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The goal of this study was to evaluate the measurement invariance of an adapted assessment of motivations for social withdrawal ("Social Preference Scale--Revised"; SPS-R) across cultural contexts and explore associations with loneliness. Participants were a large sample of university students (N = 4,397; M[subscript age] = 20.08 years, SD = 2.96; 66% females) from 10 countries (Argentina, Australia, Canada, China, India, Italy, South Korea, Norway, Turkey, and the United States). With this cross-cultural focus, we illustrate the "multiple-group factor analysis alignment method," an approach developed to assess measurement invariance when there are several groups. Results indicated approximate measurement invariance across the 10 country groups. Additional analyses indicated that overall, shyness, avoidance, and unsociability are three related, but distinct factors, with some notable country differences evident (e.g., in China, India, and Turkey). Shyness and avoidance were related positively to loneliness in all countries, but the strength of the association between shyness and loneliness differed in Italy and India relative to the other countries. Results also indicated that unsociability was related positively to loneliness in the United States only. Theoretical and assessment implications are discussed.

Cognitive Behavioural Therapy (CBT) programs adapted to children with Autism Spectrum Disorder (ASD) effectively reduce anxiety when run in university clinics. Forty-nine children aged 8-14 years participated in a waitlist controlled study in a general child psychiatric hospital setting. Post-treatment 30% of the children were free of their primary anxiety diagnoses and 5% were free of all anxiety diagnoses. No statistically significant difference between the two trial conditions were found on primary outcomes. However, statistically significant differences were found on secondary outcomes indicating clinically meaningful treatment responses. Together with high program satisfaction this study shows the CBT program to be feasible and potentially efficacious in treating anxiety in children with ASD in a general child psychiatric hospital setting.

Cognitive Behavioural Therapy (CBT) programs adapted to children with Autism Spectrum Disorder (ASD) effectively reduce anxiety when run in university clinics. Forty-nine children aged 8-14 years participated in a waitlist controlled study in a general child psychiatric hospital setting. Post-treatment 30% of the children were free of their primary anxiety diagnoses and 5% were free of all anxiety diagnoses. No statistically significant difference between the two trial conditions were found on primary outcomes. However, statistically significant differences were found on secondary outcomes indicating clinically meaningful treatment responses. Together with high program satisfaction this study shows the CBT program to be feasible and potentially efficacious in treating anxiety in children with ASD in a general child psychiatric hospital setting., Author(s): Tina R. Kilburn [sup.1] , Merete J. Sørensen [sup.2] , Mikael Thastum [sup.4] , Ronald M. Rapee [sup.5] , Charlotte U. Rask [sup.1] [sup.2] [sup.3] , Kristian B. Arendt [...]

To examine treatment fidelity in a randomized controlled trial of indicated school-based cognitive-behavioral therapy (CBT) delivered in groups to youth with anxiety. We investigated whether adherence and competence (a) differed across brief and standard-length CBT, and (b) if adherence and competence predicted change in anxiety symptoms and impairment. Method: Sessions were observationally coded with the "Competence and Adherence Scale for CBT for Anxiety Disorders in Youth." Coders (N = 7) rated 104 sessions from 52 groups delivered by 32 facilitators (M age = 43.2 years, SD = 8.1) to 295 youth (M age = 14.0 years, SD = 0.8). Outcomes were youth- and parent-reported anxiety symptoms and impairment at post-intervention and 1-year follow-up. Linear mixed effect models were used to analyze whether fidelity predicted clinical outcomes. Results: Levels of adherence and competence were adequate in both programs, but higher in brief compared to standard-length CBT p < 0.001 and p = 0.010, respectively). Neither adherence nor competence predicted clinical outcomes at any timepoints. Conclusion: Higher levels of adherence and competence in brief CBT suggest that it may be easier for novice CBT providers to achieve fidelity in simplified and less flexible interventions. Contrary to expectation, adherence and competence did not predict clinical outcomes.

Many young people with mental disorders are not identified until some years after the first onset of symptoms and then frequently do not receive professional intervention. One promising strategy to better identify these young people is mental health screening in schools. Despite a growing literature on the benefits of school-based screening, it remains a relatively uncommon practice and little is known about the practices of those schools that do screen. Moreover, the barriers that prevent schools from screening are not well understood. This study reports on the perceptions of school psychologists about universal mental health screening in schools regarding the prevalence of screening; the practices within schools that do screen; and the perceived barriers to implementing screening. Results indicated that screening remains uncommon, with only 14.8% of school psychologists working in schools that screened in the previous 12 months. The most significant barriers to screening related to being adequately resourced to implement programs, and particularly concerns about how to follow-up students identified as being at-risk. Despite this, school psychologists endorse the potential benefit of screening and report being likely to run screening programs if perceived barriers could be reduced.

