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Background:Peer victimization and anxiety frequently co-occur and result in adverse outcomes in youth. Cognitive behavioural treatment is effective for anxiety and may also decrease children’s vulnerability to victimization.Aims:This study aims to examine peer victimization in youth who have presented to clinical services seeking treatment for anxiety.Method:Following a retrospective review of clinical research data collected within a specialized service, peer victimization was examined in 261 children and adolescents (55.6% male, mean age 10.6 years, SD = 2.83, range 6–17 years) with a diagnosed anxiety disorder who presented for cognitive behavioural treatment. Youth and their parents completed assessments of victimization, friendships, anxiety symptoms, and externalizing problems.Results:High levels of victimization in this sample were reported. Children’s positive perceptions of their friendships were related to lower risk of relational victimization, while conduct problems were related to an increased risk of verbal and physical victimization. A subsample of these participants (n = 112, 57.1% male, mean age 10.9 years, SD = 2.89, range 6–17 years) had completed group-based cognitive behavioural treatment for their anxiety disorder. Treatment was associated with reductions in both self-reported anxiety and victimization. Results confirm the role of friendships and externalizing symptoms as factors associated with increased risk of victimization in youth with an anxiety disorder in a treatment-seeking sample.Conclusions:Treatment for anxiety, whether in a clinic or school setting, may provide one pathway to care for young people who are victimized, as well as playing a role in preventing or reducing victimization.

Adolescents experiencing both anxiety and mood disorders show greater life impairment than those with either disorder alone. The aim of this study was to evaluate the efficacy of an online cognitive behavior therapy (CBT) program for these comorbid youth.Ninety-one adolescents aged 12 to 17 years (M = 14.29, S.D. = 1.62; 66% female) participated if they met DSM-5 criteria for both an anxiety and depressive disorder. Diagnoses were assessed by structured interview and participants also completed measures of symptoms, negative thoughts, and life interference. Participants were randomly allocated to either active treatment (n = 45) or wait (n = 46). Treatment comprised access to an 8-module, online program and was supported by 8, 30-minute telephone sessions with a therapist and the youth, of which the caregiver participated in four.Treated participants showed significantly greater reduction than waiting participants on the primary outcome: total number of disorders and were more likely to remit from all anxiety and mood disorders (43.8% vs 20.9%). Secondary outcomes covering symptoms of anxiety and depression showed similar group by time differences, but there was no significant group by time interaction on life interference.This brief, easily accessible, online intervention that requires relatively low levels of therapist time showed promising impact for a very impaired population.This trial was registered on the ANZ clinical trials registry-ACTRN12616000139471.

Objective A bi-directional relationship between technology use and adolescent sleep is likely, yet findings are mixed, and it is not known whether parental control of technology use can protect sleep. The current study examined bi-directionality between technology use on school nights and morning/eveningness, sleep duration and daytime sleepiness in early adolescents. We also examined whether time spent using technology mediated the relationship between parental control of technology and adolescent sleep. Methods Adolescents and their primary caregiver (96% mothers) completed questionnaire measures of sleep, technology use and parental control across three, annual waves: Wave 1 (N = 528, Mage = 11.18, SD = 0.56, range = 10–12, 51% male), Wave 2 (N = 502, Mage = 12.19, SD = 0.53, 52% male) and Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male). Results When examining the direct relationship between sleep and technology use, cross-lagged panel models showed that time spent using technology predicted shorter sleep duration and greater daytime sleepiness in adolescence, and evening diurnal preference and shorter sleep duration contributed to increased technology use over time. The relationship between technology use and sleep duration was bi-directional. Time spent using technology and adolescent sleep predicted, yet were not predicted by, parental control of technology use. Conclusions While normative changes in sleep (eg, increased eveningness) may promote increased technology use, technology use may further impinge upon sleep. Results suggest it may be pertinent to instead find creative ways in which adolescents themselves can mitigate their risk of inadequate sleep.

Contains fulltext : 218120.pdf (Publisher’s version ) (Open Access) The current study aimed to investigate the discrepancy between self-reported and peer-reported likeability among children, and the relation with social anxiety, depression, and social support. In total, 532 children between 7 and 12 years completed questionnaires about social anxiety symptoms, depressive symptoms, and social support, estimated their own likeability, and indicated how much they liked their classmates. Children with higher levels of social anxiety or depression overestimated their likeability less or even underestimated their likeability. Social anxiety symptoms, but not depressive symptoms, were significant predictors of the discrepancy. Social support was positively related to likeability and negatively related to social anxiety, but did not moderate the association between social anxiety symptoms and perception accuracy of likeability. These results are in line with cognitive theories of childhood social anxiety, and they stress the importance of using multi-informant measures when studying the relation between social anxiety and social functioning in children. 18 p.

Objectives Preadolescent social media use is normative and could influence mental health. This study investigated: (a) Differences between preadolescent users and non-users of various social media platforms on mental health, (b) unique links between time spent on those platforms, appearance-based activities on social media, and mental health, and (c) the moderating role of biological sex on those relationships. Method Preadolescent youth (N = 528; 50.9% male) completed online surveys. Results Users of YouTube, Instagram, and Snapchat reported more body image concerns and eating pathology than non-users, but did not differ on depressive symptoms or social anxiety. Appearance investment uniquely predicted depressive symptoms. Appearance comparisons uniquely predicted all aspects of mental health, with some associations stronger for females than males. Conclusions Preadolescents could be encouraged to reduce their opportunities to make appearance comparisons and to invest less in their appearance on social media. Preadolescents may benefit from social media intervention programs.

Background Social anxiety and depressive symptoms increase markedly during adolescence. Most research examining the emergence of these symptoms has used a variable-centered approach providing little information about how these symptoms group together in individuals over time. Method A person-centered approach utilizing latent profile and latent transitional analyses was applied to a large adolescent sample (N = 2742, Mage=13.65; SD=0.63; 47.9% girls). Subgroups differing in their expressions of social anxiety and depressive symptoms at each of four annual time points were identified and then change in membership of these groups was evaluated. Results Four subgroups were identified: 1. Low Distress, 2. Socially Anxious, 3. Dysphoric, and 4. Comorbid. The low distress group was the largest and most stable, followed by the socially anxious group, who most commonly transitioned into the comorbid group. In contrast, the dysphoric group were most likely to remit and move to the low distress group. The comorbid group was the smallest and least stable, although once in this group, three quarters of adolescents remained in this group over time. Conclusion Early intervention is particularly imperative for socially anxious adolescents with or without comorbid depressive symptoms as they are the least likely to improve across the adolescent years.

The efficacy of the Cool Kids program has been consistently demonstrated both within Australia and internationally, but limited data are available on the use of Cool Kids as a universal program. The purpose of the study is to evaluate Cool Kids as a universal program for preventing childhood anxiety in the school context. There were 73 Italian children (35 boys and 36 girls, ages 10–13 years) attending the last year of primary school and the first year of middle school who participated in an active intervention based on a school adaptation of the Cool Kids protocol. Results of t-test analyses highlighted a downward trend of anxiety symptoms, especially in total anxiety, somatic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia at post-treatment assessed by children. Even the score of depression symptoms, measured as a second outcome measure, decreased after the treatment. This study contributes to the evidence base for the Cool Kids program as a universal program for preventing childhood anxiety in the school context. Although these preliminary results show some promise, their replication in future research is necessary given current study limitations.

