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Background: Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period.Method: A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum.Results: Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training.Conclusions: Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. [ABSTRACT FROM AUTHOR]

Background: A magnetic resonance imaging (MRI) procedure can cause preprocedural and periprocedural anxiety in children. Psychosocial interventions are used to prepare children for the procedure to alleviate anxiety, but these interventions are time-consuming and costly, limiting their clinical use. Virtual reality (VR) is a promising way to overcome these limitations in the preparation of children before an MRI scan. Objective: The objective of this study is (1) to develop a VR smartphone intervention to prepare children at home for an MRI procedure; and (2) to examine the effect of the VR intervention in a randomized controlled trial, in which the VR intervention will be compared to care as usual (CAU). CAU involves an information letter about an MRI examination. The primary outcome is the child's procedural anxiety during the MRI procedure. Secondary outcomes include preprocedural anxiety and parental anxiety. We hypothesize that the VR preparation will result in a higher reduction of the periprocedural anxiety of both parents and children as compared to CAU. Methods: The VR intervention provides a highly realistic and child-friendly representation of an MRI environment. In this randomized controlled trial, 128 children (aged 6 to 14 years) undergoing an MRI scan will be randomly allocated to the VR intervention or CAU. Children in the VR intervention will receive a log-in code for the VR app and are sent cardboard VR glasses. Results: The VR smartphone preparation app was developed in 2020. The recruitment of participants is expected to be completed in December 2022. Data will be analyzed, and scientific papers will be submitted for publication in 2023. Conclusions: The VR smartphone app is expected to significantly reduce pre- and periprocedural anxiety in pediatric patients undergoing an MRI scan. The VR app offers a realistic and child-friendly experience that can contribute to modern care. A smartphone version of the VR app has the advantage that children, and potentially their parents, can get habituated to the VR environment and noises in their own home environment and can do this VR MRI preparation as often and as long as needed. [ABSTRACT FROM AUTHOR]

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Objective: To conduct a systematic review of pain anxiety, pain catastrophizing, and fear of pain measures psychometrically established in youth with chronic pain. The review addresses three specific aims: (1) to identify measures used in youth with chronic pain, summarizing their content, psychometric properties, and use; (2) to use evidence-based assessment criteria to rate each measure according to the Society of Pediatric Psychology (SPP) guidelines; (3) to pool data across studies for meta-analysis of shared variance in psychometric performance in relation to the primary outcomes of pain intensity, disability, generalized anxiety, and depression.Methods: We searched Medline, Embase, PsycINFO, and relevant literature for possible studies to include. We identified measures studied in youth with chronic pain that assessed pain anxiety, pain catastrophizing, or fear of pain and extracted the item-level content. Study and participant characteristics, and correlation data were extracted for summary and meta-analysis, and measures were rated using the SPP evidence-based assessment criteria.Results: Fifty-four studies (84 papers) met the inclusion criteria, including seven relevant measures: one assessed pain anxiety, three pain catastrophizing, and three fear of pain. Overall, five measures were rated as "well established." We conducted meta-analyses on four measures with available data. We found significant positive correlations with the variables pain intensity, disability, generalized anxiety, and depression.Conclusion: Seven measures are available to assess pain anxiety, pain catastrophizing, and fear of pain in young people with chronic pain, and most are well established. We present implications for practice and directions for future research. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children and adolescents are at a significantly high risk of mental health problems during their lifetime, among which are depression and anxiety, which are the most common. Life skills education is one of the intervention programmes designed to improve mental wellbeing and strengthen their ability to cope with the daily stresses of life. This review aimed to identify and evaluate the effect of life skills intervention on the reduction of depression, anxiety and stress among children and adolescents. Following the Population, Intervention, Comparison and Outcome (PICO) model and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2009 checklist, eight databases (Academic Search Complete, CINAHL, Cochrane, MEDLINE, Psychology and Behavioural Sciences Collection, PubMed, Scopus and Web of Science) were systematically reviewed from 2012 to 2020. The search was limited to English papers only. It included published experimental and quasi-experimental studies addressing the effect of life skills interventions on the reduction of at least one of the following mental health disorders: depression, anxiety and stress among children and adolescents (from the age of 5 years old to 18 years old). We used the Joanna Briggs Institute checklist for experimental and quasi-experimental studies to evaluate the quality of the included studies. This study was registered in PROSPERO [CRD42021256603]. The search identified only 10 studies (three experimental and seven quasi-experimental) from 2,160 articles. The number of the participants was 6,714 aged between 10 years old and 19 years old. Three studies in this review focused on depression and anxiety, whereas one study investigated depression and the other anxiety. Three studies targeted only stress and two examined the three outcomes, namely, depression, anxiety and stress. Almost in all studies, the life skills intervention positively impacted mental disorders, considering the differences among males and females. The overall methodological quality of the findings was deemed to be moderate to high. Our results clearly indicated the advantages of life skills programmes among adolescents in different settings and contexts. Nonetheless, the results highlight some important policy implications by emphasising the crucial roles of developers and policymakers in the implementation of appropriate modules and activities. Further research examining life skills intervention with a cultural, gender perspective, age-appropriate and long-term effect is recommended. [ABSTRACT FROM AUTHOR]

The article discusses a paper that investigated if MathWise, an eight week one-on-one math tutoring program alleviates math anxiety in elementary school-aged children between seven-nine years. It informs that during the study participants underwent functional magnetic resonance imaging (fMRI) and also reported math anxiety levels using the Scale for Early Mathematics Anxiety (SEMA). The result showed that the intervention reduced math anxiety scores in the children.

