Klaus Ranta

The Mini-Social Phobia Inventory: psychometric properties in an adolescent general population sample.

BACKGROUND Onset of social phobia (SP) typically occurs in adolescence. Short screening instruments for its assessment are needed for use in primary health and school settings. The 3-item Mini-Social Phobia Inventory (SPIN) has demonstrated effectiveness in screening for generalized SP (GSP) in adults. This study examined the psychometrics of the Mini-SPIN in an adolescent general population sample. METHODS Three hundred fifty adolescents aged 12 to 17 years were clinically interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version for identification of SP and other Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I disorders, blind to their Mini-SPIN status. Associations between SP; subclinical SP; other anxiety, depressive, and disruptive disorders; and Mini-SPIN scores were examined, and diagnostic efficiency statistics were calculated. The association between Mini-SPIN scores and the generalized subtype of SP was also examined. RESULTS As in adults, the Mini-SPIN items differentiated subjects with SP from those without. A score of 6 points or greater was found optimal in predicting SP with a sensitivity of 86%, specificity of 84%, and positive and negative predictive values of 26% and 99%. The Mini-SPIN also possessed discriminative validity, as scores were higher for adolescents with SP than they were for those with depressive, disruptive, and other anxiety disorders. The Mini-SPIN was also able to differentiate adolescents with GSP from the rest of the sample. CONCLUSIONS The Mini-SPIN has good psychometrics for screening SP in adolescents from general population and may have value in screening for GSP.

Psychophysiological responses to eye contact in adolescents with social anxiety disorder.

We investigated whether eye contact is aversive and negatively arousing for adolescents with social anxiety disorder (SAD). Participants were 17 adolescents with clinically diagnosed SAD and 17 age- and sex-matched controls. While participants viewed the stimuli, a real person with either direct gaze (eye contact), averted gaze, or closed eyes, we measured autonomic arousal (skin conductance responses) and electroencephalographic indices of approach-avoidance-motivation. Additionally, preferred viewing times, self-assessed arousal, valence, and situational self-awareness were measured. We found indications of enhanced autonomic and self-evaluated arousal, attenuated relative left-sided frontal cortical activity (associated with approach-motivation), and more negatively valenced self-evaluated feelings in adolescents with SAD compared to controls when viewing a face making eye contact. The behavioral measures and self-assessments were consistent with the physiological results. The results provide multifaceted evidence that eye contact with another person is an aversive and highly arousing situation for adolescents with SAD.

Community-oriented family-based intervention superior to standard treatment in improving depression, hopelessness and functioning among adolescents with any psychosis-risk symptoms

The aim of the present study was to compare change in functioning, affective symptoms and level of psychosis-risk symptoms in symptomatic adolescents who were treated either in an early intervention programme based on a need-adapted Family- and Community-orientated integrative Treatment Model (FCTM) or in standard adolescent psychiatric treatment (Treatment As Usual, TAU). 28 pairs were matched by length of follow-up, gender, age, and baseline functioning. At one year after the start of treatment, the matched groups were compared on change in functioning (GAF-M), five psychosis-risk dimensions of the Structured Interview for Psychosis-Risk Syndromes (SIPS), and self-reported anxiety, depression, and hopelessness symptoms (BAI, BDI-II, BHS). FCTM was more effective in improving functioning (20% vs. 6% improvement on GAF-M), as well as self-reported depression (53% vs. 14% improvement on BDI-II) and hopelessness (41% vs. 3% improvement on BHS). However, for psychosis-risk symptoms and anxiety symptoms, effectiveness differences between treatment models did not reach statistical significance. To conclude, in the present study, we found greater improvement in functioning and self-reported depression and hopelessness among adolescents who received a need-adapted Family- and Community-orientated integrative Treatment than among those who were treated in standard adolescent psychiatry.

