Psychometric Properties of the Parent Version of the Revised Child Anxiety and Depression Scale in a Clinical Sample of Turkish Children and Adolescents.

The Revised Child Anxiety and Depression Scale-Parent version (RCADS-P) is a self-report questionnaire that assesses dimensions of DSM-based anxiety and depressive disorders in children and adolescents. The present study examined the psychometric properties of the Turkish version in a clinical sample of 483 children and adolescents. The child and parent versions of the RCADS, parent versions of the Screen for Child Anxiety Related Emotional Disorders, the Strengths and Difficulties Questionnaire and Adolescent Symptom Inventory-Depression Scale were administered. Current psychiatric diagnoses were assessed via the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Version. The RCADS-P demonstrated high internal consistency and test-retest reliability, and good convergent, divergent, and discriminant validity. Confirmatory factor analysis supported the DSM-related six-factor structure. With its demonstrated favorable psychometric properties, the Turkish RCADS-P is currently the only validated parent-report instrument that assesses DSM-based anxiety and depressive disorders in children and adolescents in Turkey.

Fit of evidence-based treatment components to youths served by wraparound process: a relevance mapping analysis.

This study investigated whether and which evidence-based treatment (EBT) components might generalize to youths served by the wraparound process. To examine these questions, the study used relevance mapping, an empirical methodology that compares youths in a given clinical population with participants in published randomized trials to determine who may be "coverable" by EBTs and which treatments may collectively be most applicable. In a large diverse clinical sample, youths receiving wraparound services (n = 828) were compared with youths receiving other services (n = 3,104) regarding (a) demographic and clinical profiles, (b) "coverability" by any EBTs, and (c) specific practices from those EBTs that most efficiently applied to each group. Participants in studies of EBTs matched the demographic and clinical characteristics of nearly as many youths receiving wraparound (58-59%) as those receiving non-wraparound services (61-64%). Moreover, the best-fitting solutions of relevant sets of practices were highly similar across groups. These results provide the first large-scale empirical characterization of fit between EBTs and youths receiving wraparound and suggest that these youths are well suited to benefit from clinical strategies commonly used in EBTs.

The role of violence exposure and negative affect in understanding child and adolescent aggression.

Aggressive behaviors in youth tend to be relatively stable across the lifespan and are associated with maladaptive functioning later in life. Researchers have recently identified that both violence exposure and negative affective experiences are related to the development of aggressive behaviors. Children exposed to violence also often experience negative affect (NA) in the form of anxiety and depression. Bringing these findings together, the current study used a clinical sample of youth (N = 199; ages 7-17 years) referred to a psychiatric residential treatment facility to examine the specific contributions of NA and exposure to violence on the development of aggressive behaviors in youth. Using structural equation modeling, both NA and recent exposure to violence significantly predicted aggressive behaviors. More importantly, negative affect partially mediated the relationship between exposure to violence and aggression. Implications of these findings from a clinical perspective and future directions for research on aggression are discussed.

Symptom differentiation of anxiety and depression across youth development and clinic-referred/nonreferred samples: An examination of competing factor structures of the Child Behavior Checklist DSM-oriented scales.

This study examined the psychometric properties of the DSM-oriented scales of the Child Behavior Checklist (Achenbach, Dumenci, & Rescorla, 2003) using confirmatory factor analysis to compare the six-factor structure of the DSM-oriented scales to competing models consistent with developmental theories of symptom differentiation. We tested these models on both clinic-referred (N = 757) and school-based, nonreferred (N = 713) samples of youths in order to assess the generalizability of the factorial structures. Although previous research has supported the fit of the six-factor DSM-oriented structure in a normative sample of youths ages 7 to 18 (Achenbach & Rescorla, 2001), tripartite model research indicates that anxiety and depressive symptomology are less differentiated among children compared to adolescents (Jacques & Mash, 2004). We thus examined the relative fit of a six- and a five-factor model (collapsing anxiety and depression) with younger (ages 7-10) and older (ages 11-18) youth subsamples. The results revealed that the six-factor model fit the best in all samples except among younger nonclinical children. The results extended the generalizability of the rationally derived six-factor structure of the DSM-oriented scales to clinic-referred youths and provided further support to the notion that younger children in nonclinical samples exhibit less differentiated symptoms of anxiety and depression.

Application of the tripartite model to a complicated sample of residential youth with externalizing problems.

