The structure of negative emotions in a clinical sample of children and adolescents.

The authors sought to define the latent factors associated with childhood anxiety and depression, using a structural equations/confirmatory factor-analytic approach involving multiple informants (i.e., parent and child report) of symptoms. A sample of 216 children and adolescents with diagnoses of an anxiety disorder or comorbid anxiety and mood disorders and their parents were administered measures of childhood fear, anxiety, and depression. Results of comparative modeling best supported 3-factor solutions (fear, anxiety, and depression) that were consistent with recent conceptual models of anxiety and depression (e.g., tripartite model). Results also suggested that 3 widely used measures of childhood negative emotion are conceptually heterogeneous (containing item sets that loaded on different latent factors) . Implications for the assessment of childhood negative emotions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical evaluation of DSM-IV generalized anxiety disorder criteria in children and adolescents

Evaluated the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) generalized anxiety disorder (GAD) criteria in children and adolescents. Clinic-referred children meeting criteria for DSM-IV GAD, those meeting criteria for another DSM-IV anxiety disorder, and normal children participated in a structured interview and completed self-report questionnaires. Groups were compared in terms of interview and self-report measures to examine convergent and discriminant validity. In addition, developmental differences, cross-informant symptom and syndrome agreement, and validity of parent and child report were determined. Finally, the symptoms comprising the GAD associated symptom criterion (Criterion C) were examined in terms of rate of endorsement and predictive power. Results showed that parameters of worry differentiated children with GAD from those with other anxiety disorders and controls. Developmental differences in the sample did not appear to necessitate a separate criteria set for the classification of generalized anxiety in children of this age. Symptoms from GAD Criterion C evidenced moderately high rates of endorsement and acceptable predictive power. Overall, the DSM-IV GAD criteria for children and adolescents are supported, but further evaluation is necessary before firm conclusions can be drawn.     

Evaluation of the Brief Problem Checklist: Child and caregiver interviews to measure clinical progress.

Objective: To support ongoing monitoring of child response during treatment, we sought to develop a brief, easily administered, clinically relevant, and psychometrically sound measure. Method: We first developed child and caregiver forms of a 12-item Brief Problem Checklist (BPC) interview by applying item response theory and factor analysis to Youth Self-Report (YSR; Achenbach & Rescorla, 2001) and Child Behavior Checklist (CBCL;Achenbach & Rescorla, 2001) data for a sample of 2,332 youths. These interviews were then administered weekly via telephone to an ethnically diverse clinical sample of 184 boys and girls 7–13 years of age and their caregivers participating in outpatient treatment, to examine psychometric properties and feasibility. Results: Internal consistency and test–retest reliability were excellent, and factor analysis yielded 1 internalizing and 1 externalizing factor. Validity tests showed large and significant correlations with corresponding scales on paper-and-pencil administrations of the CBCL and YSR as well as with diagnoses obtained from a structured diagnostic interview. Discriminant validity of the BPC interviews was supported by low correlations with divergent criteria. Longitudinal data for the initial 6 months of treatment demonstrated that the BPC significantly predicted change on related measures of child symptoms. Estimates obtained from random coefficient growth models showed generally higher slope reliabilities for the BPC given weekly relative to the CBCL and YSR given every 3 months. Conclusions: Given their combination of brevity and psychometric strength, the child and caregiver BPC interviews appear to be a promising strategy for efficient, ongoing assessment of clinical progress during the course of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A bifactor model of negative affectivity: Fear and distress components among younger and older youth.

The Positive and Negative Affect Schedule for Children (PANAS-C) is a 27-item youth-report measure of positive affectivity and negative affectivity. Using 2 large school-age youth samples (clinic-referred sample: N = 662; school-based sample: N = 911), in the present study, we thoroughly examined the structure of the PANAS-C NA and PA scales and fit a bifactor model to the PANAS-C NA items. Our exploratory factor analytic results demonstrated that negative affectivity is comprised of 2 main components—NA: Fear and NA: Distress—specifically among older youth. A bifactor model also evidenced the best model fit relative to a unidimensional and second-order factor structure of the PANAS-C NA items. The NA: Fear group factor evidenced significant correspondence with external criterion measures of anxiety. However, the original PANAS-C NA scale evidenced equal (and in some cases greater) correspondence with criterion measures of anxiety. We thus recommend continued usage and interpretation of the full PANAS-C NA scale despite the identification of the fear and distress group factors underlying general negative affectivity. The identification of these fear and distress group factors nonetheless suggest that negative affectivity may be comprised largely of a fear and distress component among older youth. The implications of these findings are discussed in relation to better understanding the structure of psychopathology across childhood development and informing the development of future treatments of negative emotions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal.

