495 results on '"Ronald M. Rapee"'
Search Results
2. Minimising young children’s anxiety through schools (MY-CATS): protocol for a cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of an online parent-led intervention compared with usual school practice for young children identified as at risk for anxiety disorders
- Author
-
Tessa Reardon, Helen Dodd, Claire Hill, Bec Jasper, Peter J. Lawrence, Fran Morgan, Ronald M. Rapee, Obioha C. Ukoumunne, Mara Violato, Emily Davey, Gemma Halliday, Benjamin Jones, Lindsey Martineau, Amy McCall, Natascha Niekamp, Anna Placzek, Ruth Potts, Tamatha Weisser, and Cathy Creswell
- Subjects
Anxiety ,Children ,Prevention ,Early intervention ,Screening ,Schools ,Medicine (General) ,R5-920 - Abstract
Abstract Background Identifying and supporting young children who are at risk of developing anxiety disorders would benefit children, families, and wider society. Elevated anxiety symptoms, inhibited temperament, and high parental anxiety are established risk factors for later anxiety disorders, but it remains unclear who is most likely to benefit from prevention and early intervention programmes. Delivering an online intervention through schools to parents of young children who have one or more of these risks could maximise reach. The primary aim of this trial is to evaluate the effectiveness and cost-effectiveness of delivering an online parent-led intervention, compared with usual school provision only, for children (aged 4–7) identified as at risk for anxiety disorders on the basis of at least one risk factor. We also aim to identify the characteristics of children who do and do not benefit from intervention and mechanisms of change from the intervention. Methods The design will be a parallel group, superiority cluster randomised controlled trial, with schools (clusters) randomised to intervention or usual school practice arms in a 1:1 ratio stratified according to level of deprivation within the school. The study will recruit and randomise at least 60 primary/infant schools in England, and on the basis of recruiting 60 schools, we will recruit 1080 trial participants (540 per arm). Parents of all children (aged 4–7) in sampled Reception, Year 1, and Year 2 classes will be invited to complete screening questionnaires. Children who screen positive on the basis of anxiety symptoms, and/or behavioural inhibition, and/or parent anxiety symptoms will be eligible for the trial. Parents/carers of children in schools allocated to the intervention arm will be offered a brief online intervention; schools in both arms will continue to provide any usual support for children and parents throughout the trial. Assessments will be completed at screening, baseline (before randomisation), 6 weeks, 12 weeks, and 12 months post-randomisation. The primary outcome will be the absence/presence of an anxiety disorder diagnosis at 12 months. Discussion The trial will determine if delivering an online intervention for parents of young children at risk of anxiety disorders identified through screening in schools is effective and cost-effective. Trial registration ISRCTN 82398107 . Prospectively registered on Jan. 14, 2021.
- Published
- 2022
- Full Text
- View/download PDF
3. A Randomized Controlled Trial of a Cognitive Behavior Therapy Program for Children with Clinical Anxiety Symptoms
- Author
-
Olga Zikopoulou, Ronald M. Rapee, and Gregoris Simos
- Subjects
child ,parent ,anxiety ,CBT treatment ,Psychiatry ,RC435-571 - Abstract
High anxiety and anxiety disorders are among the most prevalent mental health problems in children and lead to significant interference with children’s daily functioning. Most empirical evaluations of treatment come from English-language countries. The aim of the present study was to evaluate and replicate the effectiveness of a cognitive-behavioral intervention program to manage anxiety in children among children from Greece. Forty-one children–parent(s) dyads participated in the study. Children were 9–12 years old, with clinically elevated symptoms of anxiety, and they were assigned to either the standard group treatment (cognitive behavior therapy (CBT)) or to a waitlist group (WL). Both children and their parents in the CBT group reported statistically significant reductions in children’s anxiety symptoms at post-intervention and at the 6-month follow-up. A significant reduction was also found in life interference due to anxiety according to both child and parent reports. In contrast, no significant changes in anxiety symptoms or life interference were reported among the WL. The current results support the effectiveness of a CBT program for anxious children from a non-clinic, non-school setting in Greece.
- Published
- 2021
- Full Text
- View/download PDF
4. A scoping review investigating the use of exposure for the treatment and targeted prevention of anxiety and related disorders in young people
- Author
-
Alessandra K. Teunisse, Lorna Pembroke, Maddison O’Gradey‐Lee, Megan Sy, Ronald M. Rapee, Viviana M. Wuthrich, Cathy Creswell, and Jennifer L. Hudson
- Subjects
anxiety ,behaviour ,internalising disorder ,intervention ,obsessive–compulsive disorder ,therapy ,Pediatrics ,RJ1-570 ,Psychiatry ,RC435-571 - Abstract
Abstract Background Cognitive Behavioural Therapy (CBT) is the gold standard intervention for anxiety and related mental health disorders among young people; however, the efficacy of individual elements of CBT (e.g., exposure to feared stimuli) have received little scrutiny. Aims This scoping review, informed by three stakeholder groups and a scientific advisory group, aimed to identify the nature and extent of the available research literature on the efficacy of exposure to feared stimuli, moderators of effectiveness in young people aged 14–24 years. Method Three international stakeholder groups composed of clinicians (N = 8), parents/carers (N = 5) and youth with lived experience of anxiety (N = 7) provided input into study design and results. Using the PRISMA extension for scoping reviews, a search of MEDLINE/Ovid, PsycINFO, PubMed, CINAHL, SCOPUS, EMBASE, ERIC, and Health Collection (informit) was conducted using terms related to anxiety, ages 14–24, and exposure. Results From 3508 unique abstracts, 64 papers were included for the review. While there was evidence for the efficacy of exposure as a treatment for youth anxiety disorders, fundamental gaps in knowledge of exposure in this age group were identified. Most studies examined post‐traumatic stress disorder, obsessive–compulsive disorder, and specific phobias with no randomised clinical trials uniquely evaluating exposure for the treatment of DSM‐5 anxiety disorders. Exposure was typically delivered accompanied by other anxiety management techniques. A multitude of optimisation strategies have been tested, yet only one of these effects (timing relative to sleep) showed preliminary evidence of replication. Conclusions A systematic and theoretically driven program of research investigating the efficacy of exposure in young people and factors that moderate its efficacy, along with methods to overcome barriers for delivery, is urgently needed.
- Published
- 2022
- Full Text
- View/download PDF
5. Improving mental health and social participation outcomes in older adults with depression and anxiety: Study protocol for a randomised controlled trial
- Author
-
Jessamine Tsan-Hsiang Chen, Viviana M. Wuthrich, Ronald M. Rapee, Brian Draper, Henry Brodaty, Henry Cutler, Lee-Fay Low, Andrew Georgiou, Carly Johnco, Michael Jones, Denise Meuldijk, and Andrew Partington
- Subjects
Medicine ,Science - Abstract
Background Increasing both the frequency and quality of social interactions within treatments for anxiety and depressive disorders in older adults may improve their mental health outcomes and quality of life. This study aims to evaluate the clinical efficacy and cost utility of an enhanced cognitive behavioural therapy (CBT) plus social participation program in a sample of older adults with depression and/or anxiety. Methods A total of 172 community-dwelling adults aged 65 years or older with an anxiety and/or depressive disorder will be randomly allocated to either an enhanced CBT plus social participation program (n = 86) or standard CBT (n = 86). Both treatments will be delivered during 12 weekly individual sessions utilising structured manuals and workbooks. Participants will be assessed at pre-treatment, post-treatment, and 12-month follow-up. The primary outcome evaluates mean change in clinician-rated diagnostic severity of anxiety and depressive disorders from baseline to post-treatment (primary endpoint) based on a semi-structured diagnostic interview. Secondary outcomes evaluate changes in symptomatology on self-report anxiety and depression measures, as well as changes in social/community participation, social network, and perceived social support, loneliness, quality of life, and use of health services. Economic benefits will be evaluated using a cost-utility analysis to derive the incremental cost utility ratios for the enhanced CBT program. Discussion Outcomes from this study will provide support for the establishment of improved psychosocial treatment for older adults with anxiety and/or depression. Study outcomes will also provide health systems with a clear means to reduce the impact of poor emotional health in older age and its associated economic burden. In addition to the empirical validation of a novel treatment, the current study will contribute to the current understanding of the role of social participation in older adult wellbeing. Trial registration Prospectively registered on the Australian New Zealand Clinical Trials Registry (ID: ACTRN12619000242123; registered 19th February 2019) and the ISRCTN registry (ID: ISRCTN78951376; registered 10th July 2019).
