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Mordeno IG, Bigcas JD, Mordeno ER. Examining the Latent Dimensions of Social Anxiety Disorder. Psychol Rep 2025; 128:483-517. [PMID: 36773037 DOI: 10.1177/00332941231156815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, College of Education, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Jimayma D Bigcas
- School of Graduate Studies, College of Education, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Emelyn R Mordeno
- Department of Psychology, College of Arts and Social Sciences, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
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Cai RY, Edwards C, Love AM, Brown L, Gibbs V. Self-compassion improves emotion regulation and mental health outcomes: A pilot study of an online self-compassion program for autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2572-2585. [PMID: 38584374 DOI: 10.1177/13623613241235061] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
LAY ABSTRACT Self-compassion is when we are aware of our feelings and thoughts, are friendly toward ourselves, and realize everyone feels pain and makes mistakes. Self-compassion is associated with having better mental health and well-being in autistic and non-autistic people. But we do not know if autistic people's self-compassion can be improved through psychoeducation and self-compassion practices. We co-produced an online self-guided self-compassion program based on evidence-based self-compassion practices for autistic adults called the Self-compassion Program for Autistic Adults. This program included live-experiences videos of autistic adults reflecting on their self-compassion and self-critical experiences. This study piloted the program with 39 autistic adults. We wanted to see if these autistic adults' self-compassion, emotion regulation, mental health, and psychological well-being improved after completing this program. We found that the autistic participants' self-compassion, emotion regulation, mental health, and psychological well-being improved significantly after completing the program over 5 weeks. We also found that just over half of the participants reported experiencing negative reactions associated with self-compassion practices. We suggested some clinical implications, including a recommendation for emotion regulation interventions to incorporate self-compassion to help promote access to the affiliative system. In addition, autistic adults who are psychologically vulnerable may need to work with mental health professionals while developing self-compassion to help manage the possible negative reactions associated with some self-compassion practices.
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Affiliation(s)
- Ru Ying Cai
- Autism Spectrum Australia, Australia
- La Trobe University, Australia
| | | | | | - Lydia Brown
- La Trobe University, Australia
- The University of Melbourne, Australia
- Healthscope Hospitals, Australia
| | - Vicki Gibbs
- Autism Spectrum Australia, Australia
- The University of Sydney, Australia
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Cai RY, Hall G, Pellicano E. Predicting the financial wellbeing of autistic adults: Part I. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1203-1215. [PMID: 37665058 DOI: 10.1177/13623613231196085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
LAY ABSTRACT Researchers have found the way people feel about their financial situation is related to their quality of life. We know that many autistic people find it hard to find a job. And for those autistic people who have a job, they are often underpaid. Not having a job or being underpaid often means having low income. Having low income is likely to influence how autistic people feel about their financial situation. However, no research has looked at these issues for autistic people. This is the first study that helps us learn more about what autistic adults think about their financial situation. We looked at autistic people's thoughts on this issue compared to people from the general Australian population. We also looked at what things might impact how autistic people feel about their financial situation-which might be how much money they earn, what they do with that money, and their mental health. Many autistic adults felt they were struggling with financial wellbeing and this was connected both to the level of their income and how they said they managed their money. Those who were able to save and not borrow for everyday expenses reported feeling a greater sense of financial wellbeing. Concrete changes might help to improve autistic people's financial wellbeing. We need to investigate how we can help autistic people find and keep well-paying jobs. And we need to work out the best ways of equipping autistic people with the skills they need in financial matters.
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Affiliation(s)
- Ru Ying Cai
- Autism Spectrum Australia, Australia
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Gabrielle Hall
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Elizabeth Pellicano
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- University College London, UK
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Pellicano E, Hall G, Ying Cai R. Autistic adults' experiences of financial wellbeing: Part II. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1090-1106. [PMID: 37795595 PMCID: PMC11067415 DOI: 10.1177/13623613231191594] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
LAY ABSTRACT Money matters in people's lives. It helps to meet people's basic needs (food, clothes, shelter) and live the lives they want to. When people talk about 'financial wellbeing', they mean how much you feel in control over day-to-day finances and how much freedom you have to make choices to enjoy life. We don't know what autistic people think about these things. That's why we did our study. We spoke to 21 autistic adults (24-69 years) about how they felt about their financial situation. We deliberately spoke to people who had told us previously they felt 'financially well' or 'financially unwell' so we could hear a range of opinions. Autistic people told us financial wellbeing meant having enough money to pay for their basics needs, to have a safety net for unexpected bills and not having to worry about money now or in the future. But many felt that good financial wellbeing was not possible for them. They often did not have a stable income to cover day-to-day expenses. This limited the choices they could make. Despite these challenges, autistic people told us they worked hard to budget and save money when they could - because feeling financial insecure was just too stressful, especially when they could not rely on family or friends for support. It made them feel mentally unwell. Our study shows there are many factors that influence autistic people's financial wellbeing. We need more research to help us understand how autistic people can be supported to achieve financial security.
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Affiliation(s)
- Elizabeth Pellicano
- University College London, UK
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Gabrielle Hall
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Ru Ying Cai
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Aspect Australia, Australia
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Cai RY, Love A, Robinson A, Gibbs V. The Inter-Relationship of Emotion Regulation, Self-Compassion, and Mental Health in Autistic Adults. AUTISM IN ADULTHOOD 2023; 5:335-342. [PMID: 37663445 PMCID: PMC10468559 DOI: 10.1089/aut.2022.0068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background Emotion regulation is one of the key factors that influence mental health outcomes in autistic and nonautistic populations. Recent research has also identified self-compassion as a negative correlate of depression and positive correlate of psychological well-being in autistic adults. Empirical evidence from the general population supports the notion that being kind and compassionate toward oneself during stressful and difficult moments can help with one's ability to regulate negative emotions, which then has flow-on effects on mental health outcomes. However, the inter-relationship between self-compassion, emotion regulation, and mental health has not been examined in autistic samples. Therefore, the aim of this study was to determine if emotion regulation mediates the relationship between self-compassion and anxiety or depression in a sample of autistic adults. Methods Participants were 153 adults (meanage = 35.70, standard deviationage = 12.62) who had either self-reported a clinical diagnosis of autism spectrum disorder or self-identified as autistic. They completed an online survey capturing self-compassion, emotion regulation, anxiety, and depression. We hypothesized that emotion regulation would mediate the relationship between self-compassion and anxiety or depression, and self-compassion would not mediate the relationship between emotion regulation and anxiety or depression. Results As predicted, only emotion regulation mediated the relationship between self-compassion and mental health outcomes. Self-compassion did not mediate the relationship between emotion regulation and mental health outcomes. Conclusion This study provides preliminary evidence for the role that self-compassion plays in improving emotion regulation and mental health in autistic adults. If this mechanism of emotion regulation mediating the relationship between self-compassion and mental health is consistently found in future studies, then it would be helpful for future research to examine the clinical benefits of including a self-compassion component in emotion regulation interventions to improve mental health outcomes of autistic adults.