Contains fulltext : 250296.pdf (Publisher’s version ) (Open Access) Objective: The current study examined whether children with a social anxiety disorder (SAD) demonstrate divergent facial emotion processing and a disorder-specific negative interpretation bias in the processing of facial emotional expressions. This study aimed to overcome previous study limitations by including both a nonsocially anxious control group and a healthy control group to examine whether childhood SAD is characterized by a general emotion labeling deficit, and/or by a negative interpretation bias, indicated by systematic misclassifications, or a lower threshold for recognizing threatening emotions. Method: Participants were 132 children aged 7-12 years (Mage = 9.15; 45.5% female). Children with SAD (n = 42) were compared to children with other, nonsocial, anxiety disorders (n = 40) and healthy control children (n = 50) on a novel facial emotion recognition task. Children judged ambiguous happy/neutral, angry/neutral and fear/neutral faces that were morphed at different intensities (10%, 30%, 50%, 70%). Results: Children with SAD did not differ from other groups in their accuracy of identifying emotions. They did not show systematic misclassifications or a heightened sensitivity to negative, threatening faces either. Rather, children with nonsocial anxiety disorders showed a generally heightened sensitivity to emotional faces. Conclusions: The current study does not provide evidence for a general deficit in labeling of emotional faces in childhood SAD. Childhood SAD was not characterized by an interpretation bias in processing emotional faces. Children with nonsocial anxiety disorders may benefit from assistance in accurately interpreting the degree of emotionality in interpersonal situations. 15 p.

Background Parenting is a modifiable factor proposed to underpin the transmission of anxiety and depression from parents to children. This study examined the role of parenting in the intergenerational transmission of anxiety and depression across pre- and early adolescence. Method Participants were 531 youth (Mage = 11.18, SD = 0.56; 50.85% boys) and their parent. Child and parent anxiety and depression, and parental rejection, warmth and overprotection were assessed annually over 3 years. Bidirectional relationships between parent and child anxiety and depression, and the mediating role of parenting behaviors, were examined using cross-lagged panel models. Results Results suggest bidirectional associations over time between parent and child depression, and parental rejection and child depression. Parental rejection and low warmth were associated with increases in child depression, but did not mediate depression transmission. Parental anxiety was associated with increases in child anxiety and depression, but there was no bidirectional association from child psychopathology to parental anxiety. There was little evidence that parenting predicted changes in child anxiety over time. Child anxiety and depression were associated with subsequent increases in parental depression. Conclusion Parental depression, rejection and low warmth are independent risk factors for child depression. Parental rejection may also be a consequence of parenting a depressed youth. Parenting did not account for the apparent transmission of parental anxiety to increased child anxiety and depression. Child psychopathology increases risk of parental depression. Parental rejection may be an important modifiable risk factor for youth depression in early adolescence, and may also reduce later risk of parent depression.

Background Up to 60% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) meet diagnostic criteria for at least one anxiety disorder, including Social, Generalized and/or Separation Disorder. Anxiety in children with ADHD has been shown to be associated with poorer child and family functioning. Small pilot studies suggest that treating anxiety in children with ADHD using cognitive-behavioral therapy (CBT) has promising benefits. In a fully powered randomized controlled trial (RCT), we aim to investigate the efficacy of an existing CBT intervention adapted for children with ADHD and comorbid anxiety compared with usual care. Methods This RCT is recruiting children aged 8–12 years (N = 228) from pediatrician practices in Victoria, Australia. Eligibility criteria include meeting full diagnostic criteria for ADHD and at least one anxiety disorder (Generalized, Separation or Social). Eligible children are randomized to receive a 10 session CBT intervention (Cool Kids) versus usual clinical care from their pediatrician. The intervention focuses on building child and parent skills and strategies to manage anxiety and associated impairments including cognitive restructuring and graded exposure. Minor adaptations have been made to the delivery of the intervention to meet the needs of children with ADHD including increased use of visual materials and breaks between activities. The primary outcome is change in the proportion of children meeting diagnostic criteria for an anxiety disorder at 5 months randomization. This will be assessed via diagnostic interview with the child’s parent (Anxiety Disorders Interview Schedule for Children V) conducted by a researcher blinded to intervention condition. Secondary outcomes include a range of child (e.g., anxiety symptoms, ADHD severity, behavior, quality of life, sleep, cognitive functioning, school attendance) and parent (e.g., mental health, parenting behaviors, work attendance) domains of functioning assessed at 5 and 12 months post-randomization. Outcomes will be analyzed using logistic and mixed effects regression. Discussion The results from this study will provide evidence on whether treating comorbid anxiety in children with ADHD using a CBT approach leads to improvements in anxiety and/or broader functional outcomes. Trial registration This trial was prospectively registered: Current Controlled Trials ISRCTN59518816 (10.1186/ISRCTN59518816). The trial was first registered 29/9/15 and last updated 15/1/19.

This research investigated associations between socially prescribed and self-orientated perfectionism, and the social functioning of 510 preteens (Mage = 11.2). The study focused on predictions from the Perfectionism Social Disconnection Model (PSDM) by determining whether rejection sensitivity and social isolation, in that sequence, mediated the associations between both perfectionism types and mental health outcomes. Employing both survey and experimental methods, findings indicated that both types of perfectionism in preadolescence were associated with increased interpersonal difficulty, rejection sensitivity and feelings of social isolation, as well as higher levels of eating disorder symptoms, depression, and anxiety. Results from serial mediation analyses found general support for the theoretical predictions of the PSDM for socially prescribed perfectionism, and extending upon previous research, for self-orientated perfectionism. The age of the sample suggests that both forms of perfectionism may be important targets in programs to prevent the development of mental health problems.

Existing literature suggests that anticipatory processing and post-event processing—two repetitive thinking processes linked to social anxiety disorder (SAD)—might be better conceptualized as facets of an underlying unidimensional repetitive thinking construct. The current study tested this by examining potential factor structures underlying anticipatory processing and post-event processing. Baseline data from two randomized controlled trials, consisting of 306 participants with SAD who completed anticipatory processing and post-event processing measures in relation to a speech task, were subjected to confirmatory factor analysis. A bifactor model with a General Repetitive Thinking factor and two group factors corresponding to anticipatory processing and post-event processing best fit with the data. Further analyses indicated an optimal model would include only the General Repetitive Thinking factor (reflecting anticipatory processing and a specific aspect of post-event processing) and Post-event Processing group factor (reflecting another specific aspect of post-event processing that is separable), providing evidence against a unidimensional account of repetitive thinking in SAD. Analyses also indicated that the General Repetitive Thinking factor had moderately large associations with social anxiety and life interference (rs = .43 to .47), suggesting its maladaptive nature. The separable Post-event Processing group factor only had small associations with social anxiety (rs = .16 to .27) and was not related to life interference (r = .11), suggesting it may not, in itself, be a maladaptive process. Future research that further characterises the bifactor model components and tests their utility has the potential to improve the conceptualisation and assessment of repetitive thinking in SAD.