- Published
- 2022
6. Exploring the stress sensitization theory with temperamentally inhibited children: a population-based study
- Author
-
Amy Brown, Joanna Bennet, Ronald M. Rapee, Dina R. Hirshfeld-Becker, and Jordana K. Bayer
- Subjects
Child ,Internalizing problems ,Anxiety ,Depression ,Life-stressors ,Pediatrics ,RJ1-570 - Abstract
Abstract Background This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors. Methods A validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7–10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life. Results Only one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties. Conclusions Early life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.
- Published
- 2020
- Full Text
- View/download PDF
7. Does the treatment of anxiety in children with Attention-Deficit/Hyperactivity Disorder (ADHD) using cognitive behavioral therapy improve child and family outcomes? Protocol for a randomized controlled trial
- Author
-
Emma Sciberras, Daryl Efron, Pooja Patel, Melissa Mulraney, Katherine J. Lee, Cathy Mihalopoulos, Lidia Engel, Ronald M. Rapee, Vicki Anderson, Jan M. Nicholson, Rachel Schembri, and Harriet Hiscock
- Subjects
ADHD ,Anxiety ,Child ,Randomized controlled trial ,Efficacy ,Treatment ,Psychiatry ,RC435-571 - Abstract
Abstract 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 (https://doi.org/10.1186/ISRCTN59518816). The trial was first registered 29/9/15 and last updated 15/1/19.
- Published
- 2019
- Full Text
- View/download PDF
8. Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care
- Author
-
Bente S. M. Haugland, Mari Hysing, Valborg Baste, Gro Janne Wergeland, Ronald M. Rapee, Asle Hoffart, Åshild T. Haaland, and Jon Fauskanger Bjaastad
- Subjects
adolescents ,anxiety symptoms ,depressive symptoms ,primary health care ,insomnia ,sleep onset latency ,Psychology ,BF1-990 - Abstract
There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents (12–16 years; mean age 14.0, SD = 0.84, 84.0% girls) referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration (
- Published
- 2021
- Full Text
- View/download PDF
9. Evaluation of a transdiagnostic treatment for adolescents with comorbid anxiety and depression
- Author
-
Carolyn A. Schniering and Ronald M. Rapee
- Subjects
Anxiety ,Depression ,Comorbidity ,Adolescent ,Transdiagnostic ,Treatment ,Mental healing ,RZ400-408 - Abstract
Background: Evidence suggests that adolescents with comorbid anxiety and depression are a high-risk group in terms of symptom severity, life quality and prognosis, with unique treatment needs compared to their peers who meet criteria for a single diagnosis. The current study evaluated the efficacy of a transdiagnostic treatment designed specifically to target shared mechanisms underlying comorbid anxiety and depression in adolescents. Method: Eighty-two adolescents (12–17 years) with a concurrent diagnosis of an anxiety and a mood disorder were randomly allocated to either active treatment or wait-list. Effects on diagnoses, symptoms and life interference were assessed at post-treatment, 6- and 12-month follow-up based on reports from both the young person and parents. Results: Compared to waitlist, treatment was associated with a significantly greater reduction in total number of diagnoses and clinician rated severity of diagnoses over time. Life interference also showed significantly greater improvement in active treatment compared to wait-list, however other self and parent-reported indicators improved significantly but similarly over time in both groups. Effects were maintained at 6- and 12-month follow up. Conclusions: The transdiagnostic package targeting common underlying mechanisms demonstrated reductions in anxiety and depression in adolescents on key measures, including diagnostic criteria and life interference and shows promise as an efficacious treatment for comorbid anxiety and depression in adolescents. The outcomes point to a valuable initial program for clinical use, although further development will be needed to strengthen effects.
- Published
- 2020
- Full Text
- View/download PDF
10. Rationale and design for cognitive behavioral therapy for anxiety disorders in children with autism spectrum disorder: a study protocol of a randomized controlled trial
- Author
-
Tina R. Kilburn, Merete Juul Sørensen, Mikael Thastum, Ronald M. Rapee, Charlotte Ulrikka Rask, Kristian Bech Arendt, and Per Hove Thomsen
- Subjects
Autism spectrum disorder ,anxiety disorders ,children ,cognitive behavioral therapy ,Medicine (General) ,R5-920 - Abstract
Abstract 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.
- Published
- 2018
- Full Text
- View/download PDF
11. The Italian Version of the Preschool Anxiety Scale--Revised (PAS-R): Factor Structure and Psychometric Properties
- Author
-
Marcella Caputi, Erika Bazzoli, Barbara Forresi, Silvia Grazioli, Ronald M. Rapee, and Simona Scaini
- Abstract
This study assessed the psychometric properties of the Italian version of the Preschool Anxiety Scale--Revised (PAS-R), a parent-reported measure of their preschool child's anxiety symptoms. The participants were mothers of 279 Italian preschoolers (age 2-7 years, M = 4.5 years). According to information criteria derived from a confirmatory factor analysis, the four originally identified factors (generalized anxiety, social anxiety, separation anxiety, specific fears) provided the best fit to the data. Reliability was excellent for the total score and acceptable for the subscales. PAS-R total score showed moderate correlation with internalizing subscales of the Strengths and Difficulties Questionnaire (SDQ) and of the Child Behavior Checklist and weak correlation with the externalizing subscale of the SDQ, demonstrating convergent and concurrent validity, respectively. Test-retest reliability of the PAS-R was good after 1 month. The results suggest good psychometric properties of the Italian PAS-R, although its factor structure needs further investigation with different samples.
- Published
- 2024
- Full Text
- View/download PDF
12. The self-perception of flexible coping with stress: A new measure and relations with emotional adjustment
- Author
-
Melanie J. Zimmer-Gembeck, Ellen A. Skinner, Kathryn L. Modecki, Haley J. Webb, Alex A. Gardner, Tanya Hawes, and Ronald M. Rapee
- Subjects
stress ,coping ,internalizing symptoms ,general self-worth ,Psychology ,BF1-990 ,Neurophysiology and neuropsychology ,QP351-495 - Abstract
Objective: To develop a theoretically grounded measure of self-perceived ability to cope with stress in a flexible (i.e. non-rigid) manner and test associations with well-being. Method: Participants in Study 1 (N = 395, 17–56 years) completed surveys to report flexible coping with stress and well-being. In Studies 2 (N = 645, 17–27 years) and 3 (N = 558, 12–19 years), youth completed surveys with the 18-item Self-Perception of Flexible Coping with Stress (SFCS), and coping and well-being measures. Results: Three SFCS factors were supported, which aligned to the conceptualization including multiple coping strategy use (multiple CSU), coping rigidity, and situational coping. The SFCS subscales had good reliability and were modestly correlated with each other. Also, multiple CSU and situational coping were linked to better mental health, emotion regulation, greater use of adaptive coping strategies, and better self-worth. Coping rigidity was linked with more symptoms of anxiety and depression, more emotion dysregulation, greater use of problem-coping behaviors, and lower self-worth. Older participants reported they were higher in flexible coping and sex differences in multiple CSU and situational coping were found. Conclusions. The SFCS, a measure of the deployment of a coping “toolbox” that could allow individuals to respond adroitly to stressors, is reliable, valid, and associated with well-being.
