ArticlePublisher preview available

A Systematic Review of the Factor Structure of Anxiety Sensitivity Among Children: Current Status and Recommendations for Future Directions

Authors:
Sarah E. Francis at University of Toledo
Sarah E. Francis
Valerie Noel at Douglas Mental Health University Institute
Valerie Noel
Stephanie L. Ryan
Stephanie L. Ryan
Stephanie L. Ryan
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Read publisher preview
Download citation
To read the full-text of this research, you can request a copy directly from the authors.

Abstract and Figures

Background Child anxiety sensitivity (AS) is measured almost exclusively using the Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepancies regarding the CASI factors and how they are scored and reported, it remains unclear whether the CASI reliably and validly assesses the purported multifactorial AS construct. Objective This paper will: (1) provide a comprehensive summary of previous CASI factor analyses by which these factor structures were identified, (2) evaluate evidence regarding the multifactorial nature of AS in youth, and (3) discuss potential directions for continued research in this area. Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018 were identified for inclusion if they examined the factor structure of the CASI or reported data on the CASI subscales as administered to child participants. Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does not consistently yield internally reliable assessments of specific AS facets, (2) significant discrepancies exist regarding the CASI subscales identified, the items comprising these scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the multifactorial construct of AS in youth do exist, but they have not been systematically examined in the literature. Conclusions Directions for future study include further examining expanded scales for AS in youth, continued study of shorter scales assessing more consistently reliable AS content, and evaluating the utility of an expanded response scale for the CASI.
Figures - available from: Child & Youth Care Forum
This content is subject to copyright. Terms and conditions apply.
A preview of this full-text is provided by Springer Nature.
Learn more
Content available from Child & Youth Care Forum
This content is subject to copyright. Terms and conditions apply.
Vol.:(0123456789)
Child & Youth Care Forum (2019) 48:603–632
https://doi.org/10.1007/s10566-019-09502-y
1 3
REVIEW
A Systematic Review oftheFactor Structure
ofAnxiety Sensitivity Among Children: Current Status
andRecommendations forFuture Directions
SarahE.Francis1 · ValerieA.Noël2 · StephanieL.Ryan3
Published online: 9 April 2019
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Background Child anxiety sensitivity (AS) is measured almost exclusively using the
Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepan-
cies regarding the CASI factors and how they are scored and reported, it remains unclear
whether the CASI reliably and validly assesses the purported multifactorial AS construct.
Objective This paper will: (1) provide a comprehensive summary of previous CASI factor
analyses by which these factor structures were identified, (2) evaluate evidence regarding
the multifactorial nature of AS in youth, and (3) discuss potential directions for continued
research in this area.
Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018
were identified for inclusion if they examined the factor structure of the CASI or reported
data on the CASI subscales as administered to child participants.
Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does
not consistently yield internally reliable assessments of specific AS facets, (2) significant
discrepancies exist regarding the CASI subscales identified, the items comprising these
scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the
multifactorial construct of AS in youth do exist, but they have not been systematically
examined in the literature.
Conclusions Directions for future study include further examining expanded scales for AS
in youth, continued study of shorter scales assessing more consistently reliable AS content,
and evaluating the utility of an expanded response scale for the CASI.
Keywords Anxiety sensitivity· Child· Childhood Anxiety Sensitivity Index· Subscale·
Factor structure
* Sarah E. Francis
sarah.francis@utoledo.edu
1 Department ofPsychology, University ofToledo, MS #948, 2801 W. Bancroft Street, Toledo,
OH43606, USA
2 Westat, Lebanon, NH, USA
3 Department ofPsychology, York University, Toronto, Canada
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Certain items can also be summed to create the following subscales: Fear of Cardiovascular Symptoms (α = 0.88), Fear of Respiratory Symptoms (α = 0.88), Fear of Cognitive Dyscontrol (α = 0.81), and Fear of Publicly Observable Anxiety Reactions (α = 0.85) (Muris et al., 2008). (Francis et al., 2019a(Francis et al., , 2019b. The CASI-R also has good internal consistency (α = 0.90), good reliability (α > 0.70), and convergent validity (r = 0.29, 0.38, 0.47 with significance at α = 0.05, 0.01, and 0.001) in adolescent samples (Francis et al., 2019a(Francis et al., , 2019b. ...
