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This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionAutism includes core symptoms affecting general and social development. Up to 60% of autistic adolescents experience co-occurring anxiety disorders negatively influencing educational, social, and general development together with quality of life. A manualised cognitive behavioural therapy (CBT) program ‘Cool Kids - Autism Spectrum Adaptation (ASA)’ has previously demonstrated efficacy in reducing anxiety in children with co-occurring autism. The current study investigates the feasibility of adapting this program for adolescents.Fifteen autistic adolescents, aged 14–17 years, with co-occurring anxiety disorders were enrolled in the study. Outcome measures collected from both adolescents and parents pre-, post-treatment and at 3-month follow-up included participant evaluation of the program, scores from a semi-structured anxiety interview, and questionnaires on anxiety symptoms, life interference, and quality of life.92% of the families who completed the program found it useful and would recommend it to other families in a similar situation. At follow-up, 55% no longer met the criteria for their primary anxiety diagnosis and 34% of adolescents were free of all anxiety diagnoses. Of the five adolescents who did not attend school before treatment three (60%) had returned to school after treatment.This study suggests that the adaptation of the program ‘Cool Kids - ASA’ into an adolescent version is feasible and has the potential to show good effects thus enhancing the possibility of education, development and independence in future life for this group. Larger RCTs studies are, however, needed to examine the efficacy of the adolescent version. [ABSTRACT FROM AUTHOR]

Background: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Methods: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Results: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Conclusion: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively. [ABSTRACT FROM AUTHOR]

The Metacognitions Questionnaire – Short Form (MCQ-30) was designed as a parsimonious measure of the metacognitive beliefs and processes implicated in the maintenance of Generalized Anxiety Disorder (GAD). The present study sought to examine the psychometric properties and clinical utility of the MCQ-30 among people with GAD. One hundred and thirty-nine adults diagnosed with GAD and 76 non-clinical controls completed the MCQ-30 and self-report measures of worry, fear of anxiety, attempted thought suppression, distress, GAD symptoms, and interference. A five-factor structure was evaluated using confirmatory factor analysis (CFA). Among the clinical sample, CFA supported the construct validity of the scale, although the relationship between the factors differed from community samples. Evidence was found for the internal consistency, test-retest reliability, and concurrent, convergent and criterion validity of the MCQ-30 in people with GAD. The treatment sensitivity and clinical responsiveness of the scale were also demonstrated, with the Uncontrollability and Danger Beliefs subscale identified as the most accurate predictor of clinical status. This subscale also exhibited the strongest correlations with most symptom measures, highlighting the cardinal role played by negative beliefs about worry in maintaining clinical levels of GAD. This study provides the first evidence of the reliability, validity and clinical utility of the MCQ-30 with people diagnosed with GAD. [ABSTRACT FROM AUTHOR]

This three-wave panel study examined the prospective and bidirectional relationships between parental control of social media use, and parents' and adolescents' perceived time spent on social media over a 2-year period. Adolescents (52% males, T1: M age = 12.19, SD = 0.52) and one of their parents (96% mothers, T1: M age = 45.26, SD = 4.28) completed annual surveys (T1: N = 498, T2: N = 477 and T3: N = 440). Data were analysed using cross-lagged panel models. More adolescent time spent on social media predicted small decreases in parental control 1 year later, but parental control did not predict adolescent time on social media. More parental time spent on social media predicted small increases in adolescent time spent on social media 1 year later, but adolescent use did not predict parent use. Examining factors related to parental use, rather than restriction, may be more effective to reduce adolescents' social media use. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Children and adolescents demonstrate diverse patterns of symptom change and disorder remission following cognitive behavioural therapy (CBT) for anxiety disorders. To better understand children who respond sub‐optimally to CBT, this study investigated youths (N = 1,483) who continued to meet criteria for one or more clinical anxiety diagnosis immediately following treatment or at any point during the 12 months following treatment.Data were collected from 10 clinical sites with assessments at pre‐and post‐treatment and at least once more at 3, 6 or 12‐month follow‐up. Participants were assigned to one of three groups based on diagnostic status for youths who: (a) retained an anxiety diagnosis from post to end point (minimal responders); (b) remitted anxiety diagnoses at post but relapsed by end point (relapsed responders); and (c) retained a diagnosis at post but remitted to be diagnosis free at end point (delayed responders). Growth curve models assessed patterns of change over time for the three groups and examined predictors associated with these patterns including demographic, clinical and parental factors, as well as treatment factors.Higher primary disorder severity, being older, having a greater number of anxiety disorders, having social anxiety disorder, as well as higher maternal psychopathology differentiated the minimal responders from the delayed and relapsed responders at the baseline. Results from the growth curve models showed that severity of the primary disorder and treatment modality differentiated patterns of linear change only. Higher severity was associated with significantly less improvement over time for the minimal and relapsed response groups, as was receiving group CBT, when compared to the delayed response group.Sub‐optimal response patterns can be partially differentiated using variables assessed at pre‐treatment. Increased understanding of different patterns of change following treatment may provide direction for clinical decision‐making and for tailoring treatments to specific groups of clinically anxious youth. Future research may benefit from assessing progress during treatment to detect emerging response patterns earlier. [ABSTRACT FROM AUTHOR]