Gastroparesis (GP) is a chronic, gastric dysmotility disorder with significant morbidity and mortality. The hallmark of GP is the delayed emptying of the contents of the stomach in the absence of any mechanical obstruction. Patients most commonly report chronic symptoms of nausea, vomiting, feeling full quickly when eating, bloating, and abdominal pain. Treatments are limited with relatively poor efficacy. As such, children with GP are at significant risk for the development of psychological co-morbidities. In this paper, we provide a topical review of the scientific literature on the psychological, social, and emotional impacts of gastroparesis in pediatric patients. We aim to document the current state of research, identify gaps in our knowledge with appropriate recommendations for future research directions, and highlight the unique challenges pediatric patients with GP and their families may face as they manage this disease. Based on the current review, research into the psychosocial impacts in children with GP is essentially non-existent. However, when considering research in children with other chronic digestive diseases, children with GP are likely to face multiple psychosocial challenges, including increased risk for anxiety and depression, stigma, and reduced quality of life. These significant gaps in the current understanding of effects of GP across domains of childhood functioning allow for ample opportunities for future studies to address psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Psihiatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The transition from primary to secondary school can be a period of anxiety for many children. Although most schools have developed systems to ease this process, it has been argued that the emphasis is often on administrative and organisational procedures. In contrast, children and parents are typically more concerned with personal and social issues. It may be that such concerns have received insufficient attention in the past. This paper employs theoretical perspectives from the literature on resilience and self-esteem to examine key aspects of the process of transition from the perspective of the individual child. It is argued that for some children at least, transition can be legitimately considered ‘a challenge of living’ because of the social and personal messages which are received from a range of experiences within a concentrated period of time. The nature and source of these messages are discussed, and some implications for practitioners suggested. It is argued that in order to help vulnerable individuals cope with, and even benefit from, the period of transition, we need to focus more on the way social and personal experiences are interpreted at this time. [ABSTRACT FROM AUTHOR]

In this paper ambivalent commitments to parenting and family life by the New Labour government are explored by reference to the example of adoption support. Developments in adoption illuminate contrasting expectations in family policy and children's services more generally. Traditional normative concerns to support family status and parental autonomy are unsettled by contemporary anxieties about child outcomes and social mobility. Impatience with the attitudes and behaviour of parents has led to a ‘progressive universalism’ in which enhanced parenting services and expectations for all are combined with increasingly insistent and targeted interventions for the particularly needy, reluctant or recalcitrant few. At the same time demands for greater service modernization and professional effectiveness have led government to position parents as (potential) consumers too. The paper discusses these policy and practice tensions and concludes that new spaces are being opened up for the negotiation between parents and professionals about rights and responsibilities in family life and its support. [ABSTRACT FROM AUTHOR]

Background and Objectives: The essence of Problem-based Learning (PBL) is to find a prêt-à-porter solution to a problem, which is also known as scenario. Several features differentiate this teaching methodology from other typical approaches in language teaching contexts. In order to reinforce the association between learners' construction of the required knowledge to solve an ill-structured problem when assessing different possible solutions and attempting to find an acceptable solution, learners need to collect necessary information mostly on their own with the help of a teacher as a facilitator. PBL can also be considered as a potentially useful approach to language teaching and learning, especially with regard to productive skills in which leaners practice more fluently if they experience more involvement in the learning process. The PBL also contributes to learners and learning psychological aspects. Despite the generally acknowledged benefits of PBL, it has not been commonly used, especially in foreign language learning contexts. One reason for this may have been concerns about how the method might affect foreign language learners' feeling of anxiety, self-efficacy and willingness to communicate. The major objective of this study was to bridge the gap in our understanding of how the implementation of the PBL approach affects English as a Foreign Language (EFL) learners' psychological factors of willingness to communicate, self-efficacy, and classroom anxiety. Materials and Methods: Ninety pre-intermediate EFL students were selected according to the Oxford Placement Test (OPT) and purposeful sampling method. They were randomly assigned into 3 groups of online PBL, face-to-face PBL, and control group with 30 learners in each. Students in both online PBL and face-to-face PBL classes embarked on a 10-session speaking course according to the framework of the PBL approach. Meanwhile, the control group received speaking instruction based on a conventional method other than the PBL. Three questionnaires of Willingness to Communicate (WTC), English selfefficacy, and foreign language classroom anxiety scale were administered before and after the course to all participants. Analysis of covariance (ANCOVA) was employed to analyze the data. Findings: Results showed that EFL learners in the online and face-to-face PBL classes outperformed those in the control group in their WTC and self-efficacy. In addition, learners in the online and face-to-face PBL groups meaningfully experienced a lower level of classroom anxiety compared with the control group. Conclusions: The findings of the present study suggest that the PBL approach efficiently motivates learners to communicate and interact within the classroom context. In addition, learners in the online and conventional PBL groups felt more self-determining and responsible for their learning as a result of feeling more comfortable in the learning environment. Results also shed light on the idea that due to the experiential aspect of PBL, when learners explore the solutions to the problem/scenario and discuss them with others, that forms an environment with a minimized classroom speaking anxiety. Implications are also discussed at the end of the study. [ABSTRACT FROM AUTHOR]