... (Francis et al., 2019a(Francis et al., , 2019b. The CASI-R also has good internal consistency (α = 0.90), good reliability (α > 0.70), and convergent validity (r = 0.29, 0.38, 0.47 with significance at α = 0.05, 0.01, and 0.001) in adolescent samples (Francis et al., 2019a(Francis et al., , 2019b. ...
The Relationships Between Adolescent Anxiety Sensitivity, Parent Emotional Availability, and Gender in the Context of Adolescent Anxiety
Article
Full-text available
  • Feb 2025
  • J PSYCHOPATHOL BEHAV
Anxiety disorders often onset in adolescence and continue into adulthood. Multiple factors contribute to anxiety disorder development, such as parent emotional availability (EA) and adolescent anxiety sensitivity (AS). Previous research determined attachment is a similar construct to EA, and attachment is related to anxiety disorders. Moreover, EA is a more specific construct than attachment that can be targeted in therapy. It has been determined that adolescent attachment to parental figures contributes to anxiety, with AS mediating this relationship. The present research sought to determine if AS is one mechanism underlying the relationship between parent EA and adolescent anxiety, while exploring the moderating roles of parent and adolescent gender. In a Midwestern sample (13–19 years old), this study examined adolescent AS as a mediator of the relationship between perceived parent EA and adolescent anxiety, and gender as a potential moderator. Self-report data were collected from adolescents via Qualtrics. The findings supported the mechanism of adolescent AS as a mediator between perceived parent EA and adolescent anxiety. As AS emerges during adolescence, it is a pertinent treatment target for youth anxiety. Furthermore, this study underscores the significance of parent and adolescent gender and parental EA as treatment targets for adolescent anxiety. While targeting adolescent AS and enhancing parental EA can be beneficial for both male and female adolescents, focusing on parental EA may offer greater benefits for male adolescents. In sum, these findings can increase the efficacy of current parenting programs and further increase treatment outcomes for youth and families.
View
... For this purpose, this study aims to investigate the psychometric properties of the Childhood Anxiety Sensitivity Index, which was designed and presented by Silverman et al. (20). The most common structure of the Childhood Anxiety Sensitivity Index is a three-factor model consisting of physical, psychological, and social concerns (21)(22). The results of the Widenfelt et al.'s research (23) showed the internal consistency and appropriate validity of the Childhood Anxiety Sensitivity Index. ...
... In the Widenfelt et al.'s study (23), exploratory and confirmatory factor analysis was performed by comparing different models, and the model with 3 lower order factors found in previous studies showed an acceptable fit. Also, the findings of the present study are consistent with the results of the Francis et al.'s systematic review (22), which showed that published factor analytic studies mostly support a three-factor model (physical, social, and psychological concerns). In terms of convergent validity, the findings indicate that this scale has a positive and significant correlation with the Multidimensional anxiety scale for children. ...
Evaluation of Psychometric Properties of the Childhood Anxiety Sensitivity Index
Article
Full-text available
  • Nov 2023
Background and Purpose: Anxiety disorders is one of the most common psychological problems in children. To prevent and treat anxiety, a valid instruments is needed. Therefore, the present study was conducted with the aim of accessing to the valid instruments to prevent, evaluate, and treat childhood anxiety sensitivity. Method: This research was carried out using the descriptive-survey method. The statistical population consisted of all 10-to-13-year-old, fourth-to-sixth-grade students in Kermanshah in the academic year of 1400-1401. From the target population, 592 students were selected as the study sample, using cluster random sampling method, and responded to the Childhood Anxiety Sensitivity Index (Silverman et al., 1991) and the Multidimensional anxiety scale for children (March et al., 1997). Data were analyzed in SPSS-22 and R- 4.0.2 software. Result: The study indicates that the anxiety sensitivity scale has an acceptable internal consistency (α=0.85); the correlation between the two implementations of this scale within two weeks was in the range of 0.71 to 0.92 (p<0.01). Also, the results of confirmatory factor analysis showed that the threefactor model of this scale has an appropriate fit in Iranian society. Conclusion: The Childhood Anxiety Sensitivity Index in Iran has appropriate psychometric properties and this instrument can be used to assess the degree of the childhood anxiety sensitivity.
