The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.

Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, Neer SM.

Child Psychiatry Department, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.

OBJECTIVE: To develop a reliable and valid child and parent self-report instrument to screen children with anxiety disorders. METHOD: An 85-item questionnaire was administered to 341 outpatient children and adolescents and 300 parents. Utilizing item analyses and factor analyses, the original scale was reduced to 38 items. A subsample of children (n = 88) and parents (n = 86) was retested an average of 5 weeks (4 days to 15 weeks after the initial screening. RESULTS: The child and parent Screen for Child Anxiety Related Emotional Disorders (SCARED) both yielded five factors: somatic/panic, general anxiety, separation anxiety, social phobia For the total score and each of the five factors, both the child and parent SCARED demonstrated good internal consistency (alpha = .74 to .93), test-retest reliability (intraclass correlation coefficients = .70 to .90), discriminative validity (both between anxiety and other disorders and within anxiety disorders), and moderate parent-child agreement (r = .20 to .47, p < .001, all correlations). CONCLUSIONS: The SCARED shows promise as a screening instrument for anxiety disorders. Future studies using the SCARED in community samples are indicated.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9100430&dopt=Abstract anxiety medicine




The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity.

March JS, Parker JD, Sullivan K, Stallings P, Conners CK.

Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.

OBJECTIVE: To describe the history, factor structure, reliability, and validity of the Multidimensional Anxiety Scale for Children (MASC). METHOD: In two separate school-based population studies, principal-components factor analysis was used, first, to test a theory-driven factor structure, and second, to develop an empirically derived factor structure for the MASC. In a separate study using a clinical population, test-retest reliability at 3 weeks and 3 months, interrater concordance, and convergent and divergent validity were examined. RESULTS: The final version of the MASC consists of 39 items distributed across four major factors, three of which can be parsed into two subfactors each. Main and subfactors include (1) physical symptoms (tense/restless and somatic/autonomic), (2) social anxiety (humiliation/rejection and public performance fears), (3) harm avoidance (perfectionism and anxious coping), and (4) separation anxiety. The MASC factor structure, which presumably reflects the in the vivo structure of pediatric anxiety symptoms, is invariant across gender and age and shows excellent internal reliability. As expected, females show greater anxiety on all factors and subfactors than males. Three-week and 3-month test-retest reliability was satisfactory to excellent. Parent-child agreement was poor to fair. Concordance was greatest for easily observable symptom clusters and for mother-child over father-child or father-mother pairs. Shared variance with scales sampling symptom domains of interest was highest for anxiety, intermediate for depression, and lowest for externalizing symptoms, indicating adequate convergent and divergent validity. CONCLUSION: The MASC is a promising self-report scale for assessing anxiety in children and adolescents.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9100431&dopt=Abstract anxiety medicine




Anxiety responses of parents during and after the hospitalization of their 5- to 11-year-old children.

Tiedeman ME.

College of Nursing, Brigham Young University, Provo, UT 84602-5449, USA.

The purpose of this study was to examine the anxiety responses of parents (N = 52) of 5- to 11-year-old children during and after the hospitalization of their child. The study assessed the level of parental anxiety and its change over time and it examined the relationship between parental anxiety and their children's anxiety, age, gender, length of hospitalization, and previous admission. The study also examined the feelings reported by the parents. Parents showed a decrease in anxiety from admission to discharge whereas anxiety remained fairly constant from discharge to posthospitalization. There was a positive relationship between parental anxiety and the length of the child's hospitalization. There were both positive and negative relationships between the various measures of parental and child anxiety. No relationship was found between parental anxiety and the children's age, gender, and previous admission. Findings of this study have implications for practice and further research.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9103779&dopt=Abstract anxiety medicine




Antecedents of state anxiety in rugby.

Lane AM, Rodger JS, Karageorghis CI.

Department of Sport Sciences, Brunel University College, Middlesex, England, United Kingdom.