Background and aims Design Setting Participants Intervention and comparator Measurements Comments 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.This RCT will be conducted with a 1:1 parallel group.The study will be a web‐based trial in Australia.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.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).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.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]

This study examined the impact of COVID-19 lockdowns and physical distancing requirements on engagement with and sense of connectedness to social activities among older adults. Community-dwelling cognitively healthy older adults (N = 126) completed self-report questionnaires post-lock down (November 2020 to February 2021) assessing participation format (face-to-face with restrictions, online), frequency of attendance, and connectedness with a range of existing social groups. Thirty-two percent of participants stopped and had not re-engaged with social activities post lockdown. These participants reported the lowest connectedness ratings and quality of life related to psychological health than compared to those who continued to engage with social groups, albeit in a controlled format. Adapted face-to-face formats were associated with significantly greater connectedness than engagement via online methods for hobbies, cultural activities, meal entertainment, and other social activities, but not for sporting, community, religious, or volunteering activities. Qualitative data suggested online social participation was not as enjoyable as adapted face-to-face formats. For older adults who attended social activities via online formats, sense of connectedness was reduced for some activities. Given the importance of social connectedness for well-being in late life, interventions may be needed to help older adults re-engage in face-to-face formats without restrictions. What is already known about this topic: Poor social connection is associated with reduced mental well-being and physical health in older adults. Local lockdown orders in response to the 2020 wave of the COVID-19 pandemic led to temporary closure of community activities groups, suspension of religious, sporting, and social activities. and restrictions on face-to-face contact with family. Many community organisations, social groups, and families adapted activities to online formats. What this topic adds: Older adult who stopped attending and did not re-engage in social groups had the lowest connectedness ratings and quality of life related to psychological health, compared to those who continued to engage with social groups in some format. Face-to-face engagement, even with restrictions, was associated with significantly greater connectedness in older adults than engagement online for hobby, cultural activities, meal entertainment and other social activities besides sporting, community, religious, or volunteering activities. Qualitative data suggested that online social participation was not as enjoyable as adapted face-to-face formats. [ABSTRACT FROM AUTHOR]

This study assessed the psychometric properties of the Italian version of the Preschool Anxiety Scale-Revised (PAS-R), a parent-reported measure of their preschool child's anxiety symptoms. The participants were mothers of 279 Italian preschoolers (age 2–7 years, M = 4.5 years). According to information criteria derived from a confirmatory factor analysis, the four originally identified factors (generalized anxiety, social anxiety, separation anxiety, specific fears) provided the best fit to the data. Reliability was excellent for the total score and acceptable for the subscales. PAS-R total score showed moderate correlation with internalizing subscales of the Strengths and Difficulties Questionnaire (SDQ) and of the Child Behavior Checklist and weak correlation with the externalizing subscale of the SDQ, demonstrating convergent and concurrent validity, respectively. Test–retest reliability of the PAS-R was good after 1 month. The results suggest good psychometric properties of the Italian PAS-R, although its factor structure needs further investigation with different samples. [ABSTRACT FROM AUTHOR]

The aim of this randomized controlled trial was to evaluate an adapted cognitive behavioural therapy (CBT) programme for treating anxiety in adolescents with acquired brain injury (ABI). Participants with ABI (12–19 years, N = 36) recruited from two sites were randomly allocated into either the intervention receiving 11 sessions of CBT (n = 19) or a wait-list control group (n = 17). The primary outcome was participants' anxiety and secondary outcomes were participants' depression, self-perception, and participation in daily activities, and parental stress, measured at (i) pre-intervention, (ii) immediately post-intervention, (iii) 2 months post-intervention and (iv) 6 months post-intervention. Repeated measures ANOVAs revealed significant treatment effects with the intervention group demonstrating greater improvements in self-reported anxiety, as well as self- and parent-reported depression from pre- to immediately post-treatment, compared to wait-list controls. Little evidence of treatment effects was found for the remaining outcomes (parent-reported anxiety, self-perception, daily participation, and parental stress). Significant improvement in self-reported anxiety found immediately post-treatment was maintained at two- and six-month follow-up. Findings provide support for adapted CBT as an effective means of reducing anxious and depressive symptomatology in adolescents with ABI compared to waitlist controls, and offer support for the use of these techniques to manage anxiety in this population. [ABSTRACT FROM AUTHOR]

