A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic.

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

We longitudinally examined predictors of symptoms of adjustment disorder in 15,563 adults during the COVID-19 pandemic.We found stressors, risk, and protective factors predicting adjustment disorder symptom levels at different stages of the pandemic.For some predictors, the effects appear to change in different phases of a pandemic.

Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries: Findings from the ESTSS ADJUST study.

BACKGROUND: The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety. OBJECTIVES: This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries. METHOD: A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate measurement equivalence across countries, gender, and age groups. RESULTS: The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country. CONCLUSIONS: The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population. LIMITATIONS: The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.

Shaped by the COVID-19 pandemic: Psychological responses from a subjective perspective-A longitudinal mixed-methods study across five European countries.

BACKGROUND: Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors. METHODS: The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022. RESULTS: The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues). CONCLUSIONS: Our findings indicate that people's reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

You can't do anything about it, but you can make the best of it: a qualitative analysis of pandemic-related experiences in six European countries.

Background: The complex system of stressors related to the coronavirus disease 2019 (COVID-19) pandemic has affected the global population, provoking a broad range of psychological reactions. Although numerous studies have investigated the mental health impact of COVID-19, qualitative research and cross-country comparisons are still rare. Objective: This qualitative study aimed to explore self-perceived challenges and opportunities related to COVID-19 across six European countries. The overall objective was to provide a differentiated picture of individual subjective experiences in the early stages of the pandemic. Method: The present study included 7309 participants from Austria, Croatia, Georgia, Greece, Poland, and Portugal. We performed qualitative content analysis according to Mayring analyse open-ended questions regarding stressful events, positive and negative aspects of the pandemic, and recommendations to cope with the pandemic situation. MAXQDA software was used for data management and analysis. Results: Participants' accounts were moderately consistent across the countries. The most prominent themes regarding stressful and negative pandemic aspects included: Restrictions and changes in daily life, Emotional distress, and Work and finances. Answers about positive pandemic consequences were mainly centred around the themes Reflection and growth, Opportunity for meaningful/enjoyable activities, and Benefits on interpersonal level. Key themes identified from participants' recommendations to cope with the pandemic included Beneficial behavioural adjustment, Beneficial cognitive-emotional strategies, and Social support. Conclusions: Participants experienced various challenges, but also shared several positive pandemic consequences and recommendations to cope with the pandemic. These first-hand data could inform mental health practices to promote well-being during COVID-19 and similar global challenges in the participating countries and possibly beyond. HIGHLIGHTS: We examined COVID-19-related experiences in 7309 adults from six European countries.Besides challenges, participants identified many positive pandemic consequences.Participants' recommendations to cope with COVID-19 included behavioural and cognitive-emotional strategies.

Disentangling the associations between past childhood adversity and psychopathology during the COVID-19 pandemic: The mediating roles of specific pandemic stressors and coping strategies.

BACKGROUND: Individuals with a history of adverse childhood experiences (ACEs) display heightened symptoms of psychopathology during the COVID-19 pandemic. Yet, no study has investigated what aspects of the pandemic are of particular concern for this population and ways in which strategies to coping with pandemic stressors may exacerbate their clinical symptomatology. OBJECTIVE: This study explores what pandemic stressors and coping strategies are associated with ACEs, depression, and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic, before investigating whether the identified chief stressors and coping styles mediate the effects of ACEs on depression and PTSD. PARTICIPANTS AND SETTING: 1107 Greek adults were sampled from the general population. METHODS: Participants completed the Adverse Childhood Experiences Questionnaire, Patient Health Questionnaire, Primary Care PTSD Screen for DSM-5, Pandemic Stressor Scale, and Brief Cope Scale. RESULTS: ACEs and depression were both predominantly associated with difficult housing conditions as a stressor (b = 0.079, p < .001 and b = 0.046, p < .001, respectively), whereas PTSD was mainly related to fear of contracting the COVID-19 virus (b = 0.065, p < .001). Self-blame was the main coping strategy associated with both ACEs (b = 0.046, p = .010), depression (b = 0.071, p < .0005), and PTSD (b = 0.088, p < .0005). Difficult housing conditions and self-blame further demonstrated a significant serial mediation effect in the relationship between ACEs with both depression (b = 0.105, 95% CI [0.0607, 0.158]) and PTSD (b = 0.019, 95% CI [0.011, 0.031]). CONCLUSIONS: The findings indicate that policy makers should identify ways of ameliorating challenging housing conditions, and that service providers should target self-blame in the psychological treatment of adults with ACEs during the COVID-19 pandemic.

Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic - findings from a pan-European study.

HIGHLIGHTS: N = 4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic.The prevalence for probable posttraumatic stress disorder was 17.7%.We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

COVID-19 Unmasked Global Collaboration Protocol: longitudinal cohort study examining mental health of young children and caregivers during the pandemic.

BACKGROUND: Early empirical data shows that school-aged children, adolescents and adults are experiencing elevated levels of anxiety and depression during the COVID-19 pandemic. Currently, there is very little research on mental health outcomes for young children. OBJECTIVES: To describe the formation of a global collaboration entitled, 'COVID-19 Unmasked'. The collaborating researchers aim to (1) describe and compare the COVID-19 related experiences within and across countries; (2) examine mental health outcomes for young children (1 to 5 years) and caregivers over a 12-month period during the COVID-19 pandemic; (3) explore the trajectories/time course of psychological outcomes of the children and parents over this period and (4) identify the risk and protective factors for different mental health trajectories. Data will be combined from all participating countries into one large open access cross-cultural dataset to facilitate further international collaborations and joint publications. METHODS: COVID-19 Unmasked is an online prospective longitudinal cohort study. An international steering committee was formed with the aim of starting a global collaboration. Currently, partnerships have been formed with 9 countries (Australia, Cyprus, Greece, the Netherlands, Poland, Spain, Turkey, the UK, and the United States of America). Research partners have started to start data collection with caregivers of young children aged 1-5 years old at baseline, 3-months, 6-months, and 12-months. Caregivers are invited to complete an online survey about COVID-19 related exposure and experiences, child's wellbeing, their own mental health, and parenting. DATA ANALYSIS: Primary study outcomes will be child mental health as assessed by scales from the Patient-Reported Outcomes Measurement Information System - Early Childhood (PROMIS-EC) and caregiver mental health as assessed by the Depression Anxiety Stress Scale (DASS-21). The trajectories/time course of mental health difficulties and the impact of risk and protective factors will be analysed using hierarchical linear models, accounting for nested effects (e.g. country) and repeated measures.

Antecedentes: Los primeros datos empíricos muestran que los niños en edad escolar, los adolescentes y los adultos están experimentando niveles elevados de ansiedad y depresión durante la pandemia de COVID-19. Actualmente, hay muy poca investigación sobre los resultados de salud mental de los niños pequeños. Objetivos: Describir la formación de una colaboración global titulada 'COVID-19 Desenmascarado'. Los investigadores colaboradores tienen como objetivos (1) describir y comparar las experiencias relacionadas con COVID-19 dentro y entre países; (2) examinar los resultados de salud mental de los niños pequeños (de 1 a 5 años) y los cuidadores durante un período de 12 meses durante la pandemia de COVID-19; (3) explorar las trayectorias/temporalidad de los resultados psicológicos de los niños y los padres durante este período e (4) identificar los factores de riesgo y de protección para las diferentes trayectorias de salud mental. Los datos de todos los países participantes se combinarán en un gran conjunto de datos transculturales de acceso abierto para facilitar más colaboraciones internacionales y publicaciones conjuntas. Métodos: COVID-19 Desenmascarado es un estudio de cohorte longitudinal prospectivo en línea. Se formó un comité directivo internacional con el objetivo de iniciar una colaboración global. Actualmente, se han formado asociaciones con 9 países (Australia, Chipre, Grecia, Países Bajos, Polonia, España, Turquía, Reino Unido y Estados Unidos de América). Los socios de investigación han comenzado la recopilación de datos con los cuidadores de niños pequeños de 1 a 5 años al inicio, a los 3 meses, a los 6 meses y a los 12 meses. Se invita a los cuidadores a completar una encuesta en línea sobre la exposición y las experiencias relacionadas con COVID-19, el bienestar del niño, su propia salud mental y parentalidad. Análisis de datos: Los resultados primarios del estudio serán la salud mental infantil según la evaluación de las escalas del Sistema De Información De medición de Resultados Informados Por El Paciente ­ Primera Infancia (PROMIS-EC) y la salud mental del cuidador según la evaluación de la Escala de estrés, ansiedad y depresión (DASS-21). Las trayectorias/temporalidad de las dificultades de salud mental y el impacto de los factores de riesgo y de protección se analizarán utilizando modelos lineales jerárquicos, teniendo en cuenta los efectos anidados (por ejemplo, el país) y las medidas repetidas.