For children with profound disabilities affecting communication, it can be extremely challenging to identify salient emotions such as anxiety. If left unmanaged, anxiety can lead to hypertension, cardiovascular disease, and other psychological diagnoses. Physiological signals of the autonomic nervous system are indicative of anxiety, but can be difficult to interpret for non-specialist caregivers. This paper evaluates an auditory interface for intuitive detection of anxiety from physiological signals. The interface, called "Biomusic," maps physiological signals to music (i.e., electrodermal activity to melody; skin temperature to musical key; heart rate to drum beat; respiration to a "whooshing" embellishment resembling the sound of an exhalation). The Biomusic interface was tested in two experiments. Biomusic samples were generated from physiological recordings of typically developing children (n = 10) and children with autism spectrum disorders (n = 5) during relaxing and anxiety-provoking conditions. Adult participants (n = 16) were then asked to identify "anxious" or "relaxed" states by listening to the samples. In a classification task with 30 Biomusic samples (1 relaxed state, 1 anxious state per child), classification accuracy, sensitivity, and specificity were 80.8% [standard error (SE) = 2.3], 84.9% (SE = 3.0), and 76.8% (SE = 3.9), respectively. Participants were able to form an early and accurate impression of the anxiety state within 12.1 (SE = 0.7) seconds of hearing the Biomusic with very little training (i.e., <10 min) and no contextual information. Biomusic holds promise for monitoring, communication, and biofeedback systems for anxiety management. [ABSTRACT FROM AUTHOR]

Background: Evidence about relevant outcomes is required in the evaluation of clinical interventions for children with autism spectrum disorders (ASD). However, to date, the variety of outcome measurement tools being used, and lack of knowledge about the measurement properties of some, compromise conclusions regarding the most effective interventions. Objectives: This two-stage systematic review aimed to identify the tools used in studies evaluating interventions for anxiety for high-functioning children with ASD in middle childhood, and then to evaluate the tools for their appropriateness and measurement properties. Methods: Electronic databases including Medline, PsychInfo, Embase, and the Cochrane database and registers were searched for anxiety intervention studies for children with ASD in middle childhood. Articles examining the measurement properties of the tools used were then searched for using a methodological filter in PubMed, and the quality of the papers evaluated using the COSMIN checklist. Results: Ten intervention studies were identified in which six tools measuring anxiety and one of overall symptom change were used as primary outcomes. One further tool was included as it is recommended for standard use in UK children's mental health services. Sixty three articles on the properties of the tools were evaluated for the quality of evidence, and the quality of the measurement properties of each tool was summarised. Conclusions: Overall three questionnaires were found robust in their measurement properties, the Spence Children's Anxiety Scale, its revised version – the Revised Children's Anxiety and Depression Scale, and also the Screen for Child Anxiety Related Emotional Disorders. Crucially the articles on measurement properties provided almost no evidence on responsiveness to change, nor on the validity of use of the tools for evaluation of interventions for children with ASD. PROSPERO Registration number: CRD42012002684. [ABSTRACT FROM AUTHOR]

Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contacts with parents of children and adolescents suffering from mental illness, and it is a precondition for the availability of support for these parents. This paper describes how such parents perceive collaboration between professionals in mental health care, social services, and schools. Methods: This was a small-scale qualitative study. Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health patient records kept by the Stockholm County Council (Sweden), and they all lived in a catchment area for Child and Adolescent Mental Health outpatient services in Stockholm. Results and discussion: Our results suggest that when the encounter between parents and professionals is characterised by structure and trust, it is supportive and serves as a holding environment. Parents think that communication links and coordination between professionals from different organisations are needed in the collaboration, along with appropriately scheduled and well-performed joint meetings to create structure in the parent-professional encounter. Parents also think that establishment of trust in this interaction is promoted by individual professionals who are available, provide the parents with adequate information, are skilled, and show empathy and commitment. [ABSTRACT FROM AUTHOR]

Linked Content This article is linked to Ludvigsson et al and Kilincalp and Haji papers. To view these articles, visit https://doi.org/10.1111/apt.14991 and https://doi.org/10.1111/apt.15110. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Lituanica is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects [1,2]. Intervention with Virtual Reality (VR) games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. Methods: This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5-18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. Results: The average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8) Conclusion: The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain. [ABSTRACT FROM AUTHOR]

ABSTRACT There has been a tendency in the sociology of education to stress the anxieties and fears that are so potently aroused in relation to the transition to secondary school. While this work is extremely important we suggest that an emphasis on fear and anxiety cannot get to grips with the very real sense of excited anticipation with which the children's talk in our study is also infused. The focus of this paper is to consider some of the ways in which anxiety does figure in children's narratives around the secondary school transfer. We examine some of the positive functions of anxiety as part of a developmental process, placing it as an integral and necessary force in transitional states, particularly those connected to changes which impact powerfully on children's construction of 'self'. We consider some of the ways in which some psycho-dynamic frameworks (object relations theories) and social theories (particularly modernism) conceptualise anxiety and its place in the struggle involved in the project of 'selfhood'. [ABSTRACT FROM AUTHOR]