View
... Finally, we qualitatively explored if children would use physiological, psychological/mental incapacitation, emotional, and social reasons in describing the potential negative impact of experiencing or showing anxiety sensations. While there is a lack of complete agreement in the literature with regard to the number of factors, three or four has been most consistent (Francis et al. 2019). The factors typically center on physical concerns, social concerns, emotional concerns and mental incapacitation concerns (Silverman et al. 1999;see Francis et al. 2019). ...
... These themes help illustrate the types of social reasons, for example with regards to vignette 2, where the anticipation of negative adult social response was common such as "mom/ dad will be mad at me," "teacher would be angry," getting punished in addition to the negative consequences of failing, or a bad grade generally, as well as controlling feelings, controlling actions, concentration, paying attention, and emotional regulation. As noted, anxiety sensitivity has been assessed through self-report measures and researchers have recently called for the expansion of items to improve the assessment of anxiety sensitivity in youth (Francis et al. 2019). The data from this study made serve to help guide the development of such additional items. ...
Developmental Differences in Child and Adolescent Reasoning About Anxiety Sensations
Article
Full-text available
  • Feb 2021
  • COGNITIVE THER RES
Background The development of reasoning as to the potential negative consequences of emotional sensations is a critical aspect of emotion knowledge and central to cognitive risk for anxiety disorders. The purpose of this paper is to explore the reasoning children and adolescents give for negative interpretations of anxiety sensations, testing a priori hypotheses quantitatively and exploring the content of the reasons qualitatively. Methods This study used a cross sectional design with interviews as well as cognitive and emotional assessments in a sample of 227 youth aged 6–17 years. Coding schemes to assess the logical validity, affective valence, and qualitative reasons that youth give to evaluate anxiety sensations and anxiety situations were developed. Results Findings indicated diverse reasoning was used and responses could be reliably coded with developmental differences across age, cognitive, and verbal development. The logical sophistication of the reasoning used by youth increased across age in a non-linear manner and linearly with cognitive and verbal abilities. Child anxiety sensitivity and internalizing symptom levels moderated the main effect of age. Conclusions The results add to the existing understanding of emotional development and are consistent with the idea that the process of cognitive-emotional understanding is not a simple linear one because various domains may show differential development.
View
... The results of the CFA indicated the presence of a single factor for the PATS, further supporting the unidimensional structure found in the original study (Zenker et al, 2021). Understanding anxiety as a unidimensional construct is common in the psychological literature (Francis, et al., 2019;Olatunji & Wolitzky-Taylor, 2009), so the findings are consistent with this approach (Silva et al., 2020). Having a unidimensional measure allows for a parsimonious model, less complex and with few parameters that allow a better fit (Lúcio et al., 2021). ...
VALIDATION STUDY OF THE SPANISH VERSION OF THE PANDEMIC (COVID-19) ANXIETY TRAVEL SCALE IN PERU
Article
Full-text available
  • Oct 2023
The COVID-19 pandemic has changed tourists' thoughts, feelings and ways of travelling. In this regard, the aim of the present study was to evaluate the psychometric properties of the Pandemic Anxiety Travel Scale (PATS) using CTT and IRT. A total of 454 participants, with a mean age of 31.4 years (SD = 15.7), completed the PATS, a sociodemographic questionnaire, a measure of perceived health risk, and the Preventive COVID-19 Infection Behaviors Scale. CFA models, Cronbach's alpha and the Composite Reliability Index coefficients were used to estimate reliability. In addition, Item Response Theory (IRT) methods were employed, specifically, the Graded Response Model. The results of the CFA indicated the presence of a single factor for the PATS and high reliability. The IRT results suggest that the PATS items may significantly differentiate responses based on trait level and that a person with low frequency of travel anxiety symptoms during the pandemic will tend to choose the lower response alternatives. Likewise, age, gender, health risk perception, and COVID-19 preventive behaviors significantly predict travel anxiety. In conclusion, the PATS is a brief and reliable measure that appears to be a valid measure of travel anxiety symptoms in the general Peruvian population during the pandemic.