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic - First results of the ESTSS COVID-19 pan-European ADJUST study.

Background: The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective: This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods: Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results: The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions: We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Antecedentes: La pandemia de COVID-19 expone a las personas a múltiples factores estresantes, como la cuarentena, el distanciamiento físico, la pérdida del trabajo, el riesgo de infección, y la pérdida de seres queridos. Esta compleja serie de factores estresantes puede potencialmente conducir a síntomas del trastorno de adaptación.Objetivo: Este estudio exploratorio transversal examinó las relaciones entre los factores de riesgo y de protección, los factores estresantes, y los síntomas del trastorno de adaptación durante el primer año de la pandemia de COVID-19.Métodos: Se utilizaron datos de la primera ola del estudio longitudinal ADJUST de la Sociedad Europea de Estudios de Estrés Traumático (ESTSS en su sigla en inglés). N = 15.563 participantes de 18 años o más fueron reclutados en once países (Austria, Croacia, Georgia, Alemania, Grecia, Italia, Lituania, Países Bajos, Polonia, Portugal, y Suecia) de junio a noviembre de 2020. Se examinaron mediante regresión lineal multivariante las asociaciones entre los factores de riesgo y de protección (p. ej., género, diagnóstico de un trastorno de salud mental), factores estresantes (p. ej., miedo a la infección, contacto restringido cara a cara), y síntomas del trastorno de adaptación (ADNM-8 en su sigla en inglés).Resultados: La prevalencia del trastorno de adaptación probable autoinformado fue del 18,2%. Los factores de riesgo asociados con niveles más altos de síntomas del trastorno de adaptación fueron género femenino, edad avanzada, riesgo de enfermedad grave por COVID-19, peor estado de salud general, exposición a un trauma actual o anterior, un trastorno de salud mental actual o anterior, y una exposición más prolongada a las noticias de COVID-19. Los factores de protección relacionados con niveles más bajos de síntomas del trastorno de adaptación fueron mayores ingresos, estar jubilado, y tener más contacto cara a cara con sus seres queridos o amigos. Los factores estresantes relacionados con la pandemia que se asociaron con niveles más altos de síntomas del trastorno de adaptación incluyeron miedo a la infección, manejo gubernamental de crisis, contacto social restringido, problemas relacionados con el trabajo, actividad restringida, y condiciones de vivienda difíciles.Conclusiones: Identificamos factores estresantes, de riesgo, y protectores que pueden ayudar a identificar a las personas con mayor riesgo de trastorno de adaptación.

Pubertal timing and callous-unemotional traits in girls: Associations across two samples from the UK and Cyprus.

INTRODUCTION: Girls remain an understudied group when examining delinquency. Callous-unemotional traits are chief among personality traits that relate to delinquency. Some suggest, however, that girls who evince callous-unemotional traits delay their delinquent behavior until adolescence. This transitional period encompasses physical factors that relate to engagement in risky decision making, but we don't know how these factors relate to callous-unemotional traits. Early pubertal timing shows positive associations with delinquency; we tested if this was also the case for callous-unemotional traits. METHODS: We tested associations among pubertal timing (i.e., maturity and menarche age), delinquency, and callous-unemotional traits within girls (ages 11-18 years) sampled from two European countries (UK and Cyprus). We also tested the interaction between callous-unemotional traits and pubertal timing in statistically predicting delinquency to test if associations between early puberty and delinquency were moderated by callous-unemotional traits. RESULTS: Greater callous-unemotional traits were surprisingly negatively related to early pubertal timing. Those girls in the delayed menarche group had the highest level of callous-unemotional traits, higher than the typical and early menarche groups. Only callous-unemotional traits statistically predicted variance in delinquency and no moderation was evident. CONCLUSIONS: The implications are that callous-unemotional traits and the transition to puberty may be particularly important for girls' adjustment in adolescence, particularly if menarche is delayed allowing girls to avoid punishment by capitalizing on their immaturity.

Can Callous-Unemotional Traits be Reliably Measured in Preschoolers?