- Published
- 2018
- Full Text
- View/download PDF
13. Prevention and early intervention of anxiety problems in young children: A pilot evaluation of Cool Little Kids Online
- Author
-
Amy J. Morgan, Ronald M. Rapee, and Jordana K. Bayer
- Subjects
Anxiety disorders ,Prevention ,Internet ,Parent training ,Inhibition ,Information technology ,T58.5-58.64 ,Psychology ,BF1-990 - Abstract
Anxiety disorders are common, debilitating, and begin early in life. Early intervention to prevent anxiety disorders in children who are at risk could have long-term impact. The ‘Cool Little Kids’ parenting group program has previously been shown to be efficacious in preventing anxiety disorders in temperamentally inhibited young children. Wider dissemination of the program could be achieved with an internet-based delivery platform, affording greater accessibility and convenience for parents. The aim of this study was to evaluate ‘Cool Little Kids Online’, a newly developed online version of the existing parenting group program. Fifty-one parents of children aged 3–6 years were recruited to evaluate the online program's acceptability and preliminary efficacy in reducing inhibited young children's anxiety problems. Parents were randomized to receive either a clinician-supported version or an unsupported version of the program. Parents had 10 weeks to access the program and completed questionnaires at baseline and post-intervention. Both groups showed medium-to-large reductions in children's anxiety symptoms, emotional symptoms, number of child anxiety diagnoses, and improvements in life interference from anxiety. The effect of clinician support was inconsistent and difficult to interpret. Parents reported high levels of satisfaction with the program. These encouraging results indicate that the online version is acceptable and useful for parents with temperamentally inhibited young children. Cool Little Kids Online may be a promising direction for improving access to an evidence-based prevention and early intervention program for child anxiety problems. A large randomized trial is warranted to further evaluate efficacy.
- Published
- 2016
- Full Text
- View/download PDF
14. Enhanced effects of combined cognitive bias modification and computerised cognitive behaviour therapy on social anxiety
- Author
-
Emma Butler, Sirous Mobini, Ronald M. Rapee, Bundy Mackintosh, and Shirley A. Reynolds
- Subjects
social anxiety ,cognitive bias modification ,computerised cognitive behaviour therapy ,Psychology ,BF1-990 ,Neurophysiology and neuropsychology ,QP351-495 - Abstract
This study examines whether combined cognitive bias modification for interpretative biases (CBM-I) and computerised cognitive behaviour therapy (C-CBT) can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT) or an active control (neutral CBM-I + C-CBT). At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 × 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition.
- Published
- 2015
- Full Text
- View/download PDF
15. Investigating longitudinal and bidirectional relationships between parental factors and time spent on social media during early adolescence.
- Author
-
Jasmine Fardouly, Natasha R. Magson, Ronald M. Rapee, Ella L. Oar, Carly J. Johnco, Cele Richardson, and Justin Freeman
- Published
- 2024
- Full Text
- View/download PDF
16. Psychometric properties of the Children’s Revised Impact of Events Scale (CRIES) with Bangladeshi children and adolescents
- Author
-
Farah Deeba, Ronald M. Rapee, and Tania Prvan
- Subjects
Assessment ,Trauma ,Post-traumatic stress ,Children ,Bangla ,Bangladesh ,Medicine ,Biology (General) ,QH301-705.5 - Abstract
Identification of possible cases suffering post-traumatic stress disorder (PTSD) is important, especially in developing countries where traumatic events are typically prevalent. The Children’s Revised Impact of Events Scale is a reliable and valid measure that has two brief versions (13 items and 8 items) to assess reactions to traumatic events among young people. The current study evaluated the psychometric properties of both versions of the CRIES in a sample of 1,342 children and adolescents aged 9–17 years (M = 12.3 years, SD = 2.12) recruited from six districts of Bangladesh. A sub-group of 120 children from four schools was re-tested on the measures within 3.5 weeks. Confirmatory factor analysis supported factor structures similar to those found in other studies for both versions of the CRIES. Multiple group confirmatory factor analysis showed gender and age-group differences within the sample, supporting established age and gender differences in prevalence of PTSD symptoms. Analyses also indicated moderate to excellent internal consistency and test-retest reliability and clear discriminant and convergent validity. These data support use of both the CRIES-13 and CRIES-8 to provide quick and psychometrically sound assessment of symptoms of PTSD among children and adolescents from Bangla-speaking communities.
- Published
- 2014
- Full Text
- View/download PDF
17. Emotional and social loneliness and their unique links with social isolation, depression and anxiety
- Author
-
Nine E. Wolters, Lynn Mobach, Viviana M. Wuthrich, Peter Vonk, Claudia M. Van der Heijde, Reinout W. Wiers, Ronald M. Rapee, Anke M. Klein, Ontwikkelingspsychologie (Psychologie, FMG), and Research of the Student Medical Service
- Subjects
Psychiatry and Mental health ,Clinical Psychology - Abstract
BackgroundLoneliness and social isolation are known to be associated with depression, general anxiety, and social anxiety. However, knowledge on the overlapping and unique features of these relationships, while differentiating between social loneliness (perceived absence of an acceptable social network) and emotional loneliness (perceived absence of close connections), is lacking.MethodsWe constructed a network analysis to examine the relationships between self-reported social loneliness, emotional loneliness, social isolation, depression, general anxiety and social anxiety in a large sample of university students (N = 7314, 67.4 % female, range 16.3–75.8 years, Mage = 23.9, SDage = 5.7). Hierarchical regression analyses were used to examine whether depression, general anxiety and social anxiety moderated the relationship between social isolation and loneliness types. As comorbidity between anxiety and depression is high, the role of anxiety as a moderator in the relationship between depression and loneliness types was also examined.ResultsThe network analysis showed that social loneliness was most strongly explained by social isolation, whereas emotional loneliness was most strongly explained by social anxiety and depression. General anxiety was solely related to loneliness through depression. The regression analyses showed that general and social anxiety and depression did not moderate the relationship between social isolation and loneliness types.LimitationsDifferences found between loneliness types may be influenced by a methodological artifact of the DJGLS.ConclusionsThese findings highlight the importance of social anxiety over general anxiety in relation to loneliness. Also, it showed unique relationships for social- and emotional loneliness with psycho-social variables, which has important implications for research- and clinical settings.