Objectives: To determine the feasibility, acceptability and initial efficacy of telephone-delivered cognitive behavioral therapy (CBT) for the treatment of anxiety and depressive symptoms in people...

Background Cultural factors influence both the expression of social anxiety and the interpretation and functioning of social anxiety measures. This study aimed to test the measurement equivalence of two commonly used social anxiety measures across two sociocultural contexts using individuals with social anxiety disorder (SAD) from Australia and Japan. Methods Scores on the straightforwardly-worded Social Interaction Anxiety Scale (S-SIAS) and the Social Phobia Scale (SPS) from two archival datasets of individual with SAD, one from Australia (n = 201) and one from Japan (n = 295), were analysed for measurement equivalence using a multigroup confirmatory factor analysis (CFA) framework. Results The best-fitting factor models for the S-SIAS and SPS were not found to be measurement equivalent across the Australian and Japanese samples. Instead, only a subset of items was invariant. When this subset of invariant items was used to compare social anxiety symptoms across the Australian and Japanese samples, Japanese participants reported lower levels of fear of attracting attention, and similar levels of fear of overt evaluation, and social interaction anxiety, relative to Australian participants. Limitations We only analysed the measurement equivalence of two social anxiety measures using a specific operationalisation of culture. Future studies will need to examine the measurement equivalence of other measures of social anxiety across other operationalisations of culture. Conclusions When comparing social anxiety symptoms across Australian and Japanese cultures, only scores from measurement equivalent items of social anxiety measures should be used. Our study highlights the importance of culturally-informed assessment in SAD.

Item does not contain fulltext Background and objectives: Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. Methods: In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. Results: Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. Limitations: Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. Conclusions: The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT. 7 p.

Contains fulltext : 196717.pdf (Publisher’s version ) (Open Access) We investigated the role of self-reports and behavioral measures of interpretation biases and their content-specificity in children with varying levels of spider fear and/or social anxiety. In total, 141 selected children from a community sample completed an interpretation bias task with scenarios that were related to either spider threat or social threat. Specific interpretation biases were found; only spider-related interpretation bias and self-reported spider fear predicted unique variance in avoidance behavior on the Behavior Avoidance Task for spiders. Likewise, only social-threat related interpretation bias and self-reported social anxiety predicted anxiety during the Social Speech Task. These findings support the hypothesis that fearful children display cognitive biases that are specific to particular fear-relevant stimuli. Clinically, this insight might be used to improve treatments for anxious children by targeting content-specific interpretation biases related to individual disorders. 9 p.

The restrictions put in place to contain the COVID-19 virus have led to widespread social isolation, impacting mental health worldwide. These restrictions may be particularly difficult for adolescents, who rely heavily on their peer connections for emotional support. However, there has been no longitudinal research examining the psychological impact of the COVID-19 pandemic among adolescents. This study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. Two hundred and forty eight adolescents (Mage = 14.4; 51% girls; 81.8% Caucasian) were surveyed over two time points; in the 12 months leading up to the COVID-19 outbreak (T1), and again two months following the implementation of government restrictions and online learning (T2). Online surveys assessed depressive symptoms, anxiety, and life satisfaction at T1 and T2, and participants’ schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 only. In line with predictions, adolescents experienced significant increases in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, which was particularly pronounced among girls. Moderation analyses revealed that COVID-19 related worries, online learning difficulties, and increased conflict with parents predicted increases in mental health problems from T1 to T2, whereas adherence to stay-at-home orders and feeling socially connected during the COVID-19 lockdown protected against poor mental health. This study provides initial longitudinal evidence for the decline of adolescent’s mental health during the COVID-19 pandemic. The results suggest that adolescents are more concerned about the government restrictions designed to contain the spread of the virus, than the virus itself, and that those concerns are associated with increased anxiety and depressive symptoms, and decreased life satisfaction.

Questionnaire measures offer a time and cost-effective alternative to full diagnostic assessments for identifying and differentiating between potential anxiety disorders and are commonly used in clinical practice. Little is known, however, about the capacity of questionnaire measures to detect specific anxiety disorders in clinically anxious preadolescent children. This study aimed to establish the ability of the Spence Children's Anxiety Scale (SCAS) subscales to identify children with specific anxiety disorders in a large clinic-referred sample (N = 1,438) of children aged 7 to 12 years. We examined the capacity of the Separation Anxiety, Social Phobia, Generalized Anxiety, and Physical Injury Fears (phobias) subscales to discriminate between children with and without the target disorder. We also identified optimal cutoff scores on subscales for accurate identification of children with the corresponding disorder, and examined the contribution of child, mother, and father reports. The Separation Anxiety subscale was able to accurately identify children with separation anxiety disorder, and this was replicated across all 3 reporters. Mother- and father-reported Social Phobia subscales also accurately identified children with social anxiety disorder, although child report was only able to accurately detect social anxiety disorder in girls. Using 2 or more reporters improved the sensitivity of the Separation Anxiety and Social Phobia subscales but reduced specificity. The Generalized Anxiety and Physical Injury Fears subscales failed to accurately identify children with the corresponding disorders. These findings have implications for the potential use of mother-, father-, and child-report SCAS subscales to detect specific disorders in preadolescent children in clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Much of the literature investigating the association between coping and psychopathology is cross-sectional, or associations have been investigated in a unidirectional manner; hence, bidirectionality between coping and psychopathology remains largely untested. To address this gap, this study investigated bidirectional relations between coping and psychopathology during pre-adolescence. Participants (N = 532, 51% male) and their primary caregiver both completed questionnaires assessing pre-adolescents’ coping (i.e., avoidant, problem solving, social support seeking) and symptoms of psychopathology (i.e., generalized anxiety, social anxiety, depression, eating pathology) in Wave 1 (Mage = 11.18 years, SD = 0.56, range = 10–12) and Wave 2 (Mage = 12.18 years, SD = 0.53, range = 11–13, 52% male), one year later. Cross-lagged panel models showed child-reported avoidant coping predicted increases in symptoms of generalized and social anxiety, and eating pathology. In separate child and parent models, symptoms of depression predicted increases in avoidant coping. Greater parent-reported child depressive symptoms also predicted decreases in problem solving coping. Taken together, results suggest unique longitudinal associations between coping and psychopathology in pre-adolescence, with avoidant coping preceding increases in symptoms of anxiety and eating pathology, and depressive symptoms predicting later increases in maladaptive coping.

