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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jecp.2004.06.003 Byline: Allison M. Waters (a), Ottmar V. Lipp (b), Susan H. Spence (b) Keywords: Attentional bias; Fear stimuli; Anxiety; Children Abstract: Research investigating anxiety-related attentional bias for emotional information in anxious and nonanxious children has been equivocal with regard to whether a bias for fear-related stimuli is unique to anxious children or is common to children in general. Moreover, recent cognitive theories have proposed that an attentional bias for objectively threatening stimuli may be common to all individuals, with this effect enhanced in anxious individuals. The current study investigated whether an attentional bias toward fear-related pictures could be found in nonselected children (n =105) and adults (n =47) and whether a sample of clinically anxious children (n =23) displayed an attentional bias for fear-related pictures over and above that expected for nonselected children. Participants completed a dot-probe task that employed fear-related, neutral, and pleasant pictures. As expected, both adults and children showed a stronger attentional bias toward fear-related pictures than toward pleasant pictures. Consistent with some findings in the childhood domain, the extent of the attentional bias toward fear-related pictures did not differ significantly between anxious children and nonselected children. However, compared with nonselected children, anxious children showed a stronger attentional bias overall toward affective picture stimuli. Author Affiliation: (a) School of Applied Psychology, Griffith University, Gold Coast, Qld. 9726, Australia (b) School of Psychology, University of Queensland, Brisbane 4072, Australia Article History: Received 19 December 2003; Revised 14 April 2004

The study examined whether the efficacy of cognitive behavioral treatment for Social Anxiety Disorder for children and adolescents is increased if intervention addresses specific cognitive and behavioral factors linked to the development and maintenance of SAD in young people, over and above the traditional generic CBT approach. Participants were 125 youth, aged 8–17 years, with a primary diagnosis of SAD, who were randomly assigned to generic CBT (CBT-GEN), social anxiety specific CBT (CBT-SAD) or a wait list control (WLC). Intervention was delivered using a therapist-supported online program. After 12-weeks, participants who received treatment (CBT-SAD or CBT-GEN) showed significantly greater reduction in social anxiety and post-event processing, and greater improvement in global functioning than the WLC but there was no significant difference between CBT-SAD and CBT-GEN on any outcome variable at 12-weeks or 6-month follow-up. Despite significant reductions in anxiety, the majority in both treatment conditions continued to meet diagnostic criteria for SAD at 6-month follow-up. Decreases in social anxiety were associated with decreases in post-event processing. Future research should continue to investigate disorder-specific interventions for SAD in young people, drawing on evidence regarding causal or maintaining factors, in order to enhance treatment outcomes for this debilitating condition. [ABSTRACT FROM AUTHOR]

The current paper presents an update to the model of social anxiety disorder (social phobia) published by Rapee and Spence (2004). It evaluates the research over the intervening 11 years and advances the original model in response to the empirical evidence. We review the recent literature regarding the impact of genetic and biological influences, temperament, cognitive factors, peer relationships, parenting, adverse life events and cultural variables upon the development of SAD. The paper draws together recent literature demonstrating the complex interplay between these variables, and highlights the many etiological pathways. While acknowledging the considerable progress in the empirical literature, the significant gaps in knowledge are noted, particularly the need for further longitudinal research to clarify causal pathways, and moderating and mediating effects. The resulting model will be valuable in informing the design of more effective treatment and preventive interventions for SAD and will provide a useful platform to guide future research directions. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To investigate whether help-seeking intentions for depressive symptoms vary for adolescents experiencing low, mild-to-moderate, and high levels of depressive symptoms. Methods: A total of 5,362 participants aged 12–14 years had completed the baseline assessment for a randomized controlled trial evaluating the effectiveness of a universal intervention designed to reduce depressive symptoms among high school students. The participants reported their help-seeking intentions in response to a vignette describing an individual experiencing depressive symptoms consistent with a diagnosis of a minor depressive disorder. Standard measures were used to assess participants'' level of depressive symptoms and perceived level of social support. Results: Logistic regression models examined relationships between help-seeking intentions and levels of depression, after adjustment for demographic characteristics and perceived support. As compared with those with low levels of depressive symptoms, adolescents with high levels of symptoms reported less intention to seek help from friends (odds ratio [OR] = .42) or family members (OR = .29). They were also four times more likely to report that they would not seek help from anybody (OR = 4.55). A similar pattern was evident during comparisons of help-seeking intentions reported by adolescents with mild-to-moderate levels of depressive symptoms versus those with low levels of symptoms. Conclusions: Targeted and universal interventions need to encourage peers and family members to actively engage with young adolescents experiencing depressive symptoms rather than waiting for them to initiate help-seeking. This is particularly important for adolescents experiencing higher levels of depressive symptoms who may not initiate help-seeking themselves. [Copyright &y& Elsevier]

