Brian Fisak

The prevention of child and adolescent anxiety: a meta-analytic review.

The purpose of this study was to provide a comprehensive review of the effectiveness of child and adolescent anxiety prevention programs. Mean weighted effect sizes were calculated, and studies were encoded for potential moderator variables. A statistically significant effect size of .18 was obtained at post-intervention, which is consistent with effect sizes reported in reviews of depression, eating disorder, and substance abuse prevention programs. However, the effect sizes obtained at follow-up yielded mixed results. Significant moderators of program effectiveness were found including provider type (professional versus lay provider) and the use of the FRIENDS program. In contrast, program duration, participant age, gender, and program type (universal versus targeted) were not found to moderate program effectiveness. Clinical implications and directions for future research are discussed, including the need for more long-term follow-up, early prevention programs, and studies that systematically examine the impact of parent involvement on program effectiveness.

Reexamination of the MASC factor structure and discriminant ability in a mixed clinical outpatient sample.

Anxiety problems in youth are common, suggesting the need for developmentally appropriate and psychometrically sound measures in this area. The Multidimensional Anxiety Scale for Children (MASC) was created with this goal in mind, but has yet to be examined with samples representative of youth typically seen in clinical settings. Two hundred and sixty‐two outpatient youth with mixed clinical presentations completed the MASC, a measure that includes a total anxiety score, as well as subscale scores for social anxiety, harm avoidance, separation anxiety/panic, and physical symptoms of anxiety. Internal consistency, means, and factor structure were comparable to that reported previously. Model invariance was supported across gender, diagnosis, and age. The MASC total score significantly differentiated children who received anxiety disorder diagnoses from those who did not. The social anxiety subscale significantly predicted social phobia and the harm avoidance subscale significantly predicted generalized anxiety disorder. Further support was found for the MASC. However, caution should be exercised given mixed discriminant ability findings. That is, the MASC seems best suited as a screening instrument for anxiety and when used in conjunction with a multiple method/informant assessment approach. Depression and Anxiety, 2008.

The relation between parental influence, body image, and eating behaviors in a nonclinical female sample

The purpose of the current study is to create a comprehensive composite measure of parental influence based on previously developed measures to clarify the underlying dimensions of parental influence and to determine the degree to which parental influence relates to body image and dysfunctional weight concerns. Previously published literature was reviewed for measures of parental influence, and items from 22 measures were condensed and combined into a single questionnaire, which was completed by 367 female undergraduate psychology students. Two dimensions emerged from a principle components analysis: Direct Influence, which includes weight and eating related comments, and Modeling, which includes parental modeling of dieting and related behavior. Direct Influence and Modeling were significantly related to eating disturbance, such as drive for thinness and bulimic symptomatology. Overall, the results integrate the previous literature and clarify the underlying dimensions of parental influence. Further, this study provides directions for future research related to the development and maintenance of body image and eating disturbance.

Validation of the food thought suppression inventory.

The Food Thought Suppression Inventory (FTSI) was designed as a domain-specific measure of food-related thought suppression, and the FTSI has been found to be associated with eating pathology, including binge eating. Although initial research in this area is promising, as it may provide understanding of the cognitive processes related to the development of eating pathology and obesity, little is known about the psychometric properties of the FTSI. In the current study, the validity of the FTSI was examined, and the FTSI was found to be a valid, reliable, single factor measure of food thought suppression.

Assessment and Behavioral Treatment of Selective Mutism

Children with selective mutism present with a complicated set of symptoms, as they not only refuse to speak in particular social situations but are often shy, socially isolative, anxious, and may present as oppositional and negativistic in their behavior. Limited research on treatments for selective mutism suggests a need for additional research examining intervention possibilities. The following case description presents a 10-year-old male with selective mutism and concurrent anxiety symptoms. Treatment included the use of a significantly modified version of Social Effectiveness Therapy for Children (SET-C), a manualized behavioral treatment for social anxiety. In addition to SET-C, treatment also included concurrent parent training in the management of child anxiety. The rationale for the treatment selection and a description of treatment course are provided. Further, a discussion is presented concerning challenges to treatment progress, including cultural differences between the primary clinician and the client.

