Prevalence of DSM-5 anxiety disorders, comorbidity, and persistence of symptoms in Spanish early adolescents.

Anxiety Disorders (AD) are the most prevalent mental disorders in children and adolescents and a relevant public health problem. The study aimed to determine the prevalence of ADs, the comorbidity, the sociodemographic correlates, and the functional impairment in Spanish school children. The initial sample included 1514 subjects (720 boys; mean age = 10.2), who filled out the Screen for Children's Anxiety-Related Emotional Disorders (SCARED). In a second phase, 562 subjects at risk and not-at-risk of anxiety were assessed with the Mini-International Neuropsychiatric Interview for Children and Adolescents to obtain DSM-5 diagnoses. Two years later (third phase; mean age 13.5), the SCARED was re-administered. The weighted prevalence of any AD was 11.8%. The most prevalent subtypes were specific phobia (16.2%) and generalized anxiety disorder (GAD) (6.9%). Girls showed higher rates of social anxiety (5.5%) than boys. Apart from being female, low socioeconomic status was also a risk factor for AD. The heterotypic comorbidity of any AD was 40.7%, and the homotypic comorbidity was 35.6%. After controlling for age and other ADs, we found that subjects with GAD had the highest risk of having other depressive disorders and ADs. Only 33.3% of the subjects with any AD had sought professional help. 52.9% of the subjects diagnosed with any of the ADs still had anxiety symptoms after a 2-year follow-up. These findings highlight that in Spain, ADs in early adolescence are an important public health problem and that detection and access to treatment need to be improved.

Transphobia and Gender Bashing in Adolescence and Emerging Adulthood: The Role of Individual Differences and Psychosocial Variables.

Although research in recent years has revealed widespread discrimination against transgender people, few studies have addressed the attitudes of those who discriminate. In fact, although studies report that bullying is very common in adolescence, little is known about the attitudes of adolescents towards transgender people. This study aimed to determine the roles of social reputation, family socialisation, the big five personality traits and aggressiveness in transphobia and gender bashing among adolescents. The sample consisted of 479 students (50.1% boys) aged 14-19 (M = 15.04; SD = 1.06). The results revealed that transphobia and gender bashing were significantly related to the study variables. Specifically, the results showed that transphobia is largely predicted by variables of the type related to affect and personality, while gender bashing is largely related to variables of a social and reputational nature. Similarly, differences were found between genders, with boys having significantly higher scores than girls for transphobia and gender bashing, as well as specificity of predictors. The implications of these findings are discussed.

Impulsivity and internalizing disorders in childhood.

Impulsivity has often been related to externalizing disorders, but little is known about how it is related to symptoms of internalizing disorders. This study aims to examine the relationship between impulsivity and depression and anxiety symptoms of depression and anxiety in childhood, and compare it with its relationship with a measure of aggressive behavior, which is present in many externalizing disorders. We administered the Barratt Impulsiveness Scale-11 for children, the Children's Depression Inventory and the Screen for Children's Anxiety Related Emotional Disorders to a case-control sample of 562 children aged between 9 and 13 who were selected from an epidemiological study of anxiety and depression and whose teachers provided information about their proactive and reactive aggression. Impulsivity was related to measures of anxiety, depression and aggressive behavior, and showed higher relationships with measures of internalizing symptoms than with aggression. Motor impulsivity, a component of impulsivity related to inhibition deficits, was the component most related to anxiety and depression. Cognitive impulsivity, on the other hand, was negatively related to anxiety and depression. The relationships between impulsivity and symptoms of internalizing disorders seem to indicate that impulsivity should be taken into account not only in externalizing problems, but also in depression and anxiety in children and adolescents.

Stability of the factor structure of Barrat's Impulsivity Scales for children across cultures: a comparison of Spain and Colombia.

Despite the great importance of impulsivity in many childhood and adolescence disorders, there are few self-reports on child impulsivity. Recently, a modified version of Barratt's BIS-11 questionnaire adapted for children has been developed, which may be useful in assessing this personality dimension. The present study reports an adaptation of this questionnaire in a different culture (Colombia) and assesses the degree of convergence between the factor structures of both adaptations using consensus oblimin rotation. The results indicate not only that the factor structure of the test remains stable across both adaptations, and that two of the three scales in the Colombian version show acceptable reliabilities, but also that cultural and linguistic issues are important in test adaptation even when the same language is used.

Functional Impairment and Clinical Correlates in Adolescents with Bipolar Disorder Compared to Healthy Controls. A Case-control Study.