Abstract: Purpose: To investigate the effectiveness of a universal intervention designed to reduce depressive symptoms experienced by adolescents at high school. The results from annual assessments during the 3-year intervention and a 2-year follow-up are reported. Methods: Twenty-five pairs of secondary schools matched on socio-economic status were randomly assigned to either an intervention or a comparison group (n = 5,633 year 8 students, mean age = 13.1 years, SD = .5). The intervention used a comprehensive classroom curriculum program, enhancements to school climate, improvements in care pathways, and community forums. A range of measures completed by students and teachers was used to assess changes in depressive symptoms, risk and protective factors relevant to depression, and the quality of the school environment. Results: Changes in the levels of depressive symptoms and in the levels of risk and protective factors experienced by students in the two groups did not differ significantly over the 5 years of the study. Statistically significant differences in the ratings of school climate across this time were found only for teacher-rated assessments. Conclusions: There was little evidence that a multicomponent universal intervention delivered over a 3-year period reduced levels of depressive symptoms among participating students. Implementing universal interventions to improve student mental health is difficult in school settings that commonly have a crowded agenda of educational and health-related programs. Successful implementation will require programs which are perceived by teachers and students as relevant to educational and learning goals, and which can be effectively delivered in conjunction with other school programs. [ABSTRACT FROM AUTHOR]

Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11–17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts. • The BEDSY is a new, brief, self-report scale of emotional distress in young people. • It has promise as a brief screen for identifying emotionally distressed youth in community contexts. • It aims to identify youth who are likely to benefit from early intervention. • The scale has strong internal consistency, good construct validity, and discriminant validity. [ABSTRACT FROM AUTHOR]

Research into the etiology of social phobia has lagged far behind that of descriptive and maintaining factors. The current paper reviews data from a variety of sources that have some bearing on questions of the origins of social fears. Areas examined include genetic factors, temperament, childrearing, negative life events, and adverse social experiences. Epidemiological data are examined in detail and factors associated with social phobia such as cognitive distortions and social skills are also covered. The paper concludes with an initial model that draws together some of the current findings and aims to provide a platform for future research directions. [Copyright &y& Elsevier]

The psychometric properties of the Spence Children’s Anxiety Scale (SCAS) were examined with 875 adolescents aged 13 and 14 years. This self-report measure was designed to evaluate symptoms relating to separation anxiety, social phobia, obsessive-compulsive disorder, panic-agoraphobia, generalized anxiety, and fears of physical injury. Results of confirmatory and exploratory factor analyses supported six factors consistent with the hypothesized subtypes of anxiety. There was support also for a model in which the first-order factors loaded significantly on a single second-order factor of anxiety in general. The internal consistency of the total score and sub-scales was high, and 12-week test–retest reliability was satisfactory. The SCAS correlated strongly with a frequently used child self-report measure of anxiety and significantly, albeit at a lower level, with a measure of depression. [Copyright &y& Elsevier]

Presents information on a study which examined the structure of anxiety symptoms in preschoolers. Exploratory factor analysis; Confirmatory factor analysis; Prevalence of anxiety symptoms; Symptoms of post-traumatic stress disorder.

Presents a study which investigated the efficacy of eye movement desensitization and reprocessing (EMDR) and the necessity of eye movements within a veteran population. Information on Posttraumatic Stress Disorder; Methodology; Results and discussion.

Provides information about the Spence Children's Anxiety Scale (SCAS), a child self-report measure. Methodology of the study; Confirmatory factor analysis loadings of anxiety symptoms on predicted six factors; Results and discussion.

An abstract for the study "Screening for Posttraumatic Stress Disorder After Accidental Injury," by Justin A. Kenardy and Alexandra C. Macleod is presented.

Abstract: Background: To investigate prospectively over one year, the extent to which greater exposure to negative life events, greater use of more negative coping strategies, and less use of positive coping strategies and an optimistic thinking style, predicts the onset of depressive symptoms among adolescents. Methods: A prospective longitudinal study of 5,634 adolescents (Mean Age=13.1, SD=0.5) enrolled in Year 8 at secondary school. Standard questionnaires were used to assess depressive symptoms and the predictor variables. Results: Over a one-year period, there was an independent and statistically significant relationship between transition to a CES-D score above the recommended cut-off score and i) greater exposure to negative life events and use of negative coping strategies, and ii) less use of positive coping strategies and an optimistic thinking style. Among males who experienced a higher number of negative life events, the impact on depressive symptoms was greater among those who made more use of negative coping strategies. Limitations: Self-report questionnaires completed by adolescents were employed to evaluate all the variables in the study. Only two assessment points were available. Ten percent of adolescents did not complete the follow-up assessment. Conclusions: Particularly among females, early adolescence is marked by increased susceptibility to depressive symptoms. Helping young adolescents to adopt more positive coping strategies and optimistic thinking styles may reduce their risk for the onset of depressive symptoms. This may be particularly important for young males who experience high levels of adverse life events and utilise negative coping strategies. [Copyright &y& Elsevier]