The tripartite model of anxiety and depression has received strong support among child and adolescent populations. Clinical samples of children and adolescents in these studies, however, have usually been referred for treatment of anxiety and depression. This study investigated the fit of the tripartite model with a complicated sample of residential youths with externalizing problems. Structural Equation Modeling was used to test the tripartite model relationships between negative affect, positive affect, and mood symptoms. Multiple fit indices were used to provide a reliable and conservative evaluation of the model. As predicted, the tripartite model provided a good fit for symptoms of emotional disorders in this complicated sample of children and adolescents. Implications of these findings are discussed in terms of the utility of the tripartite model in understanding anxiety and depression in more diverse populations and recommendations for residential assessment.

Parenting stress and child behavior problems among clinic-referred youth: cross-cultural differences across the US and Korea.

Due to increased multiculturalism in the US and abroad, there is a need for increased understanding of the different ways in which parenting stress is related to child problems across cultures. In the present study, we investigated (a) differences in reported parenting stress and childhood problem behaviors across a Korean (n = 71) and US (n = 71) sample, as well as (b) differences in the ways in which parenting stress and childhood problems were related across Korean and US children based on mothers' reports. Results revealed that Korean mothers reported significantly higher parenting stress yet significantly lower childhood problem behaviors compared to US mothers. In addition, mother-based reports of child problems were significantly associated with parenting stress in the US sample, but not in the Korean sample. Clinical implications and culturally-relevant issues relevant to these findings are addressed, including a potential under-reporting bias of child problems among Asian parents.

The Loneliness Questionnaire-Short Version: an evaluation of reverse-worded and non-reverse-worded items via item response theory.

Although reverse-worded items have often been incorporated in scale construction to minimize the effects of acquiescent reporting biases, some researchers have more recently begun questioning this approach and wondering whether the advantages associated with incorporating reverse-worded items is worth the complexities that they bring to measures (e.g., Brown, 2003 ; Marsh, 1996 ). In this study, we used item response theory (IRT) to determine whether there is statistical justification to eliminate the reverse-worded items (e.g., "I have lots of friends") from the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) and retain only the non-reverse-worded items (e.g., "I'm lonely") to inform the provision of a shortened LQ version. Using a large sample of children (Grades 2-7; n = 6,784) and adolescents (Grades 8-12; n = 4,941), we examined the psychometric properties of the 24-item LQ and found support for retaining the 9 non-reverse-worded LQ items to make up a shortened measure of loneliness in youth. We found that the non-reverse-worded items were associated with superior psychometric properties relative to the reverse-worded items with respect to reliability and IRT parameters (e.g., discrimination and item information). A 3-point Likert-type scale was also found to be more suitable for measuring loneliness across both children and adolescents compared to the original 5-point scale. The relative contributions of reverse-worded and non-reverse-worded items in scale development for youth instruments are also discussed.

The importance of modeling method effects: resolving the (uni)dimensionality of the loneliness questionnaire.

This study sought to resolve the dimensionality of the Loneliness Questionnaire (LQ; Asher, Hymel, & Renshaw, 1984) by applying recommended confirmatory factor analytic procedures that control for method effects (Brown, 2003). This study was needed given that inconsistent findings have been reported recently regarding the structure of this instrument (Bagner, Storch, & Roberti, 2004) and all models to date have not accounted for method effects due to the non-reversed-worded and reversed-worded items of this instrument. Using a large sample of youth in Grades 2 through 12 (N = 11,725), we compared the previously reported 1- and 2-factor models with a newly posited 1-factor model that incorporated correlated error terms to account for method effects. We found that the 1-factor model that included correlated error terms fit the data best, and that this factor structure evidenced measurement invariance across boys and girls in childhood, but not in adolescence. The meaning of the LQ indicators was also consistent for boys across development, but evidenced differences for girls in childhood versus adolescence. More generally, it was demonstrated that modeling method effects is vital to accurately understanding the dimensionality of loneliness when reversed-worded and non-reversed-worded items are used as indicators. The measurement and clinical implications of these findings are discussed.

The youth self report: applicability and validity across younger and older youths.

The Youth Self Report (YSR) is a widely used measure of youth emotional and behavioral problems. Although the YSR was designed for youths ages 11 to 18, no studies have systematically evaluated whether youths younger than age 11 can make valid reports on this measure. This study thus examined the reliability and validity of the YSR scales scores for younger (ages 7-10; n = 184) and older (ages 11-14; n = 147) youths. Results demonstrated that younger youths were able to provide reliable reports on the YSR broad band (Internalizing, Externalizing) scales, though less so on the narrow band scales. Across all scales, the externalizing scales performed more favorably than the internalizing scales among both younger and older youth. Younger youths' DSM-oriented scales corresponded significantly with DSM diagnoses.