The purpose of this study was to extend research investigating the antecedents of multidimensional state anxiety into the sport of rugby. Participants (N = 86; age: M = 23.7 yr., SD = 4.8 yr.) completed a 10-item Prematch Questionnaire developed to assess the antecedents of anxiety and the Competitive State Anxiety Inventory-2 1 hr. prior to competition. Factor analysis of intercorrelations of scores on the Prematch Questionnaire indicated that three factors accounted for 63.3% of the variance. These were labelled Perceived Readiness, Match Conditions, and Coach Influence. Stepwise multiple regression indicated that Perceived Readiness predicted rated Self-confidence and Somatic Anxiety. Game conditions also predicted Self-confidence. Collectively, these factors accounted for 30% of Self-confidence and 11% of Somatic Anxiety. No factor predicted Cognitive Anxiety. Findings support the notion that each sport has unique stressors and that researchers should seek sport-specific measures of the antecedents of anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9106830&dopt=Abstract anxiety medicine




Facilitating and debilitating trait anxiety, situational anxiety, and coping with an anticipated stressor: a process analysis.

Raffety BD, Smith RE, Ptacek JT.

Department of Psychology, University of Washington, Seattle 98195-1525, USA. raffety u.washington.edu

Participants completed anxiety and coping diaries during 10 periods that began 7 days before an academic stressor and continued through the evening after the stressor. Profile analysis was used to examine the anxiety and coping processes in relation to 2 trait anxiety grouping variables: debilitating and facilitating test anxiety (D-TA and F-TA). Anxiety and coping changed over time, and high and low levels of D-TA and F-TA were associated with different daily patterns of anxiety and coping. Participants with a debilitative, as opposed to facilitative, trait anxiety style had lower examination scores, higher anxiety, and less problem-solving coping. Covarying F-TA, high D-TA was associated with a pattern of higher levels of tension, worry, distraction, and avoidant coping, as well as lower levels of proactive coping. Covarying D-TA, high F-TA was associated with higher levels of tension (but not worry or distraction), support seeking, proactive and problem-solving coping.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9108702&dopt=Abstract anxiety medicine




Parents' and children's appraisals of each other's anxiety while facing a common threat.

Rosenbaum M, Ronen T.

Department of Psychology, Tel-Aviv University, Israel. miker freud.tau.ac.il

The ability of 11-to 12-year-old children and their parents to infer each other's anxiety level under the threat of missile attacks during the 1991 Gulf War in Israel was investigated. An information exchange model for appraising other people's emotions served as the basis for predicting agreement rates among family members. As predicted, children's ratings of parental anxiety were primarily associated with their own anxiety (projected information), whereas parents' ratings of their spouses' and their children's anxiety were primarily predicted from spouses' self-reported anxiety (target-emitted information) and spouses' evaluations of the children's anxiety (shared information), respectively. Mother-father concordance on ratings of each other's and children's anxiety was significantly higher than parent-child agreement on parental and child anxiety. Agreement on parental anxiety among the 3 sources was partially a function of physical closeness among informants. The results suggest that at least within the nuclear family, under an external threat inferences about each other's anxiety level are partly based on social exchange of emotionally relevant information. However, it remains for future research to determine how exactly emotionally relevant information is communicated and processed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9118175&dopt=Abstract anxiety medicine




Child and adolescent anxiety disorders and early attachment.

Warren SL, Huston L, Egeland B, Sroufe LA.

Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis.