Callous-unemotional (CU) traits designate an important subgroup of antisocial individuals at risk for early-starting, severe, and persistent conduct problems, but this construct has received limited attention among young children. The current study evaluated the factor structure, psychometric properties, and validity of scores on a comprehensive measure of CU traits, the Inventory of Callous-Unemotional Traits (ICU), in relation to measures of antisocial/prosocial behavior and emotional processing, administered to preschool children. The sample included 214 boys (52 %) and girls (48 %, M age = 4.7, SD = 0.69) recruited from mainstream and high-risk preschools. Confirmatory factor analyses supported a two-factor structure including callous and uncaring dimensions from 12 of the 24 original ICU items. Scores on the parent- and teacher-reported ICU were internally consistent and combined CU scores showed expected associations with an alternate measure of CU traits and measures of empathy, prosocial behavior, conduct problems, and aggression. Preschool children high on CU traits were less accurate, relative to children scoring low, in recognizing facial expressions. They were also less attentionally engaged by images of others in distress when co-occurring conduct problems presented. Findings extend the literature by supporting the psychometric properties of the ICU among young children, and open several avenues for studying early precursors to this severe personality disturbance.

Types of Relational Aggression in Girls Are Differentiated by Callous-Unemotional Traits, Peers and Parental Overcontrol.

Adolescent girls often perpetrate aggression by gossiping and spreading rumours about others, by attempting to ruin relationships and by manipulating and excluding others. Further, males and females engage in reactive and proactive relational aggression differently. In this study, we examined the individual, peer and parental contextual factors that best explained the use of reactive and proactive relational aggression in girls. Female participants (n = 614; ages 11-18 years) completed questionnaires on aggression, callous-unemotional (CU) traits, delinquency, peer delinquency, gender composition of their peer group, resistance to peer influence and perceived parental overcontrol. Multinomial logistic regression was used to examine the effects of individual, peer- and parent-related variables on the likelihood of being classified as a low aggressor, reactive aggressor or proactive/reactive aggressor. Girls in the combined reactive/proactive aggression group were younger, had greater CU traits, a lower proportion of male peers and greater perception of parental control than both the reactive and low aggressive groups. Both highly aggressive groups were more delinquent and had greater peer delinquency than the low aggressive group. This study suggests those girls who show relational aggression for the purpose of gaining status and revenge feel restrained by their parents and may gravitate toward relationships that support their behaviour.

Psychometric properties of the Strength and Difficulties Questionnaire from five European countries.

The Strength and Difficulties Questionnaire (SDQ) is a brief screening instrument for assessing emotional and behavioural problems in children and adolescents. This study examined the factor structure and validity of the self-report original English version of the SDQ and four of its many translations (German, Cypriot Greek, Swedish, and Italian). A total of 2418 adolescents from five European countries (Germany, Cyprus, England, Sweden, Italy), ages 12 to 17 years, participated. The sample was drawn from general (school) populations. In addition to the SDQ, all participants completed the Spence Children's Anxiety Scale (SCAS), a measure of anxiety symptoms. The internal consistency and validity of the SDQ total difficulties were good for most countries. Confirmatory factor analysis showed that both five- and three-factor models provided good fit for the whole sample; however, the three-factor model fit somewhat better than the five-factor model. The factor structure differed across countries, with the three-factor model showing better fit indices in Cyprus, whereas the five-factor model fitted better in Germany. Fit indices for the UK, Sweden, and Italy were poor for both models. When the reversed items were removed, the goodness-of-fit improved significantly for the total sample and in each country. It is therefore recommended that the reversed items be removed or re-worded in future studies.

Psychometric properties of the Spence Children's Anxiety Scale (SCAS) in Cypriot children and adolescents.

The Spence Children's Anxiety Scale (SCAS) is a 38-item self-report questionnaire which measures symptoms of DSM-IV anxiety disorders in children and adolescents. This study examined the psychometric properties of the Greek translation of SCAS in a large community sample of children and adolescents (N = 1,072), aged 12-17 years, in the non-occupied territory of Cyprus. A subsample of these participants was retested 8 weeks after the initial assessment. The SCAS demonstrated high internal consistency (alpha = .92) and test-retest reliability (r = .88). The SCAS total scores correlated significantly with the anxious/depressed subscale of the Youth Self-Report, the Columbia Impairment Scale, and with the emotional subscale of the Strength and Difficulties Questionnaire. Confirmatory factor analyses revealed the same six-factor structure as the original SCAS. The SCAS proved to be a reliable and valid measure of anxiety symptoms in the Cypriot context.

Disinhibited behaviors in young children: relations with impulsivity and autonomic psychophysiology.