Structure, Reliability, Measurement Stability, and Construct Validity of the Polish Version of the Revised Child Anxiety and Depression Scale.

The Revised Child Anxiety and Depression Scale (RCADS) is a self-report questionnaire that aims to assess symptoms of anxiety and depressive disorders in children. Two studies were conducted to evaluate the psychometric properties of the Polish version of the RCADS. Study 1 was conducted to analyze the structural validity and reliability of the RCADS scores and Study 2 assessed the longitudinal measurement of stability over time. Data were collected from a community sample of 501 children and adolescents aged 8 to 14 years in Poland. The original 47-item version of the Polish RCADS was compared with two shortened versions: 30- and 20-item versions. Overall results revealed support for the structural and construct validity, reliability, and stability of the Polish version of the RCADS.

What Therapy Practices Do Providers Value in Youth Behavioral Health? A Measure Development Study.

Existing measures of attitudes toward evidence-based practices (EBPs) assess attitudes toward manualized or research-based treatments. Providers of youth behavioral health (N = 282) completed the Valued Practices Inventory (VPI), a new measure of provider attitudes toward specific practices for youth that avoids mention of EBPs by listing specific therapies-some of which are drawn from EBPs (e.g., problem solving) and some of which are not included in EBPs (e.g., dream interpretation). Exploratory factor analysis revealed two factors: practices derived from the evidence base (PDEB) and alternative techniques (AT). The PDEB scale was significantly correlated with scales on the Evidence-Based Practice Attitude Scale-50 (Aarons et al. in Administration and Policy in Mental Health and Mental Health Services Research, 39(5): 331-340, 2012), whereas the AT scale was not. Attitudes toward PDEB and AT were also related to provider characteristics such as years of experience and work setting. The VPI offers a complementary approach to existing measures of attitudes because it avoids mention of EBPs, which may help prevent biases in responses.

A bifactor model of obsessive beliefs: Specificity in the prediction of obsessive-compulsive disorder symptoms.

Although current cognitive-behavioral models suggest that maladaptive "obsessive beliefs" about threat, responsibility, uncertainty, perfectionism, importance, and control of thoughts contributes to the development of obsessive-compulsive disorder (OCD), the structure of such beliefs is unclear. The current study evaluated a bifactor model of obsessive beliefs, as assessed by the Obsessive Beliefs Questionnaire (OBQ-44), and its association with OCD symptoms in clinical (Study 1; N = 264) and nonclinical (Study 2; N = 437) samples. The goals were as follows: (a) to evaluate whether obsessive beliefs should be conceptualized as unidimensional or whether distinct dimensions should be interpreted, and (b) to use structural equation modeling to examine the extent to which distinct beliefs predict OCD symptoms above and beyond a general obsessive belief factor. Results revealed that in both clinical and nonclinical samples, a bifactor model fit the data well and significantly better than a standard three-factor model of the OBQ-44 that specified 3 separate, yet correlated factors (Responsibility/Threat Estimation, Perfectionism/Certainty, and Importance/Control of Thoughts). Despite evidence that the OBQ-44 consists of a general factor and the 3 specific factors, structural equation modeling showed that only the general factor uniquely predicted a broad OCD symptom latent factor in clinical and nonclinical samples. Although obsessive beliefs about Perfectionism/Certainty did predict symmetry and ordering symptoms of OCD when controlling for the general factor in both studies, the general factor was a more robust predictor of specific OCD symptoms than the 3 factors. These findings suggest that the general factor of the OBQ-44 may have more utility than its specific factors in predicting the heterogeneity of OCD symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Depression, Anxiety, and Stress: How Should Clinicians Interpret the Total and Subscale Scores of the 21-Item Depression, Anxiety, and Stress Scales?