BACKGROUND: Evidence shows that most adolescents with bipolar disorder (BD) achieve syndromic recovery after being referred to specialized treatment. However, functional recovery is reached in less than 50% of those cases. METHOD: Descriptive cross-sectional case-control study, based on a clinical sample of 44 BD patients aged 12-19, matched by age and sex with 44 healthy controls (HC). Psychopathology was ascertained using the KSADS-PL, in addition to the clinical scales. Information about previous academic performance was included, as well as functional outcome based on the Children's Global Assessment Functioning Scale (CGAS). Previous exposure to stressful experiences was assessed using the Schedule for Stressful Life Events (SLES). All analyses were performed using either conditional or stepwise logistic regression models. RESULTS: Once they have become stabilized, and even after controlling for socio-demographic differences, BD patients were associated with lower levels of functionality [OR 0.65 (0.46, 0.93), p=0.02], and worse performance at school [OR 0.03 (0.01, 0.67), p=0.03] compared with HC. Persistent sub-syndromal psychosis showed the strongest negative correlation with functionality (rho=-0.65, -0.57 for BD and HC respectively; p<0.001). Although BD was associated with more stressful life events, this association did not remain significant in the multivariate models. LIMITATIONS: The small sample size limits our ability to detect differences between groups, and between BD subtypes. CONCLUSIONS: Even when early detection and intervention is provided, BD has a significant impact on functioning and academic performance. It is important to address persistent sub-threshold symptoms and to emphasize the social and rehabilitative components of treatment.

CONTEXTE: Les données probantes indiquent que la plupart des adolescents souffrant de trouble bipolaire (TB) obtiennent un rétablissement syndromique après avoir été adressés à un traitement spécialisé. Cependant, le rétablissement fonctionnel n'est réalisé que dans moins de 50 % de ces cas. MÉTHODE: Une étude cas-témoins transversale descriptive, basée sur un échantillon clinique de 44 patients de TB âgés de 12 à 19 ans, appariés selon l'âge et le sexe avec 44 témoins en santé (TS). La psychopathologie a été déterminée à l'aide de KSADS-PL, en plus des échelles cliniques. L'information sur le rendement scolaire antérieur était incluse de même que le résultat fonctionnel basé sur l'échelle d'évaluation globale du fonctionnement pour les enfants (CGAS). L'exposition précédente à des expériences stressantes a été évaluée à l'aide de l'échelle des événements stressants de la vie (SLES). Toutes les analyses ont été menées à l'aide de modèles de régression logistique conditionnelle ou séquentielle. RÉSULTATS: Une fois stabilisés, et même après contrôle des différences sociodémographiques, les patients de TB ont été associés à des niveaux plus faibles de fonctionnalité [RC 0,65 (0,46, 0,93), p = 0,02], et à un rendement scolaire plus mauvais [RC 0,03 (0,01, 0,67), p = 0,03] comparé aux TS. Une psychose sous-syndromale persistante présentait la corrélation négative la plus forte avec la fonctionnalité (rho =−0,65, −0,57 pour TB et TS respectivement; p < 0,001). Bien que le TB soit associé à des événements plus stressants, cette association ne demeurait pas significative dans les modèles multivariés. LIMITATIONS: La taille modeste de l'échantillon limite notre capacité de détecter les différences entre les groupes, et entre les sous-types de TB. CONCLUSIONS: Même lorsque la détection et l'intervention précoces sont fournies, le TB a un effet significatif sur le fonctionnement et sur le rendement scolaire. Il est important de prendre en compte les symptômes de sous-seuil persistants et de mettre l'accent sur les composantes sociale et de rétablissement du traitement.

The INventory of Callous-Unemotional Traits and Antisocial Behavior (INCA) for Young People: Development and Validation in a Community Sample.

Callous-unemotional traits are defined as potential markers of psychopathy in children and adolescents. Previous studies with the most widely used instrument designed specifically to assess these traits, the Inventory of Callous-Unemotional Traits (ICU), have shown major methodological problems. For this reason, the purpose of the present study was to develop a valid and reliable test to assess callous-unemotional traits for the adolescent population free of the response biases social desirability (SD) and acquiescence (AC). In order to obtain responses free of these biases, we used SD item markers as well as content balanced items to identify a factor related to SD and AC, so that SD and AC effects can be removed from the individual scores on content factors. As well as the CU traits (unemotional, callousness, and uncaring scales), this new questionnaire also contains an additional scale for assessing antisocial behaviors. The test was administered to 719 adolescents between 13 and 19 years old. Exploratory and confirmatory factor analysis yielded the following expected four dimensions with a good fit: Unemotional, Callousness, Uncaring, and Antisocial Behavior. These scales also showed good psychometric properties with good reliability, and convergent, discriminant and criterion validity.

Psychometric properties of the Spanish adaptation of the Barratt Impulsiveness Scale-11-A for children.