- Published
- 2023
18. The meditating role of sleep in the longitudinal associations between peer victimization and internalizing symptoms: A cross-lagged panel analysis
- Author
-
Gillian R. Bartlett, Natasha M. Magson, Cele E. Richardson, Ronald M. Rapee, Jasmine Fardouly, and Ella L. Oar
- Subjects
Psychiatry and Mental health ,Developmental and Educational Psychology - Abstract
Adolescence is a time of heightened vulnerability for both peer victimization (PV) and internalizing symptoms. While the positive association between them is well established, there is little understanding of the mechanisms underpinning this relationship. To address this gap, the current study aimed to investigate sleep hygiene and school night sleep duration as individual and sequential mediators of the relationship between PV and both depressive and social anxiety symptoms during pre- to mid-adolescence. The study drew upon a community sample of 528 Australian youth aged 10–12 years at baseline (M age = 11.19, SD = .55; 51.1% boys) and data were collected over five annual measurement occasions. Direct and indirect longitudinal and bidirectional associations were examined using cross-lagged panel analysis. There was no evidence of sequential mediation through both sleep hygiene and sleep duration to depression and social anxiety. Instead, the findings show that sleep hygiene mediated the prospective association between PV and both depressive and social anxiety symptoms, and between PV and sleep duration. Overall, sleep hygiene represents a modifiable transdiagnostic factor that can be targeted to break the cycle of PV, inadequate sleep, and internalizing symptoms.
- Published
- 2023
19. The role of distorted cognitions in mediating treatment outcome in children with social anxiety disorder: A preliminary study
- Author
-
Lynn Mobach, Ronald M. Rapee, and Anke M. Klein
- Subjects
Experimental Psychopathology and Treatment ,Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Treatment outcome ,Social anxiety ,Developmental and Educational Psychology ,Cognition ,Dysfunctional family ,sense organs ,Psychology ,behavioral disciplines and activities ,Clinical psychology - Abstract
Contains fulltext : 238968.pdf (Publisher’s version ) (Open Access) This study examined whether distorted cognition changes during cognitive behavioural therapy (CBT) in children (N = 61; aged 7-12) with social anxiety disorder (SAD) and whether changes in distorted cognition from pre- to post-treatment predict SAD at 6-month follow-up. Baseline distorted cognition was also examined as a predictor of post-treatment outcome. Multiple informant SAD-measures were obtained pre-treatment, post-treatment and at 6-month follow-up. Children reported on interpretation bias and dysfunctional beliefs. A decrease in interpretation bias and dysfunctional beliefs was prospectively related to greater SAD change between post-treatment and 6-month follow-up. Child-reported SAD-change at post-treatment predicted greater change in dysfunctional beliefs at 6-month follow-up. Higher baseline interpretation bias predicted greater change in SAD-severity at post-treatment. Children with greater distorted cognition reductions during treatment, showed greater treatment gains at 6-month follow-up. Children who do not show this reduction may require additional efforts focused on distorted cognition to maximally benefit from treatment. 12 p.
- Published
- 2023
20. Examining the Prospective Bidirectional Associations between Subjective and Objective Attractiveness and Adolescent Internalizing Symptoms and Life Satisfaction
- Author
-
Natasha R. Magson, Ella L. Oar, Jasmine Fardouly, Ronald M. Rapee, Justin Y. A. Freeman, Cele E. Richardson, and Carly J. Johnco
- Subjects
Social Psychology ,Developmental and Educational Psychology ,Social Sciences (miscellaneous) ,Education - Abstract
Research has consistently shown that more physically attractive individuals are perceived by others to be happier and better psychologically adjusted than those perceived as less attractive. However, due to the lack of longitudinal research in adolescents, it is still unclear whether poor mental health predicts or is predicted by either objective or subjective attractiveness during this critical developmental period. The purpose of the current study was to examine prospective bidirectional associations between both subjective and objective ratings of attractiveness, life satisfaction and symptoms of social anxiety, depression and eating disorders (i.e., internalizing symptoms) from early to mid-adolescence. Participants (T1: N = 528, 49.9% girls; Mage = 11.19; SD = 0.55) were followed annually over four time points. The cross-lagged panel model results revealed evidence of prospective associations between both forms of attractiveness and life satisfaction and internalizing symptoms, which were driven more by changes in the mental health outcomes than by changes in the subjective and objective attractiveness ratings. The results also indicated that the pattern, strength, and direction of the associations tested were robust across boys and girls, and white and non-white ethnic groups. Overall, the findings suggest that it is important to find effective ways of educating adolescents who are unhappy with their appearance that making changes to improve their mental health, rather than focusing on their physical appearance, will have benefits not only for how they perceive themselves but also for how they are perceived by others.
- Published
- 2022
21. Cross-cultural measurement of social withdrawal motivations across 10 countries using multiple-group factor analysis alignment
- Author
-
Julie C. Bowker, Stefania Sette, Laura L. Ooi, Sevgi Bayram-Ozdemir, Nora Braathu, Evalill Bølstad, Karen Noel Castillo, Aysun Dogan, Carolina Greco, Shanmukh Kamble, Hyoun K. Kim, Yunhee Kim, Junsheng Liu, Wonjung Oh, Ronald M. Rapee, Quincy J. J. Wong, Bowen Xiao, Antonio Zuffianò, and Robert J. Coplan
- Subjects
Subtypes ,Social Psychology ,Loneliness ,social withdrawal motivations ,Difficulties ,Measurement Invariance ,Social Preference Scale-R ,culture ,Education ,multiple-group factor analysis alignment ,Adjustment ,Developmental Neuroscience ,Developmental and Educational Psychology ,Shyness ,university students ,Fit Indexes ,Life-span and Life-course Studies ,Social Sciences (miscellaneous) - Abstract
The goal of this study was to evaluate the measurement invariance of an adapted assessment of motivations for social withdrawal (Social Preference Scale-Revised; SPS-R) across cultural contexts and explore associations with loneliness. Participants were a large sample of university students (N = 4,397; M-age = 20.08 years, SD = 2.96; 66% females) from 10 countries (Argentina, Australia, Canada, China, India, Italy, South Korea, Norway, Turkey, and the United States). With this cross-cultural focus, we illustrate the multiple-group factor analysis alignment method, an approach developed to assess measurement invariance when there are several groups. Results indicated approximate measurement invariance across the 10 country groups. Additional analyses indicated that overall, shyness, avoidance, and unsociability are three related, but distinct factors, with some notable country differences evident (e.g., in China, India, and Turkey). Shyness and avoidance were related positively to loneliness in all countries, but the strength of the association between shyness and loneliness differed in Italy and India relative to the other countries. Results also indicated that unsociability was related positively to loneliness in the United States only. Theoretical and assessment implications are discussed., Social Science and Humanities Research Council of Canada Insight Grant [4352017-0849], The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article:This research was supported, in part, by a Social Science and Humanities Research Council of Canada Insight Grant (4352017-0849) to authors R.J.C. and J.C.B.
- Published
- 2022
22. School-based victimization in children and adolescents presenting for cognitive behavioural treatment of anxiety disorders
- Author
-
Caroline Hunt, Kay Bussey, Lorna Peters, Jonathan Gaston, Alice Lo, and Ronald M. Rapee
- Subjects
Male ,Clinical Psychology ,Cognition ,Adolescent ,Bullying ,Humans ,Female ,General Medicine ,Child ,Anxiety Disorders ,Crime Victims ,Peer Group - Abstract
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.
- Published
- 2022
23. Online treatment of adolescents with comorbid anxiety and depression: A randomized controlled trial
- Author
-
Carolyn A. Schniering, Danielle Einstein, Jessica J.L. Kirkman, and Ronald M. Rapee
- Subjects
Male ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Adolescent ,Cognitive Behavioral Therapy ,Depression ,Humans ,Female ,Anxiety ,Anxiety Disorders ,Internet-Based Intervention - Abstract
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.