The 21-item Depression, Anxiety, and Stress Scales (DASS-21) is a self-report measure that is easy to administer, quick to score, and is freely available. Widely used in diverse settings and populations, confirmatory factor analytic evidence has accumulated for a bifactor model underlying this multidimensional measure. Studies employing an exploratory bifactor approach to more closely examine its underlying structure and inter-relations of factors, however, have been scarce. This is unfortunate because confirmatory techniques often employ indirect ways of handling model misspecification, whereas exploratory methods enable more direct approaches. Moreover, more precise approaches to modeling an exploratory bifactor structure have not been examined with the DASS-21. Based on several large samples of undergraduate students in the United States, the first two parts of the paper (Studies 1 and 2) utilized both exploratory (M = 19.7 years of age) and confirmatory factor analytic methods (M = 19.7 years of age) following those presented by contemporary multidimensional modeling theorists. Building upon these results, the third part of the paper (Study 3; M = 20.0 years of age) examined sensitivity-/specificity-related indices to provide cut-off score recommendations for a revised DASS-21 instrument based on a newly identified and supported bifactor structure. Implications of these results are discussed in terms of taxonomy, challenges inherent in multidimensional modeling, and potential use of the revised DASS-21 measure as a component of an actuarial decision-making strategy to inform clinical referrals.

Prospective associations between disgust proneness and OCD symptoms: Specificity to excessive washing compulsions.

Although considerable evidence has linked disgust proneness (DP) to obsessive-compulsive disorder (OCD), few studies have examined the extent to which DP predicts OCD symptoms over time. Further, it remains unclear if DP is a risk factor for the contamination subtype of OCD specifically or if it is prospectively associated with other OCD symptom subtypes. The present study sought to address these gaps in the literature with a large sample of unselected community participants (n = 497) that completed measures of DP and OCD symptoms monthly over a 6-month period. Latent growth analysis revealed that initial levels of DP were associated with higher initial level of total OCD symptoms when controlling for depression, but not the slope of change in total OCD symptoms over time. Initial levels of total OCD symptoms were also associated with higher initial levels of DP when controlling depression, but not the slope of change in DP over time. Examination of symptom specificity revealed that initial levels of DP were associated with initial levels of washing, neutralizing, obsessing, ordering, and hoarding symptoms. However, initial levels of DP were associated only with the slope of change in the washing subtype when controlling for depression such that high initial levels of DP were associated with steeper increases in washing symptoms of OCD over the 6-month period. These findings suggest that although DP may have concurrent associations with symptoms of OCD more broadly, prospective associations are specific to the contamination/washing subtype of OCD. The implications of these findings for the etiology and treatment of contamination-based OCD are discussed.

A re-examination of the BIS/BAS scales: Evidence for BIS and BAS as unidimensional scales.

OBJECTIVES: Carver and White's behavioral inhibition system and behavioral activation system (BIS/BAS) scales are the most widely used to assess constructs of the revised reinforcement sensitivity theory. This study provides a re-examination of the latent structure of the original BIS/BAS scales. METHODS: The interpretability of the three purported BAS subfactors relative to a "general behavioral activation" factor was assessed using Schmid-Leiman and standard confirmatory factor analysis. Regarding the BIS scale, comparisons were made between (a) Carver and White's unidimensional BIS model, (b) Johnson, Turner, and Iwata's 2-factor BIS model, (c) Heym, Ferguson, and Lawrence's alternative 2-factor BIS model, and (d) a modified Heym et al. model (unidimensional) controlling for method effects of reverse-scored items. RESULTS: Results revealed the majority of variance of individual BAS items was accounted for by a common, general BAS dimension. Additionally, for the BIS scale, results of the χ2 difference statistical test supporting the 1-factor model, as well as the noted theoretical and psychometric difficulties in interpreting a multifactor BIS scale, provide converging support that BIS items actually represent a single, unidimensional factor. CONCLUSIONS: The collective results suggested that the BIS and BAS scales should be conceptualized as separate unidimensional measures, which is consistent with theory behind the original development.

Psychometric investigation of the specific phobia of vomiting inventory: A new factor model.

Well-validated, standardized measures are lacking for the assessment of emetophobia, the specific phobia of vomiting. The Specific Phobia of Vomiting Inventory (SPOVI) was recently developed and shows promise as a useful measure of emetophobia. The goal of the present study was to further examine and investigate the psychometric properties of the SPOVI in a large student sample (n = 1626), specifically focusing on its factor structure, measurement invariance across gender, and convergent/divergent validity. Confirmatory factor analysis results provide support for a one-factor model of the SPOVI, in contrast to the previously proposed two-factor model. Internal consistency of the SPOVI was good (α = 0.89) and measurement invariance across gender invariance was supported. The SPOVI also demonstrated good psychometric properties with respect to convergent and divergent validity. The present study's demonstration of the reliability and validity of the SPOVI suggests that the instrument may be a valuable tool for assessing emetophobia symptoms based on its one-factor structure.

