Aneta Lakic

The impact of depression and anxiety disorder symptoms on the health-related quality of life of children and adolescents with epilepsy

This study evaluated the effects of depression and anxiety disorder symptoms on the health‐related quality of life (HRQOL) of children and adolescents with epilepsy. Sixty children and adolescents and their parents participated in the study. Symptoms of anxiety disorders were identified by the Screen for Child Anxiety Related Emotional Disorders questionnaire (SCARED) and symptoms of depression by the Mood and Feeling Questionnaire (MFQ). The Pediatric Quality of Life Inventory (PedsQL) was used for HRQOL assessments. A series of simple and partial correlations revealed that the levels of HRQOL significantly decrease as symptoms of depression or anxiety disorders increase and vice versa. Stepwise regression method of children’s ratings resulted in a final model of school achievement and symptoms of generalized anxiety and separation anxiety disorder as predictors that explain 50.9% of the variation in HRQOL (F = 11.21, p < 0.000). For parents’ ratings, the final model included symptoms of depression and separation anxiety disorder as predictors that explain 38.4% of the variation in HRQOL (F = 10.82, p < 0.000). In summary, symptoms of depression and generalized and separation anxiety disorders have the most significant impact on HRQOL.

Parental knowledge, attitudes, and behaviors towards children with epilepsy in Belgrade (Serbia).

OBJECTIVE The aim of our study was to assess knowledge, attitudes, and behaviors of parents whose children were diagnosed with epilepsy. METHODS This cross-sectional study included 213 consecutive parents who accompanied their children, diagnosed with epilepsy, at regular checkups in the outpatient department of the Child and Adolescent Neurology and Psychiatry Clinic in Belgrade. Data were obtained through a questionnaire before completion of the childs neurological checkup, while clinical parameters of children with epilepsy were taken from medical records. RESULTS Almost all respondents knew that epilepsy is not an infectious disease (99.5%), while the least proportion of parents (31.9%) knew that epilepsy is not, for the most part, hereditary. Parents felt that their family and friends should know that their child is suffering from epilepsy (average score: 4.3 out of 5). Also, parents felt the most confident in taking care of their child during seizures (4.7 out of 5), while they felt the least confident in letting their child go on school trips for several days (3.4 out of 5). Parental longer schooling (i.e., higher education level) was an independent predictor of higher epilepsy knowledge. Taking less number of medications was an independent predictor of more supportive parental behavior towards children with epilepsy. CONCLUSION Some epilepsy-related issues still require improvement in parental knowledge. Ensuring education and support at community and school levels for both parents and children with epilepsy should be the principal goal of health-care service.

The psychometric study of the Serbian KINDL questionnaire for health‐related quality of life assessment in children and adolescents

OBJECTIVES Health-related quality of life (HRQOL) is the most frequently evaluated patient-reported outcome. It is unexplored in Serbia and there are no methods for its evaluation. This study was aimed to analyse the psychometric properties of the Serbian version of the KINDL questionnaire for HRQOL assessment in children and adolescents. METHODS The KINDL-Kid-S completed 100 children and the KINDL-Kiddo-S 92 adolescents. Both versions were descriptively analysed and explored the items-sub-scales relationships. Cronbachs coefficient was used to explore the reliability of the versions. RESULTS The means of all sub-scales were located on the positive side of the response scale. The total score was 78.84 for the KINDL-Kid-S and 75.51 for the KINDL-Kiddo-S. Within the versions, the items showed significant correlations with its sub-scale total score and the total score. Between the sub-scales, there were significant relationships also. The Cronbachs coefficient exceeded 0.8 for the internal consistency reliability of the total score in both, and ranged 0.45-0.7 for the sub-scales. CONCLUSIONS Besides substantial inter- and intra-sub-scale correlations, the reliability coefficients of some sub-scales are low in the Serbian KINDL, emerging the needs for revisions before extensive uses.