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Affiliation(s)
- Ru Ying Cai
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
- School of Psychological Sciences, Monash University, Clayton, Australia
| | - Abigail Love
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
| | - Ainslie Robinson
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
| | - Vicki Gibbs
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, Frenchs Forest, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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Cai RY, Gibbs V, Love A, Robinson A, Fung L, Brown L. "Self-compassion changed my life": The self-compassion experiences of autistic and non-autistic adults and its relationship with mental health and psychological wellbeing. J Autism Dev Disord 2023; 53:1066-1081. [PMID: 35904649 DOI: 10.1007/s10803-022-05668-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/24/2022]
Abstract
Self-compassion is a gentle way of relating to oneself, linked to a host of mental health benefits in non-autistic people. Although many autistic individuals report high anxiety and depression symptoms, no research to-date has examined the self-compassion experiences of autistic individuals and determined if self-compassion is associated with psychopathology. Therefore, the purpose of the current study was to address this research gap. The participants (153 autistic and 93 non-autistic adults) completed on online survey and 11 autistic participants were also interviewed. Autistic participants reported significantly lower self-compassion than non-autistic adults, and in both groups, those with higher self-compassion reported higher psychological wellbeing and lower depression symptoms. Demographic predictors of self-compassion were identified. These findings have both clinical and research implications.
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Affiliation(s)
- Ru Ying Cai
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia.
- School of Psychological Sciences, Monash University, 3168, Clayton, VIC, Australia.
| | - Vicki Gibbs
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, 2050, Camperdown, NSW, Australia
| | - Abigail Love
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
| | - Ainslie Robinson
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
| | - Lawrence Fung
- Department of Psychiatry & Behavioral Sciences, Stanford University, 94305, Stanford, CA, USA
| | - Lydia Brown
- Melbourne School of Psychological Sciences, University of Melbourne, 2010, Parkville, VIC, Australia
- North Eastern Rehabilitation Centre, Healthscope Hospitals, 3079, Ivanhoe, VIC, Australia
- Office of the Provost, School of Science, Health and Engineering, La Trobe University, 3083, Bundoora, VIC, Australia
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Deng W, Everaert J, Bronstein MV, Joormann J, Cannon T. Social Interpretation Inflexibility and Functioning: Associations with Symptoms and Stress. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2023. [DOI: 10.1521/jscp.2023.42.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Introduction: Interpretation inflexibility has been implicated in a range of mental health problems, including depression, social anxiety, and paranoia. Inflexible interpretation of social situations may be particularly important as it can set the stage for problems in social functioning, a symptom cutting across all three groups of disorders. Methods: This study aimed to examine the interrelations among interpretation inflexibility, social functioning impairment, and affective and psychotic symptoms. The study also explored the potential moderating effects of COVID-related preoccupation, as an example of a major stressor, on these relationships. Results: Based on a sample recruited from the general population (N = 247), interpretation inflexibility was found to be associated with social functioning impairment, with affective symptoms and paranoia as statistical mediators of the association. These relationships were magnified by ambient stress during the COVID-19 pandemic—a moderated mediation that was found only in relation to affective symptoms but not paranoia. A parallel network analysis further confirmed the moderating effects of COVID-related preoccupation on the relation between interpretation inflexibility and depression. Limitations: Measuring ambient stress with a self-report question on COVID-related preoccupation may not be representative of the amount of distress an individual experienced during the pandemic. Also, our mediation models were performed on cross-sectional data, thus not necessarily implying a feed-forward causal mediational relationship. Conclusions: These findings highlight the importance of examining social functioning as a crucial outcome, as well as the differential role of stress in modulating social interpretation flexibility with respect to affective vs. psychotic symptoms.
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Gibbons AB, Farmer C, Shaw JS, Chung JY. Examining the factor structure of the DSM-5 Level 1 cross-cutting symptom measure. Int J Methods Psychiatr Res 2022:e1953. [PMID: 36318494 DOI: 10.1002/mpr.1953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/12/2022] [Accepted: 10/07/2022] [Indexed: 02/28/2023] Open
Abstract
OBJECTIVES The DSM-5 Level 1 Cross-Cutting Symptom Measure (DSM-XC) was developed by the American Psychiatric Association as a transdiagnostic mental health symptom survey. Despite its promise as a screening tool, few studies have assessed its latent dimensionality or provided guidance on interpreting responses. We examined the factor structure of the DSM-XC in a convenience sample of participants with varying degrees of psychopathology. METHODS Participants (n = 3533) were enrolled in an online study on the mental health impact of COVID-19 (NCT04339790). We used a factor analytic framework with exploratory and confirmatory analyses to evaluate candidate factor solutions. Convergent validity analysis with concurrent study measures was also performed. RESULTS Six-factor and bifactor candidate solutions both had good fit and full measurement invariance across age, sex, and enrollment date. The six-factor solution resulted in constructs labeled as: mood, worry, activation, somatic, thought, and substance use. A general psychopathology factor and two residual factors (mood and anxiety constructs) explained the variance of the bifactor solution. CONCLUSIONS Our analysis supports that the DSM-XC is a multidimensional instrument spanning many mental health symptoms. We provide scoring solutions for two factor structures that capture broader constructs of psychopathology. Use of a convenience sample may limit generalizability of findings.