Background: Children of caregivers with problematic substance use are at an increased risk for adverse childhood experiences, such as neglect, intentional and unintentional abuse, and household dysfunction. These experiences can contribute to anxiety, which is the most common mental health concern for children. Anxiety has multiple short- and long-term adverse effects. Aim: To describe the anxiety-provoking experiences of children living with caregivers who experience problematic substance use. Methods: Secondary analysis using exploratory, inductive thematic analysis was conducted on 16 interviews of individuals affected by substance use disorder in the Prince Albert, Saskatchewan area. The focus of the analysis is to describe anxiety-provoking experiences of children living in homes affected by a caregiver's substance use. Results: Three main themes were identified and included experiencing trauma, living in an unstable home environment, and resiliency in adulthood. Conclusion: Children who lived with caregivers with problematic substance use faced anxiety while living in an unstable home environment and experiencing traumatic events. This anxiety continued into adulthood. These children demonstrated resiliency despite the hardships they faced. This research contributes to understanding childhood anxiety in the context of living with caregivers with problematic substance use and the importance of using a trauma-informed approach when working with children. [ABSTRACT FROM AUTHOR]

The article highlights the paper "The Transsexual Syndrome in Males. I. Primary Transsexualism," by Ethel Person and Lionel Ovesey. The authors aimed to examine male transsexualism in more detail. They found that in male transsexualism, the child countered separation anxiety by resorting to a separative fantasy of symbiotic fusion with the mother. This resulted to an ambiguity of core gender identity, referring to the sense of maleness. In addition, the authors showed the different solutions found in transvestism and effeminate homosexuality.

Suggests that the measurement of palmar sweat might be a practical means of measuring changes in autonomic nervous-system activity in children which presumably is related to the construct of anxiety. Increases in sweating observed in four- and five-year-old children after hearing a short story that was mildly anxiety-arousing; Measurements that can be made without disrupting the child's ongoing activity.

Background: Considering the heterogenous evidence, a systematic review of the change in anxiety in European children and adolescents associated with the COVID-19 pandemic is lacking. We therefore assessed the change compared with pre-pandemic baselines stratified by gender and age as well as evaluated the impact of country-specific restriction policies. Methods: A registration on the 'International Prospective Register of Systematic Reviews' (PROSPERO) occurred and an a priori protocol was published. We searched six databases (PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, WHO COVID-19) using a peer-reviewed search string with citation tracking and grey literature screening. Primary outcomes were: (1) general anxiety symptoms; and (2) clinically relevant anxiety rates. We used the Oxford COVID-19 Stringency Index as an indicator of pandemic-related restrictions. Screening of title/abstract and full text as well as assessing risk of bias (using the 'Risk of Bias in Non-randomized Studies of Exposure' [ROBINS-E]) and certainty of evidence (using the 'Grading of Recommendations Assessment, Development and Evaluation' [GRADE]) was done in duplicate. We pooled data using a random effects model. Reporting is in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. Results: Of 7,422 non-duplicate records, 18 studies with data from 752,532 pre-pandemic and 763,582 pandemic participants met full inclusion criteria. For general anxiety symptoms the total change effect estimate yielded a standardised mean difference (SMD) of 0.34 (95% confidence interval [CI], 0.17–0.51) and for clinically relevant anxiety rates we observed an odds ratio of 1.08 (95%-CI, 0.98–1.19). Increase in general anxiety symptoms was highest in the 11–15 years age group. Effect estimates were higher when pandemic-related restrictions were more stringent (Oxford Stringency Index > 60: SMD, 0.52 [95%-CI, 0.30–0.73]) and when school closures (School Closure Index ≥ 2: SMD, 0.44 [95%-CI, 0.23–0.65]) occurred. Conclusion: General anxiety symptoms among children and adolescents in Europe increased in a pre/during comparison of the COVID-19 pandemic; particularly for males aged 11–15 years. In periods of stringent pandemic-related restrictions and/or school closures a considerable increase in general anxiety symptoms could be documented. PROSPERO registration: CRD42022303714. [ABSTRACT FROM AUTHOR]

