Effectiveness of a transdiagnostic computerized self-applied program targeting children with emotional problems: A randomized controlled trial.

BACKGROUND: Super Skills for Life (SSL) is an eight-session transdiagnostic program based on cognitive-behavioral therapy (CBT), aimed at the indicated prevention of childhood emotional problems, which has been implemented with positive short- and long-term results. The present study aimed to examine the effects of a self-applied computerized program based on SSL that maintains the same objectives and contents as the face-to-face program. METHODS: In this randomized controlled study, 75 children (49.3 % female) aged 8-12 years (Mage = 9.45, SD = 1.31), selected for exhibiting emotional symptoms, were randomly assigned to either the intervention (n = 35) or the waiting list control (WLC) group (n = 40). Pre- and post-intervention data were collected through self-reports and the report of parents who completed parallel versions of the same measures of emotional and behavioral problems. RESULTS: Overall, compared to the WLC group, the intervention group showed positive effects on targeted emotional symptomatology in the short term. Based on parents' reports, a significant reduction was found in outcomes such as anxiety, depression, emotional symptoms, and internalizing problems, while self-reported results were similar except for anxiety. In addition, a positive impact was found on symptoms related to other types of difficulties (e.g., externalizing problems and general difficulties measured). LIMITATIONS: Small sample size, non-inclusion of follow-up assessment and other informants (e.g., teachers). CONCLUSIONS: In conclusion, this research provides novel and promising data on the self-applied computerized adapted version of the SSL program, within a multi-informant approach, suggesting that it may be a useful tool for the indicated prevention of childhood emotional problems.

Nighttime coping response in children: Development and validation of a new scale.

Coping strategies can play an important role in dealing with nighttime fears and related anxiety problems in school-aged children, but well-established self-reporting tools are lacking, and research in this area is limited. The aim of this study was to develop a new self-report instrument assessing coping strategies in school-aged children when facing nighttime fears, the Nighttime Coping Response Scale (NCRS), and to examine its psychometric properties. Participants were 786 children (48.7% boys) aged 8-12 years, who completed the NCRS and other measures related to anxiety and behavioral problems. The construction of the NCRS was based on relevant prior literature and experts' criteria. Exploratory and confirmatory analyses supported a three-factor structure, comprising 15 items measuring coping strategies related to self-control, social support seeking, and avoidance. The NCRS was shown to have good internal consistency, test-retest reliability, and convergent and divergent validity. This research found preliminary support for the use of the NCRS, suggesting the potential suitability of this brief tool to be used by clinicians and researchers to identify and address the use of children's maladaptive coping strategies when dealing with nighttime fears. The NCRS could also be important to enable the development of further research in this field.

COVID-19: Psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents.

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.

Improving Social Performance Through Video-feedback with Cognitive Preparation in Children with Emotional Problems.

Anxious children report a more negative perception of their social performance and increased nervous behaviors. The video-feedback with cognitive preparation allows children to contrast and modify their negative social self-image, increasing their self-confidence and decreasing anxiety behaviors. This study aimed to examine the effectiveness of the Super Skills for Life (SSL) program in improving social performance in a sample of children with emotional symptoms. Results indicated that both objective and subjective evaluation showed positive effects of the SSL program on the children's social performance, enhancing their social skills and reducing anxiety behaviors in social situations, both during the program and in the last session. Girls felt more comfortable and showed better speech and social performance than boys. Our findings increase the evidence about the short-term effects of the video-feedback with cognitive preparation of the SSL program and provide a useful transdiagnostic protocol for application in the clinical setting.

Who benefits most from an evidence-based program to reduce anxiety and depression in children? A latent profile analysis.