- Published
- 2022
24. Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis
- Author
-
Sophie J. Dickson, Rebecca-Lee Kuhnert, Cassie H. Lavell, and Ronald M. Rapee
- Subjects
Psychotherapy ,Parents ,Psychiatry and Mental health ,Clinical Psychology ,Adolescent ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Humans ,Child Behavior Disorders ,Anxiety ,Child ,Anxiety Disorders ,Education - Abstract
A substantial empirical base supports the use of psychotherapy to alleviate anxiety symptoms and diagnoses in children and adolescents. However, focusing only on symptom or diagnostic reduction provides an incomplete picture of clinically meaningful efficacy given that anxiety disorders in this age group are integrally associated with problems in functioning. A systematic review and meta-analysis (N studies = 40, N participants = 3094) evaluating the impacts of psychotherapy for anxiety was conducted on the following outcomes: global functioning, social functioning, academic functioning, and school attendance. Randomised controlled trials with a passive control condition, a child and/or adolescent sample (7–17 years) with a primary anxiety diagnosis, and receiving anxiety-focused psychotherapy were eligible for inclusion if they reported suitable outcome data. Results from the meta-analysis indicated that from pre- to post-treatment, psychotherapy led to significant improvements in global functioning according to clinician (d = 1.55), parent (d = 0.67), and child (d = 0.31) reports and on social functioning according to parent (d = 0.51), but not child (d = 0.31) reports. The qualitative review provided preliminary support psychotherapy’s efficacy in increasing family functioning and school attendance, but not so much in enhancing academic performance. These results indicate that psychotherapy improves daily functioning in anxious children and adolescents. The study also highlighted the limited attention paid to measures of functioning in the empirical literature on treatment of childhood anxiety.Trial Registry: This study is registered with PROSPERO under the identification number CRD42021246565.
- Published
- 2022
25. Effectiveness of Psychotherapy for Internalising Symptoms in Children and Adolescents When Delivered in Routine Settings: A Systematic Review and Meta-analysis
- Author
-
Viviana M. Wuthrich, Dino Zagic, Sophie J. Dickson, Lauren F. McLellan, Jessamine T.-H. Chen, Michael P. Jones, and Ronald M. Rapee
- Subjects
Psychiatry and Mental health ,Clinical Psychology ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Education - Abstract
This systematic review and meta-analysis aimed to examine the effectiveness of psychological interventions for internalising disorders in youth when delivered in routine settings. Secondary aims were to examine the effectiveness of cognitive behavioural therapy and determine moderators of treatment response. The study was pre-registered (PROSPERO 2020 CRD42020202776). Databases were systematically searched (PsycINFO, Medline, Embase, PubMed, ERIC) in December 2022 and screened according to the PRISMA 2020 statement. Inclusion: School aged participants (4–18 years) with a primary internalising disorder; psychotherapy delivered in a routine setting (e.g. outpatient clinic, school) by setting staff; compared psychotherapy to any control in a randomised controlled trial; reported pre-to-post or pre-to-follow-up comparisons on the primary disorder according to child, parent or independent evaluator report; and was published in English. Risk of bias was assessed using the ROB 2.0 Cochrane tool. Results were synthesised using random effects to pool estimates. Risk ratios were used to analyse dichotomous data and standardised mean differences (SMD) for continuous data. Forty-five studies were included (N = 4901 participants; M = 13 years; range 8–16; SD = 2.5). Nine used waitlist control, 17 treatment as usual, 4 placebo; 15 compared psychotherapy to active control. Psychotherapy was associated with small significant effects pre- to post-treatment compared to non-active controls for anxiety (SMD = − 0.24 to 0.50) and depression (SMD = − 0.19 to 0.34) with effects differing by informant. Psychotherapy led to small significant pre-to-post-benefits in youth internalising disorders in routine settings. Results are limited by reporter type and follow-up.
- Published
- 2023
26. #malefitspo: Links between viewing fitspiration posts, muscular-ideal internalisation, appearance comparisons, body satisfaction, and exercise motivation in men.
- Author
-
Scott J. Fatt, Jasmine Fardouly, and Ronald M. Rapee
- Published
- 2019
- Full Text
- View/download PDF
27. Group Based Cognitive Behavioural Therapy for Anxiety in Children with Autism Spectrum Disorder:A Randomised Controlled Trial in a General Child Psychiatric Hospital Setting
- Author
-
Tina R. Kilburn, Merete Juul Sørensen, Mikael Thastum, Ronald M. Rapee, Charlotte Ulrikka Rask, Per Hove Thomsen, Kristian Arendt, and Anders Helles Carlsen
- Subjects
medicine.medical_specialty ,CBT ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Developmental and Educational Psychology ,medicine ,Psychiatric hospital ,0501 psychology and cognitive sciences ,Autism spectrum disorder ,Psychiatry ,Children ,Public health ,05 social sciences ,Cognition ,medicine.disease ,Anxiety disorder ,Autism ,Anxiety ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery ,050104 developmental & child psychology - Abstract
Cognitive Behavioural Therapy (CBT) programs adapted to children with Autism Spectrum Disorder (ASD) effectively reduce anxiety when run in university clinics. Forty-nine children aged 8-14 years participated in a waitlist controlled study in a general child psychiatric hospital setting. Post-treatment 30% of the children were free of their primary anxiety diagnoses and 5% were free of all anxiety diagnoses. No statistically significant difference between the two trial conditions were found on primary outcomes. However, statistically significant differences were found on secondary outcomes indicating clinically meaningful treatment responses. Together with high program satisfaction this study shows the CBT program to be feasible and potentially efficacious in treating anxiety in children with ASD in a general child psychiatric hospital setting.
- Published
- 2023
28. Content-Specificity Of Interpretation Bias Related to Social and Emotional Loneliness in Emerging Adulthood
- Author
-
Nine Wolters, Viviana Wuthrich, Ronald M. Rapee, Peter Vonk, Jurrijn koelen, Claudia van der Heijde, Elske Salemink, Reinout Wiers, and Anke Klein
- Published
- 2023
29. Prevention and early intervention of anxiety problems in young children: A pilot evaluation of Cool Little Kids Online
- Author
-
Amy J Morgan, Ronald M. Rapee, and Jordana K. Bayer
- Subjects
050103 clinical psychology ,medicine.medical_specialty ,lcsh:BF1-990 ,Health Informatics ,law.invention ,Randomized controlled trial ,law ,Intervention (counseling) ,medicine ,0501 psychology and cognitive sciences ,Group program ,Psychiatry ,Inhibition ,Uncategorized ,Internet ,Intervention program ,lcsh:T58.5-58.64 ,Parent training ,lcsh:Information technology ,4. Education ,Prevention ,05 social sciences ,Mental health ,Full length Article ,Clinical research ,lcsh:Psychology ,Anxiety ,medicine.symptom ,Psychology ,050104 developmental & child psychology ,Clinical psychology ,Anxiety disorders - Abstract
Anxiety disorders are common, debilitating, and begin early in life. Early intervention to prevent anxiety disorders in children who are at risk could have long-term impact. The ‘Cool Little Kids’ parenting group program has previously been shown to be efficacious in preventing anxiety disorders in temperamentally inhibited young children. Wider dissemination of the program could be achieved with an internet-based delivery platform, affording greater accessibility and convenience for parents. The aim of this study was to evaluate ‘Cool Little Kids Online’, a newly developed online version of the existing parenting group program. Fifty-one parents of children aged 3–6 years were recruited to evaluate the online program's acceptability and preliminary efficacy in reducing inhibited young children's anxiety problems. Parents were randomized to receive either a clinician-supported version or an unsupported version of the program. Parents had 10 weeks to access the program and completed questionnaires at baseline and post-intervention. Both groups showed medium-to-large reductions in children's anxiety symptoms, emotional symptoms, number of child anxiety diagnoses, and improvements in life interference from anxiety. The effect of clinician support was inconsistent and difficult to interpret. Parents reported high levels of satisfaction with the program. These encouraging results indicate that the online version is acceptable and useful for parents with temperamentally inhibited young children. Cool Little Kids Online may be a promising direction for improving access to an evidence-based prevention and early intervention program for child anxiety problems. A large randomized trial is warranted to further evaluate efficacy., Highlights • An online version of an existing parenting program for child anxiety was developed. • Most parents found the program useful, user-friendly, and would recommend it. • A clinician-supported format was not clearly superior to a self-guided format.