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Affiliation(s)
- Alison B Gibbons
- National Institute of Mental Health, Office of the Clinical Director, Bethesda, Maryland, USA
| | - Cristan Farmer
- National Institute of Mental Health, Office of the Clinical Director, Bethesda, Maryland, USA
| | - Jacob S Shaw
- National Institute of Mental Health, Office of the Clinical Director, Bethesda, Maryland, USA
| | - Joyce Y Chung
- National Institute of Mental Health, Office of the Clinical Director, Bethesda, Maryland, USA
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Schmidt F, Schürmann L, Haberkamp A. Animal eMotion, or the emotional evaluation of moving animals. Cogn Emot 2022; 36:1132-1148. [PMID: 35749075 DOI: 10.1080/02699931.2022.2087600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Responding adequately to the behaviour of human and non-human animals in our environment has been crucial for our survival. This is also reflected in our exceptional capacity to detect and interpret biological motion signals. However, even though our emotions have specifically emerged as automatic adaptive responses to such vital stimuli, few studies investigated the influence of biological motion on emotional evaluations. Here, we test how the motion of animals affects emotional judgements by contrasting static animal images and videos. We investigated this question (1) in non-fearful observers across many different animals, and (2) in observers afraid of particular animals across four types of animals, including the feared ones. In line with previous studies, we find an idiosyncratic pattern of evoked emotions across different types of animals. These emotions can be explained to different extents by regression models based on relevant predictor variables (e.g. familiarity, dangerousness). Additionally, our findings show a boosting effect of motion on emotional evaluations across all animals, with an additional increase in (negative) emotions for moving feared animals (except snakes). We discuss implications of our results for experimental and clinical research and applications, highlighting the importance of experiments with dynamic and ecologically valid stimuli.
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Affiliation(s)
- Filipp Schmidt
- Experimental Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lisa Schürmann
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Anke Haberkamp
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Volz HP, Saliger J, Kasper S, Möller HJ, Seifritz E. Subsyndromal generalised anxiety disorder: operationalisation and epidemiology - a systematic literature survey. Int J Psychiatry Clin Pract 2022; 26:277-286. [PMID: 34314295 DOI: 10.1080/13651501.2021.1941120] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The diagnosis of anxiety disorders, like other psychiatric disorders also, is operationalised since the introduction of diagnostic manuals. The diagnostic criteria of Generalised Anxiety Disorder (GAD) have been tightened in the last decades. This leads to the exclusion of patients with a high level of anxiety, but not fulfilling certain of the GAD-criteria, from effective treatment. Such so-called subsyndromal, subthreshold or subclinical GAD-states, however, often exhibit a comparable burden of disease like the full syndromal disorder and often tend to develop into the full syndromal disorder. The purpose of this review is - beside systematically reporting the papers found in respective data bases from 2013 onwards - to summarise the relevant data regarding definitions, epidemiology and consequences of subsyndromal anxiety states in order to give a comprehensive review.
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Affiliation(s)
- Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Julia Saliger
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | | | - Hans-Jürgen Möller
- Clinic and Policlinic for Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
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Williams ZJ, Cascio CJ, Woynaroski TG. Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire. Front Psychol 2022; 13:897901. [PMID: 35936331 PMCID: PMC9355318 DOI: 10.3389/fpsyg.2022.897901] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Misophonia is a newly described disorder of sound tolerance characterized by strong negative emotional reactions to specific "trigger" sounds, resulting in significant distress, pathological avoidance, and impairment in daily life. Research on misophonia is still in its infancy, and most existing psychometric tools for assessing misophonia symptoms have not been extensively validated. The purpose of the current study was to introduce and psychometrically validate the duke-vanderbilt Misophonia Screening Questionnaire (DVMSQ), a novel self-report measure of misophonia symptoms that can be used to determine misophonia "caseness" in clinical and research settings. Employing large online samples of general population adults (n = 1403) and adults on the autism spectrum (n = 936), we rigorously evaluated the internal structure, reliability, validity, and measurement invariance of the DVMSQ. Results indicated that 17 of the 20 original DVMSQ items fit well to a bifactor structure with one "general misophonia" factor and four specific factors (anger/aggression, distress/avoidance, impairment, and global impact). DVMSQ total and subscale scores were highly reliable in both general population and autistic adult samples, and the measure was found to be approximately invariant across age, sex, education level, and autism status. DVMSQ total scores also correlated strongly with another measure of misophonia symptoms (Duke Misophonia Questionnaire-Symptom Scale), with correlations between these two measures being significantly stronger than correlations between the DVMSQ and scales measuring other types of sound intolerance (Inventory of Hyperacusis Symptoms [General Loudness subscale] and DSM-5 Severity Measure for Specific Phobia [modified for phonophobia]). Additionally, DVMSQ items were used to operationalize diagnostic criteria for misophonia derived from the Revised Amsterdam Criteria, which were further updated to reflect a recent consensus definition of misophonia (published after the development of the DVMSQ). Using the new DVMSQ algorithm, 7.3% of general population adults and 35.5% of autistic adults met criteria for clinically significant misophonia. Although additional work is needed to further investigate the psychometric properties of the DVMSQ and validate its theory-based screening algorithm using best-estimate clinical diagnoses, this novel measure represents a potentially useful tool to screen for misophonia and quantify symptom severity and impairment in both autistic adults and the general population.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Carissa J. Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States
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Investigating the Psychometric Properties of the Severity Measure for Specific Phobia. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Developing a novel assessment of interpretation flexibility: Reliability, validity and clinical implications. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Binasis T, Groves D, Wootton BM, Moses K. Psychometric properties of the DSM-5 social anxiety disorder dimensional scale in an Australian community sample. J Clin Psychol 2021; 78:938-950. [PMID: 34704259 DOI: 10.1002/jclp.23262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/01/2021] [Accepted: 10/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The Social Anxiety Disorder Dimensional Scale (SAD-D) is a 10-item scale developed by the Diagnostic and Statistical Manual (Fifth Edition) Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorder work group to supplement current dichotomous approaches to assessment of Social Anxiety Disorder (SAD). The aim of the present study was to evaluate the psychometric properties of the SAD-D in an Australian community sample. METHODS Two-hundred and ninety-one participants (72.9% female) aged 18-76 years (M =28.46; SD = 12.30) completed the study. RESULTS Confirmatory factor analysis indicated support for the unidimensional structure of the SAD-D (root mean square error of approximation [RMSE] = 0.08; comparative fit index [CFI] = 0.97). The measure demonstrated strong internal consistency (α = 0.94), as well as good divergent validity. The SAD-D showed excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.93). CONCLUSIONS Overall, the SAD-D appears to be a brief and reliable measure of SAD symptomatology. Limitations, including the use of a predominantly female convenience sample, and failure to include the mental health and background of the sample, are discussed.
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Affiliation(s)
- Theodora Binasis
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - David Groves
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Bethany M Wootton
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Karen Moses
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
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Stein DJ, Craske MG, Rothbaum BO, Chamberlain SR, Fineberg NA, Choi KW, de Jonge P, Baldwin DS, Maj M. The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management. World Psychiatry 2021; 20:336-356. [PMID: 34505377 PMCID: PMC8429350 DOI: 10.1002/wps.20919] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The clinical construct of "anxiety neurosis" was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.
