview, the Anxiety Disorders Interview Schedule for Children child and parent versions (ADIS-C and ADIS-P). The interviewer-observer paradigm was used. Pairs of independent clinicians examined 51 outpatients and their mothers and assigned independent primary and secondary diagnoses. Product-moment correlations were calculated between pairs of raters and by computing kappa coefficients, based upon perfect matches on primary diagnoses. Both overlap and differences were evident in the anxiety disorders diagnosed. Agreement between clinicians was moderate to high, with the exception of overanxious disorder. The latter resulted in a low kappa coefficient based upon the child interview data only. Reasons for diagnostic disagreements between the parent and child interviews are discussed.
A distinction is proposed between anxiety (frequency of symptom occurrence) and anxiety sensitivity (beliefs that anxiety experiences have negative implications). In Study 1, a newly-constructed Anxiety Sensitivity Index (ASI) was shown to have sound psychometric properties for each of two samples of college students. The important finding was that people who tend to endorse one negative implication for anxiety also tend to endorse other negative implications. In Study 2, the ASI was found to be especially associated with agoraphobia and generally associated with anxiety disorders. In Study 3, the ASI explained variance on the Fear Survey Schedule—II that was not explained by either the Taylor Manifest Anxiety Scale or a reliable Anxiety Frequency Checklist. In predicting the development of fears, and possibly other anxiety disorders, it may be more important to know what the person thinks will happen as a result of becoming anxious than how often the person actually experiences anxiety. Implications are discussed for competing views of the ‘fear of fear’.
A Fear Survey Schedule for Children (FSS-FC) was developed. This scale and the Children's Manifest Anxiety Scale (CMAS) were administered to fifty-nine boys and forty girls ages 9 through 12. A factor analysis was performed on each scale yielding factored subscales intended for use in clinical assessment and research in children's fears. A comparison was made between the fear and anxiety scales and an overall correlation of 0.49 between the FSS-FC and CMAS was similar to that obtained in adult studies.
The Child Assessment Schedule (CAS) was developed to address the need for a standardized child interview that could be used for research and clinical purposes. The CAS has several distinguishing characteristics: (1) Questions and responses are standardized, (2) the format was designed to enhance rapport with the child, and (3) information necessary for DSM III childhood diagnoses is explicitly solicited. The CAS was administered to 32 child outpatients, 18 inpatients, and 37 normal controls. Derived scores were obtained for total psychopathology, 11 content areas, and 9 symptom complexes. Interrater reliability for the total CAS score was quite high. The CAS was able to discriminate among the three groups in total score indicating degree of psychopathology, on 9 of the 11 content areas, and on 8 of the 9 symptom complexes. Significant correlations were found between the CAS and maternal report of child behavior and between the CAS and child self-report of internal affects. It was concluded that the CAS has adequate reliability and validity, although further research is indicated.
Fear of anxiety: Development and valida-tion of an assessment scale (Doctoral dissertation, Univer-sity of Illinois at Chicago, 1982) Dissertation Abstracts In-ternational, 43, 685692 The development of a child assessment interview for research and clinical use
- W S Epstein
- K Hodges
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Epstein, W. S. (1982). Fear of anxiety: Development and valida-tion of an assessment scale (Doctoral dissertation, Univer-sity of Illinois at Chicago, 1982). Dissertation Abstracts In-ternational, 43, 685692. Hodges, K., Kline, J., Stem, L., Cytryn, L., & McKnew, D. (1982). The development of a child assessment interview for research and clinical use. Journal of Abnormal Child Psy-chology, 10, 173-189.
Manual for the State-Trait Inventoy for Children
- C Spielberger
Spielberger, C. (1973). Manual for the State-Trait Inventoy for Children. Palo Alto, CA: Consulting Psychologists Press. Received December 11, 1989 Revision received April 17, 1990 Downloaded by [McMaster University] at 09:31 12 December 2014
- Chambless D. L.
The Interview Schedule for Children (ISC): Form C and the follow-up form
- M Kovacs