Comorbidity between anxiety and depression symptoms is often high in children. Person-oriented statistical approaches are useful to detect heterogeneity of individuals and diverse patterns of response to treatment. This study aimed to explore the different profiles in a sample of Spanish children who received the Super Skills for Life (SSL) transdiagnostic program, to identify which profile of individuals benefited most from the intervention and the likelihood of transition of symptom patterns over time. Participants were 119 children (42.9% were female) aged 8-12 years old (M = 9.39; SD = 1.26). Children completed anxiety and depression measures at the baseline, postintervention, and 12-months follow-up. Results from latent transition analysis (LTA) revealed two groups depending on the severity of the anxiety and depression symptoms: low symptoms (LS) and high symptoms (HS). LS group remained stable and HS decreased by 25%, switching to the LS group. Children with greater social anxiety benefited most from the program over time. Furthermore, older children were more likely to improve rapidly one year after the intervention compared to younger children. This study provides information to consider when implementing preventive interventions for schoolchildren and to tailor them according to the target population characteristics to increase their effectiveness.

Corrigendum: Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

[This corrects the article DOI: 10.3389/fpsyg.2021.565657.].

Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date. Children and adolescents' behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: (1) to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, (2) to analyze the differences in these behaviors in three countries, and (3) to examine the relationship between different coping modalities and adaptation. Participants were 1,480 parents of children aged 3-18 years from three European countries (n Spain = 431, n Italy = 712, and n Portugal = 355). The children's mean age was 9.15 years (SD = 4.27). Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening (58.9%), collaborating with quarantine social activities (e.g., drawings on the windows, supportive applauses) (35.9%), acting as if nothing is happening (35.5%), highlighting the advantages of being at home (35.1%), and not appearing to be worried about what is happening (30.1%). Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries. Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep, behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation (considered a low presence of psychological symptoms). Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children.

"Who Are at Higher Sexual Risk?" Latent Class Analysis of Behavioral Intentions among Spanish Adolescents.

Consistent condom use tends to be limited in youth, which makes this group especially vulnerable for sexually transmitted infections (STIs) and unplanned pregnancies. It is known that sexual risk may vary as a function of behavioral intentions (e.g., condom use intention or having sex under the influence of alcohol), but no studies have yet characterized the sexual risk profiles considering behavioral intentions. This study utilizes latent class analysis (LCA) to explore the subtyping of behavioral intentions related to sexual risk in a community-based sample of adolescents aged 14 to 16 years from Spain. Multinomial logistic regression was used to assess the association between class membership and participants' sociodemographic variables (sex, age, educational level, socioeconomic status, and family situation), and behavioral variables (sexual experience and percentage of condom use). Among the 1557 participants, four latent classes of risk were identified: "Condom + drugs", "abstinent", "condom + no drugs", and "no condom + drugs". Differences in adolescents' sex, age, educational level, sexual experience, and condom use across latent classes were found. Findings highlight opportunities for psychologists, educators, and health-care providers to promote condom use in adolescents with differing sexual risk profiles. Increased understanding of behavioral intentions among adolescents may help to reduce sexual risk behaviors in this group.

Colombian Adaptation of the HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI) in an Adolescent Population.

Colombia has one of the highest rates of sexually transmitted infections (STIs) and teenage pregnancies among Latin American countries. Knowledge about HIV/AIDS and other STIs has been identified as a factor in promoting healthy sexual behavior. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI) is an instrument created in Spain to assess sexual health knowledge in adolescents. In view of the lack of scales that measure this construct in Colombia, this study aims to culturally adapt and validate the KSI for the Colombian adolescent population. The sample was comprised of 866 adolescent school children (458 females and 408 males) aged between 14 and 19 years (M = 15.97, SD = 1.36) from 12 schools in the cities of Bogotá (n = 467) and Barranquilla (n = 400). Results showed good item psychometric properties and adequate discrimination and difficulty indices. Factorial analysis confirmed a five-dimensional factor structure. The indicators of validity showed significant correlations with constructs related on theoretical grounds. In sum, the study presents a valid and reliable scale for evaluating knowledge about HIV and other STIs in Colombian adolescent population.

How does depression facilitate psychological difficulties in children? The mediating role of cognitive emotion regulation strategies.