In light of concerning evidence that many young people with mental disorders are not receiving appropriate mental health intervention, school-based mental health screening has been advocated as one way to improve identification of at-risk youth. Despite having much promise, universal screening in schools remains a relatively uncommon practice internationally. Various barriers that deter school psychologists and counsellors from screening have been identified, including lack of resourcing to implement screening, lack of knowledge about the mechanics of how to carry out a screening program, and concern about how to manage the anticipated increased workload generated by following up identified students. In this practice-based paper we discuss a four-stage process that guides school psychologists and counsellors in the establishment of a school-based screening program, with specific reference to overcoming perceived barriers.

Bullying is a pervasive and debilitating issue for youth that can lead to substance abuse, worse outcomes at school, mental and physical health problems, and in some instances serious acts of school violence. There are three criteria that must be present in order to be classified as bullying: Repetition, intentionality, and imbalance of power. Most efforts in this area have focused on reducing bullying behavior, with both whole of school and targeted approaches showing some success. However, a meta-analytic review of bullying interventions revealed that on average, school-based interventions led to only a small decrease in bullying (20-23%) and an even smaller decrease in victimization (17-20%) while programs that worked with peers actually led to an increase in victimization. One therapeutic technique that may help to reduce negative emotional outcomes for victims is encouraging forgiveness. The aim of this study was to determine the effects of imagery re-scripting terminating in images of either forgiveness or revenge of a bullying victimization scenario on affect and evaluative responses to the bullying.

Social anxiety is a common mental disorder with an average age of onset in early adolescence. Current theories focus largely on risk factors that are present from early in life, but reasons for onset of the disorder as youth move into adolescence are rarely discussed. We recently proposed a model of the onset of certain mental disorders during the adolescent years based on characteristics of adolescent development. While this model will require longitudinal testing, the current article establishes concurrent associations between relevant variables in a cohort of 528 preadolescents (M[subscript age] = 11.2 years) at baseline. Youth with social anxiety disorder differed significantly from other youth on measures of social comparison (including physical appearance comparisons, self-rated attractiveness, and negative peer comparisons on social media) as well as positive peer connections (including self-reported school belonging, number of friends, victimization, and peer affiliation). A structural equation model showed that symptom levels of social anxiety were directly related to social comparisons and peer connections, as well as indirectly associated with pubertal development and social comparisons. This pattern was not moderated by sex of youth.

Background and aims: Alcohol use and anxiety often co‐occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost‐effectiveness of a web‐based, self‐guided alcohol and anxiety‐focused program, compared with a web‐based brief alcohol‐focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects. Design: This RCT will be conducted with a 1:1 parallel group. Setting: The study will be a web‐based trial in Australia. Participants: Individuals aged 17–30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety (n = 500) will be recruited through social media, media (TV, print) and community networks. Intervention and comparator: Participants will be randomly allocated to receive a web‐based, integrated alcohol‐anxiety program plus technical and motivational telephone/e‐mail support (intervention) or a web‐based brief alcohol‐feedback program (control). Measurements Clinical measures will be assessed at baseline, post‐intervention (2 months), 6 months (primary end‐point), 12 months and 18 months. Co‐primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge‐drinking frequency; alcohol‐related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post‐intervention), health‐care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention‐to‐treat framework. The economic evaluation will analyze individual‐level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change. Comments This will be the first trial to test whether a developmentally targeted, web‐based, integrated alcohol‐anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol‐anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to determine how youth with anxiety recruited for a school-based randomized controlled trial (RCT) compare demographically and clinically to clinically referred youth with anxiety who participated in an RCT conducted in community mental health clinics. Youth ("N" = 99) with anxiety aged 12-15 years were: (a) 37 youth ("M" age = 13.70, SD = 0.89; 97.3% Norwegian; 19.0% male) from a school-based RCT and (b) 62 youth ("M" age = 13.8, SD = 1.0; 88.7% Caucasian; 29.5% male) from an RCT conducted in community mental health clinics. The youth were assessed for anxiety diagnoses, functional impairment, internalizing symptoms, and externalizing symptoms. Compared to the clinically referred youth who received care in community mental health clinics, the youth in the school sample met criteria for fewer anxiety diagnoses, lower severity of diagnoses, and less functional impairment caused by mental health problems. However, the school sample had significantly higher levels of youth-rated anxiety symptoms, "t"(95) = -2.33, "p" = 0.02, parent-rated depression, "t"(94) = 4.45, "p" < 0.001, and externalizing symptoms, "t"(96) = 2.86, "p" = 0.005. Finally, only 12.1% of the youth who met diagnostic criteria reported receiving services at a community mental health clinic in the last year. Although many of the youth in the school sample met diagnostic criteria for one or more anxiety disorders, few had received services in community mental health clinics. This suggests that recruiting in schools may help identify youth with anxiety that may not otherwise seek mental health services.