View
... The internal consistency for the present sample is 0.896, and the cutoff values are 9 for boys and 11 for girls, indicating anxiety sensitivity, respectively (Ren Fang, 2012). Although several hierarchical models have been proposed for the factor structure of CASI, in this study, a 3-factor model was administered because of its stability and consistency (Francis et al., 2019). ...
Risk Factors Associated With Increased Anxiety Sensitivity in Children and Adolescents in Northwest China During COVID-19 Pandemic Lockdown
Article
Full-text available
  • Jul 2022
Purpose A large body of evidence has revealed that the sudden outbreak of public health emergencies induces dramatic effects on the mental health of the general public. We aimed to investigate the level of anxiety sensitivity and its risk factors in children and adolescents from northwest China during the COVID-19 pandemic lockdown in early 2020. Methods A cross-sectional survey was conducted through the Wenjuanxing platform using a convenience sampling method between 18 and 26 February 2020. The self-designed questionnaire contained sociodemographic characteristics, factors associated with the COVID-19 pandemic, and the Childhood Anxiety Sensitivity Index (CASI) scale. The data from 1,091 valid questionnaires from students aged 9–17 years were analyzed using ANOVA, multiple linear regression, and binary logistic regression. Results The average CASI scores were 11.47 ± 6.631, and 642 students (58.9%) had prominent anxiety sensitivity. Gender, education level, family members participating in anti-COVID-19 work, getting ill and needing medical help during the lockdown, feeling afraid or having heart palpitations on hearing things associated with COVID-19, believing that COVID-19 would have adverse impacts on themselves or their family in the future, and fear of infection were identified as significant factors for elevated levels of anxiety sensitivity (p < 0.05). We established a multiple linear regression model for the anxiety sensitivity score. Risk factors found for anxiety sensitivity in children and adolescents during the COVID-19 lockdown included studying in secondary or high school, becoming ill during the pandemic, feeling afraid or experiencing rapid heartbeat or palpitations on hearing about the COVID-19 pandemic, thinking that COVID-19 would have an adverse impact on themselves or their family in the future, and fear of infection. Conclusions During the COVID-19 pandemic and home quarantine, scores measuring the prevalence of anxiety sensitivity in children and adolescents from northwest China were elevated. We should develop measures that especially target possible risk factors to intervene against and prevent anxiety sensitivity in children and adolescents in both the current and future pandemics.
View
... The understanding of anxiety as a unidimensional construct has been prevalent throughout the psychological literature (Francis, Noel, & Ryan, 2019;Olatunji & Wolitzky-Taylor, 2009). Our results are consistent with this approach and conceive anxiety as a persistent and excessive concern that is usually accompanied by physical symptoms, such as muscle tension, heart racing, sweating, and insomnia. ...
COVID-19 anxiety scale (CAS): Development and psychometric properties
Article
Full-text available
  • Aug 2022
  • CURR PSYCHOL
The objective of the present research is to develop and validate the COVID-19 Anxiety Scale (CAS). We conducted three studies to gather evidence regarding content and construct validity, as well to evaluate the reliability of the measure. Study 1 is subdivided into two studies. In Study 1a, we analyze the content validity of the new measure through content expert analysis (N = 10 expert raters). In Study 1b (N = 30), we perform a pilot study with a sample from the target population. In Study 2 (N = 352), we explored the unifactorial structure of the measure, and analyzed its internal consistency verified. Finally, in Study 3 (N = 200), we assess the adequacy of the factor structure and gather evidence on convergent-discriminant validity and gender-scale invariance. In summary, our results demonstrate that CAS is a reliable and adequate instrument to assess COVID-19 related anxiety.