- Published
- 2023
- Full Text
- View/download PDF
30. Imagery-Enhanced CBT for Social Anxiety Disorder
- Author
-
Peter M. McEvoy, Lisa M. Saulsman, Ronald M. Rapee and Peter M. McEvoy, Lisa M. Saulsman, Ronald M. Rapee
- Published
- 2017
31. Barriers to remission from child and adolescent anxiety disorders following extensive treatment: An exploratory study
- Author
-
Sarah Farraway, Viviana M. Wuthrich, Heidi Lyneham, Jennifer Hudson, Maria Kangas, Mary-Lou Chatterton, Catherine Mihalopoulos, and Ronald M. Rapee
- Subjects
Psychiatry and Mental health ,Clinical Psychology ,Neuropsychology and Physiological Psychology - Published
- 2022
32. Acceptability and Feasibility of Stepped-Care for Anxious Adolescents in Community Mental Health Services: A Secondary Analysis
- Author
-
Jessica Belcher, Ann Wignall, Ronald M. Rapee, Viviana M. Wuthrich, Melissa M. Norberg, Lauren F. McLellan, and Tess Jagiello
- Subjects
Staffing ,Psychological intervention ,Flexibility (personality) ,Mental health ,law.invention ,Psychiatry and Mental health ,Randomized controlled trial ,Nursing ,law ,Secondary analysis ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,medicine ,Anxiety ,Stepped care ,medicine.symptom ,Psychology - Abstract
Initial research suggests stepped-care approaches to therapy for youth anxiety is associated with reduced therapy time with similar therapeutic outcomes to treatment-as-usual in real-world settings. Research on the acceptability and feasibility of stepped-care approaches in routine practice is very limited. In a secondary analysis of a pilot randomised controlled trial that compared stepped-care to treatment-as-usual in adolescent mental health services, we examine acceptability and feasibility from consumer and clinician perspectives. Fifteen adolescents and ten clinicians provided brief quantitative and qualitative feedback. Some benefits were noted and these related to improved access to treatment; however, major barriers were also noted. Concerns related to the lack of consumer and clinician choice and flexibility in delivery of stepped interventions, challenges engaging adolescents with internet interventions and associated guided telephone calls, and workplace issues. Systemic changes to facilitate consumer preferences, clinician flexibility and staffing are needed for stepped-care to be feasible in routine care.
- Published
- 2021
33. Interventions to improve social connections: a systematic review and meta-analysis
- Author
-
Dino Zagic, Nine Wolters, Ronald M. Rapee, and Viviana M. Wuthrich
- Subjects
Health (social science) ,Social Psychology ,Epidemiology ,Social connectedness ,Applied psychology ,Psychological intervention ,Loneliness ,PsycINFO ,Social engagement ,Psychiatry and Mental health ,Distress ,Meta-analysis ,medicine ,Social isolation ,medicine.symptom ,Psychology - Abstract
The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote ‘objective social contact’ and the ‘quality of social connections’; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials. A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0. Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges’ g = 0.43) and perceived quality of social connections (Hedges’ g = − 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges’ g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges’ g = − 0.53). In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress.
- Published
- 2021
34. Assessing Functional Impairment in Youth: Development of the Adolescent Life Interference Scale for Internalizing Symptoms (ALIS-I)
- Author
-
Alexander H. Queen, Carolyn A. Schniering, Viviana M. Wuthrich, Ronald M. Rapee, Jill Ehrenreich-May, and Miriam K. Forbes
- Subjects
Functional impairment ,Psychometrics ,Community control ,Psychiatry and Mental health ,Scale (social sciences) ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,medicine ,Anxiety ,medicine.symptom ,Positive Youth Development ,Psychology ,Reliability (statistics) ,Depression (differential diagnoses) ,Clinical psychology - Abstract
This study described the psychometric properties of a self-report measure of functional impairment related to anxiety and depression in adolescents, the Adolescent Life Interference Scale for Internalizing symptoms (ALIS-I). A clinical sample of 266 adolescents and a community sample of 63 adolescents, aged 11 to 18 years (Mean = 14.7, SD = 1.71) completed the ALIS-I and additional measures assessing internalizing problems. Exploratory factor analyses indicated four distinct but correlated factors of life interference related to personal withdrawal/avoidance, peer problems, problems with study/work, and somatic symptoms. Reliability and retest reliability (8–12 weeks) of the total score were high and psychometric properties of the subscales were acceptable. The ALIS-I effectively discriminated between clinical and community control groups, and expected correlations were shown between ALIS-I subscales and other related symptom measures. The ALIS-I is a promising instrument for the assessment of functional impairment related to internalizing disorders in youth.
- Published
- 2021
35. From barriers to implementation: Advancing universal mental health screening in schools
- Author
-
Ronald M. Rapee and John R. Burns
- Subjects
Social Psychology ,Nursing ,education ,Developmental and Educational Psychology ,Psychology ,Mental health ,Education - Abstract
In light of concerning evidence that many young people with mental disorders are not receiving appropriate mental health intervention, school-based mental health screening has been advocated as one way to improve identification of at-risk youth. Despite having much promise, universal screening in schools remains a relatively uncommon practice internationally. Various barriers that deter school psychologists and counsellors from screening have been identified, including lack of resourcing to implement screening, lack of knowledge about the mechanics of how to carry out a screening program, and concern about how to manage the anticipated increased workload generated by following up identified students. In this practice-based paper we discuss a four-stage process that guides school psychologists and counsellors in the establishment of a school-based screening program, with specific reference to overcoming perceived barriers.
- Published
- 2021
36. A Cross-Cultural Comparison of the Bivalent Fear of Evaluation Model for Social Anxiety
- Author
-
Jung-Hye Kwon, Satoko Sasagawa, Melissa M. Norberg, Ronald M. Rapee, Shin-ichi Ishikawa, Honami Arai, Norman B. Schmidt, Sho Okawa, and Eiji Shimizu
- Subjects
Individualistic culture ,Social anxiety ,Collectivism ,Fear of negative evaluation ,Mental health ,Cross-cultural studies ,Psychiatry and Mental health ,Clinical Psychology ,Neuropsychology and Physiological Psychology ,medicine ,Anxiety ,medicine.symptom ,Psychology ,Path analysis (statistics) ,Clinical psychology - Abstract
Social anxiety is one of the most common mental health problems worldwide; however, the prevalence of social anxiety symptoms differs between collectivistic and individualistic cultures. These differences may have important implications for guiding cognitive-behavioral treatment. The purpose of this study was to determine whether differences in the experience of social anxiety exist across countries with varying cultures, and whether the bivalent fear of evaluation model is valid for both individualistic (Australia and the United States) and collectivistic countries (Korea and Japan). A total of 704 participants (279 from Australia, 137 from the United States, 101 from Korea, and 187 from Japan) completed questionnaires assessing these constructs. Analysis of covariance with age and gender as covariates revealed that symptoms of social anxiety and fear of negative evaluation are reported more in collectivistic countries, while fear of positive evaluation (FPE) is higher in individualistic countries. The results of path analysis and multiple group path analysis indicated that the structure of the bivalent fear of evaluation model differs across cultures. A direct path from FPE to social anxiety was only observed in individualistic countries; however, the relationship between disqualification of positive social outcomes (DPSO) and social anxiety was stronger in collectivistic countries. These findings imply that FPE and DPSO may have different functions of relevance to social anxiety in individualistic and collectivistic countries, and indicate that modifications may be necessary in the application of cognitive-behavioral treatment strategies across cultures.