Cardiac activity has long been considered as a psychophysiological marker of adaptive psychological adjustment. Irregularities in autonomic nervous system activity have long been implicated in both externalizing and disinhibitory behaviors. The present study used a battery of assessments in children ages 4.5-5.5 years to examine the relation among disinhibitory measures. Additionally, cardiovascular activity and reactivity was examined. Mothers rated impulsivity and internalizing/externalizing behaviors. Reward-dominance and passive-avoidance response inhibition (i.e., via errors of commission) tasks were included. Results showed that behaviorally uninhibited children began with an attenuated sympathetic response (i.e., lengthened pre-ejection period) to an interview with a novel experimenter, while inhibited children began with a high level of sympathetic activity. Further, behavioral impulsivity was related to low sympathetic activity at rest. Consistent with theories of disinhibition, externalizing behaviors and measures of behavioral impulsivity were related to a reward-dominant response style. Findings are discussed with regard to motivational theories of behavior.

Psychometric properties of the Spence Child Anxiety Scale with adolescents from five European countries.

This study examined the factor structure, reliability, and validity of the original Spence Child Anxiety Scale (SCAS) and its four translations (German, Cypriot Greek, Swedish, Italian). A total of 2558 adolescents from five European countries (Germany = 495; Cyprus = 611; UK = 469; Sweden = 484; Italy = 499), ages 12-17 years, participated in the study. In addition to the SCAS, all participants completed the Strengths and Difficulties Questionnaire, a measure of general difficulties and positive attributes. The internal consistency and validity (convergent and discriminant) of the SCAS were excellent. Multiple group confirmatory factor analysis provided strong support for the generalizability of a 6-factor inter-correlated model across five European countries. Adolescents in the UK had significantly higher anxiety levels than adolescents in four other European countries. Our findings suggest that the SCAS is suitable for assessing anxiety disorder symptoms in adolescents in Germany, the UK, Cyprus, Sweden, and in Italy.

Physiologically-indexed and self-perceived affective empathy in Conduct-Disordered children high and low on Callous-Unemotional traits.

Heart rate (HR) was employed to compare vicarious affective arousal across three groups of children (aged 7.6 - 11, N = 95): Conduct Disordered (CD) elevated on Callous-Unemotional traits (CD/CU), CD low on CU traits (CD-only), and [Symbol: see text]typically-developing' controls, matched in age, gender and socioeconomic background. While watching an emotion evocative film, participants' HR was monitored. Immediately after viewing, self-reported vicarious responses were obtained. Participants also completed the Bryant Empathy Index. CD/CU children displayed lower magnitude of HR change than both CD-only and controls. Both CD groups reported fewer vicarious responses and scored lower than controls on the empathy index. These results support distinct deficits across CD subsets, suggestive of distinct mechanisms underlying their antisocial conduct.

Cognitive and affective perspective-taking in conduct-disordered children high and low on callous-unemotional traits.

BACKGROUND: Deficits in cognitive and/or affective perspective-taking have been implicated in Conduct-Disorder (CD), but empirical investigations produced equivocal results. Two factors may be implicated: (a) distinct deficits underlying the antisocial conduct of CD subgroups, (b) plausible disjunction between cognitive and affective perspective-taking with subgroups presenting either cognitive or affective-specific deficits. METHOD: This study employed a second-order false-belief paradigm in which the cognitive perspective-taking questions tapped the character's thoughts and the affective perspective-taking questions tapped the emotions generated by these thoughts. Affective and cognitive perspective-taking was compared across three groups of children: (a) CD elevated on Callous-Unemotional traits (CD-high-CU, n = 30), (b) CD low on CU traits (CD-low-CU, n = 42), and (c) a 'typically-developing' comparison group (n = 50), matched in age (7.5 - 10.8), gender and socioeconomic background. RESULTS: The results revealed deficits in CD-low-CU children for both affective and cognitive perspective-taking. In contrast CD-high-CU children showed relative competency in cognitive, but deficits in affective-perspective taking, a finding that suggests an affective-specific defect and a plausible dissociation of affective and cognitive perspective-taking in CD-high-CU children. CONCLUSION: Present findings indicate that deficits in cognitive perspective-taking that have long been implicated in CD appear to be characteristic of a subset of CD children. In contrast affective perspective-taking deficits characterise both CD subgroups, but these defects seem to be following diverse developmental paths that warrant further investigation.