View
... However, assessment of the hierarchical structure of the construct's lower-order facets has yielded equivocal results with various factor structures observed, ranging from two factors (e.g., Chorpita and Daleiden 2000) to three factors (e.g., Muris et al. 2001) to four factors (e.g., Silverman et al. 2003). The reliability of these scales has been good for items comprising the Bphysical^or Bautonomic^items of the CASI, but has been questionable or unacceptable for items comprising the remaining scales, including those assessing cognitive and social aspects of child AS (see Francis et al. 2019). Amongst those researchers who have assessed or employed a multifactorial CASI with children and adolescents, several have concluded that more items are needed to comprehensively and reliably assess AS as a multifactorial construct in youth (e.g., Essau et al. 2010;Muris et al. 2001;Walsh et al. 2004;van Widenfelt et al. 2002). ...
A Psychometric Evaluation of the Revised Childhood Anxiety Sensitivity Index (CASI-R) in a Child and Adolescent Sample
Article
Full-text available
  • Dec 2019
  • J PSYCHOPATHOL BEHAV
The multifactorial nature of anxiety sensitivity (AS) in children has been assessed almost solely with the Childhood Anxiety Sensitivity Index (CASI; Silverman et al. Journal of Clinical Child Psychology, 20(2), 162–168, 1991); however, multiple studies have suggested that the item content of the CASI is too limited to adequately assess multiple AS factors in youth. Here we examined the psychometric properties of the Revised Childhood Anxiety Sensitivity Index (CASI-R; Muris Behaviour Research and Therapy, 40, 299–311, 2002), developed to assess a higher-order global AS factor and four lower-order factors. In a non-clinical sample of youth aged 8–14 we (a) examined the psychometric properties of the CASI-R, comparing findings for children aged 11 and younger with those aged 12 and older, (b) evaluated and compared the internal consistency of the four-factor CASI-R and the three- and four-factor CASI, and (c) examined and compared the convergent validity of the CASI and CASI-R subscales with child-reported anxiety symptoms. Reliability estimates for the CASI-R total, Cardiovascular, and Respiratory scales were high for all youth; the Cognitive Dyscontrol and Publicly Observable Reactions scales yielded low estimates of internal consistency for the younger group. Compared to the parallel CASI scales, these CASI-R scales demonstrated stronger internal consistency in both the older and younger groups. Comparatively larger correlations between the CASI-R physical and cognitive scales with symptoms of panic and between the CASI-R social scale and symptoms of social anxiety were observed. These findings suggest continued use and examination of the CASI-R in child and adolescent non-clinical and clinical samples to comprehensively assess the AS construct in youth.
View
THE DEVELOPMENT OF COVID-19 BRIEF ANXIETY SCALE IN OMAN
Article
Full-text available
  • Mar 2024
Introduction: The global COVID-19 pandemic has caused increased levels of anxiety and stress. A recent study reported that 99% of its sample experienced anxiety, stress, stigma, and concerns about potential social isolation. Aims: This study aims to address the lack of a specific COVID-19 anxiety scale in Oman. Methods: The online scale was distributed via Google Form to 431 students, representing 3% of the total student population at Sultan Qaboos University (SQU). The students were enrolled in different colleges of Sultan Qaboos University. Exploratory factor analysis revealed a unidimensional factorial structure consisting of four items. Item loadings ranged from 0.617 (item 4) to 0.847 (item 3). Results: The results indicated that the validity fit indices were excellent. The RMSEA and SRMR values were greater than 0.05 indicating a perfect fit. The X2/DF value was 0.854, with a p-value of less than 0.653, while the GFI, AGFI, IFI, NFI, TLI, CFI, RMR, and RMSEA values were 0.999, 0.995, 1.003, 0.998, 0.959, 1.00, 0.015, 0.000, respectively (90% CI [0.000; 0.074]). The COBAS-4 showed convergent validity through its significant association with similar scales. Discriminant validity was established via its insignificant correlation to distinct constructs. McDonald’s omega and Cronbach’s alpha showed adequate reliability at 0.810 each. The results of multiple group CFA indicated configural, metric, and scalar invariance between male and female students (ΔCFI ≤ 0.01, ΔRMSEA ≤ 0.015). No significant differences were found between the two sexes. The scale was calibrated using the Rasch rating scale, which provided robust results. The Mantel-Haenszel test showed no differential item functioning (DIF) across sexes. Conclusion: The COBAS-4 is a valid, reliable, simple, and easy-to administer self-report instrument for assessing COVID-19-related anxiety.