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Affiliation(s)
- Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA
| | | | - Samuel R Chamberlain
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
- University of Cambridge Clinical Medical School, Cambridge, UK
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Abstract
This study examined age trends in anxious and depressive symptoms, from older adolescence to old age, and explored the association between anxious and depressive symptoms with gender, ASD severity, and socio-economic factors. Two hundred and fifty-five individuals with ASD (151 males, Mage = 33.52 years, SDage = 14.98) took part. More than one-third of participants reported clinically significant anxiety (38.4%) or depression (38%). A slight trend for an increase in the severity of both anxiety and depression from adolescence to middle adulthood, and then a slight decline in older adulthood was found. Female gender and higher ASD severity predicted more anxiety and depression symptoms. Our findings emphasise the need to provide timely assessment and treatment of anxiety and depression in ASD.
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17
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Madison A, Vasey M, Emery CF, Kiecolt-Glaser JK. Social anxiety symptoms, heart rate variability, and vocal emotion recognition in women: evidence for parasympathetically-mediated positivity bias. ANXIETY STRESS AND COPING 2020; 34:243-257. [PMID: 33156720 DOI: 10.1080/10615806.2020.1839733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Individuals with social anxiety disorder show pronounced perceptual biases in social contexts, such as being hypervigilant to threat and discounting positive social cues. Parasympathetic activity influences responses to the social environment and may underlie these biases. This study examined the associations among social anxiety symptoms, heart rate variability (HRV), and vocal emotion recognition. DESIGN AND METHOD Female undergraduate students (N = 124) self-reported their social anxiety symptoms using the Social Anxiety Disorder Dimensional Scale and completed a computerized vocal emotion recognition task using stimuli from the Ryerson Audio-Visual Database of Emotional Speech and Song stimulus set. HRV was measured at baseline and during the emotion recognition task. RESULTS Women with more social anxiety symptoms had higher emotion recognition accuracy (p = .021) and rated positive stimuli as less intense (p = .032). Additionally, although those with greater social anxiety symptoms did not have lower resting HRV (p = .459), they did have lower task HRV (p = .026), which mediated their lower positivity bias and greater recognition accuracy. CONCLUSIONS A parasympathetically-mediated positivity bias may indicate or facilitate normal social functioning in women. Additionally, HRV during a symptom- or disorder-relevant task may predict task performance and reveal parasympathetic differences that are not found at baseline.
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Affiliation(s)
- Annelise Madison
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.,Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Michael Vasey
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Charles F Emery
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.,Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA.,Department of Psychiatry and Behavioral Health, The Ohio State University Harding Hospital, Columbus, OH, USA
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18
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Meesala N, Harsha GVD, Kandikatla P, Karteekvarma PV, Nadakuditi SR, Kakaraparthi SK. Measuring the impact of COVID-19 on mental health as a preliminary procedure in primary care provision: A cross-sectional study using COVID-19 anxiety scale. J Family Med Prim Care 2020; 9:5554-5558. [PMID: 33532394 PMCID: PMC7842435 DOI: 10.4103/jfmpc.jfmpc_1244_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/13/2020] [Accepted: 09/23/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND It is imperative to acknowledge that COVID-19 poses significant burden on the psychological well-being of people. With implementation of lockdown and measures like quarantine, the mental health of people is affected, and the associated problems may range from depression to suicidal ideation. With this background, the aim of this study was to assess COVID-19 anxiety among general population of the state of Andhra Pradesh. MATERIALS AND METHODS This cross-sectional study assessed the COVID-19 anxiety among the population of Andhra Pradesh using COVID-19 Anxiety Scale (CAS-7), a seven-item validated psychometric instrument which assesses the cognitive, emotional, and physiological dimensions of COVID-19 anxiety, using a semantic differential scale. The final sample constituted 1,346 participants. Statistical analysis was done using SPSS version 20 software (IBM SPSS statistics for Windows version 20, Armonk, NY, USA). RESULTS The mean age of the study participants was 36.13 ± 10.2 years, and 55.8% were males. The mean CAS-7 score in this study was found to be 18.9 ± 6.4. The item with highest mean scores was: "How concerned are you when people cough or sneeze because of the fear that you may acquire COVID-19?" No significant differences in CAS-7 scores were found based on gender, educational qualification of the participants, while significant differences were observed based on place of residence, presence of COVID-19 affected individuals in close surroundings, tobacco, and alcohol consumption. CONCLUSION The results of this study inform that it is imperative for authorities and health care professionals to focus on the mental health aspect of COVID-19 and arrange for necessary support mechanisms.
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Affiliation(s)
- Neeraja Meesala
- Department of Orthodontics, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India
| | - GVD Harsha
- Department of Orthodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Pradeep Kandikatla
- Department of Orthodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - P Venkata Karteekvarma
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | | | - Sampath K. Kakaraparthi
- Department of Prosthodontics and Implantology, Sai Swaraj Dental Clinic, Guntur, Andhra Pradesh, India
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19
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Chandu VC, Marella Y, Panga GS, Pachava S, Vadapalli V. Measuring the Impact of COVID-19 on Mental Health: A Scoping Review of the Existing Scales. Indian J Psychol Med 2020; 42:421-427. [PMID: 33414588 PMCID: PMC7750853 DOI: 10.1177/0253717620946439] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic, associated with the economic consequences of non-pharmaceutical interventions such as lockdown, has led to mental health consequences among people worldwide. Protecting the mental well-being of populations is an imperative component of fighting the COVID-19 pandemic. This scoping review attempts to present an overview of the existing tools to measure COVID-19-related mental health problems. METHODS Literature search was conducted in the PubMed electronic database using developed key search terms. Reference lists of the identified eligible articles were reviewed to locate relevant articles missed from the electronic database search. Fifteen scales measuring COVID-19-associated mental health problems, validated among diverse populations across the world, were included in this review. RESULTS The majority of these scales were validated among middle-aged adults in Turkey. Only a few validated scales encompass the negative socioeconomic consequences of COVID-19. None of the available scales focused on the aspects of suicidal ideation or behavioral responses/coping strategies, neither were they inclusive of participants from diverse age, geographic, and COVID-19 exposure groups. CONCLUSION This scoping review highlights the need for future research to develop and validate comprehensive psychometric tools to assess COVID-19-associated mental health problems. Also, in view of the vulnerable nature of healthcare professionals for developing mental health concerns in the course of providing services for COVID-19-affected individuals, future psychometric research needs to concentrate on the development of measures specific for these professionals.
