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Background: Anxiety disorders are garnering increasing attention for their contribution to high-risk issues and functional impairment. Adolescents are typically admitted to partial hospitalization programs (PHPs) due to high-risk presentations. However, the frequency of anxiety disorders in PHPs is not well-established, in part because anxiety can be overlooked in acute settings due to limited lengths of stay and focus on stabilization. Objective: This study aims to evaluate the frequency and severity of anxiety disorders among a sample of adolescent PHP patients to assess the need for anxiety-specific assessment and interventions in higher acuity settings. Methods: Participants were 158 youths ages 13 to 19 years old (M = 15.49 years, SD = 1.50) who were admitted to an adolescent PHP and their caregivers. Clinician-reported diagnostic information was collected from the youth's electronic medical record, and self- and caregiver-rated severity of anxiety was collected using the Screen for Child Anxiety Related Emotions Disorders (SCARED-C/P). Frequency of anxiety and related disorder diagnoses and self- and caregiver-reported severity were assessed using descriptive statistical methods. Results: 75% of participants were diagnosed with an anxiety disorder (n = 118). On average, participants with anxiety disorders had elevated SCARED-C scores. Youths with depressive disorders had elevated SCARED-C scores even when they did not carry anxiety disorder diagnoses. Caregiver ratings of the youth's anxiety symptoms on the SCARED-P were elevated when youths had anxiety disorders. Conclusions: These findings suggest that anxiety is common in an adolescent PHP setting and support investing in evidence-based assessment and treatment of anxiety in high-acuity settings.

Using a Geiger-Müller tube, sound-capturing software, and a simple computer program, students measured to reasonable precision the half-value layer of steel in absorbing high-energy gamma rays from a Radium Ore Revigator (pronounced re-vig-a-tor with the accent on "vig"), an early quack medical device. This article describes the process used for conducting online radiation exposure experiments as part of an in-class Course-Based Undergraduate Research Experience (CURE) project, with their instructor acting in a more subservient role carrying out actions requested by the students. The manner in which this student-centered approach can drive similar online radiation experiments without compromising student safety is discussed.

This article examines the treatment of statistics and error analysis in introductory physics lab manuals. It compares lab manuals from community colleges and universities and identifies inconsistencies in how these topics are addressed. The article suggests that a probabilistic approach to data analysis could enhance the teaching of measurement and uncertainty in the lab. It also highlights the International Organization for Standardization's guide to uncertainty in measurement as a valuable resource for standardizing lab instruction. The article concludes that there is a need for more consistent and rigorous treatment of statistics and error in introductory physics lab manuals. [Extracted from the article]

In this article, we describe a fun and engaging card game called Speed Eleusis that teaches the process of scientific discovery and publication, including such practices as replication and retraction. Much like the traditional game of Eleusis and its variant Eleusis Express, this game involves students competing to model a pattern displayed in a sequence of ordinary playing cards. Speed Eleusis, however, features a quicker pace and is easier to manage. Although developed for introductory physics and physical science labs at a four-year university and two-year college, Speed Eleusis should prove ideal across a wide range of science subjects and age groups, especially during the first week of instruction.

Error analysis consumes much of the focus in introductory physics labs. Catastrophic cancellation is a spike in error that occurs when subtracting two measurements of roughly equal magnitude. Often termed "loss of significance" or "subtractive cancellation," this effect can easily relegate experimental results to utter worthlessness no matter how precise the measurements. A lab activity that exposes the ill effects of catastrophic cancellation in experimentation was carried out by three undergraduate students at California State University, Fresno under the direction of a faculty advisor. This lab employs the traditional elastic collision experiment performed in countless labs across the country. Traditionally, lab designers try to lower experimental error as much as possible for students to confirm conservation of momentum and energy. In this lab activity, however, the calculations performed by the students was purposely modified to generate ridiculous levels of error based on nothing more than the order in which experimental values were summed. This lab therefore teaches students that measurement is not the only source of error in an experiment; that is, the order in which mathematical operations are carried out not only introduces error into calculations, but that this error can completely obscure experimental results. Applications to common problems in numerical analysis are also discussed.

A lab activity for teaching physics students the fundamentals of statistical analysis during the first few weeks of instruction is described. This activity involves students timing a pulse of light generated by an Arduino device of fixed duration with individual timers (e.g. stopwatch, iPhone timer). To select the most precise timing methods and to calibrate their timings to account for bias, students first time a known duration of an ordinary classroom clock. Because students are not informed of the true pulse duration until after they turn in their lab reports, they must express the estimated duration of the light pulse in terms of confidence intervals. This activity arises from the need for students to leverage the power of statistics to (1) optimize lab procedures through data-driven decision-making, (2) correct for bias through calibration, and (3) gauge the quality of their work in terms of confidence rather than correctness. The authors conclude that this three-step process aligns lab procedures closer to industry practices and elevates cognition and engagement among students.