Knowing the processes of emotion regulation that children use to respond to stressful situations is essential to analyse the development of psychopathology. The objectives of this research were to study the use of nine cognitive emotion regulation strategies (CERS) in depressed children, compared with nondepressed children, and to analyse their possible mediating effects on the relationship between childhood depression and several areas related to child psychological adjustment. The sample comprised 336 children (46.7% girls) aged 8-12 years. Participants completed measures on depression symptoms (Child Depression Inventory), psychological strengths and difficulties (Strengths and Difficulties Questionnaire) and CERS (Cognitive Emotion Regulation Questionnaire for Spanish kids). Correlations and multiple regression analyses were conducted to test whether CERS and child gender and age predicted child depression. Mediation analyses were run to identify the CERS that mediate the relationship between depression and daily psychological adjustment. On multiple regression, children who score higher in self-blame (ß = .18, p < .01), catastrophizing (ß = .24, p < .001), and other-blame (ß = .14, p ≤ .01) but lower in positive reappraisal (ß = -.15, p ≤ .01) and females (ß = .10, p < .05) were more likely to present higher scores in depression. The maladaptive CERS "other-blame" mediated a positive relationship between depression and conduct problems and between depression and peer problems. Other-blame mediated a negative relationship between depression and prosocial behaviour. In conclusion, this research provides evidence of which specific CERS mediate the emergence of psychopathology in vulnerable children, and provides clues for the proper orientation of psychological interventions in childhood.

Psychological Symptoms and Behavioral Changes in Children and Adolescents During the Early Phase of COVID-19 Quarantine in Three European Countries.

The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.

The Psychological Consequences of COVID-19 and Lockdown in the Spanish Population: An Exploratory Sequential Design.

The objectives of this study were to analyze the psychological impact of the COVID-19 pandemic and the lockdown in the Spanish population and to identify what population profiles were most affected. The study used a sequential exploratory design. In the qualitative phase, 40 participants were recruited based on theoretically relevant criteria and the saturation of the information provided by the interviews. In the quantitative phase, a large representative sample was applied. The universe considered was the adult population of Spain. A total of 6789 surveys were conducted. Both the analysis of the narratives of the interviews and the responses to the panel survey showed relevant changes in attitudes and mood swings compared to the period prior to lockdown. These changes include dysphoric moods (i.e., experiences of distress such as sadness/depression, anxiety, rage, feeling of unreality, worry, etc.) and also some euphoric moods (i.e., feelings of well-being, happiness, etc.). A higher number of women were affected than men and a greater increase was observed in younger people. The findings of the study may serve as a basis for detecting needs and providing psychological support, as the symptoms detected as the most common are key for the processes of screening at-risk individuals.

Spanish Adaptation and Psychometric Properties of the Parent Version of the Short Mood and Feelings Questionnaire (SMFQ-P) in a Non-Clinical Sample of Young School-Aged Children.

The parent version of the Short Mood and Feelings Questionnaire (SMFQ-P) is a brief 13-item tool for the screening of depression in children from the age of 6 years. Despite the wide use of the SMFQ-P, its psychometric properties and factor structure remain understudied, with few data available for young school-aged children. The objective of this study was to examine for the first time the factorial structure and psychometric properties of the SMFQ-P in a non-clinical sample of Spanish-speaking children aged 6-8 years. Participants were 181 children whose parents completed the Spanish-adapted version of the SMFQ-P along with the parent version of other measures of anxiety and general difficulties and positive attributes. The SMFQ-P demonstrated adequate internal consistency (α = .83) and test-retest reliability over an eight-week period (ICC = .80), and good convergent and divergent validity. Factor analysis confirmed the original 13-item model, thus supporting the unidimensionality of the measure in the Spanish sample. Overall, this study provides initial empirical evidence for the utility of the SMFQ-P with Spanish-speaking children from early school ages, and extends the international support of the measure.

Psychometric Properties of the Colombian Version of the HIV Attitudes Scale for Adolescents.

