Common and unique factors associated with DSM-IV-TR internalizing disorders in children.

With the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV Fourth Edition-Text Revision. Author, Washington, DC. 2000) ahead, decisions will be made about the future of taxonomic conceptualizations. This study examined the factor structure of items from three internalizing disorders (Social Phobia, Generalized Anxiety Disorder, and Depression) on the Anxiety Disorders Interview Schedule for DSM-IV-Child Version (Silverman, W. K., & Albano, A. M. Anxiety disorders interview schedule for children for DSM-IV, child and parent versions. Psychological Corporation, San Antonio, 1996). Two-, three-, and four-factor models emerged in an exploratory factor analysis. Confirmatory factor analysis provided additional empirical support for the four-factor model over the two- or three-factor models. Implications for the structure of the DSM-V taxonomy in children and adolescents are discussed.

The impact of pretrauma analogue GAD and posttraumatic emotional reactivity following exposure to the September 11 terrorist attacks: a longitudinal study.

The relation between analogue generalized anxiety disorder (GAD) assessed the day before the events of September 11, 2001 (9/11) and long-term outcome was examined in 44 young adults who were directly exposed the following day to the terrorist attacks in New York City. After controlling for high exposure to the attacks, preattack analogue GAD was associated with greater social and work disability, loss of psychosocial resources, anxiety and mood symptoms, and worry, but not symptoms of posttraumatic stress, assessed 12 months after 9/11. Fear and avoidance of emotions assessed 4 months after 9/11 statistically mediated the relation between preattack analogue GAD and social and work disability, loss of psychosocial support, mood and anxiety symptoms, and worry at 12-month follow-up. Avoidance of emotions 4 months after 9/11 also mediated the relation between preattack analogue GAD and posttraumatic stress symptoms 12 months after 9/11.

Modifying the Impact of Eveningness Chronotype ("Night-Owls") in Youth: A Randomized Controlled Trial.

OBJECTIVE: To determine whether an intervention to reduce eveningness chronotype improves sleep, circadian, and health (emotional, cognitive, behavioral, social, physical) outcomes. METHOD: Youth aged 10 to 18 years with an evening chronotype and who were "at risk" in 1 of 5 health domains were randomized to: (a) Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C; n = 89) or (b) Psychoeducation (PE; n = 87) at a university-based clinic. Treatments were 6 individual, weekly 50-minute sessions during the school year. TranS-C addresses sleep and circadian problems experienced by youth by integrating evidence-based treatments derived from basic research. PE provides education on the interrelationship between sleep, stress, diet, and health. RESULTS: Relative to PE, TranS-C was not associated with greater pre-post change for total sleep time (TST) or bed time (BT) on weeknights but was associated with greater reduction in evening circadian preference (pre-post increase of 3.89 points, 95% CI = 2.94-4.85, for TranS-C, and 2.01 points, 95% CI = 1.05-2.97 for PE, p = 0.006), earlier endogenous circadian phase, less weeknight-weekend discrepancy in TST and wakeup time, less daytime sleepiness, and better self-reported sleep via youth and parent report. In terms of functioning in the five health domains, relative to PE, TranS-C was not associated with greater pre-post change on the primary outcome. However, there were significant interactions favoring TranS-C on the Parent-Reported Composite Risk Scores for cognitive health. CONCLUSION: For at-risk youth, the evidence supports the use of TranS-C over PE for improving sleep and circadian functioning, and improving health on selected outcomes. CLINICAL TRIAL REGISTRATION INFORMATION: Triple Vulnerability? Circadian Tendency, Sleep Deprivation and Adolescence. https://clinicaltrials.gov; NCT01828320.

Improving outcome for mental disorders by enhancing memory for treatment.

Patients exhibit poor memory for treatment. A novel Memory Support Intervention, derived from basic science in cognitive psychology and education, is tested with the goal of improving patient memory for treatment and treatment outcome. Adults with major depressive disorder (MDD) were randomized to 14 sessions of cognitive therapy (CT)+Memory Support (n = 25) or CT-as-usual (n = 23). Outcomes were assessed at baseline, post-treatment and 6 months later. Memory support was greater in CT+Memory Support compared to the CT-as-usual. Compared to CT-as-usual, small to medium effect sizes were observed for recall of treatment points at post-treatment. There was no difference between the treatment arms on depression severity (primary outcome). However, the odds of meeting criteria for 'response' and 'remission' were higher in CT+Memory Support compared with CT-as-usual. CT+Memory Support also showed an advantage on functional impairment. While some decline was observed, the advantage of CT+Memory Support was evident through 6-month follow-up. Patients with less than 16 years of education experience greater benefits from memory support than those with 16 or more years of education. Memory support can be manipulated, may improve patient memory for treatment and may be associated with an improved outcome.

Self-consciousness and social anxiety in youth: the Revised Self-Consciousness Scales for Children.

Despite the established relationship between self-consciousness (SC) and anxiety and depression in adults, there is a paucity of research examining SC in children and adolescents. We therefore sought to examine the factor structure, reliability, and validity of scores for a revised version of the Self-Consciousness Scales for Children, a measure of SC in youth. The Revised Self-Consciousness Scale for Children (R-SCS-C) was examined in 2 studies using a community sample of children and adolescents. In the 1st study, 1,207 youth (685 girls) ages 7 to 18 completed the R-SCS-C as well as measures of imaginary audience, anxiety, depression, and positive and negative affect. Results of an exploratory factor analysis of the R-SCS-C conducted on a randomly selected subsample (n = 603) supported a 3-factor solution, including the subscales of Public Self-Consciousness, Private Self-Consciousness, and Social Anxiety. A subsequent confirmatory factor analysis (CFA) conducted on the remaining half of the sample (n = 604) revealed that this model fit the data well. Additionally, subsequent multigroup CFAs by gender and age demonstrated good model fit across both gender and younger (ages 7 to 12 years) and older (ages 13 to 18 years) cohorts. In the 2nd study, 245 youth completed the R-SCS-C twice, approximately 2 weeks apart. The R-SCS-C scores in these samples demonstrated acceptable internal consistency, convergent and divergent validity, and test-retest reliability. Implications of these findings and directions for future research are discussed.