Using outpatients with anxiety and mood disorders (N?=?350), the authors tested several models of the structural relationships of dimensions of key features of selected emotional disorders and dimensions of the tripartite model of anxiety and depression. Results supported the discriminant validity of the 5 symptom domains examined (mood disorders; generalized anxiety disorder, GAD; panic disorder; obsessive-compulsive disorder; social phobia). Of various structural models evaluated, the best fitting involved a structure consistent with the tripartite model (e.g., the higher order factors, negative affect and positive affect, influenced emotional disorder factors in the expected manner). The latent factor, GAD, influenced the latent factor, autonomic arousal, in a direction consistent with recent laboratory findings (autonomic suppression). Findings are discussed in the context of the growing literature on higher order trait dimensions (e.g., negative affect) that may be of considerable importance to tube understanding of the pathogenesis, course, and co-occurrence of emotional disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tripartite dimensions of emotion in a child clinical sample: Measurement strategies and implications for clinical utility.

Several measurement strategies to assess the tripartite model of emotion in child and adolescent samples have been developed. However, no studies have comparatively examined the most suitable strategies in clinical samples of children and adolescents. This study involved the evaluation of 2 distinct measures of tripartite constructs relative to anxiety and depression criterion variables in a clinical sample of 226 children in Grades 1 through 12. Results indicated that the measures performed similarly overall, but some differences were pronounced enough to suggest that the measures indexed slightly different aspects of the same constructs. These differences appear consistent with the scale design of each instrument. Implications for measurement of these constructs in future research are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of anxiety: The role of control in the early environment.

Current developments in cognitive and emotion theory suggest that anxiety plays a rather central role in negative emotions. This article reviews findings in the area of anxiety and depression, helplessness, locus of control, explanatory style, animal learning, biology, parenting, attachment theory, and childhood stress and resilience to articulate a model of the environmental influences on the development of anxiety. Evidence from a variety of sources suggests that early experience with diminished control may foster a cognitive style characterized by an increased probability of interpreting or processing subsequent events as out of one's control, which may represent a psychological vulnerability for anxiety. Implications for research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical assessment of anxiety sensitivity in children and adolescents: Where do we go from here?

The literature on the assessment of anxiety sensitivity (AS) in children and adolescents is reviewed. Following a discussion of theoretical and developmental issues relevant to AS and anxiety disorders, the construct validity of measures of childhood AS is reviewed using J. Loevinger's (1957) threefold framework. The collective evidence suggests mixed support at present for the validity of the clinical assessment of AS in youths, owing to (a) a limited number of adequate measures, (b) insufficient data on construct validity, and (c) a deficiency of knowledge regarding the potential influence of developmental factors on AS and anxiety disorders. Limitations of the literature are summarized, and suggestions for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically guided coordination of multiple evidence-based treatments: An illustration of relevance mapping in children's mental health services.

Objective: Despite substantial progress in the development and identification of psychosocial evidence-based treatments (EBTs) in mental health, there is minimal empirical guidance for selecting an optimal set of EBTs maximally applicable and generalizable to a chosen service sample. Relevance mapping is a proposed methodology that addresses this problem through structured comparison of client characteristics in a service sample to participant characteristics from studies of EBTs. Method: The authors demonstrate the feasibility of relevance mapping using data from 1,781 youths in a statewide mental health system and a study data set including 437 randomized clinical trials. Relevance mapping (a) reveals who is “coverable” by any EBT, under different definitions of matches between study participants and clients, and (b) identifies minimum sets of treatments needed to serve maximum numbers of clients, across different levels of analysis for defining treatment operations. Results: In the illustration sample, all problems targeted by the study data set review were fully coverable when matching only required clients to have the same problem as EBT study participants. At the other extreme, when matching also required age, gender, ethnicity, and setting, the percentage of noncoverable youths increased to 86% in this sample. Two minimal sets of only 8 EBTs were identified that, when added to the one EBT already in place in that system, covered 100% of coverable youths when matching required problem, age, and gender. Conclusions: This methodology offers promise for the empirically guided selection and coordination of EBTs, thereby addressing one aspect of the gap between knowledge and practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)