The HIV Attitudes Scale (HIV-AS) evaluates attitudes towards different aspects of HIV. In view of the lack of scales measuring this construct in Colombia, this study sought to validate the HIV-AS test for adolescents from Colombia. A total of 867 Colombian students, aged between 14 and 19 years (M = 15.97 years; SD = 1.37) were evaluated. Participants responded to the HIV-AS test and a set of scales used to assess external validity. Content validity analyses reflected good adequacy indices for the items. Exploratory factor analyses revealed a four-factor structure and reliability indices were satisfactory. The structural equation model showed good levels of fit. Most of the items presented a discrimination index above 0.30 and contributed to the reliability of the scale, except for item 9, which was eliminated. Concurrent validity showed significant correlations among the HIV-AS and other similar constructs. A reliable measurement of attitudes toward HIV allows for an improved assessment of the risk associated with exposure to sexually transmitted infections in adolescent populations.

How Does Perfectionism Influence the Development of Psychological Strengths and Difficulties in Children?

This study aimed to examine differences in gender, age, and psychopathology, according to the perfectionism level, and to analyze how perfectionism dimensions contribute to the development of psychological strengths and difficulties in children. Participants were 319 Spanish students (52.4% girls) between 7 and 11 years old (M = 9.38, SD = 1.15). Children completed self-reported measures of perfectionism and psychological strengths and difficulties. The sample was divided into groups based on the perfectionism level (high, medium, and low). A one-way ANOVA (Analysis of variance), t-test, Pearson correlations, and 3-step hierarchical regression analyses were run. Results showed that 27.6% of the children belonged to the high perfectionism group, characterized by an elevated Socially Prescribed Perfectionism (SPP). Compared to girls, boys presented higher scores in all perfectionism measures. The younger children presented higher SPP and lower Self-oriented Perfectionism-Critical (SOP-Critical) than the older group. High perfectionism was related to psychological problems. The SOP-Critical increased the likelihood of developing emotional symptoms and total difficulties, and SPP was associated with behavioral and peer problems. In contrast, Self-oriented Perfectionism-Striving (SOP-Striving) was related to greater prosocial behavior. This research has important implications for the design of transdiagnostic strategies targeting the prevention and intervention of psychological difficulties in schoolchildren.

A text mining approach for adapting a school-based sexual health promotion program in Colombia.

A common practice among clinical psychologists and other health professionals is the use of school-based sexual health promotion programs as a means for preventing sexually transmitted infections. A fundamental criterion for the designing and adaptation of these programs is the age of their target populations because limited education and language are the most relevant factors that limit the efficacy of these programs. The contribution of this paper consists of assessing both the readability of the written materials that accompany the contents of a Spanish-written school-based sexual health promotion program used in Colombia, as well as the words co-occurrence network structure of its contents. The readability of the evaluated program corresponded to its intended target population aged between 14 and 19, with the schooling of 9-13 years of education. The resulting words co-occurrence network structure of the COMPAS program also mirrored its theoretical content. These results all together are deemed as empirical evidence of the adequacy of the program.

Effectiveness of Video-Feedback with Cognitive Preparation in Improving Social Performance and Anxiety through Super Skills for Life Programme Implemented in a School Setting.

Effectiveness of video-feedback with cognitive preparation to treat anxiety problems (especially social anxiety) has been scarcely explored on children. Super Skills for Life (SSL) is a CBT-based intervention to reduce anxiety and comorbid problems that, apart from social skills training and behavioural activation, integrates video-feedback with cognitive preparation. This study aimed to evaluate SSL effects, implemented in a school setting, on social performance and to test self-concept and social skills as potential mediators of pre- and post-test changes in social anxiety and generalized anxiety. Sample comprised 57 children aged 8-11 years with emotional symptoms. Children were video recorded in the first and last session to assess social performance. Anxiety and self-concept measures were completed by children pre-test and post-test. Participants reduced anxiety behaviours and improved social and communication skills after treatment. In general, girls showed better social performance than boys, but SSL impact was greater in males. Social self-concept was the only mediator of change in pre- to post-treatment social anxiety. This study provides evidence of SSL to improve children's social performance and reduce anxiety through video-feedback with cognitive preparation. Improving social concept seems essential to reduce social anxiety. An SSL programme is an ideal prevention protocol for anxious children.