Cross-Cultural Validation of the Modified Practice Attitudes Scale: Initial Factor Analysis and a New Factor Model.

OBJECTIVE: The objective of this study was to create the Korean version of the Modified Practice Attitudes Scale (K-MPAS) to measure clinicians' attitudes toward evidence-based treatments (EBTs) in the Korean mental health system. METHOD: Using 189 U.S. therapists and 283 members from the Korean mental health system, we examined the reliability and validity of the MPAS scores. We also conducted the first exploratory and confirmatory factor analysis on the MPAS and compared EBT attitudes across U.S. and Korean therapists. RESULTS: Results revealed that the inclusion of both "reversed-worded" and "non-reversed-worded" items introduced significant method effects that compromised the integrity of the one-factor MPAS model. Problems with the one-factor structure were resolved by eliminating the "non-reversed-worded" items. Reliability and validity were adequate among both Korean and U.S. therapists. Korean therapists also reported significantly more negative attitudes toward EBTs on the MPAS than U.S. therapists. CONCLUSIONS: The K-MPAS is the first questionnaire designed to measure Korean service providers' attitudes toward EBTs to help advance the dissemination of EBTs in Korea. The current study also demonstrated the negative impacts that can be introduced by incorporating oppositely worded items into a scale, particularly with respect to factor structure and detecting significant group differences.

Examination of a Bifactor Model of Obsessive-Compulsive Symptom Dimensions.

Although obsessive-compulsive (OC) symptoms are observed along four dimensions (contamination, responsibility for harm, order/symmetry, and unacceptable thoughts), the structure of the dimensions remains unclear. The current study evaluated a bifactor model of OC symptoms among those with and without obsessive-compulsive disorder (OCD). The goals were (a) to evaluate if OC symptoms should be conceptualized as unidimensional or whether distinct dimensions should be interpreted and (b) to use structural equation modeling to examine the convergence of the OC dimensions above and beyond a general dimension with related criteria. Results revealed that a bifactor model fit the data well and that OC symptoms were influenced by a general dimension and by four dimensions. Measurement invariance of the bifactor model was also supported among those with and without OCD. However, the general OC dimension accounted for only half of the variability in OC symptoms, with the remaining variability accounted for by distinct dimensions. Despite evidence of multidimensionality, the dimensions were unreliable after covarying for the general OC dimension. However, the four dimensions did significantly converge with a latent OC spectrum factor above and beyond the general OC dimension. The implications of these findings for conceptualizing the structure of OCD are discussed.

The Child PTSD Symptom Scale: An Investigation of Its Psychometric Properties.

The current study addresses the need for accurate measurement of posttraumatic stress disorder (PTSD) symptoms in youth by investigating the psychometric properties of the Child PTSD Symptom Scale (CPSS). The factor structure, reliability, and concurrent and discriminant validity of the CPSS were investigated in a sample of 206 6th- to 12th-grade adolescents. Exploratory and confirmatory factor analysis supported a single-factor structure, which was contrary to the hypothesized three-factor structure. Scores comprising this one-factor structure were also associated with high reliability (α = .93), and tests of concurrent and discriminant validity were also strong. The implications of these findings are discussed, with particular emphasis on future directions for research on self-report measures for adolescent PTSD symptoms.

The Loneliness Questionnaire: Establishing Measurement Invariance Across Ethnic Groups.

A state of loneliness describes an individual's perception of having dissatisfying social connections to others. Though it is notable across the life span, it may have particularly deleterious effects in childhood and adolescence, leading to increased risk of emotional impairment. The current study evaluates a widely used test of loneliness, the Loneliness Questionnaire, for measurement invariance across ethnic groups in a large, representative sample of youth in the 2nd to 12th grades ( N = 12,344; 41% African American) in Mississippi. Analyses were conducted using multigroup confirmatory factor analysis following a published, sequential method to examine invariance in form, factor loadings, and item intercepts. Overall, our results indicated that the instrument was invariant across ethnicities, suggesting that youth with equivalent manifest scores can be discerned as having comparable levels of latent loneliness. The loneliness scores also corresponded significantly with depression and anxiety scores for most subsamples, with one exception. These findings are discussed in the context of previous results comparing levels of loneliness across ethnicities. Additionally, the broader context of the need to expand invariance studies in instrumentation work is highlighted.