Given difficulty in having children assess their own behaviour, there are few self-reports on child impulsivity. With the exception of Eysenck's 16 questionnaire, there are no self-report measures of impulsivity in children with good psychometric properties. The present study tested the possibility of using the adolescent version of the Barratt Impulsiveness Scale-11 with children. For this purpose the questionnaire was translated and backtranslated and administered to school children (182 boys and 195 girls) ages 8 to 12 years (M = 10.4, SD = 0.9). The data were analysed by exploratory factor analysis, to evaluate the factorial structure of the questionnaire, the fit of the proposed solution, and internal consistency reliabilities. Results seem to indicate that this questionnaire may be useful in assessing impulsivity in children. The three-factor structure showed slight differences with the initial questionnaire proposed by Barratt and had good or sufficient internal consistency (depending upon the scale) across the 8- to 12-yr.-old age range.

Functional and dysfunctional impulsivity in childhood and adolescence.

There are few self-reports of impulsivity dealing with children, although this personality trait has been related to many behaviour problems in both children and adolescents. The appropriateness of the Dickman Impulsivity Inventory for Children (DII-c) and the Dickman Impulsivity Inventory (DII) to measure impulsivity in children and adolescents was assessed. The factorial structure of the DII-c and the internal consistencies for both inventories suggest the measured dimensions are not consistent until adulthood. These self-report measures are not appropriate for children and adolescents.

How Individual and Contextual Factors Affects Antisocial and Delinquent Behaviors: A Comparison between Young Offenders, Adolescents at Risk of Social Exclusion, and a Community Sample.

The problems associated with violence during adolescence have been on the rise in recent decades. Many studies have focused only on environmental causes or individual causes of violence, although a combination of both variables would seem to be the best option for prediction. The current study aims to assess the relevance of individual characteristics (personality traits, intelligence, and historical and clinical factors linked to the risk of violence), contextual risk factors and protective factors in explaining antisocial and delinquent behaviors in adolescence by comparing three different samples: a community sample, a sample at risk of social exclusion, and a sample of juvenile offenders. The results show that the samples at risk of social exclusion and the sample of juvenile offenders have a very similar profile in terms of personality traits and intelligence, although they differ from the community sample. However, these two samples do differ in such contextual variables as peer delinquency, poor parental management, community disorganization, or early caregiver disruption.

Suicidal ideation in adolescents assessed with the three-mode component approach

Proactive coping is a multidimensional and future-looking quality of life strategy that can predict positive outcomes and regulate distress. Recently, social support has been seen as an essential resource for effective coping with stressors. On this basis, a cross-sectional study examining a theoretical model was investigated using a path analysis. It was hypothesized that social support would be associated with proactive coping in the synergistic relationship and in relation to the positive psychological variable of well-being. Moreover, direct relationships between well-being and feelings of depression were expected. In a sample of 482 full-time university students attending public university, the results showed that social support and comparable proactive coping directly contributed to an increase in well-being. Furthermore, well-being was directly related to depression. Besides direct effects, an indirect pathway from social support to well-being was tested confirming the hypothesis that proactive coping functions as a partial mediator between social support and well-being. Generalizability of the findings was tested across gender and age performing multi-group analyses. Furthermore, practical implications, study limitations, and future research are discussed

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I-DAQ: a new test to assess direct and indirect aggression free of response bias.

Self-reports of aggression are deeply impacted by response bias, especially by social desirability, but there are no specific methods for controlling this bias. Furthermore, despite the importance of the subject few instruments have been designed to assess both direct and indirect forms of aggression. The aim of the present research was to develop a brief measure that comprises both forms of aggression and which makes it possible to obtain scores free of social desirability and acquiescence effects. The scales were created using recently developed methods for controlling response bias effects in a sample of 750 participants over a wide age range. The items were chosen by a panel of judges from among the best of the existing aggression measures. Confirmatory factor analysis showed the expected three factor structure (CFI = .98; AGFI = .97 and RSMEA = .078, 90% C.I. = .074 - .083) and the scales showed good psychometric properties in that they had good reliability (ranging from θxx = .77 to θxx = .83), and convergent and criterion validity.

Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population.

We aimed to find a valid cutoff score for the Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C) and parent (SCARED-P) Spanish versions for detecting Anxiety Disorders (AD) in a non-clinical population. The predictive accuracy of the SCARED-C and SCARED-P was assessed using the Area Under the Curve (AUC) of ROC curves. In general, the predictive accuracy of the SCARED-C (full version, short version, and four factors) was good and better than that of the SCARED-P. To differentiate between children who meet the diagnostic criteria for any AD and children who do not, we propose cutoff scores of 25 and 17 for the SCARED-C and SCARED-P, respectively. The sensitivities are 75.9% and 62.8%, and the specificities are 68.5% and 69.5%. The SCARED-C factor that had the best predictive accuracy was Somatic panic followed by Separation Anxiety, Generalized Anxiety and Social Phobia. The SCARED-P factor with the best predictive accuracy was Separation Anxiety. The results support the use of SCARED-C as a screening test for Anxiety disorders while SCARED-P should only be used as complementary information.