Behavior therapy is a well-established and empirically supported treatment for tic disorders (TDs). However, concerns have been expressed about the negative effects of behavioral interventions, such as tic worsening, tic substitution, and excessive effort. This study explored perceived negative effects of tic management strategies in adults with TDs and predictors of these experiences. Participants (N = 72) completed semi-structured interviews 11 years after receiving behavior therapy or supportive therapy in a randomized clinical trial. We examined responses to interview questions about managing tics and predictors of reported negative effects. Most participants did not experience tic worsening (84%) or tic substitution (75%) from tic management strategies. The majority felt they could manage tics while participating in their environment (87%) and did not report life interference from tic management (77%). About half (45%) felt less present when managing tics. Treatment non-responders in the original trial were more likely to report negative effects of tic management strategies. No differences in reported negative consequences were found between those who received behavior therapy versus supportive therapy, suggesting that behavior therapy specifically does not lead to such adverse effects. These findings could reduce misconceptions about behavior therapy for TDs and enhance its acceptability and utilization. [ABSTRACT FROM AUTHOR]

Computer-assisted interviewing techniques have increasingly been used in program and research settings to improve data collection quality and efficiency. Little is known, however, regarding the use of such techniques with American Indian (AI) adolescents in collecting sensitive information. This brief compares the consistency of AI adolescent mothers' reporting of sensitive sexual and drug use behaviors gathered through three distinct interviewing techniques: computer-assisted (ACASI), self-administered questionnaire (SAQ), and face-to-face interview (FTFI). Endorsement of drug use and reporting of sexual activity was highest for ACASI, followed by SAQ, and was significantly lower for FTFI. Relatively strong agreement was measured between ACASI and SAQ, and relatively poor agreement was measured between the ACASI and FTFI. Findings support the use of computer-assisted interviewing techniques with AI adolescents, and implications for future research are discussed. (Contains 2 tables.)

Background: Pharmacotherapy is considered an evidenced-based treatment for anxious youth. There is a need to better understand the relation between medication adherence and child outcomes. Objective: This study prospectively examined: (1) baseline predictors of adherence and (2) the relation between medication adherence and clinical outcomes in children and adolescents with anxiety disorders. Method: Participants were 349 youth randomized to sertraline, pill placebo, or sertraline plus cognitive behavioral therapy in the Child/Adolescent Anxiety Multimodal Study and followed over 12 weeks. The measure of pharmacotherapy adherence used was pharmacotherapist (PT) ratings of adherence at each session. Four domains of baseline predictors were examined (demographics, child clinical variables, family/parent variables, and treatment variables). Results: Multiple regression analyses revealed few significant predictors of adherence. The most robust predictors of greater adherence were living with two parents and parents' positive expectations that medication would lead to better outcomes. PTs ratings of higher adherence predicted higher global functioning at post treatment and treatment responder status. Conclusions: In order to increase adherence, improving expectations and instilling hope for positive outcomes and problem solving ways to overcome pragmatic barriers associated with single parent families is recommended.

This study (a) examined anxious youth with and without asthma on measures of negative self-talk, parental psychopathology, worry content, physical symptoms, panic symptoms, generalized symptoms, and separation anxiety symptoms, and (b) tested if outpatient CBT or medication were differentially effective in reducing anxiety for youth with asthma and anxiety. This secondary analysis separated youth with an anxiety disorder into asthma and non-asthma groups. Youth were also compared on response to treatments (i.e. CBT, sertraline, combined, and placebo). A total of 488 participants participated in the original study, with an average age of 10 years (SD 2.87). Youth with comorbid asthma and anxiety demonstrated higher rates of negative self-talk. Youth with comorbid asthma and anxiety did not differ from the non-asthma group on measures of physical symptoms, anxiety disorder specific symptoms, parental psychopathology, or worry content. Youth with asthma and anxiety responded similarly to the non-asthma group to treatment across treatment conditions. Treatment was comparably effective for youth with comorbid asthma and anxiety and youth with anxiety. Future research could examine the effects of psychopharmaceuticals on asthma and anxiety comorbidity. [ABSTRACT FROM AUTHOR]