Background The aim was to determine outcomes in the first year of school of a population-delivered parenting program to prevent internalising problems in temperamentally inhibited preschool children and predictors of engagement in parenting groups. Method Design: Randomised controlled trial. Setting 307 preschool services across eight socio-economically diverse government areas in Melbourne, Australia. Participants 545 parents of inhibited 4-year-old children; 469 (86%) retained at two-year follow-up. Intervention Cool Little Kids program. Primary outcomes were child internalising symptoms and anxiety disorders. Secondary outcomes were parenting, parent well-being and engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. Results In the first year of school (M (SD) age 6.7 (0.4) years), child anxiety symptoms were reduced in the intervention versus control arm (PAS-R M (SD): total 36.2 (17.2) versus 39.4 (18.5); adjusted difference -3.26, 95% CI -6.46 to -0.05, p = .047; specific fears 9.1 (6.2) versus 10.7 (6.8), adjusted difference -1.53; 95% CI -2.69 to -0.38, p = .009). However, there was little difference in broader child internalising (CMFWQ M (SD): 2.2 (0.5) versus 2.3 (0.6); adjusted difference -0.03, 95% CI -0.13 to 0.06, p = .489) or anxiety disorders (37.6% vs. 42.6%; adjusted OR 0.79, 95% CI 0.53 to 1.18, p = .242). Lower income, younger mothers, less educated and more culturally diverse fathers engaged less with the intervention. Continued skills practice was less frequent for parents of girls and in advantaged neighbourhoods. Conclusions There were population effects of Cool Little Kids in the first year of school for anxiety symptoms but not disorders. Considering motivation techniques to engage subgroups of families would be helpful in translation research.

Background Despite considerable evidence on parenting risk and protective factors for child anxiety and depressive disorders, the development of interventions based on this evidence is still lagging behind. To address this gap, the web-based Parenting Resilient Kids (PaRK) program was developed to target these risk and protective factors. This study evaluated the effects of the program at 12-month follow-up. Methods A randomized controlled trial was conducted with a community sample of 355 parents and 342 children (Mchild age = 9.79). Parents randomized into the web-based PaRK intervention condition received a personalized feedback report about their parenting and were recommended a tailored course of up to 12 interactive modules. Parents in the control condition received a standard set of web-based educational factsheets. Results Parents in the intervention group demonstrated significantly greater improvement in self-reported parenting compared to control group parents from baseline to 12-month follow-up, d = 0.24, 95% CI [0.03, 0.45]. Both groups showed reductions in child anxiety and depressive symptoms, parental psychological control and unhealthy family functioning; and improvements in parental acceptance, child- and parent- health-related quality of life. Limitations The PaRK intervention was tailored based on the parents’ own report of their parenting behaviors. There was an over-representation of highly-educated mothers and only one parent-child dyad was included per family. Conclusions PaRK improved parenting for up to 12 months, but had no superior effect on children's mental health outcomes compared with an educational-factsheet intervention. Further follow-up is needed to assess longer-term effects.

This study developed an online diagnostic tool for anxiety disorders in youth, and evaluated its reliability and validity amongst 297 children aged 6-16 years (M

Methods to deliver empirically validated treatments for anxious youth that require fewer therapist resources (low intensity) are beginning to emerge. However, the relative efficacy of low-intensity treatment for youth anxiety against standard face-to-face delivery has not been comprehensively evaluated. Young people aged 6-16 years with a primary anxiety disorder (N = 281) were randomly allocated to treatment delivered either face-to-face or in a low-intensity format. Face-to-face treatment comprised ten, 60-min sessions delivered by a qualified therapist. Low intensity comprised information delivered in either printed (to parents of children under 13) or electronic (to adolescents aged 13 +) format and was supported by up to four telephone sessions with a minimally qualified therapist. Youth receiving face-to-face treatment were significantly more likely to remit from all anxiety disorders (66%) than youth receiving low intensity (49%). This difference was reflected in parents' (but not child) reports of child's anxiety symptoms and life interference. No significant moderators were identified. Low intensity delivery utilised significantly less total therapist time (175 min) than face-to-face delivery (897 min) and this was reflected in a large mean difference in therapy costs ($A735). Standard, face-to-face treatment for anxious youth is associated with significantly better outcomes than delivery of similar content using low-intensity methods. However, the size of this difference was relatively small. In contrast, low-intensity delivery requires markedly less time from therapists and subsequently lower treatment cost. Data provide valuable information for youth anxiety services.Clinical trial registration information: A randomised controlled trial of standard care versus stepped care for children and adolescents with anxiety disorders; https://anzctr.org.au/ ; ACTRN12612000351819.

Recent research has started to examine the applicability of influential adult models of the maintenance of social anxiety disorder (SAD) to youth. This research is limited by the lack of psychometrically validated measures of underlying constructs that are developmentally appropriate for youth. One key construct in adult models of SAD is maladaptive social-evaluative beliefs. The current study aimed to develop and validate a measure of these beliefs in youth, known as the Report of Youth Social Cognitions (RYSC). The RYSC was developed with a clinical sample of youth with anxiety disorders (N = 180) and cross-validated in a community sample of youth (N = 305). In the clinical sample, the RYSC exhibited a 3-factor structure (negative evaluation, revealing self, and positive impression factors), good internal consistency, and construct validity. In the community sample, the 3-factor structure and the internal consistency of the RYSC were replicated, but the test of construct validity showed that the RYSC had similarly strong associations with social anxiety and depressed affect. The RYSC had good test-retest reliability overall, although the revealing self subscale showed lower temporal stability which improved when only older participants were considered (age ≥9 years). The RYSC in general was also shown to discriminate between youth with and without SAD although the revealing self subscale again performed suboptimally but improved when only older participants were considered. These findings provide psychometric support for the RYSC and justifies its use with youth in research and clinical settings requiring the assessment of maladaptive social-evaluative beliefs. (PsycINFO Database Record

The aim of this study was to explore how some temperamentally inhibited young children and not others in the general population develop anxiety disorders and broader clinical-level internalizing (anxious/depressive) problems, with a focus on the family. A brief screening tool for inhibition was universally distributed to parents of children in their year before starting school across eight socioeconomically diverse government areas in Melbourne, Australia (307 preschool services). Screening identified 11% of all children as inhibited. We invited all parents of inhibited children to participate in a longitudinal prevention study. Participants were 545 parents of inhibited pre-schoolers (78% uptake) of whom 498 (91%) completed assessment one year later and 469 (86%) two years later. Parents completed questionnaires to assess parenting practices, parent wellbeing, and child internalizing problems. Parents also engaged in structured diagnostic interviews to assess child anxiety disorders. During the follow up period close to half of the inhibited young children had anxiety disorders and one in seven had clinical-level internalizing problems, with girls perhaps at higher risk. The family variables significantly predicted inhibited children's anxiety disorders and broader internalizing problems. For child anxiety disorders, overinvolved/protective parenting was particularly important for girls and boys, and poorer parent wellbeing contributed. For child anxious/depressive problems, harsh discipline was a consistent predictor for girls and boys, and poorer parent wellbeing again contributed. These etiological findings support early intervention for temperamentally inhibited young children that focuses on the family environment to prevent the development of mental health problems.

