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Rationale: Anxiety is a common comorbidity of chronic obstructive pulmonary disease (COPD) that is associated with higher morbidity and mortality. We evaluated three anxiety screening questionnaires: the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), and the Anxiety Inventory for Respiratory Disease (AIR).Objectives: To evaluate and compare the test performance characteristics of three anxiety screening questionnaires, using the Mini-International Neuropsychiatric Interview (MINI), version 7.0, as the "gold standard."Methods: Individuals with COPD were recruited at 16 centers. The MINI and questionnaires were administered by trained research coordinators at an in-person visit and readministered by telephone 2-4 weeks later. A composite score for the presence of any Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) anxiety disorder was computed, based on the MINI as the gold standard, compared with a participant screening positive on self-report measures for these analyses.Results: Two hundred and twenty eligible individuals with COPD were enrolled; 219 completed the study. Eleven percent were identified as having a DSM-V anxiety disorder, based on the MINI. Elevated anxiety symptoms based on questionnaires were 38% for the AIR, 30% for the GAD-7, and 20% for the HADS-A. Area under the receiver operating characteristic curve (AUC) was highest for the GAD-7 (0.78; 95% confidence interval [CI], 0.69-0.87), followed by the HADS-A (0.74; 95% CI, 0.64-0.84) and the AIR (0.66; 95% CI, 0.56-0.76). The AUC for the GAD-7 was significantly greater than for the AIR (P = 0.014). Sensitivity was not statistically different among the questionnaires: 77% for the GAD-7, 63% for the HADS-A, and 66% for the AIR. The HADS-A had the highest specificity, 85%, which was significantly higher than that of the GAD-7 (77%; P

Many subareas share a common interest in students' "motivational resilience," defined broadly as patterns of action that allow students to constructively deal with, overcome, recover, and learn from encounters with academic obstacles and failures. However, research in each of these areas often progresses in relative isolation, and studies rarely utilize developmental or social-contextual approaches. As a result, we do not yet have a clear understanding of how to help children and adolescents develop a rich and flexible repertoire of tools to deal productively with everyday academic challenges and difficulties. In this article, we knit together these disparate areas of work to create an integrated developmental and social-contextual framework that can guide the future study of these processes. First, we summarize nine areas of work that focus on students' actions on the ground when they encounter academic difficulties: academic resilience, mastery versus helplessness, engagement and re-engagement, academic coping, self-regulated learning, adaptive help seeking, emotion regulation, and buoyancy as well as tenacity, perseverance, and productive persistence. In each area, we highlight work that is explicitly developmental and that depicts key social-contextual factors that shape motivational resilience. Second, we sketch an overarching social-contextual and developmental framework that holds a place for each of these processes. Third, we identify multiple areas where cross-fertilization among researchers can contribute to improved educational practice and study of the development of motivational resilience. An overarching goal of this article (and the special section more generally) is to take first steps toward "field building" on this crucial topic.

ObjectiveWe examined the mechanisms that underlie the observed relationships between loneliness and depressed mood and poor sleep quality in college students. This study was the first to investigate whether rumination and trait anxiety are psychological mechanisms that mediate this relationship.MethodsIn Study 1 (n = 1,244), using factor analysis with cross-sectional data, we established that loneliness and rumination are distinct constructs. We then collected survey data in two cross-sectional samples (ns = 300 and 218) and one prospective (n = 334) sample to test whether rumination and anxiety were mediators of the relationship between loneliness and depressed mood and poor sleep quality. Structural equation modeling was used to test the proposed relationships. Participants completed self-report measures of loneliness, rumination, trait anxiety, depressed mood, and sleep quality. In addition, measures of hostility, neuroticism, negative affect, and tobacco use were also assessed and tested as mediators, while social support was assessed and tested as a moderator.ResultsConsistent across the three studies, we found that rumination and trait anxiety fully mediated the associations between loneliness and depressed mood as well as poor sleep quality; these relationships held after testing all other factors.ConclusionThis study helps explain how loneliness dynamics relate to poor health and suggests specific points of departure for the development of interventions.