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Affiliation(s)
- Viswa Chaitanya Chandu
- Dept. of Public Health Dentistry, SIBAR
Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
| | - Yamuna Marella
- Dept. of Periodontology, SIBAR Institute of
Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
| | - Gnana Sarita Panga
- Dept. of Public Health Dentistry, SIBAR
Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
| | - Srinivas Pachava
- Dept. of Public Health Dentistry, SIBAR
Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
| | - Viswanath Vadapalli
- Dept. of Public Health Dentistry, SIBAR
Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
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20
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Sunderland M, Batterham PJ, Calear AL, Carragher N, Slade T. The psychometric properties of 30-day versions of the DSM-5 dimensional severity scales for social anxiety disorder and panic disorder. Psychiatry Res 2020; 291:113229. [PMID: 32580090 DOI: 10.1016/j.psychres.2020.113229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The current study aimed to investigate the psychometric properties of the DSM-5 dimensional severity scales for social anxiety disorder (SAD) and panic disorder (PD) using a past 30 day timeframe. METHODS Data were from a sample of 1,052 Australian community dwelling adults (aged 18 years or older) recruited using online advertisements. Respondents completed the DSM-5 severity scales for SAD and PD as well as a range of additional widely used self-administered scales for SAD and PD in the past 30 days prior to the survey. RESULTS Both scales exhibited high internal consistency (alpha>=0.94) and a strong general factor that justified unidimensional item response analysis (OmegaH=0.96). There was no evidence of significant local dependence amongst item pairs after accounting for the single factor. Similarly, there was no evidence for meaningful differential item functioning of the scales across sex, age, education level, and residential location. There was high convergent validity (0.71 - 0.85) amongst conceptually related scale and moderate to high correlations (0.54 - 0.80) between conceptually unrelated scales. CONCLUSIONS These findings provide support for the use of past month versions of the DSM-5 severity scales for SAD and PD by researchers and clinicians to inform and supplement diagnostic decisions.
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Affiliation(s)
- Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | | | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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21
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Soraci P, Ferrari A, Abbiati FA, Del Fante E, De Pace R, Urso A, Griffiths MD. Validation and Psychometric Evaluation of the Italian Version of the Fear of COVID-19 Scale. Int J Ment Health Addict 2020; 20:1913-1922. [PMID: 32372892 PMCID: PMC7198091 DOI: 10.1007/s11469-020-00277-1] [Citation(s) in RCA: 243] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The advent of COVID-19 worldwide has led to consequences for people's health, both physical and psychological, such as fear and anxiety. This is the case in Italy, one of the countries most affected by the pandemic. Given the heightened fear concerning COVID-19 in Italy., the present study analyzed the psychometric properties of the Italian version of the Fear of COVID-19 Scale (FCV-19S). Methods The sample comprised 250 Italian participants who were administered Italian versions of the FCV-19S, the Hospital Anxiety and Depression Scale (HADS), and the Severity Measure for Specific Phobia-Adult (SMSP-A). Several psychometric tests were performed to investigate the validity and reliability of the test including confirmatory factor analysis. Results Analysis of the data showed satisfactory psychometric characteristics and confirmed the scale's unidimensional properties. The seven FCV-19S items had acceptable correlations with the test total (from .443 to .784). Furthermore, the loadings on the factor were significant and strong (from .684 to .897). The internal consistency was very good (α = .871). Construct validity for the FCV-19S was supported by significant and positive correlations with the HADS (r=.649) and SMSP-A (r=.703). Conclusions The Italian version of the Fear of COVID-19 Scale is valid and reliable in assessing fear of COVID-19 among the general Italian population.
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Affiliation(s)
- Paolo Soraci
- Group Cognitive Behavioral Psychology Association, Rome, Italy
| | - Ambra Ferrari
- Department of Human Science for Education ‘Riccardo Massa’, Università degli Studi di Milano Bicocca, Milan, Italy
| | - Francesco A. Abbiati
- Department of Psychology, Università degli Studi di Torino – UNITO, Turin, Italy
| | - Elena Del Fante
- Department of Psychology, Università degli Studi di Torino – UNITO, Turin, Italy
| | | | - Antonino Urso
- Facoltà di Scienze Sociali, Pontificia Università San Tommaso, Rome, Italy
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
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22
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Hedley D, Uljarević M, Bury SM, Dissanayake C. Predictors of mental health and well-being in employed adults with autism spectrum disorder at 12-month follow-up. Autism Res 2019; 12:482-494. [DOI: 10.1002/aur.2064] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Darren Hedley
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne VIC Australia
| | - Mirko Uljarević
- Stanford Autism Center; Stanford University; Stanford California
| | - Simon M. Bury
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne VIC Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne VIC Australia
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23
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Cai RY, Richdale AL, Dissanayake C, Trollor J, Uljarević M. Emotion regulation in autism: Reappraisal and suppression interactions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:737-749. [PMID: 29792076 DOI: 10.1177/1362361318774558] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Emotion regulation has been proposed to be a transdiagnostic factor in the development and maintenance of psychopathology in the general population, yet the nature of the relationships between emotion regulation strategy use and psychological well-being has not been comprehensively explored in individuals with autism spectrum disorder (ASD). The aim of this study was to assess how the individual differences in self-reported emotion regulation strategy use relate to levels of both positive and negative psychological well-being. In total, 56 individuals with ASD aged 14-24 years (Mage = 18.15; SDage = 2.30) completed Emotion Regulation Questionnaire, Diagnostic and Statistical Manual of Mental Disorders-5 Generalized Anxiety Disorder Dimensional Scale, Patient Health Questionnaire-9, Warwick-Edinburgh Mental Well-being Scale and Autism-Spectrum Quotient - Short. Individuals were grouped into four clusters based on their Emotion Regulation Questionnaire subscale scores. Individuals in the high suppression and low reappraisal group expressed higher depressive symptoms and lower positive well-being when compared with the low suppression and high reappraisal group. Interestingly, individuals who self-reported using both high suppression and reappraisal expressed relatively high positive well-being and low depression symptoms. We suggest that the maladaptive effect of habitual suppression usage may be buffered by the habitual use of reappraisal, and this interaction between adaptive and maladaptive emotion regulation strategy use has clinical implications.