Measuring Positive and Negative Affect and Physiological Hyperarousal Among Serbian Youth

This study extended previous cross-cultural work regarding the tripartite model of anxiety and depression by developing Serbian translations of the Positive and Negative Affect Scale for Children (PANAS–C), the Physiological Hyperarousal Scale for Children (PH–C), and the Affect and Arousal Scale (AFARS). Characteristics of the scales were examined using 449 students (M age = 12.61 years). Applying item retention criteria established in other studies, PH–C, PANAS–C, and AFARS translations with psychometric properties similar to English-language versions were identified. Preliminary validation of the scales was conducted using a subset of 194 students (M age = 12.37 years) who also completed measures of anxiety and depression. Estimates of reliability, patterns of correlations among scales, and age and gender differences were consistent with previous studies with English-speaking samples. Findings regarding scale validity were mixed, although consistent with existing literature. Serbian translations of the PH–C, PANAS–C, and AFARS mirror the original English-language scales in terms of both strengths and weaknesses.

Can we really use available scales for child and adolescent psychopathology across cultures? A systematic review of cross-cultural measurement invariance data:

In this systematic review, we assessed available evidence for cross-cultural measurement invariance of assessment scales for child and adolescent psychopathology as an indicator of cross-cultural validity. A literature search was conducted using the Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases. Cross-cultural measurement invariance data was available for 26 scales. Based on the aggregation of the evidence from the studies under review, none of the evaluated scales have strong evidence for cross-cultural validity and suitability for cross-cultural comparison. A few of the studies showed a moderate level of measurement invariance for some scales (such as the Fear Survey Schedule for Children-Revised, Multidimensional Anxiety Scale for Children, Revised Child Anxiety and Depression Scale, Revised Childrens Manifest Anxiety Scale, Mood and Feelings Questionnaire, and Disruptive Behavior Rating Scale), which may make them suitable in cross-cultural comparative studies. The remainder of the scales either showed weak or outright lack of measurement invariance. This review showed only limited testing for measurement invariance across cultural groups of scales for pediatric psychopathology, with evidence of cross-cultural validity for only a few scales. This study also revealed a need to improve practices of statistical analysis reporting in testing measurement invariance. Implications for future research are discussed.

Early screening for autism spectrum disorder in Serbia: A pilot study of screening instruments for parents and child care workers

Introduction: Early diagnosis of autism spectrum disorder (ASD) can lead to early interventions, which may improve developmental and academic outcomes in children with ASD. Early screening is thus of significant importance. Aims: This study had two aims. First, it was aimed to translate into Serbian five screening instruments for ASD: Modified Checklist for Autism in Toddlers - Revised, (M-CHATR), Quantitative Checklist for Autism in Toddlers (Q-CHAT), Infant-Toddler Checklist (ITC), and Early Screening Autistic Traits Questionnaire (ESAT) for parents and the Checklist for Early Signs of Developmental Disorders (CESDD) for child care workers. Second, it was aimed to test the feasibility of the included data from parents and child care workers in early ASD screening. Methods: The translation and cultural adaptation process included standardized forward and backward translation with pilot testing. For screening within a childcare setting, one day-care center was selected. Data from at least one parent and a child care worker were collected for 47 children aged 28.94 months on average (SD = 8.39). Results: The face and content validity of each version of the instruments is satisfactory. The correlations among the scores showed that the ESET, M-CHAT-R, Q-CHAT, and ITC evaluate slightly different aspects of ASD. The M-CHAT covers similar aspects to the CESDD. Eight (17%) children were positively screened for ASD with at least one instrument. All positively screened with the ESAT, QCHAT, or ITC were also positive with the CESDD, while not all positively screened with M-CHAT-R were detected with the CESDD. All five instruments were able to detect the child with confirmed ASD in the final stage - clinical assessment. Conclusions: All five screening instruments are targeting ASD symptoms at early stage of life in our population. It is feasible to include reports from parents and child care workers in early ASD screening and there is an added value of combining data from the two.