View
Longitudinal Associations Between Anxiety Sensitivity and Substance Use in Adolescents: Mediation by Depressive Affect
Article
Full-text available
  • Jun 2023
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.
View
The Spanish Version of the Childhood Anxiety Sensitivity Index: Factorial Dimensions and Invariance across Gender in a Sample of Adolescents
Article
Full-text available
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.
View
The Role of Anxiety Sensitivity in the Relationship Between Emotion Dysregulation and Internalizing Psychopathology Among Trauma-Exposed Inpatient Adolescents
Article
Full-text available
  • Dec 2018
  • COGNITIVE THER RES
The present investigation examined the underlying role of anxiety sensitivity and its facets in the association between emotion dysregulation and three of the most prevalent and debilitating symptom classes among trauma-exposed psychiatric inpatient youth: posttraumatic stress disorder (PTSD), anxiety, and depression symptoms. Participants (N = 50; 52.0% female; Mage = 15.1 years, SD = .51, range 12–17 years) completed an assessment battery that included measures of emotion dysregulation anxiety sensitivity, PTSD, anxiety, and depression symptoms. Consistent with hypotheses, the global construct of anxiety sensitivity, as well as its mental incapacitation concerns and disease concerns facets, explained, in part, associations between emotion dysregulation and the three symptom classes. The study results provide novel and clinically meaningful findings regarding the potential mechanistic role of anxiety sensitivity in the relation of emotion dysregulation to PTSD and internalizing symptoms among trauma-exposed inpatient adolescents. As such, findings underscore the potential value of targeting anxiety sensitivity in general, and mental incapacitation and disease concerns specifically, as a means of reducing risk for internalizing psychopathology among trauma-exposed inpatient youth. © 2018 Springer Science+Business Media, LLC, part of Springer Nature
View
Spanish Validation of the Separation Anxiety Assessment Scale
Article
Full-text available
  • Jun 2017
  • CHILD PSYCHIAT HUM D
The aim of this study was to investigate the factorial structure and psychometric properties of the Separation Anxiety Assessment Scale (SAAS) with Spanish schoolchildren. The participants in Study 1 were 1281 children aged 8–11. Exploratory factor analysis identified four factors: worry about calamitous events, fear of abandonment, fear of being alone, and fear of physical illness, which explained 47.77 % of the variance. The participants of Study 2 were 4628 schoolchildren aged 8–11. The four related factors model was validated by confirmatory factor analysis. The internal consistency (α = .84) and temporal stability (r = .77) were good. The convergent validity was evident from the pattern of correlations with the measures of separation anxiety, sensitivity to anxiety and school fears. The sensitivity of the scale was 83 %, and its specificity, 93 %. The complementary subscales predicted the diagnosis of separation anxiety disorder. The results support the reliability, validity and clinical utility of the SAAS.
