Eline L. Möller

Dimensional assessment of anxiety disorders in parents and children for DSM-5†

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 childs 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. Copyright

Parental perceptions of child vulnerability in a community- based sample: Association with chronic illness and health-related quality of life

The study aimed to assess the prevalence of parental perceptions of a child’s vulnerability (PPCV) in a Dutch community-based sample and its relationship with children’s health and health-related quality of life (HRQoL). Parents completed the Child Vulnerability Scale and a socio-demographic questionnaire. The Pediatric Quality of Life Inventory 4.0 was administered to measure HRQoL. The prevalence of PPCV was assessed in relation to socio-demographic and health-related characteristics. In a three-step multiple hierarchical regression model, the mediational role of PPCV in the association between chronic illness and HRQoL was investigated. Participants were 520 Dutch children aged 5–18 years from nine Dutch schools. In all, 69 (13.3%) had a chronic illness; 1.9% was perceived vulnerable, 3.0% in groups 5–7 and 1.7% in groups 8–12 and 13–18. Younger age of the child, presence of a chronic illness and low HRQoL were associated with PPCV. PPCV partially mediated the negative association between chronic illness and HRQoL. In conclusion, PPCV is associated with adjustment to chronic illness. More research is needed regarding the mechanisms through which PPCV affects HRQoL and to examine whether PPCV can be targeted in parenting interventions.

The DSM‐5 Dimensional Anxiety Scales in a Dutch non‐clinical sample: psychometric properties including the adult separation anxiety disorder scale

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.

The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample

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.

Sociale angst bij kinderen: de rol van ouders

De sociale angststoornis is de meest voorkomende angststoornis en ontstaat meestal in de kindertijd. De sociale angststoornis kenmerkt zich door hardnekkige angst voor situaties waarin het kind wordt blootgesteld aan mogelijke kritische beoordeling door anderen en waarin hij/zij bang is zich belachelijk te maken. Ouders kunnen sociale angst bij hun kind in de hand werken door (1) zich angstig te gedragen; (2) hun kind overmatig te controleren, over te beschermen of af te wijzen; of (3) bedreigende dingen te vertellen over sociale situaties. Afhankelijk van de cultuur kan hetzelfde gedrag van ouders een ander effect op de sociale angst van kinderen hebben. Cognitieve gedragstherapie is effectief voor de behandeling van sociale angststoornis bij kinderen, maar het betrekken van de ouders bij de behandeling heeft geen meerwaarde. Uitdagend opvoedingsgedrag van vaders lijkt een gunstig effect te hebben op sociaal-angstige kinderen, maar meer experimenteel onderzoek is hard nodig.