We aimed to assess anxiety of children with primary ciliary dyskinesia (PCD) and their primary caregivers at the beginning of Coronavirus disease-2019 (COVID-19) pandemic and change in levels of anxiety in first year with prolongation of pandemic. This was a two-step study; first step was questionnaire-based, conducted via teleconference. In first step, 29 patients and 105 healthy children and their mothers were participated; 25 children with PCD and their mothers were in second step. Demographic characteristics, clinical informations were recorded. Children's and mothers' state and trait anxiety levels were assessed and compared. Anxiety levels of mothers of patients were assessed according to clinical characteristics of children. Mothers' knowledge of COVID-19 and effect of teleconference on their anxiety was evaluated. State anxiety levels in the first year of pandemic of children with PCD and their mothers were also compared. Compared to control group, state anxiety of children in 13-18 age group and trait anxiety of their mothers were lower (p<0.05). In both groups, trait and state anxiety of 13-18 years old children and mothers positively correlated. Trait anxiety of mothers of patients negatively correlated with patients' FEV1 and MEF25-75. Patients' mothers reported feeling less anxiety at the end of teleconference. Anxiety of mothers of patients (especially under 9 years old) had increased as pandemic continued. At the beginning of pandemic, children with PCD were less anxious than healthy children, and their mothers had lower trait anxiety than mothers of healthy children. Being followed for chronic disease and obtaining information about COVID-19 may have reduced anxiety of children with PCD and their mothers. However, as pandemic continues, need to protect their children with PCD from infection, especially of mothers with younger children, may have raised their concerns. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence supports the efficacy of measurement-based care (MBC) for children and adolescents experiencing mental health concerns, particularly anxiety and depression. In recent years, MBC has increasingly transitioned to web-based spaces in the form of digital mental health interventions (DMHIs), which render high-quality mental health care more accessible nationwide. Although extant research is promising, the emergence of MBC DMHIs means that much is unknown regarding their effectiveness as a treatment for anxiety and depression, particularly among children and adolescents. Objective: This study uses preliminary data from children and adolescents participating in an MBC DMHI administered by Bend Health Inc, a mental health care provider that uses a collaborative care model to assess changes in anxiety and depressive symptoms during participation in the MBC DMHI. Methods: Caregivers of children and adolescents participating in Bend Health Inc for anxiety or depressive symptoms reported measures of their children's symptoms every 30 days throughout the duration of participation in Bend Health Inc. Data from 114 children (age 6-12 years) and adolescents (age 13-17 years) were used for the analyses (anxiety symptom group: n=98, depressive symptom group: n=61). Results: Among children and adolescents participating in care with Bend Health Inc, 73% (72/98) exhibited improvements in anxiety symptoms and 73% (44/61) exhibited improvement in depressive symptoms, as indicated by either a decrease in symptom severity or screening out of completing the complete assessment. Among those with complete assessment data, group-level anxiety symptom T-scores exhibited a moderate decrease of 4.69 points (P=.002) from the first to the last assessment. However, members' depressive symptom T-scores remained largely stable throughout their involvement. Conclusions: As increasing numbers of young people and families seek DMHIs over traditional mental health treatments due to their accessibility and affordability, this study offers promising early evidence that youth anxiety symptoms decrease during involvement in an MBC DMHI such as Bend Health Inc. However, further analyses with enhanced longitudinal symptom measures are necessary to determine whether depressive symptoms show similar improvements among those involved in Bend Health Inc. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop an explanatory model of assertiveness based on parenting styles mediated by anxiety and self-esteem. Methods: This study is descriptive-correlational modeling with partial least squares. The statistical population included singleton children of the sixth grade of the elementary school in the 3rd District of Tehran in the academic year 2017-18. The sampling method was multistage sampling; eight schools (four all-boys and four all-girls) were randomly selected from all primary schools in the 3rd District of Tehran, then, a sixth-grade class was randomly selected in each school. The singleton students of those classes participated in the present study as the study sample. The sample size was 118 students (81 girls and 37 boys). The instruments of this research included the Persian forms of adaptive and aggressive assertiveness scales (AAA-S), the Baumrind parenting scale, Beck anxiety inventory (BAI), and Rosenberg self-esteem scale (RSES). To analyze the data, the SPSS software, version 26. Results: The results indicated that authoritative and permissive parenting styles had a significant effect on assertiveness among the parenting styles. The total effects indicated that authoritative and permissive parenting styles explained 0.22 and 0.20 of the variances of assertiveness. The results also showed that the authoritarian parenting style had no significant effect on assertiveness. Discussion: The suggested model was acceptably fit, according to the results of the study. Permissive and authoritative parenting styles had impact on assertiveness. [ABSTRACT FROM AUTHOR]

The DREAM project is a joint venture between the medical world, university professors and developers with one goal in mind: create an efficient distraction tool to reduce pain and anxiety in children receiving medical treatments. Growing evidence in the medical literature suggests that virtual reality is a very potent and effective way of creating distraction. In turn, distraction has been shown to reduce pain and anxiety in children who are receiving painful medical procedures. The pediatric population offers quite a challenge when it comes to pain control, especially the pain caused by medical procedure. Anxiety and anticipation greatly modulates pain perception and can often je opardize a tre atme nt if a child's collaboration cannot be obtained. With those premises in mind, our team is trying to create an efficient virtual reality game for distracting kids from their pain. The DREAM game has been tailored for the very specific needs and characteristics of our target population. The experience is optimized for the oculus rift and the controls have been simplified to work in various medical settings with minimal preparation time. Our main concern was to create a game that delivers a potent distractive effect while inciting almost no side effects or cyber sickness. The DREAM project is currently being tested on children with burn injuries . The objective of this paper is to present the methodology used to validate our hypotheses. [ABSTRACT FROM AUTHOR]

