Search

Anxiety disorders are the most prevalent disorders among youth and understanding cognitive vulnerabilities for these disorders is crucial for early prevention and treatment. The present study examined the role of intolerance of uncertainty (IU) in predicting the severity of anxiety disorder symptoms among a sample of Iranian youth. The relationships between IU and anxiety disorder symptoms among youth [N = 683, ages 8-18, M (SD).sub.age= 14.02 (2.43); 58.07% girls] with and without anxiety disorders, and their parents [N = 676, ages 27-58, M (SD).sub.age= 40.63 (5.72); 61.8% female], were examined. Significant associations were found between youth- and parent-report IU and youth anxiety disorder symptoms. Youth with higher scores on total IU and prospective/inhibitory IU dimensions had significantly higher levels of anxiety disorder symptoms. Furthermore, youth-reported prospective/inhibitory IU were significantly related to specific youth anxiety and related disorder symptoms including generalized anxiety, separation anxiety, physical injury fears, obsessive-compulsive, social anxiety and panic/agoraphobia disorder symptoms. Findings provide cross-sectional support for the role of IU as a transdiagnostic feature in predicting a wide range of anxiety disorder symptoms in youth. Implications for future clinical applications are discussed., Author(s): Mehdi Zemestani [sup.1] , Rasoul Heshmati [sup.2] , Jonathan S. Comer [sup.3] , Philip C. Kendall [sup.4] Author Affiliations: (1) https://ror.org/04k89yk85, grid.411189.4, 0000 0000 9352 9878, Department of Psychology, [...]

ObjectiveCommonly-used youth anxiety measures may not comprehensively capture fears, worries, and experiences related to the pervasive impact of the COVID-19 pandemic. This study described the development of the Fear of Illness and Virus Evaluation (FIVE) scales and validated the caregiver-report version.MethodAfter initial development, feedback was obtained from clinicians and researchers, who provided suggestions on item content/wording, reviewed edits, and provided support for the updated FIVE's content and face validity. Factor structure, measurement invariance, and psychometric properties were analyzed using data from a multi-site, longitudinal study of COVID-19-related effects on family functioning with 1599 caregivers from the United States and Canada.ResultsConfirmatory factor analyses indicated a hierarchical five-factor structure best fit the data, resulting in a 31-item measure with four lower-order subscales: (1) Fears about Contamination and Illness; (2) Fears about Social Distancing, (3) Avoidance Behaviors, and (4) Mitigation Behaviors, and a higher-order factor, (5) Total Fears, indicated by the two fear-related lower-order subscales. Measurement invariance by country of residence, child age, and child sex was found. All subscales demonstrated strong internal consistency, appropriate item-scale discrimination, and no floor or ceiling effects. The Total Fears subscale demonstrated appropriate test-retest reliability. Concurrent validity supported by strong correlation with a youth anxiety measure.DiscussionThe FIVE provides a psychometrically-sound measure of COVID-19-related fears and behaviors in youth in a caregiver-report format. Future research is necessary to evaluate correlates and longitudinal symptom patterns captured by the FIVE caregiver-report, as well as the validity and reliability of a youth self-report version of the FIVE.

Background Despite progress in youth anxiety assessment, there is need for a measure that is simultaneously (a) free, (b) brief, (c) focused broadly on anxiety and avoidance severity, frequency, and interference, and (d) concerned with the past week. The adult overall anxiety severity and impairment scale (OASIS) was adapted to yield a caregiver-report of past week youth anxiety and interference (OASIS-Y). Methods In a sample of diverse youth seeking anxiety services (N = 132; 67% racial/ethnic minority) and their caregivers, analyses examined the OASIS-Y factor structure, internal consistency, and convergent and divergent validity. Hierarchical linear modeling in a participant subset examined OASIS-Y sensitivity to treatment-related change. Results OASIS-Y internal consistency was high and confirmatory factor analysis supported a single-factor structure similar to that found in adults. OASIS-Y convergent validity was supported by a medium-sized association with an established, commercially available measure of youth anxiety, and divergent validity was supported by the absence of unique associations with measures of youth attention and externalizing problems. In a sample subset, session-by-session OASIS-Y scores significantly declined across treatment, and declined at a steeper rate among treatment "responders" versus "non-responders," providing evidence of OASIS-Y sensitivity to treatment-related change. Limitations This study focused on a clinical sample and cannot speak to OASIS-Y performance in community settings. Shared method-variance may have also influenced findings. Conclusions This study offers the first psychometric evaluation of the OASIS-Y, and underscores the promising clinical utility of the measure for assessing past week youth anxiety and impairment and for supporting routine outcome monitoring.

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm's way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue using data from nearly 400 9- to 11-year-old children collected before and after Hurricane Irma, evaluating whether pre-existing neural patterns moderate associations between hurricane experiences and later PTS. The 'dose' of both self-reported objective exposure and media exposure predicted PTS, the latter even among children far from the hurricane. Furthermore, neural responses in brain regions associated with anxiety and stress conferred particular vulnerability. For example, heightened amygdala reactivity to fearful stimuli moderated the association between self-reported media exposure and PTS. Collectively, these findings show that for some youth with measurable vulnerability, consuming extensive disaster-related media may offer an alternative pathway to disaster exposure that transcends geography and objective risk.