Background Autism spectrum disorder (ASD) is found in approximately 1% of the population and includes core symptoms that affect general and social development. Beside these core symptoms, it is suggested that up to 60% of children with ASD suffer from comorbid anxiety disorders which may further affect educational, social and general development as well as quality of life. The main goal of this study is to examine the effectiveness of a manualized cognitive behavioral therapy (CBT) anxiety program adapted for children with ASD. Methods This study is a randomized controlled trial (RCT). Fifty children with ASD and anxiety, aged 7 to 13 years, will be randomly assigned to group CBT or a wait-list control (WL) condition. The design will follow a two (CBT and WL) by two (pre–post assessment) mixed between–within design. The control group will receive intervention after the waitlist period of 13 weeks. Primary outcomes are diagnostic status and severity of the anxiety disorders, measured with The Anxiety Disorder Interview Schedule for DSM-IV, Parent and Child Versions. Secondary outcomes are parent and child ratings on questionnaires on the child’s level of anxiety and impact on everyday life. Additional outcomes entail information gathered from parents, child and teachers on the child’s behavior and negative self-statements, together with social and adaptive skills. Follow-up data will be collected 3 months after intervention. Discussion This study aims to evaluate the effectiveness of a manualized CBT program in Danish children with ASD and anxiety within a mental health clinic setting. The hypothesis is that training anxiety reduction skills will decrease anxiety in children, as well as ensure better psychosocial development for the child in general. Trial registration https://ClinicalTrials.gov (NCT02908321). Registered 19th of September 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2591-x) contains supplementary material, which is available to authorized users.

Previous research has identified factors related to outcome in child anxiety treatment and parent training programs for child behavior problems. However, it is unclear what factors predict outcomes in interventions delivered online to parents of young children at risk of anxiety. This study investigated predictors of child anxiety outcomes among 433 families with young children (3-6 years) who participated in a randomized controlled trial of Cool Little Kids Online, an eight-module early intervention program for child anxiety based on cognitive-behavioral therapy (CBT). Potential predictors included baseline demographic factors, child and parent mental health factors, and indicators of program use, including number of online modules completed and frequency of homework practice. Results showed that only access to a printer moderated intervention effectiveness. Printer access predicted lower child anxiety in the Cool Little Kids Online group, but had no effect on outcomes in the wait-list group. In both groups, higher levels of child anxiety symptoms, child-inhibited temperament, and poorer parent mental health at baseline predicted higher levels of child anxiety symptoms at 6-month follow-up. The amount of online program use was not related to improvements in child anxiety symptoms. However, parents who reported practicing the program skills more frequently showed greater reductions in child anxiety, and access to a printer was related to frequency of program skills practice. These findings provide empirical support for the important role of skills practice in online CBT interventions, and suggest that practicing program skills may be more important than completing the online modules.

Research suggests that mothers may influence the development of body image concerns and eating disturbances in their daughters by modeling negative body image beliefs and unhealthy eating behaviors. However, the causal nature of that mode of influence is yet to be established. This study implemented an experimental design to examine the impact of mothers' modeling of negative comments about their own appearance and diet on their daughters' body image concerns and eating behaviors. Participants were 8–12 year old girls and their mothers (N = 50). While viewing thin-ideal magazine advertisements with their daughter, mothers were instructed to make either negative comments about their own weight, shape, and diet or to make no appearance or diet related comments. Daughters' levels of body esteem, body satisfaction, and eating attitudes were assessed pre- and post-manipulation, and their actual eating habits were measured post-manipulation. Girls whose mothers had made self-critical comments about their own appearance and diet reported lower body esteem, lower body satisfaction, more problematic eating attitudes, and ate significantly fewer sweets than girls whose mothers had not made self-critical comments. These results have implications for disordered eating prevention programs, suggesting that greater emphasis be placed on discouraging negative modeling behaviors among mothers.

Despite growing recognition of childhood anxiety as a common and often debilitating clinical concern, we have limited knowledge of the particular ways in which anxiety interferes with daily life for young children who have not yet entered formal schooling. The present study evaluated the psychometric properties of the Child Anxiety Life Interference Scale - Preschool Version (CALIS-PV). The CALIS-PV is a brief (18 item) parent-report measure of the impacts of a young child's anxiety on their own life and that of her or his parent. Participants were 784 parents of a child aged 3-7 years, who completed the CALIS-PV as a part of the follow-up assessment battery for two anxiety prevention trials targeted at preschool children with temperamental inhibition. Confirmatory factor analysis supported three CALIS-PV factors reflecting anxiety-related life interference at home, outside home and on parent life. The three factors showed good internal consistency and good convergent and divergent validity, and successfully differentiated children with and without an anxiety diagnosis. Findings provide initial support for the CALIS-PV as a reliable and valid measure of the daily life impacts of childhood anxiety for preschool-aged children and their parents.

Objective Stepped care is embraced as an ideal model of service delivery but is minimally evaluated. The aim of this study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) for child anxiety delivered via a stepped-care framework compared against a single, empirically validated program. Method A total of 281 youth with anxiety disorders (6−17 years of age) were randomly allocated to receive either empirically validated treatment or stepped care involving the following: (1) low intensity; (2) standard CBT; and (3) individually tailored treatment. Therapist qualifications increased at each step. Results Interventions did not differ significantly on any outcome measures. Total therapist time per child was significantly shorter to deliver stepped care (774 minutes) compared with best practice (897 minutes). Within stepped care, the first 2 steps returned the strongest treatment gains. Conclusion Stepped care and a single empirically validated program for youth with anxiety produced similar efficacy, but stepped care required slightly less therapist time. Restricting stepped care to only steps 1 and 2 would have led to considerable time saving with modest loss in efficacy. Clinical trial registration information —A Randomised Controlled Trial of Standard Care Versus Stepped Care for Children and Adolescents With Anxiety Disorders; http://anzctr.org.au/ ; ACTRN12612000351819.

Exposure to stressors is associated with an increased risk for child anxiety. Investigating the family origins of stressors may provide promising avenues for identifying and intervening with children at risk for the onset of anxiety disorders and their families. The aim of this study was to compare the frequency of parent-dependent negative life events and chronic adversities experienced by children with an anxiety disorder (n = 34) in the 12 months prior to the onset of the child’s most recent episode, compared to healthy controls (n = 34). Life events and chronic adversities were assessed using maternal report during an investigator-based interview, which provided independent panel ratings of the extent that reported experiences were related to parent behaviour. There were no group differences in the number of parent-dependent negative life events for anxious children compared to controls. However, significantly more parent-dependent chronic adversities were present for anxious children compared to controls. Findings suggest that parents contribute to an increased frequency of chronic adversities but not negative life events prior to their child’s most recent onset of anxiety. Furthermore, increased child exposure to parent-dependent chronic adversities was related to parental history of mental disorder.