Background: Internet-based treatments for child anxiety may help to increase access to evidence-based therapies; however, user engagement, uptake, and adherence within routine clinical practice remain as challenges. Involving the intended end users in the development process through user-centered design and usability testing is crucial for maximizing user engagement and adoption of internet-based treatments, but so far this has been lacking for internet-based treatments for child anxiety. Objective: The aim of this study is to develop an internet-based treatment for child anxiety through a process of user-centered design (phase 1) and usability testing (phase 2), based on an existing evidence-based, face-to-face, therapist-supported, parent-led cognitive behavioral therapy intervention. It is intended that the internet-based version of this treatment would consist of a parent website, case management system for clinicians, and mobile game app for children. Methods: Parents, children, and clinicians who were familiar with the face-to-face version of the treatment were recruited from 2 National Health Service clinics. In phase 1, participants participated in 3 workshops to gain feedback on the overall concept, explore their wants and needs for the websites and game, generate ideas on how the treatment may look, and gain feedback on initial mock-ups of the websites and game. In phase 2, participants attended 3 individual usability testing sessions where they were presented with working prototypes of the website or game and asked to perform a series of tasks on the website (parents and clinicians) or play the game (children). The frequency and details on usability errors were recorded. Participants were asked for their feedback on the website and game using a standardized usability questionnaire and semistructured interviews. The websites and game were iterated after each round of usability testing in response to this feedback. Results: In phase 1, participants approved the general concept and rated the initial mock-ups of the website and game positively. In phase 2, working prototypes were rated positively and usability errors declined across the iterations and were mainly cosmetic or minor issues relating to esthetic preference, with few issues regarding ability to navigate the website or technical issues affecting functionality. Feedback from the semistructured interviews further supported the positive response of participants to the website and game, and helped identify areas for improvement during the iteration process. The final iteration of the website and game are presented. Conclusions: Taking an iterative approach to development through user-centered design and usability testing has resulted in an internet-based treatment for child anxiety (Online Support and Intervention for child anxiety) that appears to meet the needs and expectations of the intended users (parents, children, and clinicians) and is easy and enjoyable to use. [ABSTRACT FROM AUTHOR]

Background: Facial scales are used in the assessment of emotional states. The scales present different numbers of faces to measure the varying levels of intensity of children's emotional responses. This paper seeks to analyze the whether the subjects are able to match the appropriate descriptors of a degree of anxiety with the corresponding facial image. Method: A sample of 463 children aged 6 to 12 years was taken from the Autonomous Communities of Murcia and the Balearics. Results: Significant differences were obtained among the six-year-olds, M = 2.58 (SD = 0. 85), in the three face scale and M = 2.98 (SD = 1.52) in the five-face scale. From 7 years on, there were no significant differences in the number of correct responses between the two scales. In general, girls scored higher than boys on both the three-face scale (M = 2.89, SD = 0.50 vs. M = 2.75, SD = 0.70) and the five face scale (M = 4.08, SD = 1.41 vs. M = 3.76, SD = 1.56). Conclusion: The three-face scale is more appropriate for the correct matching of descriptors to different degrees of anxiety for children aged 6 to 12 years, whereas the five-face scale is more suited to children over 6 years. [ABSTRACT FROM AUTHOR]

Equine-facilitated activities (EFA) are generally considered to be an alternative treatment method by using the natural body form, gait and behavior of horses. EFA have been used for many years to treat and to improve the living conditions of people with disorders or disabilities such as autism, cerebral palsy (CP), arthritis, multiple sclerosis, stroke, spinal cord injury, behavioral and psychiatric disorders. This study aims to examine the effects of adaptive riding (AR), which is a subdiscipline under EFA, on anxiety, empathy, aggression, and emotional regulation of children diagnosed with cerebral palsy. Maternal depression and anxiety level measurements were also included in the study. Twenty children with CP, between 7 and 10 years old and their mothers participated in the study. They were randomly assigned to one of two groups (intervention and control) consisting of 10 participants. Pre and post measurements were implemented at the beginning and at the end of 8 weeks of AR intervention. The Screen for Anxiety Related Emotional Disorders, Bryant Index of Empathy Measurement for Children and Adolescents, Buss-Perry Aggression Questionnaire, Beck Depression Inventory, The State-Trait Anxiety Inventory were used to measure the psychological and emotional status of the participants and depression, anxiety levels of mothers. Aggression, anxiety, and maternal depression decreased; empathy and emotional regulation improved in the intervention group. No significant differences found in the control group. This study provides strong evidence that an 8-week AR intervention has positive effects on children with cerebral palsy. Significant improvements regarding both maternal and children’s psychological and emotional aspects showed how an alternative therapy with animals can be constructive. [ABSTRACT FROM AUTHOR]

Background: Every year, millions of children undergo medical procedures that require anesthesia. Fear and anxiety are common among young children undergoing such procedures and can interfere with the child's recovery and well-being. Relaxation, distraction, and education are methods that can be used to prepare children and help them cope with fear and anxiety, and serious games may be a suitable medium for these purposes. User-centered design emphasizes the involvement of end users during the development and testing of products, but involving young, preschool children may be challenging. Objective: One objective of this study was to describe the development and usability of a computer-based educational health game intended for preschool children to prepare them for upcoming anesthesia. A further objective was to describe the lessons learned from using a child-centered approach with the young target group. Methods: A formative mixed methods child (user)-centered study design was used to develop and test the usability of the game. Preschool children (4-6 years old) informed the game design through playful workshops (n=26), and usability testing was conducted through game-playing and interviews (n=16). Data were collected in Iceland and Finland with video-recorded direct observation and interviews, as well as children's drawings, and analyzed with content analysis and descriptive statistics. Results: The children shared their knowledge and ideas about hospitals, different emotions, and their preferences concerning game elements. Testing revealed the high usability of the game and provided important information that was used to modify the game before publishing and that will be used in its further development. Conclusions: Preschool children can inform game design through playful workshops about health-related subjects that they are not necessarily familiar with but that are relevant for them. The game's usability was improved with the participation of the target group, and the game is now ready for clinical testing. [ABSTRACT FROM AUTHOR]