It has been proposed that negative mental imagery plays an important role in the persistence of social fears. Experiencing vivid and distressing 'flashforward' images of a potential social catastrophe appears to be of relevance in speech anxiety. To clarify the role of these images, the current experimental study tested if reducing the vividness and distressing properties of recurring negative flashforward images subsequently reduces anxiety and avoidance tendencies regarding a speech. Methods : Participants were female undergraduates high in speech anxiety (N = 134) who joined our study online. In the experimental condition, we used a visuospatial dual-task to reduce the vividness and distress of flashforward imagery. Primary outcomes were participants' self-reported anxiety and avoidance ratings in anticipation of and during an actual speech. As a secondary outcome, we used observer ratings of participants' anxiety during the speech. Results: Participants reported moderate to high frequency and interference of their vivid and distressing flashforward images in daily life. The dual-task resulted in reductions in image vividness and distress. However, we found no differences between conditions in anxiety and avoidance ratings before and during the speech. Limitations: The imagery manipulation effect was moderate to small. Moreover, we included a subclinical sample. Conclusions: Reducing negative flashforward imagery vividness and distress with a visuospatial dual-task did not directly lead to less anxiety and avoidance tendencies related to a later speech. Thus, findings provided no support for the hypothesis that experiencing highly vivid and distressing flashforward images causally contributes to social fears. • We tested individuals high in speech anxiety with recurring flashforward imagery. • Image vividness and distress were experimentally reduced using a dual-task. • Subsequently, participants delivered a speech and rated anxiety and avoidance. • Anxiety and avoidance were not lower in experimental than in control condition. • No support for causal impact of highly vivid and distressing flashforwards on fear. [ABSTRACT FROM AUTHOR]

Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional impairment and quality of life (QoL) is increasing; however, there is yet to be a systematic review and meta-analysis of these relationships in pediatric samples. This systematic review and meta-analysis were conducted to determine the extent of impairments in functioning and QoL that young people with anxiety disorders experience relative to their healthy peers, as well as sociodemographic and clinical moderators of these relationships. Studies were included when they compared young people (mean age range within studies 7–17 years) with a primary clinical anxiety disorder to a healthy comparison group and measured impairment and/or QoL via a validated instrument. A total of 12 studies met criteria for this review (N = 3,129 participants). A majority of studies (K = 9) assessed impairment as an outcome measure, and three assessed QoL outcomes. Meta-analysis of nine studies (N = 1,457 children) showed large relationships between clinical anxiety and life impairment (g = 3.23) with the strongest effects seen for clinician report (g = 5.00), followed by caregiver (g = 2.15) and child (g = 1.58) report. The small number of studies and diversity in methodology prevented quantitative investigation of moderating factors. In the systematic review of QoL outcomes, all three studies reported significantly poorer QoL for youth with anxiety disorders relative to unaffected peers. Findings support the importance of measuring functioning and QoL as outcomes in clinical research and practice among anxious young people.This study is registered with PROSPERO under the identification number CRD42023439040. [ABSTRACT FROM AUTHOR]

What are the major vulnerabilities in people with social anxiety? What are the most promising directions for translational research pertaining to this condition? The present paper provides an integrative summary of basic and applied translational research on social anxiety, emphasizing vulnerability factors. It is divided into two subsections: intrapersonal and interpersonal. The intrapersonal section synthesizes research relating to (a) self-representations and self-referential processes; (b) emotions and their regulation; and (c) cognitive biases: attention, interpretation and judgment, and memory. The interpersonal section summarizes findings regarding the systems of (a) approach and avoidance, (b) affiliation and social rank, and their implications for interpersonal impairments. Our review suggests that the science of social anxiety and, more generally, psychopathology may be advanced by examining processes and their underlying content within broad psychological systems. Increased interaction between basic and applied researchers to diversify and elaborate different perspectives on social anxiety is necessary for progress. • We review research on proposed basic processes in social anxiety. • Intrapersonal processes include self-referential, emotion, & information processing. • Interpersonal processes include approach, avoidance, social rank, & affiliation. • Future work should examine multiple processes and their interactions. • Collaboration between basic and applied researchers can advance the field. [ABSTRACT FROM AUTHOR]

Online treatment delivery has the potential to increase access to evidence-based mental health care for children with anxiety disorders. Using a randomized controlled trial design, we evaluated the efficacy of Cool Kids Online, a family-based and therapist supported internet-delivered cognitive behavioral treatment (CBT) designed to target anxiety disorders in children. Ninety-five children aged 7–12 years with a DSM-5 anxiety disorder were randomly allocated to Cool Kids Online or a waitlist control. Children were assessed at baseline, week 11, and 6-months following treatment. Children in waitlist received treatment after week 11 and also completed assessments immediately and six months after treatment, allowing treatment maintenance to be evaluated for all children. Compared to waitlist, Cool Kids Online led to significantly greater remission of anxiety disorders (primary and all anxiety diagnoses) and greater reduction of caregiver-reported anxiety symptoms and interference at week 11. Child-reported anxiety symptoms and interference and child- and caregiver-reported depressive or externalizing symptoms did not differ significantly between conditions. Medium to large within-treatment effects were observed for all children from pre to post treatment with post treatment effects maintained until follow-up. Overall, the findings provide support for the efficacy of the program in treating anxiety. Cool Kids Online compared to waitlist for the remission of anxiety disorders in clinically anxious children; anzctr.org.au ; ACTRN12615000947505. • Online family-based cognitive behaviour therapy reduces child anxiety disorders. • Therapist support during online child anxiety programs may be important for change. • Cool Kids Online is a promising method to improve access to child anxiety treatment. [ABSTRACT FROM AUTHOR]