Existing research suggests that temperamental traits that emerge early in childhood may have utility for early detection and intervention for common mental disorders. The present study examined the unique relationships between the temperament characteristics of reactivity, approach-sociability, and persistence in early childhood and subsequent symptom trajectories of psychopathology (depression, anxiety, conduct disorder, and attention-deficit hyperactivity disorder; ADHD) from childhood to early adolescence. Data were from the first five waves of the older cohort from the Longitudinal Study of Australian Children (n = 4983; 51.2% male), which spanned ages 4-5 to 12-13. Multivariate ordinal and logistic regressions examined whether parent-reported child temperament characteristics at age 4-5 predicted the study child's subsequent symptom trajectories for each domain of psychopathology (derived using latent class growth analyses), after controlling for other presenting symptoms. Temperament characteristics differentially predicted the symptom trajectories for depression, anxiety, conduct disorder, and ADHD: Higher levels of reactivity uniquely predicted higher symptom trajectories for all 4 domains; higher levels of approach-sociability predicted higher trajectories of conduct disorder and ADHD, but lower trajectories of anxiety; and higher levels of persistence were related to lower trajectories of conduct disorder and ADHD. These findings suggest that temperament is an early identifiable risk factor for the development of psychopathology, and that identification and timely interventions for children with highly reactive temperaments in particular could prevent later mental health problems.

Social isolation may be a unique risk factor for depression and anxiety in early adolescence. However, optimal sleep may protect adolescents from the emotional sequela of social isolation. The present study aimed to investigate whether sleep moderates the relationship between social isolation and symptoms of anxiety and depression in early adolescence. Five hundred and twenty eight early adolescents (M = 11.18 years, SD = 0.56, range 10-12 years, 51% male) completed online questionnaires assessing social isolation, sleep duration, daytime sleepiness and symptoms of generalised anxiety, social anxiety, separation anxiety and depression. Sleep duration moderated the effect of social isolation on symptoms of generalised anxiety, social anxiety and depression, but not separation anxiety. Daytime sleepiness emerged as an additional sleep-related risk factor in the relationship between social isolation and depressive symptoms. Therefore, sleep may be an important modifiable risk or protective factor to target, in the prevention of depression and anxiety in adolescence.

Experiences of peer victimization are common in adolescence and have been associated with a broad variety of psychopathology in adolescence. The present study aimed to test whether some types of victimization are more harmful than others; whether the harms associated with different types of peer victimization are specific to particular domains of psychopathology; and whether these relationships vary by gender. Participants included adolescents aged 14–15 from a nationally representative cohort study (n= 3335; mean age 14.4 years; 49.1% female; 90.1% spoke English as the main language at home). Participants provided self-report information on their experiences of peer victimization, as well as symptoms of depression, anxiety, conduct problems, hyperactivity and inattention, and substance use. These data were analyzed in a dimensional and hierarchical framework using latent variable indirect effects modeling. The associations between peer victimization and psychopathology were not unique to specific symptom domains, but rather showed broadband associations with all symptom domains via a transdiagnostic association with general psychopathology. For example, an average of only 9% of the total relationship with each symptom domain was unique to the symptom-domain level, with the remaining proportion accounted for by higher-order factors (i.e., internalizing, externalizing, and general psychopathology). Further, the strength of the relationships did not vary as a function of the type of peer victimization experience (i.e., physical, verbal, or relational), and showed evidence of strict measurement invariance by gender. These findings suggest that peer victimization might present a useful target for the prevention of general psychopathology.

Objective A translational trial evaluated the effectiveness of screening for inhibited childhood temperament, followed by a preventive parenting program -Cool Little Kids. This study determined the cost-effectiveness from societal and health sector perspectives using trial data. Method Resources to deliver the screening and parenting sessions were determined from study records. Parents completed a questionnaire reporting resources used at one-year follow-up. Standard Australian unit costs were applied. Clinical outcomes for children and parental quality adjusted life-years (QALYs) were used to calculate incremental cost-effectiveness ratios (ICERs). Results Total societal costs were lower, but non-significant for the intervention compared to the control group (mean difference -$500 p = 0.937). Total health sector costs were significantly greater (mean difference $1,956; p = 0.015). The intervention led to significantly fewer internalising symptoms (Strengths and Difficulties Questionnaire (SDQ)-emotional difficulties adjusted mean difference −0.5; p = 0.006), fewer children with SDQ-emotional symptoms in the abnormal range (24.2 % vs. 33.0 % p = .014) and fewer with diagnosed anxiety (44.2 % vs. 50.2 % p = 0.427). From the societal perspective, the intervention would likely be cost-effective. Health sector ICERs were $1,171/SDQ-emotional symptom decrease, $51/abnormal SDQ avoided and $77/anxiety case avoided. Conclusions This economic analysis alongside an implementation study provides an early indication that Cool Little Kids may be cost-effective.

Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program-an individually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets).This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT.Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program.Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51; 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=-0.21; 95% CI -0.42 to -0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=-0.08; 95% CI -0.16 to -0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms.PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents.Australian Clinical Trials Registration Number (ACTRN): 12615000328572; http://www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj).

Repetitive negative thinking (RNT) is a key risk and maintenance factor for many psychological disorders and is considered a transdiagnostic process. However, there are few disorder-neutral measures that assess RNT in adults, only 1 of moderate length considered suitable for children, and none that are validated for both children and adults. This study aimed to address this gap by developing a brief measure of RNT that can be used with both children and adults and can be quickly administered in research and clinical contexts. In Study 1, we administered the new 5-item Persistent and Intrusive Negative Thoughts Scale (PINTS) to 527 children (50.3% boys; Mage = 11.2). A 1-factor model fit well and was invariant for boys and girls. The scale showed high internal consistency and good stability across a 2-week interval. The PINTS was significantly associated with measures of depression, anxiety, and disordered eating and was weakly associated with adaptive forms of coping, demonstrating good divergent validity. In Study 2, there were 419 adults (38.9% men; Mage = 31.7) who completed the PINTS. The results replicated and extended the results of Study 1 by demonstrating that the PINTS had good construct, convergent, and criterion validity as well as good internal consistency and stability over time and was invariant across gender and age. It was concluded that the PINTS is a brief, valid, and useful tool for investigating RNT as a transdiagnostic process in the etiology and maintenance of psychological disorders in both children and adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background We examined whether providing three sessions of treatment based on motivational interviewing (MI) prior to Cognitive Behavioral Therapy (CBT) for Social Anxiety Disorder (SAD) improved outcomes. Methods Participants diagnosed with SAD (N = 186) were randomly allocated to receive three sessions of MI (MI+CBT; n = 85) or supportive counselling (SC+CBT; n = 101) prior to a 12-week group CBT program. Assessments occurred at baseline, after preparatory treatment, after CBT, and at 6-months follow-up. Outcomes were expectations for change, number of CBT sessions attended, self- and clinician-rated CBT homework completion, and self- and clinician-rated social anxiety severity. Results Conditions did not differ significantly on expectations for change, number of CBT sessions attended, or clinician-rated homework completion. Self-rated homework completion was greater in MI+CBT than in SC+CBT. Change over time in social anxiety severity did not differ between conditions overall, however, this outcome was significantly moderated by two variables; those in MI+CBT, as compared to SC+CBT, showed significantly poorer outcomes on self-reported social anxiety severity if they were higher in change readiness and significantly better outcomes on clinician-rated social anxiety severity if they were higher in functional impairment. Limitations Although therapists in MI sessions were rated as behaving more consistently with MI than therapists in SC sessions, some MI consistent behaviors occurred in the SC sessions. Conclusions Addition of a MI-based discussion prior to evidence-based CBT appears to benefit people with SAD who have high functional impairment but may interfere with outcomes for those higher in readiness for change.