Student anxiety is less frequently identified and treated in school settings relative to other mental health concerns (e.g., externalizing behavior problems). Considering the perspectives of school-based mental health providers is critical for improving supports for students with anxiety in schools. The present study examined patterns and predictors of school-based provider perceptions of student anxiety, as well as factors influencing provider self-efficacy when addressing student anxiety concerns. Participants (N = 87) were providers working in a very large school district serving students from highly diverse socioeconomic and racial/ethnic backgrounds. Providers reported on their perceptions of the top-ranking student mental health concerns, as well as their own emotional exhaustion, beliefs about accommodating students who experience anxiety, and perceived self-efficacy responding to student anxiety. 71.3% of providers identified student anxiety within their top five student mental health concerns. Providers in schools with higher proportions of economically disadvantaged students were significantly less likely to consider anxiety a top five concern. On average, providers reported feeling somewhat confident addressing anxiety. Greater emotional exhaustion predicted poorer self-efficacy, whereas prior training in anxiety predicted higher self-efficacy. Beliefs about accommodating anxious students in ways that run counter to anxiety guidelines was not significantly associated with provider self-efficacy. Although anxiety is a well-recognized student mental health concern among school providers, student anxiety is less commonly perceived as a top five concern by providers working with economically disadvantaged students, which may underscore the importance of addressing acute stressors and trauma exposure in such populations. Offering more anxiety-specific training and efforts to reduce emotional exhaustion may improve provider self-efficacy for addressing anxiety. To provide more equitable mental health services and supports for anxiety in school settings, more work is needed to improve identification of student anxiety as well as provider self-efficacy for addressing it within districts serving predominately racial and ethnic minority students.

Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient treatments for these conditions before they become chronic and resistant to change. We developed and pilot-tested the Pain and Trauma Intensive Outpatient Treatment (PATRIOT) Program, a brief, intensive (3 weeks, six sessions) integrated chronic pain and PTSD treatment. An overview and session-by-session outline of the PATRIOT Program is provided, followed by results from the first pilot evaluation of the PATRIOT Program's feasibility, acceptability, and preliminary efficacy in a sample of eight participating Veterans with comorbid chronic pain and PTSD. There were no treatment dropouts. At post-treatment, there were significant reductions in PTSD symptoms based on the Clinician-Administered Assessment of PTSD (CAPS). Pain and catastrophic thinking also decreased from pre- to post-treatment. With continued investigations and support, the PATRIOT Program may offer a brief, cost-effective, and more easily accessible treatment option for individuals who could benefit from learning skills to manage pain and PTSD more effectively. [ABSTRACT FROM AUTHOR]

The scope and burdens of mental health challenges in today's world are staggering. Among the available psychological treatment approaches, cognitive and behavioral therapies, and their combinations, have garnered the strongest evidence base. That said, progress has not always been linear and most of the work is still ahead of us. Against this backdrop, Behavior Therapy has launched its State of the Science series—an exciting new journal feature offering a curated set of authoritative reviews of research in major areas of relevance to applied cognitive-behavioral science, written by distinguished scientists in each area and peer-reviewed. The vision for the Behavior Therapy State of the Science series is to launch with an initial set of articles that make up this special journal issue, with continued publication of additional State of the Science articles in future journal issues. The current article launches the State of the Science series, providing a brief summary of progress in cognitive and behavioral practice and related areas, as well as various missteps and harmful legacies that remind us that the state of the science for research focused on mental health and the alleviation of human suffering is always in flux and evolving. The 16 inaugural reviews in this special issue are then introduced one by one. Collectively, these State of the Science reviews take stock of what has been learned across key areas in the field, highlight critical knowledge gaps in need of research, and provide expert guidance for improving the effectiveness and reach of care, particularly for marginalized and underserved populations. [ABSTRACT FROM AUTHOR]

Anxiety disorders are commonly occurring among children and are associated with increased risk for poor educational outcomes. However, little is known about the specific supports and accommodations provided to anxious children in schools. This study examines reports of school functioning and school-based supports and accommodations among a sample of 51 anxious youth and their mothers seeking treatment at an outpatient clinic. Children and their mothers reported significant anxiety-related impairment in school functioning, particularly for older children. Children identified as needing special education and related services (through Individualized Education Program [IEP] and 504 plans) more often received anxiety-related supports and accommodations at school than their peers who did not receive IEP/504 services. However, these accommodations were not always well matched to child needs and, in some cases, might facilitate avoidance of anxiety. Results suggest that some children with anxiety disorders receive supports in schools that may be inconsistent with evidence-based clinical practices. School-based mental health providers can be in an important position to facilitate coordinated care for youth with anxiety disorders.