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Affiliation(s)
- Ru Ying Cai
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Amanda L Richdale
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Cheryl Dissanayake
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Julian Trollor
- 2 Cooperative Research Centre for Living with Autism, Australia.,3 UNSW Sydney, Australia
| | - Mirko Uljarević
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia.,4 Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, USA
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24
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Vasa RA, Kreiser NL, Keefer A, Singh V, Mostofsky SH. Relationships between autism spectrum disorder and intolerance of uncertainty. Autism Res 2018; 11:636-644. [PMID: 29316350 PMCID: PMC5903967 DOI: 10.1002/aur.1916] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 11/08/2017] [Accepted: 12/06/2017] [Indexed: 12/21/2022]
Abstract
Intolerance of uncertainty (IU) is a dispositional risk factor involving maladaptive responding under conditions of uncertainty. Recent data indicate that IU is likely elevated in youth with autism spectrum disorder (ASD) and is positively correlated with anxiety. This study examined whether IU may be associated with ASD independent of anxiety. Relationships between anxiety, ASD, and IU were examined in 57 children with ASD without co-occurring intellectual disability and 32 control participants, ages 7-16 years. Hierarchal linear regressions were run to examine whether ASD variables, including emotion dysregulation, were predictive of IU when controlling for anxiety. Severity of social communication deficits, repetitive behaviors, and emotion dysregulation were each related to IU when controlling for the effects of anxiety. When these variables were entered into the regression model together, emotion dysregulation was the only significant predictor of IU. These findings suggest that IU is directly related to features of ASD possibly due to shared genetic, neurological, or psychological underpinnings. Autism Res 2018, 11: 636-644. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Youth with ASD without co-occurring intellectual disability experience high levels of intolerance of uncertainty (IU), which is related to anxiety. This study found that IU may also have a relationship with certain aspects of ASD, particularly emotion dysregulation.
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Affiliation(s)
- Roma A. Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, Maryland, 21205
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, Maryland, 21287
| | - Nicole L. Kreiser
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 710, Norfolk, Virginia, 23507
| | - Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, Maryland, 21287
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, Maryland, 21211
| | - Stewart H. Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, Maryland, 21205
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 710, Norfolk, Virginia, 23507
- Department of Neurology, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, Maryland, 21205
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25
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Brief Report: Inter-Relationship between Emotion Regulation, Intolerance of Uncertainty, Anxiety, and Depression in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2017; 48:316-325. [DOI: 10.1007/s10803-017-3318-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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26
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Abbott D, Shirali Y, Haws JK, Lack CW. Biobehavioral assessment of the anxiety disorders: Current progress and future directions. World J Psychiatry 2017; 7:133-147. [PMID: 29043151 PMCID: PMC5632598 DOI: 10.5498/wjp.v7.i3.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/08/2017] [Accepted: 07/03/2017] [Indexed: 02/05/2023] Open
Abstract
It is difficult to accurately assess and differentially diagnose the anxiety disorders. The current system of assessment relies heavily on the subjective measures of client self-report, clinical observation, and clinical judgment. Fortunately, recent technological advances may enable practitioners to utilize objective, biobehavioral measures of assessment in a clinical setting. The current body of literature on two of these biobehavioral tools (eye-tracking and electrocardiogram devices) is promising, but more validation and standardization research is needed to maximize the utility of these devices. Eye-tracking devices are uniquely capable of providing data that can be used to differentially diagnose anxiety disorders from both other commonly comorbid and misdiagnosed disorders. Both eye-tracking and electrocardiogram devices are able to provide change-sensitive assessment information. This objective, real-time feedback can assist clinicians and researchers in assessing treatment efficacy and symptom fluctuation. Recently developed wearable and highly portable electrocardiogram devices, like the wearable fitness and behavior tracking devices used by many consumers, may be particularly suited for providing this feedback to clinicians. Utilizing these biobehavioral devices would supply an objective, dimensional component to the current categorical diagnostic assessment system. We posit that if adequate funding and attention are directed at this area of research, it could revolutionize diagnostic and on-going assessment practices and, in doing so, bring the field of diagnosis out of the 20th century.
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Affiliation(s)
- Deah Abbott
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Yasmin Shirali
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - J Kyle Haws
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Caleb W Lack
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
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27
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Uljarević M, Richdale AL, McConachie H, Hedley D, Cai RY, Merrick H, Parr JR, Le Couteur A. The Hospital Anxiety and Depression scale: Factor structure and psychometric properties in older adolescents and young adults with autism spectrum disorder. Autism Res 2017; 11:258-269. [PMID: 28922575 DOI: 10.1002/aur.1872] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/25/2017] [Indexed: 12/17/2022]
Abstract
Despite the high frequency of anxiety and depression symptoms in individuals with Autism Spectrum Disorder (ASD) and a significant impact of these comorbidities on both individuals with ASD and their families, research on the validity of anxiety and depression measures in the ASD population is currently lacking. The aim of this study was to explore the psychometric properties of the Hospital Anxiety and Depression Scale [HADS; Zigmond & Snaith, ] in a sample of older adolescents and young adults with ASD. One hundred and fifty one participants (UK Transition longitudinal study: N = 106; 75 males, Mage = 16.04 years, SD = 1.28; Longitudinal Study of Australian Schools Leavers with ASD: N = 45, 30 males; Mage = 18.35 years, SD = 2.55) completed the HADS and a range of mental health and well-being measures. Combination of the Principal Component Analysis and Parallel Analysis indicated two factors as an optimal solution in our sample, accounting for 43.77% of variance with factors being identical in terms of content with the structure found in the general population. Internal consistency was good for the HADS anxiety scale (HADS-A; .82-.84) and acceptable for the HADS depression scale (HADS-D; .60-.72). Convergent validity of both HADS-A and HADS-D scales was excellent and divergent validity was acceptable. Our study represents a significant contribution to the literature by providing an initial validation of the HADS in older adolescents and younger adults with ASD. Autism Res 2018, 11: 258-269. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Research on the validity of measurement of anxiety and depression in ASD is currently lacking. The aim of this study was to explore the properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of 151 young people with ASD. Participants completed HADS and a range of mental health and well-being measures. Encouragingly, our findings suggest that HADS provides a reliable and valid assessment of anxiety and depression in ASD.