OBJECTIVE: The major aim of this research is to determine whether infants who were anxiously/resistantly attached in infancy develop more anxiety disorders during childhood and adolescence than infants who were securely attached. To test different theories of anxiety disorders, newborn temperament and maternal anxiety were included in multiple regression analyses. METHOD: Infants participated in Ainsworth's Strange Situation Procedure at 12 months of age. The Schedule for Affective Disorders and Schizophrenia for School-Age Children was administered to the 172 children when they reached 17.5 years of age. Maternal anxiety and infant temperament were assessed near the time of birth. RESULTS: The hypothesized relation between anxious/resistant attachment and later anxiety disorders was confirmed. No relations with maternal anxiety and the variables indexing temperament were discovered, except for a composite score of nurses' ratings designed to access "high reactivity," and the Neonatal Behavioral Assessment Scale clusters of newborn range of state and inability to habituate to stimuli. Anxious/resistant attachment continued to significantly predict child/adolescent anxiety disorders, even when entered last, after maternal anxiety and temperament, in multiple regression analyses. CONCLUSION: The attachment relationship appears to play an important role in the development of anxiety disorders. Newborn temperament may also contribute.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9136498&dopt=Abstract anxiety medicine




Impact of parental anxiety on child emotional adjustment when a parent has cancer.

Heiney SP, Bryant LH, Walker S, Parrish RS, Provenzano FJ, Kelly KE.

Center for Cancer Treatment and Research, Richland Memorial Hospital in Columbia, SC, USA.

PURPOSE/OBJECTIVES: To describe the relationships among parent anxiety, child anxiety, and emotional adjustment in children who have a parent with cancer. DESIGN: Correlational. SETTING: A large cancer center in the southeastern United States. SAMPLE: Thirty-three child/parent with cancer dyads. METHODS: Research packets were mailed to child/parent dyads who agreed to participate in the study. Parents completed a demographic questionnaire, a Spielberger State-Trait Anxiety Scale, and a Personality Inventory for Children (PIC). Children completed the child version of the Spielberger State-Trait Anxiety Scale. MAIN RESEARCH VARIABLES: Parent anxiety, child anxiety, and child adjustment. FINDINGS: Children who have a parent with cancer and parents who have experienced cancer report significantly higher state and trait anxiety compared to a normed population sample. Parental reports on the PIC indicated that latency-aged children (i.e., 6-12 years) showed significantly greater internalization and somatic symptoms compared to the sample norm. Parent state anxiety was negatively correlated with children's internalization and somatic symptoms. Parental anxiety accounted for the greatest variance in child adjustment. IMPLICATIONS FOR NURSING PRACTICE: These study findings may provide nurses with a better understanding of the vulnerability of children who have a parent with cancer and can build a foundation for the development of supportive interventions for these children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9159781&dopt=Abstract anxiety medicine




Treatment typically provided for comorbid anxiety disorders.

Meredith LS, Sherbourne CD, Jackson CA, Camp P, Wells KB.

RAND Health Program, Santa Monica, Calif., USA.

OBJECTIVE: To study whether the extent and type of treatment for comorbid anxiety disorders varies for patients with depression, hypertension, diabetes, and heart disease treated by general medical clinicians. METHODS: Data are from 2189 general medical patients with and without comorbid anxiety disorders in the Medical Outcomes Study. Treatment data were based on clinician reports of counseling provided during a visit and patient reports of recent medication use. RESULTS: Patients with comorbid anxiety disorders were more likely to receive treatments for anxiety disorders than those without anxiety disorders. Among those with anxiety disorders, the use of psychosocial counseling and psychotropic medication was greater for patients with depression than for patients without depression who had chronic medical conditions. Minor tranquilizers were used more commonly than antidepressants, regardless of the type of comorbid condition. Among patients with anxiety disorders, those visiting medical subspecialists were more likely to use minor tranquilizers than those visiting family practitioners or internists. Patients of family physicians with chronic medical conditions (but not with depression) were less likely than similar patients of internists to use minor tranquilizers whether or not anxiety disorders were present. CONCLUSIONS: Anxiety disorders co-occurring with another disease (medical illness or depression) increases the likelihood of counseling and the use of psychotropic medication in the general medical sector. Patients with a chronic medical illness with or without comorbid anxiety disorders visiting family physicians are less likely to use minor tranquilizers than those visiting subspecialists or internists.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9161347&dopt=Abstract anxiety medicine