Background: Stepped care has been promoted for the management of mental disorders; however, there is no empirical evidence to support the cost-effectiveness of this approach for the treatment of anxiety disorders in youth. Method: This economic evaluation was conducted within a randomised controlled trial comparing stepped care to a validated, manualised treatment in 281 young people, aged 7–17, with a diagnosed anxiety disorder. Intervention costs were determined from therapist records. Administrative data on medication and medical service use were used to determine additional health care costs during the study period. Parents also completed a resource use questionnaire to collect medications, services not captured in administrative data and parental lost productivity. Outcomes included participant-completed quality of life, Child Health Utility – nine-dimension and parent-completed Assessment of Quality of Life – eight-dimension to calculate quality-adjusted life years. Mean costs and quality-adjusted life years were compared between groups at 12-month follow-up. Results: Intervention delivery costs were significantly less for stepped care from the societal perspective (mean difference −$198, 95% confidence interval −$353 to −$19). Total combined costs were less for stepped care from both societal (−$1334, 95% confidence interval −$2386 to $510) and health sector (−$563, 95% confidence interval −$1353 to $643) perspectives but did not differ significantly from the manualised treatment. Youth and parental quality-adjusted life years were not significantly different between groups. Sensitivity analysis indicated that the results were robust. Conclusion: For youth with anxiety, this three-step model provided comparable outcomes and total health sector costs to a validated face-to-face programme. However, it was less costly to deliver from a societal perspective, making it an attractive option for some parents. Future economic evaluations comparing various models of stepped care to treatment as usual are recommended.

Item does not contain fulltext Cognitive theories of anxiety suggest that anxious children interpret negatively only those materials specifically related to the content of their anxiety. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes across different anxiety disorders in children, and most of them focused on social anxiety. Therefore, we examined interpretation bias and its content-specificity in a group of clinically anxious children between the ages of 6-12 years with various anxiety disorders, using an "ambiguous scenarios" task. Children were asked to finish scenarios that were related to either social threat, general threat, or separation threat. In total, 105 clinically anxious children, 21 control children and their mothers were assessed with the ADIS-C/P and the Spence Children's Anxiety Scale. As expected, clinically anxious children provided significantly more negative endings to the scenarios than control children. Within the clinically anxious group, specific interpretation biases were found: Interpretation of scenarios related to social threat, general threat, and separation threat were only predicted by the children's self-reported levels of social anxiety, generalized anxiety, and separation anxiety, respectively. These findings support the content-specificity hypothesis that clinically anxious children display interpretation biases that are specific to fear-relevant stimuli. 7 p.

Purpose: Autism spectrum disorder (ASD) includes core symptoms that affect general and social development. High risk of developing comorbid disorders such as anxiety is prominent. Up to 60% of children with ASD suffer from anxiety disorders which can negatively influence educational, social and general development together with quality of life. This study is the first to investigate the feasibility of the manualised cognitive behavioural therapy (CBT) group programme 'Cool Kids ASD' for anxiety adapted for children with ASD in a general hospital setting. Methods: Nine children, aged 9–13 years, with ASD and anxiety recruited from a public child psychiatric health clinic were enrolled in the study. Outcome measures were collected from both child and parent pre- and post-treatment and at 3-month follow-up and included scores from a semi-structured anxiety interview, together with questionnaires on anxiety symptoms, life interference, children's automatic thoughts and satisfaction with the programme. Results: Eight out of nine families found the programme useful and would recommend it to other families in a similar situation. Six families attended all 12 sessions in the programme, two missed one session and one family only managed to attend eight sessions. At follow-up, five children were free of all anxiety diagnoses and a further two out of the nine children no longer met the criteria for their primary anxiety diagnosis. Conclusions: This study suggests that the transition of the group programme 'Cool Kids ASD' from University Clinics to standard child psychiatric clinical settings is feasible. Further randomised studies are needed to confirm the efficacy of the programme in a larger sample.

Epidemiological studies indicate that as many as 1 in 5 young people will develop a mental health problem in any given year. Early detection and intervention are needed to reduce the impact that these conditions have-both for the young person and for the communities in which they live. This study reports the development of a new instrument aimed at helping identify students at risk of developing mental health difficulties. Rather than asking about the presence of symptoms of mental health conditions, the RADAR screening tool assesses a student's balance of risk and protective factors associated with the development of mental health problems. The RADAR was evaluated with a sample of 838 participants in high school Years 7-12. A robust internal factor structure was revealed using exploratory and confirmatory factor analysis. Internal consistency was satisfactory for each subscale, ranging from .73 to .90 while the reliability for the total scale was .91. Retest stability, measured over a 12 month period, was found to be strong (r = .72). Convergent validity was demonstrated with reference to standard measures of depression and behavioral problems. It is concluded that the RADAR is a promising measure for helping mental health professionals and educators decide which students may be at risk of developing mental health problems. (PsycINFO Database Record

The Mini-Social Phobia Inventory (Mini-SPIN) is a brief, three-item measure designed as a screening tool for social anxiety disorder (SAD). This study investigated the Mini-SPIN's psychometric properties in a series of trials of Internet-delivered treatment. Participants were 993 people seeking Internet-delivered cognitive behavioural therapy for a range of anxiety and mood disorders. Participants completed the Mini-SPIN, and were diagnosed using the Mini International Neuropsychiatric Interview Version 5.0.0 (MINI). They also completed measures of depression, general anxiety, panic, neuroticism and general impairment. The Mini-SPIN's ability to discriminate between people with and without SAD, within a large sample of people seeking treatment for a range of psychological disorders, was assessed at initial assessment and three-month follow-up. The Mini-SPIN's criterion group validity, internal consistency, test-retest reliability, construct validity and responsiveness to treatment were also examined. Results demonstrated that the Mini-SPIN has an excellent ability to discriminate between those with and without SAD in a highly comorbid clinical sample, and also has good criterion group validity. The Mini-SPIN also exhibited excellent internal consistency, good test-retest reliability, and was responsive to treatment. These results highlight the Mini-SPIN's potential as an efficient and reliable measure of SAD in heterogeneous populations.

BackgroundWe previously reported an association between 5HTTLPR genotype and outcome following cognitive–behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, with most reporting no association between genotype and CBT outcome.AimsTo replicate the association between 5HTTLPR and CBT outcome in child anxiety from the Genes for Treatment study (GxT Cohort 2, n = 829).MethodLogistic and linear mixed effects models were used to examine the relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both cohorts were performed.ResultsThere was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2. Mega-analyses identified a significant association between 5HTTLPR and remission from all anxiety disorders at follow-up (odds ratio 0.45, P = 0.014), but not primary anxiety disorder outcomes.ConclusionsThe association between 5HTTLPR genotype and CBT outcome did not replicate. Short-allele homozygotes showed more positive treatment outcomes, but with small, non-significant effects. Future studies would benefit from utilising whole genome approaches and large, homogenous samples.