- Published
- 2021
37. Combining CBT and sertraline does not enhance outcomes for anxious youth: a double-blind randomised controlled trial
- Author
-
Lauren F. McLellan, Jennifer L. Hudson, Viviana M. Wuthrich, Valsamma Eapen, Ronald M. Rapee, and Heidi J. Lyneham
- Subjects
Sertraline ,business.industry ,Cognition ,medicine.disease ,Placebo ,law.invention ,Double blind ,Psychiatry and Mental health ,Randomized controlled trial ,law ,Pill ,Medicine ,Anxiety ,medicine.symptom ,business ,Applied Psychology ,Anxiety disorder ,Clinical psychology ,medicine.drug - Abstract
BackgroundAnxiety disorders are the most prevalent mental disorder in children and young people. Developing effective therapy for these children is critical to reduce mental disorders across the lifespan. The study aimed to evaluate the efficacy of combining cognitive behavioural therapy (CBT) and sertraline (SERT) in the treatment of anxiety in youth, using a double-blind randomised control trial design.MethodsNinety-nine youth (ages 7–15 years) with an anxiety disorder were randomly allocated to either individual (CBT) and SERT or individual CBT and pill placebo and assessed again immediately and 6 months after treatment.ResultsThere were no significant differences between conditions in remission of primary anxiety disorder or all anxiety disorders. Furthermore, there were no significant differences in rates of change in diagnostic severity, parent-reported anxiety symptoms, child-reported anxiety symptoms or life interference due to anxiety.ConclusionsThe efficacy of CBT for children and adolescents with anxiety disorders is not significantly enhanced by combination with a short-term course of anti-depressants over and above the combined effects of pill placebo.
- Published
- 2021
38. Prediction of clinical anxious and depressive problems in mid childhood amongst temperamentally inhibited preschool children: a population study
- Author
-
Kate Noone, Margaret Nelson-Lowe, Fenny Muliadi, Natalie Bischof, Amy Brown, Lesley Bretherton, Cassima Beechey, Ronald M. Rapee, Luke A. Prendergast, Harriet Hiscock, Jordana K. Bayer, Tamsyn Gilbertson, and Cathrine Mihalopoulos
- Subjects
medicine.medical_specialty ,education.field_of_study ,media_common.quotation_subject ,Stressor ,Population ,General Medicine ,Mental health ,Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Child and adolescent psychiatry ,medicine ,Anxiety ,Temperament ,Risk factor ,medicine.symptom ,education ,Psychology ,Depression (differential diagnoses) ,media_common ,Clinical psychology - Abstract
Shy/inhibited young children are at risk for internalising difficulties; however, for many, this temperamental style does not result in mental health problems. This study followed a population-based sample of temperamentally inhibited preschool children into mid childhood to explore the aetiology of clinical-level anxious and depressive problems. Amongst inhibited preschool children, we aimed to predict each of clinical child anxiety and depressive problems in mid childhood from a broad range of potential risks (demographics, traumatic events and broader recent stressors, parents’ well-being, and parenting practices). This study is based on data from a wider population trial of Cool Little Kids that recruited a representative sample of inhibited preschool children enrolled in their year before starting school. In 2011–2012, an inhibition screen was universally distributed to parents of children in their year before school (age 4 years) across eight diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited preschoolers (78% uptake, 545/703) who were followed to mid childhood (three annual waves 2015–2017, age 7–10 years) with 84% retention (456/545). Parents completed questionnaires spanning child ages 4–10 years, along with diagnostic interviews for child anxiety. Children also completed questionnaires in mid childhood. The questionnaires encompassed a variety of potential risks including sociodemographics, traumatic events, recent life stressors, parent wellbeing and parenting practices. In mid childhood, 57% (246/430) of inhibited preschoolers had a clinical level of anxiety problems while 22% (95/432) had depressive problems (by one or more sources). The aetiology analyses highlighted parent distress and parenting practices (overinvolved/protective, harsh discipline) as key predictors of inhibited preschoolers’ internalising problems by mid childhood. Some high-risk families may not have participated. Child depression was not assessed with a diagnostic interview. The measures did not include every possible risk factor. The findings lend support to parenting programs for shy/inhibited young children that aim to prevent the development of anxiety and depression as they grow.
- Published
- 2021
39. A longitudinal investigation of sleep and technology use in early adolescence: does parental control of technology use protect adolescent sleep?
- Author
-
Carly Johnco, Ella L. Oar, Natasha R. Magson, Cele Richardson, Ronald M. Rapee, and Jasmine Fardouly
- Subjects
Male ,Parents ,Technology ,Evening ,Adolescent ,Early adolescence ,Disorders of Excessive Somnolence ,03 medical and health sciences ,0302 clinical medicine ,Primary caregiver ,Surveys and Questionnaires ,Humans ,Child ,Morning ,General Medicine ,Sleep in non-human animals ,Circadian Rhythm ,030228 respiratory system ,Early adolescents ,Female ,Sleep ,Psychology ,030217 neurology & neurosurgery ,Parental control ,Sleep duration ,Clinical psychology - Abstract
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.
- Published
- 2021
40. The Effect of Spirituality on Mood: Mediation by Self-Esteem, Social Support, and Meaning in Life
- Author
-
Ronald M. Rapee, David J Craig, and Jasmine Fardouly
- Subjects
Mediation (statistics) ,Coping (psychology) ,media_common.quotation_subject ,Religious studies ,Self-esteem ,General Medicine ,Affect (psychology) ,Developmental psychology ,Religiosity ,Social support ,Mood ,Meaning (existential) ,Psychology ,General Nursing ,media_common - Abstract
Negative correlations between religiosity or spirituality and depression symptoms have been frequently reported, but relatively few empirical studies have investigated the processes that mediate the relationships. This study investigated four theorized mediators in a single model to assess the unique contributions of self-esteem, social support, meaning in life, and positive religious coping to the relationship between religiosity, spirituality, and two markers of depression, positive affect and negative affect. Path analysis was employed to investigate multiple mediation models in a sample of 352 undergraduates. Non-significant paths were removed, and a second independent sample of 316 undergraduates was used to validate the trimmed models. Results indicated that self-esteem mediated the relationships between spirituality and both positive and negative affect. Meaning in life also mediated the relationship between spirituality and positive affect, while social support mediated the relationship between spirituality and negative affect. Positive religious coping did not mediate either relationship, possibly because the samples were not drawn from populations under stress. The relationship between intrinsic religiosity and positive affect was similarly mediated by self-esteem and meaning in life. Religiosity and negative affect were related through the mediators self-esteem and an unexpectedly adverse factor captured by positive religious coping in the models used.