Effective methods to assess mental disorders in children are necessary for accurate prevalence estimates and to monitor prevalence over time. This study assessed updates of the tic disorder and attention-deficit/hyperactivity disorder (ADHD) modules of the Diagnostic Interview Schedule for Children, Version 5 (DISC-5) that reflect changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, DSM-5). The DISC-5 tic disorder and ADHD parent- and child-report modules were compared to expert clinical assessment for 100 children aged 6–17 years (40 with tic disorder alone, 17 with tic disorder and ADHD, 9 with ADHD alone, and 34 with neither) for validation. For the tic disorder module, parent-report had high (>90%) sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, while the youth-report had high specificity and PPV, moderate accuracy (81.4%), and lower sensitivity (69.8%) and NPV (67.3%). The ADHD module performed less well: parent-report had high NPV (91.4%), moderate sensitivity (80.8%), and lower specificity (71.6%), PPV (50.0%), and accuracy (74.0%); youth-report had moderate specificity (82.8%) and NPV (88.3%), and lower sensitivity (65.0%), PPV (54.2%), and accuracy (78.6%). Adding teacher-report of ADHD symptoms to DISC-5 parent-report of ADHD increased sensitivity (94.7%) and NPV (97.1%), but decreased specificity (64.2%), PPV (48.7%), and accuracy (72.2%). These findings support the use of the parent-report tic disorder module alone or in combination with the child report module in future research and epidemiologic studies; additional validation studies are warranted for the ADHD module. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention. Objective: This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth. Methods: Participants (N = 488, age 7-17) met diagnostic criteria for social phobia, generalized anxiety disorder, and/or separation anxiety disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial. Results: Exploratory factor analysis yielded two factors (accusation/blame, social rejection). The SASSY full scale and social rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY social rejection factor accurately distinguished children and adolescents with social phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders. Conclusions: Findings suggest the potential utility of the SASSY social rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.

There is an emerging body of evidence linking the intestinal microbiota with autism spectrum disorders (ASD). Studies have demonstrated differences in the composition of gut bacteria between children with ASD and controls. Certain intestinal bacteria have been observed in abundance and may be involved in the pathogenesis of ASD; including members of the "Clostridium" and "Sutterella" genus. Evidence from animal models suggest that certain microbial shifts in the gut may produce changes consistent with the clinical picture of autism, with proposed mechanisms including toxin production, aberrations in fermentation processes/products, and immunological and metabolic abnormalities. In this article, we review studies examining the relationship between intestinal bacteria and ASD, and discuss bacterial species that may be implicated and proposed mechanisms.

Objective To describe differences in health care needs between Children with Special Health Care Needs (CSHCN) with and without anxiety and examine the association between anxiety and unmet health care needs. Methods We analyzed data from the 2009/2010 national survey of CSHCN. The independent variable was anxiety. The main outcomes were health care needs and unmet needs. Covariates included demographics, other co-morbid conditions, and the presence and quality of a medical home. We used bivariate analyses and multivariable logistic regression to assess the relationships among anxiety, covariates, and the outcomes. We stratified our analysis by age (6-11 years, 12-17 years). Propensity score matched paired analysis was used as a sensitivity analysis. Results Our final sample included 14,713 6-11 year-olds and 15,842 12-17-year-olds. Anxiety was present in 16% of 6-11 year-olds and 23% or 12-17 year-olds. In bivariate analyses, CSHCN with anxiety had increased health care needs and unmet needs, compared to CSHCN without anxiety. In multivariable analyses, only children 12-17 years old with anxiety had increased odds of having an unmet health care need compared to those children without anxiety (OR 1.44 [95% CI 1.17-1.78]). This was confirmed in the propensity score matching analysis (OR 1.12, [95% CI 1.02-1.22]). The specific unmet needs for older CSHCN with anxiety were mental health care (OR 1.54 [95% CI 1.09-2.17]) and well child checkups (OR 2.01 [95% CI 1.18-3.44]). Conclusion Better integration of the care for mental and physical health is needed to ensure CSHCN with anxiety have all of their health care needs met., Author(s): Cori Green [sup.1] , Hye-Young Jung [sup.2] , Xian Wu [sup.2] , Erika Abramson [sup.1] [sup.2] , John T. Walkup [sup.3] , Jennifer S. Ford [sup.4] , Zachary M. [...]

Abstract Objective To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS), a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT), sertraline (SRT), and their combination (COMB) against pill placebo (PBO) for the treatment of separation anxiety disorder (SAD), generalized anxiety disorder (GAD) and social phobia (SoP) in children and adolescents. Methods Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. Results CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488) children and adolescents (ages 7-17 years) with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT) and pharmacologic (SSRI) treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results of CAMS will hold important implications for informing practice-relevant decisions regarding the initial treatment of youth with anxiety disorders. Trial registration ClinicalTrials.gov NCT00052078.