View
The Roles of Sex, Anxious Reactivity to Bodily Arousal, and Anxiety Sensitivity in Coping Motives for Cigarette Smoking Among Adolescents
Article
Full-text available
  • Apr 2016
Evidence suggests that smoking to cope among adolescents is associated with a number of problematic outcomes (e.g., greater smoking frequency, higher rates of dependence). It is thus imperative to better understand factors that may increase the likelihood of smoking to cope among adolescents. Research suggests anxiety sensitivity (AS) is associated with smoking to cope among adults, although the link between AS and coping motives for cigarette use among youth is less clear. Gender differences have also been noted in AS. The current study investigates this association using a biological challenge paradigm. Specifically, the indirect effects of anxious reactivity to bodily arousal on the relation between the physical and mental AS factors and coping motives for cigarette smoking were examined within a sample of 108 adolescent cigarette smokers. Gender was examined as a moderator. Results suggested significant indirect effects of self-reported anxiety in response to bodily arousal on the relation between physical AS and coping motives for cigarette smoking. This indirect effect was moderated by gender, such that it was significant for females but not males. Models examining AS mental concerns and psychophysiological responding to the challenge were not significant. These results suggest that, relative to their low AS counterparts, female adolescents high in physical concerns respond with elevated anxiety in response to interoceptive arousal and, in turn, endorse elevated coping-related smoking motives. Findings are discussed in terms of implications for understanding the nature and origins of coping-related smoking motives and how such information can be used to inform intervention efforts. (PsycINFO Database Record
View
Association of Reactive–Proactive Aggression and Anxiety Sensitivity with Internalizing and Externalizing Symptoms in Children with Attention-Deficit/Hyperactivity Disorder
Article
Full-text available
  • Apr 2017
  • CHILD PSYCHIAT HUM D
This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.
View
Anxiety Sensitivity in School Attending Youth: Exploratory and Confirmatory Factor Analysis of the 18-Item CASI in a Multicultural South African Sample
Article
Full-text available
  • Jan 2016
Anxiety sensitivity (AS) is a risk factor for the development of anxiety disorders in youth. To date, the applicability of the Childhood Anxiety Sensitivity Index (CASI) in youth from a low or middle income country (LMIC) setting on the African continent has not been assessed. A representative sample of 1149 secondary school learners from 29 schools in Cape Town, South Africa, participated in the study. Participants completed the CASI on a single occasion. One-, two-, and four-factor models of the CASI were assessed. A one-factor solution that comprised items predominantly represented by physical concerns appeared to provide the best fit to our data, however, relatively low variance (26%) was explained. Subsequent item deletion resulted in a 9-item ‘physical concerns’ factor that showed good construct reliability (0.83) but also explained a low amount of variance (35%). In terms of gender, a one-factor model provided the best fit, however, low variance was explained (i.e., 25%). Configural, metric and scalar invariance of the CASI by gender was determined. Our results suggest that the 18-item CASI is not applicable to our target population and may require adaptation in this population; however, replication of this study in other multicultural adolescent samples in South Africa is first needed to further assess the validity of the AS construct as measured by the CASI.
View
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Article
Full-text available
  • Jan 2014
Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
View
View
Intolerance of Uncertainty, Anxiety Sensitivity, Health Anxiety, and Anxiety Disorder Symptoms in Youth
Article
  • May 2016
Intolerance of uncertainty (IU) − difficulty coping with uncertainty and its implications − is traditionally studied in adult populations, but more recently has been explored in children and adolescents. To date, the association between IU and health anxiety has not been explored in a child or adolescent sample. Further, it is unknown whether the relationship between IU and health anxiety may be mediated by anxiety sensitivity (i.e., fear of anxiety-related sensations) in this population. We sought to extend the existing research and expand our understanding of IU as a transdiagnostic construct by exploring the association between IU and health anxiety, anxiety sensitivity, and DSM-IV anxiety disorder symptom categories in 128 youth (Mage = 12.7 years, SD = .82, range 11-17 years). Participants completed measures of IU, health anxiety, anxiety sensitivity, and anxiety disorder symptom categories. Results demonstrated significant positive associations between IU and all measures. Mediation analyses supported the direct and indirect importance of each IU subscale on health anxiety. Future directions and implications are discussed.
View
Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder
Article
  • Mar 2016
  • INT J PSYCHIAT CLIN
Objective: This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). Methods: Fifty outpatients, aged 8-18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. Results: Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. Conclusions: This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.
View
View