- Published
- 2021
41. Isolating the Effect of Virtual Reality Based Exposure Therapy for Agoraphobia: a Comparative Trial.
- Author
-
Eric Malbos, Ronald M. Rapee, and Manolya Kavakli
- Published
- 2011
- Full Text
- View/download PDF
42. Barriers to Universal Mental Health Screening in Schools: The Perspective of School Psychologists
- Author
-
John R. Burns and Ronald M. Rapee
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Intervention (counseling) ,Perspective (graphical) ,School psychology ,Developmental and Educational Psychology ,medicine ,Psychology ,Psychiatry ,Mental health ,Applied Psychology ,Education - Abstract
Many young people with mental disorders are not identified until some years after the first onset of symptoms and then frequently do not receive professional intervention. One promising strategy to...
- Published
- 2021
43. A Randomized Controlled Trial of a Cognitive Behavior Therapy Program for Children with Clinical Anxiety Symptoms
- Author
-
Ronald M. Rapee, Gregoris Simos, and Olga Zikopoulou
- Subjects
High anxiety ,RC435-571 ,CBT treatment ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,General Environmental Science ,Psychiatry ,child ,Intervention program ,business.industry ,Parent reports ,Cognition ,anxiety ,Mental health ,030227 psychiatry ,Group treatment ,parent ,General Earth and Planetary Sciences ,Anxiety ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
High anxiety and anxiety disorders are among the most prevalent mental health problems in children and lead to significant interference with children’s daily functioning. Most empirical evaluations of treatment come from English-language countries. The aim of the present study was to evaluate and replicate the effectiveness of a cognitive-behavioral intervention program to manage anxiety in children among children from Greece. Forty-one children–parent(s) dyads participated in the study. Children were 9–12 years old, with clinically elevated symptoms of anxiety, and they were assigned to either the standard group treatment (cognitive behavior therapy (CBT)) or to a waitlist group (WL). Both children and their parents in the CBT group reported statistically significant reductions in children’s anxiety symptoms at post-intervention and at the 6-month follow-up. A significant reduction was also found in life interference due to anxiety according to both child and parent reports. In contrast, no significant changes in anxiety symptoms or life interference were reported among the WL. The current results support the effectiveness of a CBT program for anxious children from a non-clinic, non-school setting in Greece.
- Published
- 2021
44. A Longitudinal Investigation of Sleep Hygiene as a Mediator Linking Parental Warmth with Adolescent Sleep
- Author
-
Cele E Richardson, Natasha R Magson, Ella L Oar, Jasmine Fardouly, Carly J Johnco, Justin Y A Freeman, and Ronald M Rapee
- Subjects
Physiology (medical) ,Neurology (clinical) - Abstract
Study Objectives Parental warmth in adolescence protects sleep in early adulthood, yet the nature, directions, and mechanisms of this association across adolescence are unknown. This study examined parental warmth, adolescent sleep hygiene and sleep outcomes (morning/eveningness, school night sleep duration, and daytime sleepiness) across five annual waves, spanning four years, using a cross-lagged panel design. Methods Adolescents and one primary caregiver (96% mothers) completed questionnaires assessing parental warmth (child- and parent-report) and adolescent sleep hygiene and sleep (child-report), across five annual waves: Wave 1 (N = 531, Mage = 11.18, SD = 0.56, 51% male), Wave 2 (N = 504, Mage = 12.19, SD = 0.53, 52% male), Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male), Wave 4 (N = 440, Mage = 14.76, SD = 0.47, 51% male), and Wave 5 (N = 422, Mage = 15.75, SD = 0.49, 51% male). Results Greater child-reported parental warmth was indirectly associated with better adolescent sleep (greater morningness, longer school night sleep duration, less sleepiness) through healthier sleep hygiene. The inverse was also often observed. Warmth had a direct relationship with sleep duration and sleepiness, independent of sleep hygiene. Parent-reported parental warmth did not predict, nor was predicted by child-reported adolescent sleep. Conclusions Parental warmth may protect against developmental changes in adolescent sleep, partially by improving sleep hygiene practices. Similarly, inadequate adolescent sleep may negatively impact parental warmth via deteriorating sleep hygiene. Sleep hygiene emerged as a key mechanism for protecting adolescent sleep and parent-child relationships.
- Published
- 2022
45. The Patient‐Reported Outcomes Measurement Information System (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the Kids FACE FEARS sample
- Author
-
Gabrielle F. Freitag, Hanan Salem, Kristina Conroy, Carolina Busto, Molly Adrian, Christina P.C. Borba, Amelia Brandt, Phuonguyen V. Chu, Annie Dantowitz, Alyssa M. Farley, Lisa Fortuna, Jami M. Furr, Julia Lejeune, Leslie Miller, Rheanna Platt, Michelle Porche, Kendra L. Read, Sara Rivero-Conil, Romina D. Sanchez Hernandez, Philip Shumway, Jennifer Sikov, Andrea Spencer, Haniya Syeda, Lauren F. McLellan, Ronald M. Rapee, Dana McMakin, Donna B. Pincus, and Jonathan S. Comer
- Subjects
Psychiatry and Mental health ,Clinical Psychology - Published
- 2023
46. Creation of Interactive Virtual Environments for Exposure Therapy Through Game-Level Editors: Comparison and Tests on Presence and Anxiety.
- Author
-
Eric Malbos, Ronald M. Rapee, and Manolya Kavakli
- Published
- 2013
- Full Text
- View/download PDF
47. Evidence-Based CBT for Anxiety and Depression in Children and Adolescents: A Competencies Based Approach
- Author
-
Elizabeth S. Sburlati, Heidi J. Lyneham, Carolyn A. Schniering, Ronald M. Rapee and Elizabeth S. Sburlati, Heidi J. Lyneham, Carolyn A. Schniering, Ronald M. Rapee
- Published
- 2014
48. Healing from Bullying in Early Adolescent Boys: The Positive Impact of Both Forgiveness and Revenge Fantasies
- Author
-
Natasha Todorov, Hayley Watson, and Ronald M. Rapee
- Subjects
Forgiveness ,biology ,media_common.quotation_subject ,05 social sciences ,Miller ,food and beverages ,050301 education ,Physical health ,biology.organism_classification ,medicine.disease ,behavioral disciplines and activities ,Education ,Substance abuse ,medicine ,Early adolescents ,0501 psychology and cognitive sciences ,Safety, Risk, Reliability and Quality ,Psychology ,0503 education ,050104 developmental & child psychology ,media_common ,Clinical psychology - Abstract
Bullying is a pervasive and debilitating issue for youth that can lead to substance abuse (Tharp-Taylor et al., 2009), worse outcomes at school (Miller et al., 2000), mental and physical health pro...
- Published
- 2020
49. Latent stability and change in subgroups of social anxiety and depressive symptoms in adolescence: a latent profile and transitional analysis
- Author
-
Natasha R. Magson, Nejra van Zalk, Ewa Mörtberg, Ian Chard, Maria Tillfors, and Ronald M. Rapee
- Subjects
Male ,Psychiatry and Mental health ,Clinical Psychology ,Adolescent ,Depression ,Humans ,Female ,Comorbidity ,Anxiety - Abstract
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.
- Published
- 2022
50. Acceptability and Outcomes of the Cool Little Kids Parenting Group Program for Culturally and Linguistically Diverse Families Within an Australian Population-Based Study
- Author
-
Jordan Kha, Ronald M. Rapee, and Jordana K. Bayer
- Subjects
Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology - Published
- 2022
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.