The epidemiology of obsessive--compulsive disorder in Spanish school children.

We aimed to assess the prevalence (at three levels of severity) and other epidemiological data of OCD in a sample of 1,514 Spanish non-referred children. The estimated prevalence was 1.8% for OCD, 5.5% for subclinical OCD and 4.7% for OC symptomatology. We did not find significant differences between genders or academic grade regarding OC symptoms and OCD, but more subclinical prevalence was found in males than in females. Socio-demographic variables were not related to any level of OCD, but academic performance was significantly lower in clinical OCD. The co-morbidity between OCD and any psychiatric disorder was high (85%) and higher for emotional disorders than for behavioral disorders. The impairment was associated with comorbidity and was worse for OCD with comorbid emotional problems. The results suggest that OCD is not rare in school children and adolescents and that it has an impact on their personal functioning. We suggest the possibility of an early diagnosis and treatment.

Parent-child agreement in SCARED and its relationship to anxiety symptoms.

The aim of this study is to analyze parent-child agreement in the Spanish version of the Screen for Anxiety Related Emotional Disorders and its relationship with the anxiety symptoms reported in a scheduled interview and the Mini-International Neuropsychiatric Interview for Children and Adolescents in order to establish the best informant and the degree of incremental validity when both sources of information are combined. Results indicated that, as in the original English version, parent-children agreement is low, with parents clearly tending to report fewer severe symptoms than children. When both parent and child versions were related to anxiety symptoms of the scheduled interview, children showed higher relationships than parents with all the anxiety categories reported by the scheduled interview. Children's scores were also the best predictors of anxiety symptoms, while incremental validity of parent's reports was quite low.

I-DAQ: a new test to assess direct and indirect aggression free of response bias

Self-reports of aggression are deeply impacted by response bias, especially by social desirability, but there are no specific methods for controlling this bias. Furthermore, despite the importance of the subject few instruments have been designed to assess both direct and indirect forms of aggression. The aim of the present research was to develop a brief measure that comprises both forms of aggression and which makes it possible to obtain scores free of social desirability and acquiescence effects. The scales were created using recently developed methods for controlling response bias effects in a sample of 750 participants over a wide age range. The items were chosen by a panel of judges from among the best of the existing aggression measures. Confirmatory factor analysis showed the expected three factor structure (CFI = .98; AGFI = .97 and RSMEA = .078, 90% C.I. = .074 - .083) and the scales showed good psychometric properties in that they had good reliability (ranging from θxx = .77 to θxx = .83), and convergent and criterion validity (AU)

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Stability of the factor structure of Barrat’s Impulsivity Scales for children across cultures: a comparison of Spain and Colombia / Estabilidad de la estructura factorial de la escala de impulsividad para niños de Barratt a través de culturas: una comparación entre España y Colombia

Despite the great importance of impulsivity in many childhood and adolescence disorders, there are few self-reports on child impulsivity. Recently, a modified version of Barratt’s BIS-11 questionnaire adapted for children has been developed, which may be useful in assessing this personality dimension. The present study reports an adaptation of this questionnaire in a different culture (Colombia) and assesses the degree of convergence between the factor structures of both adaptations using consensus oblimin rotation. The results indicate not only that the factor structure of the test remains stable across both adaptations, and that two of the three scales in the Colombian version show acceptable reliabilities, but also that cultural and linguistic issues are important in test adaptation even when the same language is used (AU)

A pesar de la gran importancia de la impulsividad en múltiples patologías de la infancia y la juventud, existen pocos cuestionarios de impulsividad para niños. Recientemente se ha desarrollado una versión modificada del cuestionario BIS-11 de Barratt adaptado para niños que puede ser útil en la evaluación de esta dimensión de personalidad. Este estudio presenta una adaptación de este cuestionario a una cultura distinta (colombina) y evalúa el grado de convergencia entre las soluciones factoriales de ambas versiones del test utilizando el método de rotación consensos oblimin. Los resultados indican una elevada estabilidad de la solución factorial a través de las versiones y una fiabilidad satisfactoria para dos de las tres escalas en la adaptación colombiana. Por otra parte se pone de manifiesto la importancia de los aspectos culturales y lingüísticos en la adaptación de un test incluso cuando se trata de la misma lengua (AU)