Abstract: This research examined the nature of children''s trauma narrative themes and the relationship between these themes and concurrent and future trauma symptoms. Eighty-seven children aged 7–15 years, and their parents, participated following child exposure to a traumatic event requiring hospitalization. At 4–7 weeks post-trauma, a diagnostic interview was conducted with parents and a trauma narrative was obtained from the child. At 6 months post-trauma the diagnostic interview was re-conducted. Results provided only weak evidence of an association between dissociative trauma narrative themes and PTSD symptoms. Specifically, children who showed temporal disorganization, but not absence of emotion or dissociative amnesia, in narrative themes were more likely to report concurrent subsyndromal PTSD symptoms at 4–7 weeks post-trauma. Children who showed absence of emotion (or at least one dissociative theme) in the trauma narrative were more likely to show symptoms of hyperarousal, but not other symptoms of PTSD, at 6 months post-trauma. These findings have implications for understanding the role of dissociation and the development of PTSD in children. [Copyright &y& Elsevier]

Abstract: The habituation to intense acoustic stimuli and the acquisition of differentially conditioned fear were assessed in 53 clinically anxious and 30 non-anxious control children and young adolescents. Anxious children tended to show larger electrodermal responses during habituation, but did not differ in blink startle latency or magnitude. After acquisition training, non-anxious children rated the CS+ as more fear provoking and arousing than the CS− whereas the ratings of anxious children did not differ. However, anxious children rated the CS+ as more fear provoking after extinction, a difference that was absent in non-anxious children. During extinction training, anxious children displayed larger blink magnitude facilitation during CS+ and a trend towards larger electrodermal responses, a tendency not seen in non-anxious children. These data suggest that extinction of fear learning is retarded in anxious children. [Copyright &y& Elsevier]

Objective: Helplines are generally a population-level resource for providing free, timely, easy-to-access, and anonymous counseling and/or information. Helplines have been developed and widely implemented for specific use by young people. The current study aimed to systematically review the literature to determine the status of research into the use of helplines among young people.Method: Following the PRISMA checklist, 5 electronic databases were searched using relevant terms for literature published until May 2020. The extracted studies were summarized with the intention of identifying key themes that highlighted common findings, key implications, and important gaps in understanding.Results: A total of 52 articles fitting study inclusion criteria were identified. Most studies were quantitative papers from the United States and Australia. The types of helpline interactions studied were a mixture of telephone-based and SMS/text-based interactions. Three major themes were identified: awareness of and engagement with helpline services, nature of problems faced by young people, and service-related factors. Subthemes were use and awareness, barriers to help seeking, psychosocial problems, suicidality, telephone- versus text-based interactions, counselor-caller interaction, and provision of services to historically and systemically marginalized groups.Conclusion: It appears that helplines may provide a beneficial service to youths, and that myriad psychosocial concerns provide the basis for calling. The literature is limited by a lack of controlled trials, on one hand, and complex methodological/ethical barriers preventing such trials, on the other hand. However, more research is needed before conclusions regarding effectiveness in youths can be made, particularly for services provided to systemically marginalized groups and using online text-based approaches. [ABSTRACT FROM AUTHOR]

Abstract: This study investigated the utility of combining the Child Trauma Screening Questionnaire (CTSQ) [Kenardy, J. A., Spence, S. H., & Macleod, A. C. (2006). Screening for post-traumatic stress disorder in children after accidental injury. Pediatrics, 118, 1002–1009] and children''s heart rate (HR; emergency department and 24-h post-admission) to identify children likely to develop post-traumatic stress disorder (PTSD) symptoms at 1 and 6 months post-injury. Children completed the CTSQ within 2 weeks of injury. PTSD symptoms were assessed with the Anxiety Disorders Interview Schedule for DSM-IV [Silverman, W. K., & Albano, A. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV, Child Version, Parent Interview Schedule. Orlando, Florida: The Psychological Corporation], for 79 children aged 7–16 years. A combination of the CTSQ plus HR (CTSQ-HR) was better than the CTSQ alone or HR alone at identifying children likely to develop PTSD symptoms. These findings suggest that the CTSQ-HR screen may increase identification of children who are likely to develop PTSD symptoms, enabling development of targeted prevention programs. [Copyright &y& Elsevier]

This study examined the psychometric properties of the parent version of the Spence Children’s Anxiety Scale (SCAS-P); 484 parents of anxiety disordered children and 261 parents in a normal control group participated in the study. Results of confirmatory factor analysis provided support for six intercorrelated factors, that corresponded with the child self-report as well as with the classification of anxiety disorders by DSM-IV (namely separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, obsessive–compulsive disorder, and fear of physical injuries). A post-hoc model in which generalized anxiety functioned as the higher order factor for the other five factors described the data equally well. The reliability of the subscales was satisfactory to excellent. Evidence was found for both convergent and divergent validity: the measure correlated well with the parent report for internalizing symptoms, and lower with externalizing symptoms. Parent–child agreement ranged from 0.41 to 0.66 in the anxiety-disordered group, and from 0.23 to 0.60 in the control group. The measure differentiated significantly between anxiety-disordered children versus controls, and also between the different anxiety disorders except GAD. The SCAS-P is recommended as a screening instrument for normal children and as a diagnostic instrument in clinical settings. [Copyright &y& Elsevier]