BACKGROUND AND OBJECTIVES: Forgiveness has been found to be a useful intervention for past trauma across a variety of situations. However, this has yet to be experimentally tested in victims of bullying. The aim of the current study was to evaluate the impact of imagining forgiveness, avoidance, or revenge responses towards a perpetrator among young adult victims of bullying. METHODS: One hundred and thirty-five undergraduate psychology students aged 17-24 who reported a recent experience of being victimized were led through imagery rescripting where they recalled a personal episode of bullying and imagined a new ending to one where they forgave, avoided, or took revenge on the bully. RESULTS: Results indicated significant differences between Time 1 (imagining the event as it occurred), to Time 2 (imagining an alternate ending) for all three processes. Negative affect decreased significantly in the forgiveness and avoidance conditions, but not in the revenge condition. Positive evaluations of coping decreased significantly in the revenge condition, but not in the avoidance or forgiveness conditions. However, imagined forgiveness of the bully was more stressful than either imagined avoidance or revenge. LIMITATIONS: The short-term measurements and the researcher-directed re-scripting limit the interpretation of results, however, yield valuable information about the immediate impact of imaginal exposure and point to future research directions. CONCLUSIONS: The impact of focusing on immediate stress reduction in dealing with bullying is explored, and a combination of short-term avoidance and longer term forgiveness is highlighted as a potentially effective strategy to deal with the negative emotional consequences of victimization. Language: en

The integrated aetiological and maintenance (IAM) model of social anxiety disorder (SAD) conceptualises four social-evaluative cognitive processes (anticipatory processing, attention to the self, attention to threat in the environment, and post-event processing) as facets of a social-evaluative threat detection construct. The current study tested this by examining potential factor structures underlying the four social-evaluative cognitive processes. Baseline data from two randomised controlled trials, consisting of 306 participants with SAD who completed measures of the four social-evaluative cognitive processes in relation to a speech task, were subjected to confirmatory factor analysis. Model fit indices and bifactor model indices showed that the optimal factor structure was a bifactor model with a Social-evaluative Threat Detection General Factor and two group factors corresponding to anticipatory processing and post-event processing. Analyses also indicated that the Social-evaluative Threat Detection General Factor had moderate to large associations with other constructs in the IAM model, whereas the two group factors only had small associations with these constructs. These findings suggest that the four social-evaluative cognitive processes can be unified as facets of a social-evaluative threat detection process, consistent with the IAM model, although group factors for anticipatory processing and post-event processing need to be taken into account.

Objective We examined the effectiveness of targeted school-based cognitive-behavioral therapy (CBT) for adolescents (12−16 years of age) with anxiety, and tested whether brief CBT was noninferior to standard duration CBT. Method A randomized controlled study of 313 adolescents (mean 14.0 years, SD = 0.84, 84% girls) were recruited through school health services to 10 weeks CBT group interventions. Groups of 5 to 8 adolescents were randomly allocated to brief (5 sessions, comprising 5.5 hours) or standard CBT (10 sessions, comprising 15 hours), or 10 weeks waitlist (WL). Self-reported and parent-reported youth anxiety symptoms, impairment from anxiety, depressive symptoms,and clinical severity were assessed pre- and postintervention, after WL, and at 1-year follow-up. Results Targeted school based CBT significantly reduced adolescents’ anxiety symptoms with small to moderate effect sizes compared to WL (Cohen d = 0.34 for youth report and d = 0.53 for parent report). According to the parents, also adolescents’ impairment from anxiety was significantly reduced compared to WL (d = 0.51). Pre to post changes in anxiety symptoms were small to moderate (within-group effect sizes between d = 0.41 and d = 0.67). Although no significant differences in effects were found between brief and standard CBT, brief CBT was not noninferior to standard CBT. Outcomes from both interventions were sustained at 1-year follow-up. Conclusion Targeted school-based CBT interventions reduced anxiety, impairment, and depressive symptoms in adolescents. Both brief and standard CBT demonstrated efficacy, but brief CBT was not noninferior to standard CBT. By administering school-based CBT to youths with anxiety symptoms, we may reach young people with effective interventions at an earlier phase in their lives. Clinical trial registration information School Based Low-intensity Cognitive Behavioral Intervention for Anxious Youth (LIST); http://clinicalrials.gov/ ; NCT02279251 .

Viewing idealized images of attractive women on social media can negatively impact women’s body image and mood. Although women tend to post idealized images on social media, some also post natural no-makeup images. This study examined the impact of viewing both made up and no-makeup selfies on young women’s body image and mood. Female undergraduate students (N = 175) viewed either images of a woman wearing no makeup interspersed among idealized made up images of that woman (no-makeup condition), only idealized made up images of a woman (makeup only condition), or appearance-neutral travel images (control condition). Participants rated their state appearance satisfaction and mood pre- and post-exposure to the study images and rated their desire to change aspects of the face, hair, and skin post-exposure to the study images. Participants in the makeup only condition were less satisfied with their facial appearance and were more motivated to change aspects of their face, hair, and skin after exposure to the study images. Viewing the study images had no impact on the body image or mood of participants in the no-makeup condition. These results suggest that no-makeup selfies may reduce any negative impact of idealized made up images on women’s facial concerns.

Time spent on social media and making online comparisons with others may influence users’ mental health. This study examined links between parental control over the time their child spends on social media, preadolescents’ time spent browsing social media, preadolescents’ appearance comparisons on social media, and preadolescents’ appearance satisfaction, depressive symptoms, and life satisfaction. Preadolescent social media users (N = 284, 49.1% female; aged 10–12) and one of their parents completed online surveys. Preadolescents, whose parents reported greater control over their child’s time on social media, reported better mental health. This relationship was mediated by preadolescents spending less time browsing and making fewer appearance comparisons on social media. Parental control over time spent on social media may be associated with benefits for mental health among preadolescents.

Experiences of depression, anxiety, and peer victimization have each been found to predict one another, and to predict negative outcomes in the domains of school connectedness, social functioning, quality of life, and physical health. However, the common co-occurrence of depression, anxiety, and peer victimization experiences has made it difficult to disentangle their unique roles in these associations. The present study thus sought to characterize the precise nature of the bidirectional relationships between depressive symptoms, anxiety, and victimization over time, and to examine their unique sequelae during the transition from childhood to early adolescence. Longitudinal multi-informant (child-reported, parent-reported, and teacher-reported) data from a nationally representative sample were analyzed using path analysis when the study child was aged 10–11 (n= 4169; Mage = 10.3; 48.8% female) and aged 12–13 (n= 3956; Mage = 12.4; 48.2% female). Depressive symptoms, anxiety, and peer victimization had small but significant unique bidirectional relationships. All three constructs also uniquely and prospectively predicted poorer life functioning across all domains examined. These results demonstrate that current interventions should broaden their scope to simultaneously target depression, anxiety, and peer victimization, as each of these experiences independently act as additive risk factors for subsequent negative outcomes.