Discrepancy between self-reported and interviewed psychosis risk symptoms: auditory distortions are the most reliably reported symptom by self-report

In the recent literature, there has been growing interest in assessment methods for detecting increased risk of developing psychosis. Self‐report methods are popular but may lead to different results compared to clinical interviews.

Social phobia, depression and eating disorders during middle adolescence: longitudinal associations and treatment seeking

Abstract Background: Longitudinal associations between social phobia (SP), depression and eating disorders (EDs), and the impact of antecedent SP and depression on subsequent treatment seeking for EDs have rarely been explored in prospective adolescent population studies. Aim: We aimed to examine these associations in a large-scale follow-up study among middle adolescents. Method: We surveyed 3278 Finnish adolescents with a mean age of 15 years for these disorders. Two years later, 2070 were reached and again surveyed for psychopathology and treatment seeking. Longitudinal associations between the self-reported disorders and treatment-seeking patterns for self-acknowledged ED symptoms were examined in multivariate analyses, controlling for SP/depression comorbidity and relevant socioeconomic covariates. Results: Self-reported anorexia nervosa (AN) at age 15 years predicted self-reported depression at age 17 years. Furthermore, self-reported SP at age 15 years predicted not seeking treatment for bulimia nervosa (BN) symptoms, while self-reported depression at age 15 years predicted not seeking treatment for AN symptoms during the follow-up period. Conclusions: Adolescents with AN should be monitored for subsequent depression. Barriers caused by SP to help seeking for BN, and by depression for AN, should be acknowledged by healthcare professionals who encounter socially anxious and depressive adolescents, especially when they present with eating problems.

Developmental Transitions in Adolescence and Their Implications for Social Anxiety

Significant developmental transitions occur during adolescence across multiple areas, particularly in the biological and social realms. This chapter examines linkages between key developmental transitions and adolescent social anxiety. Specifically, it reviews literature on school transitions and associated changes in adolescents’ peer relationships; biological transitions, such as the timing and onset of puberty as well as associated physical changes; the emergence of romantic relationships and sexual activity; and family-related interactions, especially those affecting adolescents’ growing autonomy within the family. To the extent possible, for each of these key areas, we discuss pathways by which common developmental transitions might contribute to social anxiety and, in turn, why socially anxious youth might have trouble negotiating transitions. We conclude the chapter with a brief summary and recommendations for further research and practice.

Psychometric properties of the Finnish version of the Young Person’s Clinical Outcomes in Routine Evaluation (YP-CORE) questionnaire

Abstract Background: An increasing need exists for suitable measures to evaluate treatment outcome in adolescents. YP-CORE is a pan-theoretical brief questionnaire developed for this purpose, but it lacks studies in different cultures or languages. Aims: To explore the acceptability, factor structure, reliability, validity, and sensitivity to change of the Finnish translation of YP-CORE. Methods: The study was conducted at the Department of Adolescent Psychiatry, Helsinki University Central Hospital. A Finnish translation was prepared by a team of professionals and adolescents. A clinical sample of 104 patients was asked to complete the form together with BDI-21 and BAI, and 92 of them filled the forms again after a 3-month treatment. Analysis included acceptability, confirmatory factor analysis, internal and test–re-test reliability, concurrent validity, influence of gender and age, and criteria for reliable change. Results: YP-CORE was well accepted, and the rate of missing values was low. Internal consistency (α = 0.83–.92) and test–re-test reliability were good (r = 0.69), and the results of CFA supported a one-factor model. YP-CORE showed good concurrent validity against two widely used symptom-specific measures (r = 0.62–0.87). Gender had a moderately strong effect on the scores (d = 0.67), but the effect of age was not as evident. The measure was sensitive to change, showing a larger effect size (d = 0.55) than in the BDI-21 and BAI (d = 0.31–0.50). Conclusions: The results show that the translation of YP-CORE into Finnish has been successful, the YP-CORE has good psychometric properties, and the measure could be taken into wider use in clinical settings for outcome measurement in adolescents.