The relation between health‐related quality of life, treatment adherence and disease severity in a paediatric sickle cell disease sample

BACKGROUND The purpose of this study was to provide a comprehensive examination of the potential factors associated with health-related quality of life (HRQOL) in a paediatric sickle cell disease sample. METHODS Caregivers of 78 paediatric sickle cell disease patients completed surveys, which included measures of HRQOL, treatment adherence and barriers to treatment adherence. Medical chart reviews were also conducted to assess disease severity. RESULTS Barriers to treatment adherence and pain crisis frequency were found to be the most robust factors associated with HRQOL. CONCLUSIONS This study provides insight into the factors related to paediatric sickle cell disease and informs both clinicians and researchers interested in understanding and improving HRQOL in this population. In particular, the reduction of pain crises frequency and barriers to adherence may be particularly effective strategies to improve HRQOL.

What do Parents Worry About? Examination of the Construct of Parent Worry and the Relation to Parent and Child Anxiety

BACKGROUND Previous research has indicated that parent cognition, including anxious beliefs and expectations, are associated with both parent and child anxiety symptoms and may be transferred from parent to child. However, the content and frequency of parent worry in relation to their children has yet to be examined as a potential form of anxious parent cognition, and little is known about normative parent worry. AIMS The purpose of the current study is to extend the research on parent cognition and child anxiety by focusing on parent worry (i.e. parent worry in relation to their children) as a potential predictor of child anxiety. METHOD A comprehensive self-report measure of parent worry was developed and administered to a community-based sample of parents. RESULTS An exploratory factor analysis yielded a single factor solution. Parent worry was found to be a more robust predictor of child anxiety than parent anxiety symptoms, and parent worry mediated the association between parent anxiety symptoms and child anxiety. Most common worries reported by parents fell within the domains of life success and physical well-being. CONCLUSION Overall, this study adds to the literature on parent cognitive biases and has the potential to inform parent-based interventions for the treatment of child anxiety. Further, this study provides initial data on normative parent worry.

Challenging previous conceptions of vegetarianism and eating disorders

The purpose of this study was to replicate and expand upon previous research that has examined the potential association between vegetarianism and disordered eating. Limitations of previous research studies are addressed, including possible low reliability of measures of eating pathology within vegetarian samples, use of only a few dietary restraint measures, and a paucity of research examining potential differences in body image and food choice motives of vegetarians versus nonvegetarians. Two hundred and fifty-six college students completed a number of measures of eating pathology and body image, and a food choice motives questionnaire. Interestingly, no significant differences were found between vegetarians and nonvegetarians in measures of eating pathology or body image. However, significant differences in food choice motives were found. Implications for both researchers and clinicians are discussed.

Meta-worry in adolescents: examination of the psychometric properties of the meta-worry questionnaire in an adolescent sample.

BACKGROUND Meta-worry is considered a central component of the Metacognitive Model of Generalized Anxiety Disorder. Although initial research provides support for the applicability of this model to adolescent samples, the construct of meta-worry has yet to be examined in adolescents. AIMS The purpose of this study was to examine the psychometric properties of the Meta-Worry Questionnaire (MWQ), a measure designed to assess negative beliefs about worry, in an adolescent sample, and to examine the degree to which meta-worry is associated with pathological worry in adolescents. METHOD A non-referred sample of 175 adolescents completed a modified version of the MWQ along with the Meta-Cognitions Questionnaire-Children (MCQ-C) and the Penn State Worry Questionnaire for Children (PSWQ-C). RESULTS The MWQ was found to exhibit strong psychometric properties. Most noteworthy, the MWQ was found to be a particularly robust predictor of scores on the PSWQ-C, and incremental validity was also demonstrated. CONCLUSIONS Overall, the current findings provide support for the reliability and validity of the MWQ in adolescents and support for meta-worry as a predictor of worry symptoms in adolescents.

The Relation between Parent Rearing Practices and Adolescent Social Anxiety: A Factor Analytic Approach

The purpose of this study was to examine the association between parent rearing practices and adolescent social fears in a community sample (n = 348). Results of an exploratory factor analysis yielded a 3 factor measure of rearing practices, comprised of parental modeling, shame induction, and sociability. Significant differences were found between adolescents with higher levels of social anxiety when compared to adolescents with low levels of social anxiety on levels of parental modeling of social fears and parental communication of shame. However, inconsistent with previous research, no significant differences were found between groups in levels of parent sociability. These findings have the potential to inform the development or refinement of effective prevention and treatment programs for socially anxious adolescents.