Psychometric properties and factorial structure of the Spanish version of the parent-report Mood and Feelings Questionnaire (MFQ-P).

The parent-report Mood and Feelings Questionnaire (MFQ-P) is one of the few well-established available measures specifically designed to assess childhood depression from the parent's perspective. However, to date, few studies have analyzed the factorial structure of the MFQ-P. The aim of this study was to examine for the first time the psychometric properties of the scores and factorial structure of the Spanish-adapted version of the MFQ-P in a community sample of Spanish-speaking children. Parents of 181 children (54.1% boys) aged 6-8 years participated in this study. The MFQ-P was translated into Spanish and administered along with the Strengths and Difficulties Questionnaire-parent version (SDQ-P) and the Spence Children's Anxiety Scale-parent version (SCAS-P). The scale showed high internal consistency (α = .92) and acceptable test-retest reliability, and factor analysis confirmed the original single-factor structure after removing one item. Convergent and divergent validity was supported. The findings provide initial support for the use of a 33-item version of the MFQ-P in the Spanish population, adding further international evidence for this promising scale.

[Parent-reported Health-Related Quality of Life in Spanish pre-schoolers: Psychometric properties of the Kiddy-KINDL-R]. / Calidad de vida relacionada con la salud informada por los padres en preescolares españoles: propiedades psicométricas del Kiddy-KINDL-R.

INTRODUCTION: Although several tools have been developed to assess general HRQoL in children, parental reports are required to supplement this information, especially in very young children. The parents version of the Kiddy-KINDL-R was developed to assess HRQoL in children aged 3 to 7 years through the reports of their parents or legal guardians. OBJECTIVE: The aim of this study was to validate the parents version of the Kiddy-KINDL-R questionnaire and assess its psychometric properties in a sample of Spanish preschool-aged children. METHOD: Cross-sectional study in 283 parents or legal guardians of children aged 3 to 6 years that completed the Kiddy-KINDL-R questionnaire and an additional scale to assess anxiety problems. We performed confirmatory factor analysis to assess whether the original Kiddy-KINDL-R version fit the Spanish data; we assessed internal consistency by means of the ordinal alpha and the discriminant validity by means of the Preschool Anxiety Scale. RESULTS: Although the original six-factor model showed a good fit, we propose a model consisting of 22 items and the same 6 factors for the Spanish version. The reliability was excellent, and the internal consistency values were adequate. Our results showed significant negative correlations between the Kiddy-KINDL-R and the external anxiety measure, which was evidence of discriminant validity. CONCLUSION: We demonstrated that the Spanish version of the Kiddy-KINDL-R had good psychometric properties and that this questionnaire is an adequate assessment tool that could be useful in clinical practice.

Validation of the parent report version of the Spence Children's Anxiety Scale (SCAS-P) for Spanish children.

Although Spence Children's Anxiety Scale (SCAS) is a widely used anxiety measure in many countries around the world, until now, research has barely focused on the usefulness of the parent version (SCAS-P) in young children. This study examines the psychometric properties and the factor structure of the SCAS-P in a Spanish community sample of 181 children aged 6-8 years (M = 6.87, SD = 0.78). Confirmatory factor analysis showed a good fit of the original six-factor model to the Spanish sample. The internal consistency and the test-retest reliability of the scale were high. Regarding the validity of this measure, higher and significant correlations between the SCAS-P and internalizing problems and lower correlations with externalizing problems were obtained, as found in the original version. Girls seemed to show more anxiety problems than boys, but no significant differences were found. The results suggest that the SCAS-P is an adequate measure to assess anxious symptomatology in young children. The availability of measures with good psychometric properties allows psychologists to assess and carry out a correct and early diagnosis of anxiety disorders in children, making possible an early clinical intervention.