Nearly 1,100 young students living in Japan at a range of distances up to 500 km from the 1995 Kobe M7 earthquake were interviewed. A statistically significant abnormal rate of early wakening before the earthquake was found, having exponential decrease with distance and a half value approaching 100 km, but decreasing much slower than from a point source such as an epicentre; instead originating from an extended area of more than 100 km in diameter. Because an improbably high amount of variance is explained, this effect is unlikely to be simply psychological and must reflect another mechanism--perhaps Ultra-Low Frequency (ULF) electromagnetic waves creating anxiety--but probably not 222Rn excess. Other work reviewed suggests these conclusions may be valid for animals in general, not just children, but would be very difficult to apply for practical earthquake prediction. [ABSTRACT FROM AUTHOR]

The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive- compulsive disorder. Differences between epidemiological and clinical data are discussed. [ABSTRACT FROM AUTHOR]

Collaborations between healthcare and faith-based organizations have emerged in the drive to improve access to care. Little research has examined clergy views on collaborations in the provision of mental healthcare, particularly to children. The current paper reports survey responses of 25 clergy from diverse religious traditions concerning mental health care in children. Subjects queried include clergy referral habits, specific knowledge of childhood conditions such as depression and anxiety, past experiences with behavioral health workers, and resources available through their home institutions. Overall, surveyed clergy support collaborations to improve childhood mental health. However, they vary considerably in their confidence with recognizing mental illness in children and perceive significant barriers to collaborating with mental health providers. [ABSTRACT FROM AUTHOR]

Abstract: Computational models of the artificial intelligence such as rough set theory have several applications. Data clustering under rough set theory can be considered as a technique for medical decision making. One possible application is the clustering of student suffering study’s anxiety. In this paper, we present the applicability of variable precision rough set model for clustering student suffering studies anxiety. The proposed technique is based on the mean of accuracy of approximation using variable precision of attributes. The datasets are taken from a survey aimed to identify of studies anxiety sources among students at Universiti Malaysia Pahang (UMP). At this stage of the research, we show how variable precision rough set model can be used to groups student in each study’s anxiety. The results may potentially contribute to give a recommendation how to design intervention, to conduct a treatment in order to reduce anxiety and further to improve student’s academic performance. [Copyright &y& Elsevier]

Little attention has been paid to the needs of refugee children in Canada. The last decade has seen increasing numbers of Roma refugees settling in southern Ontario, and this qualitative study explored the needs of Roma refugee children in the education, health and social services sectors. We interviewed or conducted focus groups with 24 Roma and 62 service providers from those sectors. Participants indicated that Roma children had high needs for service in all these sectors, but that families were often unable or unwilling to access services effectively. Specifically, children needed schooling for language acquisition and for the development of social relationships; absenteeism was a concern. Income assistance was needed by Roma and other newly-arriving families. Continuity and quality of health care was an issue. In all sectors, barriers were related to language, culture and the unique history of the Roma people. This paper contextualizes study findings by briefly summarizing Roma historical and current experience in Europe; this experience is critical to an understanding of the difficulties that Roma encounter with institutional systems. [ABSTRACT FROM AUTHOR]

In the current paper we discuss the treatment of childhood anxiety disorders using a problem-solving consultation framework. The role of consultation as a service delivery model in a school setting is elaborated on, as well as the contribution that consultation has in the movement towards evidence-based practices in school psychology. Additionally, a description of the role of consultation specifically in the treatment of childhood anxiety is provided. The role of parents and teachers in treatment is further elucidated, and the separate influence each may have on traditional treatment outcomes is presented. Finally, we discuss the benefits of using a conjoint behavioral consultation model (CBC) of treatment, whereby a mental health professional consults with a child's parents and teachers, who collaborate to assess, monitor, and treat the child's problems. We conclude with a discussion of the benefits of this collaborative approach to treatment of childhood anxiety and illustrate the application of CBC with a case example of selective mutism. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most prevalent childhood psychological disorders. In addition to causing acute distress to the child, parent and school staff, anxiety disorders may also have a significant impact on a child's educational and social development and persist chronically into adulthood. Recent work has begun to identify the school as an important setting for both the treatment and prevention of anxiety disorders in children. This paper begins with a description of several prevalent anxiety disorders and their presentation in a school setting. It then describes some of the more common assessment tools designed specifically for the assessment of anxiety in children, as well as some of the advantages and limitations different methods of assessment offer. Three school-based treatment programs are reviewed; Cool Kids, Friends and Skills for Social and Academic Success (SASS). Both Cool Kids and Friends are suitable for the treatment of anxiety disorders broadly, whereas the SASS has been included in the review as an example of a program designed specifically for social phobia. Several practical issues such as universal versus targeted delivery, parental involvement and implementation are also discussed. [ABSTRACT FROM AUTHOR]

This article provides an overview of cognitive-behavioural strategies used in the treatment of child-anxiety problems, emphasizing the need for exposure and caregiver involvement. Most of the paper focuses on developments in empirically supported cognitive-behavioral intervention protocols for generalized anxiety disorder, separation anxiety disorder, social phobia, specific phobia, and school refusal. The research status of interventions for phobias and anxiety disorders of children with disabilities, a much neglected area, is also considered. Particular attention is given to randomized controlled trials. Analogue studies are not included in this particular review, thus strengthening conclusions regarding treatment efficacy. In general, cognitive and behavioral strategies appear to be useful for these distressing child-anxiety problems; however, there is a limited understanding of the active components in treatment, treatment mechanisms of change, and prediction of treatment outcome. [ABSTRACT FROM AUTHOR]