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Affiliation(s)
- Mirko Uljarević
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia
| | - Ru Ying Cai
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Hannah Merrick
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.,Complex Neurodevelopmental Disorders Service, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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DeSousa DA, Moreno AL, Osório FL, Crippa JAS, LeBeau R, Manfro GG, Salum GA, Koller SH. Psychometric properties of the dimensional anxiety scales for DSM-5 in a Brazilian community sample. Int J Methods Psychiatr Res 2017; 26:e1531. [PMID: 27748002 PMCID: PMC6877262 DOI: 10.1002/mpr.1531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/12/2016] [Accepted: 06/28/2016] [Indexed: 11/11/2022] Open
Abstract
The DSM-5 highlights the use of dimensional assessments of mental health as a supplement to categorical diagnoses. This study investigated the psychometric properties of the DSM-5 Dimensional Anxiety Scales in a Brazilian community sample. Dimensional scales for generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and specific phobia were administered to 930 adults aged 18 to 70, 64.2% female. Psychometric properties investigated were: unidimensionality; measurement invariance; internal consistency; composite reliability; test-retest reliability; convergent and divergent validity; category thresholds and item performance analyses. Analyses revealed unidimensionality for all scales except for specific phobia. Measurement invariance, high internal consistency and composite reliability, and convergent and divergent validity were demonstrated. Test-retest reliability was high for all scales but generalized anxiety disorder. Item-based analyses evidenced that none of the items were very easy to endorse and that the scales offered more information about subjects with high severity estimates of anxiety. The DSM-5 Dimensional Anxiety Scales are a valid and reliable alternative to assess anxiety symptomatology in community settings, although further evaluation is needed, especially for specific phobia. The scales seem to be more useful for characterizing dimensionality of symptoms for subclinical or clinical cases than for slight or mildly anxious subjects.
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Affiliation(s)
- Diogo A DeSousa
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Psychology, Tiradentes University, Aracaju, SE, Brazil
| | - André L Moreno
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Flávia L Osório
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - José Alexandre S Crippa
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Richard LeBeau
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Gisele G Manfro
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Giovanni A Salum
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Silvia H Koller
- Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Uljarević M, Richdale AL, Evans DW, Cai RY, Leekam SR. Interrelationship between insistence on sameness, effortful control and anxiety in adolescents and young adults with autism spectrum disorder (ASD). Mol Autism 2017; 8:36. [PMID: 28736608 PMCID: PMC5521115 DOI: 10.1186/s13229-017-0158-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/13/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Both self-regulation and insistence on sameness (IS) are related to anxiety, which is a common feature of individuals with autism spectrum disorder (ASD). Here, we aimed to characterise the IS-self-regulation-anxiety interrelationship by investigating the potential contribution made by self-regulation, assessed via effortful control (EC), to the IS-anxiety relationship in a sample of adolescents and young adults with ASD. METHOD Seventy-one older adolescents and younger adults with ASD (49 males, 22 females; Mage = 18.71 years, SD = 2.51, range 14.42-24.81) completed the Adult Repetitive Behaviour Questionnaire-2, Effortful Control Scale of the Adult Temperament Questionnaire and the DSM-5 Dimensional Anxiety Scales. RESULTS IS was associated with both EC (r = -.39, p = .001) and anxiety (r = .45, p < .001), and anxiety was in turn associated with EC (r = -.44, p < .001). To characterise the nature of this interrelationship, two mediation analyses were performed using the serial mediation model in PROCESS with 5000 resamples in bootstrapping. There was a significant indirect effect of EC on anxiety, through IS (b = -.06; BCa 95% CI [-.13, -.02]), and indirect effect on anxiety through EC (b = 1.62; BCa 95% CI [.59, 3.24]) with the mediators accounting for 29.07 and 26.04% of the total effect, respectively. CONCLUSIONS Our study provides the first exploration of the IS-anxiety-self-regulation link in ASD. The finding that lower levels of self-regulation are related both to anxiety and IS behaviours points to self-regulation as a viable intervention target for both anxiety and IS behaviours.
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Affiliation(s)
- Mirko Uljarević
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, VIC 3086 Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, QLD 4072 Australia
| | - Amanda L. Richdale
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, VIC 3086 Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, QLD 4072 Australia
| | - David W. Evans
- Department of Psychology, Bucknell University, Lewisburg, PA USA
| | - Ru Ying Cai
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, VIC 3086 Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, QLD 4072 Australia
| | - Susan R. Leekam
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, Wales UK
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LeBeau RT, Mesri B, Craske MG. The DSM-5 social anxiety disorder severity scale: Evidence of validity and reliability in a clinical sample. Psychiatry Res 2016; 244:94-6. [PMID: 27479097 DOI: 10.1016/j.psychres.2016.07.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/28/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022]
Abstract
With DSM-5, the APA began providing guidelines for anxiety disorder severity assessment that incorporates newly developed self-report scales. The scales share a common template, are brief, and are free of copyright restrictions. Initial validation studies have been promising, but the English-language versions of the scales have not been formally validated in clinical samples. Forty-seven individuals with a principal diagnosis of Social Anxiety Disorder (SAD) completed a diagnostic assessment, as well as the DSM-5 SAD severity scale and several previously validated measures. The scale demonstrated internal consistency, convergent validity, and discriminant validity. The next steps in the validation process are outlined.
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Affiliation(s)
- Richard T LeBeau
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States.
| | - Bita Mesri
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
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Möller EL, Bögels SM. The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample: psychometric properties including the adult separation anxiety disorder scale. Int J Methods Psychiatr Res 2016; 25:232-9. [PMID: 27378317 PMCID: PMC5129553 DOI: 10.1002/mpr.1515] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/24/2016] [Accepted: 05/17/2016] [Indexed: 11/21/2022] Open
Abstract
With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Eline L Möller
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands. .,Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands.
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.,Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
Systems for subtyping individuals with social anxiety disorder have been the focus of much research attention as a means to improve assessment and treatment of the disorder. This article highlights recent revisions to social anxiety disorder (SAD) subtypes from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to DSM-V, reviewing empirical evidence that served as the impetus for the revisions. Recent research examining the validity of the DSM-V system and alternative subtyping systems is reviewed. Overall, there appears to be greater empirical support for a dimensional subtyping system. Concerns therefore remain with the DSM-V system, which retained a categorical system but replaced the previous subtypes with a subtype of individuals fearing only performance situations. Recommendations for future research are discussed, as well as alternate options for capturing the variability in SAD presentations, including the possibility of eliminating subtyping altogether.
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Affiliation(s)
- Catherine D'Avanzato
- Rhode Island Hospital, Providence, RI, USA.
- Alpert Medical School of Brown University, Providence, RI, USA.
- , 593 Eddy Street, Potter Building 2nd floor, Providence, RI, 02903, USA.
| | - Kristy L Dalrymple
- Rhode Island Hospital, Providence, RI, USA
- , 593 Eddy Street, Potter Building 2nd floor, Providence, RI, 02903, USA
- , 146 West River Street, Suite 11B, Providence, RI, 02906, USA
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Wong QJJ, Gregory B, McLellan LF. A Review of Scales to Measure Social Anxiety Disorder in Clinical and Epidemiological Studies. Curr Psychiatry Rep 2016; 18:38. [PMID: 26893236 DOI: 10.1007/s11920-016-0677-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To advance research into social anxiety disorder (SAD) and provide efficacious treatments for individuals with SAD, researchers and clinicians must have effective assessment instruments for identifying the disorder in terms of its diagnostic criteria, symptoms, and the presence of specific maintaining factors. This review highlights the main lines of existing adult and youth research on scales that form part of diagnostic instruments that assess SAD, scales that measure social anxiety symptoms, and scales that measure theory-based psychological maintaining factors associated with SAD. The review also highlights methodological issues that impact on the use of the aforementioned scales. The continued refinement and comparative evaluation of measures for SAD, culminating in the ascertainment of optimal measures, will improve the assessment and identification of the disorder. Improved identification of the disorder will contribute to the advancement of SAD research and treatment.
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Affiliation(s)
- Quincy J J Wong
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.
| | - Bree Gregory
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
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Hovenkamp-Hermelink JH, Riese H, van der Veen DC, Batelaan NM, Penninx BW, Schoevers RA. Low stability of diagnostic classifications of anxiety disorders over time: A six-year follow-up of the NESDA study. J Affect Disord 2016; 190:310-315. [PMID: 26544613 DOI: 10.1016/j.jad.2015.10.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Stability of diagnosis was listed as an important predictive validator for maintaining separate diagnostic classifications in DSM-5. The aim of this study is to examine the longitudinal stability of anxiety disorder diagnoses, and the difference in stability between subjects with a chronic versus a non-chronic course. METHODS Longitudinal data of 447 subjects with a current pure anxiety disorder diagnosis at baseline from the Netherlands Study of Depression and Anxiety were used. At baseline, 2-, 4-, and 6-year follow-up mental disorders were assessed and numbers (and percentages) of transitions from one anxiety disorder diagnosis to another were determined for each anxiety disorder diagnosis separately and for subjects with a chronic (i.e. one or more anxiety disorder at every follow-up assessment) and a non-chronic course. RESULTS Transition percentages were high in all anxiety disorder diagnoses, ranging from 21.1% for social anxiety disorder to 46.3% for panic disorder with agoraphobia at six years of follow-up. Transition numbers were higher in the chronic than in the non-chronic course group (p=0.01). LIMITATIONS Due to the 2 year sample frequency, the number of subjects with a chronic course may have been overestimated as intermittent recovery periods may have been missed. CONCLUSIONS These data indicate that anxiety disorder diagnoses are not stable over time. The validity of the different anxiety disorder categories is not supported by these longitudinal patterns, which may be interpreted as support for a more pronounced dimensional approach to the classification of anxiety disorders.
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Affiliation(s)
- Johanna Hm Hovenkamp-Hermelink
- University of Groningen, University Medical Center Groningen (UMCG), Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation (ICPE), Groningen, the Netherlands.
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen (UMCG), Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation (ICPE), Groningen, the Netherlands
| | - Date C van der Veen
- University of Groningen, University Medical Center Groningen (UMCG), Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation (ICPE), Groningen, the Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry and EMGO Institute of Health and Care Research, VU University Medical Center Amsterdam, the Netherlands; GGZ inGeest, Amsterdam, the Netherlands
| | - Brenda Wjh Penninx
- Department of Psychiatry and EMGO Institute of Health and Care Research, VU University Medical Center Amsterdam, the Netherlands; GGZ inGeest, Amsterdam, the Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen (UMCG), Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation (ICPE), Groningen, the Netherlands
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Möller EL, Majdandžić M, Craske MG, Bögels SM. Dimensional assessment of anxiety disorders in parents and children for DSM-5. Int J Methods Psychiatr Res 2014; 23:331-44. [PMID: 24943058 PMCID: PMC6878393 DOI: 10.1002/mpr.1450] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/21/2013] [Accepted: 03/14/2013] [Indexed: 11/06/2022] Open
Abstract
The current shift in the DSM towards the inclusion of a dimensional component allows clinicians and researchers to demonstrate not only the presence or absence of psychopathology in an individual, but also the degree to which the disorder and its symptoms are manifested. This study evaluated the psychometric properties and utility of a set of brief dimensional scales that assess DSM-based core features of anxiety disorders, for children and their parents. The dimensional scales and the Screen for Child Anxiety Related Emotional Disorders (SCARED-71), a questionnaire to assess symptoms of all anxiety disorders, were administered to a community sample of children (n = 382), aged 8-13 years, and their mothers (n = 285) and fathers (n = 255). The dimensional scales assess six anxiety disorders: specific phobia, agoraphobia, panic disorder, social anxiety disorder, generalized anxiety disorder, and separation anxiety disorder. Children rated their own anxiety and parents their child's anxiety. The dimensional scales demonstrated high internal consistency (α > 0.78, except for father reported child panic disorder, for reason of lack of variation), and moderate to high levels of convergent validity (rs = 0.29-0.73). Children who exceeded the SCARED cutoffs scored higher on the dimensional scales than those who did not, providing preliminary support for the clinical sensitivity of the scales. Given their strong psychometric properties and utility for both child and parent report, addition of the dimensional scales to the DSM-5 might be an effective way to incorporate dimensional measurement into the categorical DSM-5 assessment of anxiety disorders in children.
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Affiliation(s)
- Eline L Möller
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
OBJECTIVE This article reports on the test-retest reliability and sensitivity to change of a set of brief dimensional self-rating questionnaires for social anxiety disorder (SAD-D), specific phobia (SP-D), agoraphobia (AG-D), panic disorder (PD-D), and generalized anxiety disorder (GAD-D), as well as a general cross-cutting anxiety scale (Cross-D), which were developed to supplement categorical diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). METHODS The German versions of the dimensional anxiety scales were administered to 218 students followed up approximately 2 weeks later (Study 1) and 55 outpatients (23 with anxiety diagnoses) followed-up 1 year later (Study 2). Probable diagnostic status in students was determined by the DIA-X/M-CIDI stem screening-questionnaire (SSQ). In the clinical sample, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses were assessed at Time 1 using the DIA-X/M-CIDI. At Time 2, the patient-version of the Clinical Global Impression-Improvement scale (CGI-I) was applied to assess change. RESULTS Good psychometric properties, including high test-retest reliability, were found for the dimensional scales except for SP-D. In outpatients, improvement at Time 2 was associated with significant decrease in PD-D, GAD-D, and Cross-D scores. Discussion Major advantages of the scales include that they are brief, concise, and based on a consistent template to measure the cognitive, physiological, and behavioral symptoms of fear and anxiety. Further replication in larger samples is needed. Given its modest psychometric properties, SP-D needs refinement. CONCLUSION Increasing evidence from diverse samples suggests clinical utility of the dimensional anxiety scales.
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