This paper describes the behavioral treatment of acute onset school refusal in a 5-year old girl with Separation Anxiety Disorder (SAD). A functional classification was used to select a treatment approach that involved the parent and teacher using shaping, positive reinforcement and extinction. Results showed that by the end of the fifth week of treatment, the child was attending full time schooling and no longer met the criteria for SAD. Treatment gains were maintained at 4 and 12-month follow-ups. Results are discussed in terms of the efficacy of the treatment, the involvement of teachers and parents, and the treatment utility of a functional classification. [ABSTRACT FROM AUTHOR]

(1) Background: For nearly 20 years, the wingwave® method, which combines elements of eye movement desensitization and reprocessing (EMDR) and a muscular strength test, has been used to reduce anxiety and improve relaxation in subjects. Past studies have scientifically evaluated this method in various contexts and have found it to be effective. In this study, we investigated the effects of short-term wingwave® coaching on specific anxiety parameters regarding school, concentration ability, and subjective feelings towards two self-chosen themes in schoolchildren. (2) Methods: A group of 53 schoolchildren aged 11 to 12 years were randomly divided between an experimental and a control group. The experimental group received an intervention of three wingwave® coaching sessions (one hour each). In these sessions, past and present negative feelings towards school as well as psychological resources to face future tasks in school were focused on and utilized. (3) Results: The results showed that the overall text anxiety, manifested anxiety, and dislike of school decreased significantly in the experimental group after the three coaching sessions compared to the control group. Furthermore, both concentration ability and the subjective feeling towards self-chosen subjects improved significantly in the experimental group compared to the control group. (4) Conclusions: Our results indicate that the wingwave® method is an appropriate and effective instrument to reduce school anxiety and to improve concentration performance in schoolchildren—at least in the short and medium term. [ABSTRACT FROM AUTHOR]

This paper aims to establish a theoretical approach to the problem of children's neurotic disorders and their orthodontic effects. It will provide an overview of the literature on the definition of children's neurotic disorders, summarizing specific approaches related to these disorders. The theoretical article also highlights and explains the main issues arising from orthodontic effects. The article will also explain some theoretical models that analyze specific neurotic disorders in children's early life. The novelty of this article also mentions the forefront disorders such as bruxism, biting lips, sucking finger, which arerelated with psychological and psychiatric effects on the orthodontic development. In some cases, children aged up to 5 years are developing an anxiety related to changes that occur in the development of their organic, emotional and cognitive progress. I think it is useful to understand these concepts in interrelation with the orthodontic development and be aware of correlations between these growths and the adequacy of treatment. [ABSTRACT FROM AUTHOR]

Considers racial comparisons in the adaptation of the Taylor manifest anxiety scale (CMAS) in children in Illinois. Interrelation between learning tasks, school achievement, intelligence and social status; Administration of the CMAS test on a group basis; Statistical analysis of the anxiety difference between Blacks and White.

Background: Quality of life and self-esteem are functional domains that may suffer when having mental problems. In this study, we examined the change in quality of life and self-esteem when targeting anxious and depressive symptoms in school children (8–12 years) using a CBT-based transdiagnostic intervention called EMOTION, Kids Coping with anxiety and depression. The aim of this study was to investigate quality of life and self-esteem in children with elevated levels of anxious and depressive symptoms, and further if the EMOTION intervention could influence these important functional domains. Methods: The study had a clustered randomized design (cRCT), where N = 795 children recruited from 36 schools participated. The children were included based on self-reports of anxious and depressive symptoms. Schools were the unit of randomization and were assigned to intervention or control condition. Children in the intervention condition received the 10-week EMOTION intervention. Mixed effects models were used to take account of the possible clustering of data. Separate models were estimated for the dependent variables. Results: Children with elevated levels of anxious and depressive symptoms reported lower levels of quality of life and self-esteem compared to normative samples, with girls and older children reporting the lowest levels. For both genders and older children, a large and significant increase in quality of life and self-esteem was found among the children who received the intervention compared to the children in the control condition. Children in the intervention group reporting both anxious and depressive symptoms showed a significantly larger increase in both quality of life and self-esteem compared to the controls. Reductions in quality of life and self-esteem were partially mediated by reductions in symptoms of anxiety and depression. Conclusions: Participating in an intervention targeting emotional symptoms may have a positive effect on quality of life and self-esteem in addition to reducing anxious and depressive symptoms. Improved quality of life may increase the child's satisfaction and subjective perception of wellbeing. As low self-esteem may lead to anxious and depressive symptoms, improving this functional domain in children may make them more robust dealing with future emotional challenges. Trial registration NCT02340637, retrospectively registered [ABSTRACT FROM AUTHOR]

Children with persistent asthma were compared with an age and sex matched control group for psychological problems and temperamental traits. Childhood Psychopathology Measurement Schedule (CPMS) and Temperament Measurement Schedule were used to assess psychological problems and temperamental traits, respectively. 69% of children in the study group scored more than the cut-off score on the CPMS compared to 13% in the control group (P<0.01). Children in the study group showed significantly more behavior problems, conduct symptoms, anxiety, depression and emotional problems compared to children in the control group. Children with asthma also received significantly low score on the temperament dimension of rhythmicity. [ABSTRACT FROM AUTHOR]