Mikael Julius Sømhovd

A Confirmatory Approach to Examining the Factor Structure of the Strengths and Difficulties Questionnaire (SDQ): A Large Scale Cohort Study

The aim of this study was to examine the factor structure of the Strengths and Difficulties Questionnaire (SDQ) using a Structural Confirmatory Factor Analytic approach. The Danish translation of the SDQ was distributed to 71,840 parents and teachers of 5–7 and 10–12-year-old boys and girls from four large scale cohorts. Three theoretical models were examined: 1. a model with five first order factors (i.e., hyperactivity/inattention, conduct, emotional, peer problems and prosocial), 2. a model adding two internalising and externalising second order factors to model 1, and 3. a model adding a total difficulties second order factor to model 1. Model fits were evaluated, multi-group analyses were carried out and average variance extracted (AVE) and composite reliability (CR) estimates were examined. In this general population sample, low risk sample models 1 and 2 showed similar good overall fits. Best model fits were found when two positively worded items were allowed to cross load with the prosocial scale, and cross loadings were allowed for among three sets of indicators. The analyses also revealed that model fits were slightly better for teachers than for parents and better for older children than for younger children. No convincing differences were found between boys and girls. Factor loadings were acceptable for all groups, especially for older children rated by teachers. Some emotional, peer, conduct and prosocial subscale problems were revealed for younger children rated by parents. The analyses revealed more internal consistency for older children rated by teachers than for younger children rated by parents. It is recommended that model 1 comprising five first order factors, or alternatively model 2 with additionally two internalising/externalising second order factors, should be used when employing the SDQ in low risk epidemiological samples.

Assessing the Revised Child Anxiety and Depression Scale (RCADS) in a National Sample of Danish Youth Aged 8–16 Years

Early identification of anxiety among youth is required to prevent them from going unrecognised and untreated by mental health professionals. A precise identification of the young person’s primary difficulty is also required to guide treatment programs. Availability of a valid and easily administrable assessment tool is crucial for identifying youth suffering from anxiety disorders. The purpose of the present study was therefore to examine the psychometric properties of the Danish version of the Revised Children’s Anxiety and Depression Scale (RCADS). A total of 667 youth from community schools (4th through 9th grade) across Denmark participated in the study. The psychometric properties of the RCADS-DAN resembled those reported in US and Europe. Within scale reliability was excellent with Chronbach’s alpha of.96. All subscales also showed good to excellent internal reliability. The study provides convincing evidence that the RCADS-DAN is a valid assessment tool for screening anxiety in Danish youth.

Anxiety in adolescents born preterm or with very low birthweight: a meta-analysis of case-control studies.

Aim  To determine if adolescents who are born very preterm (<32wks; of gestation) and/or with very low birthweight (VLBW; <1500g) have a higher risk of experiencing clinically significant anxiety problems.

Meta-Worry, Worry, and Anxiety in Children and Adolescents: Relationships and Interactions

The metacognitive model has increased our understanding of the development and maintenance of generalized anxiety disorders in adults. It states that the combination of positive and negative beliefs about worry creates and sustains anxiety. A recent review argues that the model can be applied to children, but empirical support is lacking. The aim of the 2 presented studies was to explore the applicability of the model in a childhood sample. The first study employed a Danish community sample of youth (n = 587) ages 7 to 17 and investigated the relationship between metacognitions, worry and anxiety. Two multiple regression analyses were performed using worry and metacognitive processes as outcome variables. The second study sampled Danish children ages 7 to 12, and compared the metacognitions of children with a GAD diagnosis (n = 22) to children with a non-GAD anxiety diagnosis (n = 19) and nonanxious children (n = 14). In Study 1, metacognitive processes accounted for an additional 14% of the variance in worry, beyond age, gender, and anxiety, and an extra 11% of the variance in anxiety beyond age, gender, and worry. The Negative Beliefs about Worry scale emerged as the strongest predictor of worry and a stronger predictor of anxiety than the other metacognitive processes and age. In Study 2, children with GAD have significantly higher levels of deleterious metacognitions than anxious children without GAD and nonanxious children. The results offer partial support for the downward extension of the metacognitive model of generalized anxiety disorders to children.

A structural assessment of the 30-item Metacognitions Questionnaire for Children and its relations to anxiety symptoms.

Theoretical models of anxiety have been developed in adult populations. The applicability of these models in child samples has been assessed using downward extensions of the questionnaires developed to assess the proposed theoretical mechanisms. This poses a challenge, as children are still in the process of developing the skills that are being assessed. Psychometrically sound assessment tools are therefore needed for this developing population, in order to ensure the early detection of mechanisms leading to anxiety disorders in children. This study examined if metacognitions, which play a key role in generalized anxiety disorder (GAD) in adults, can also be reliably assessed in childhood. The study investigated the psychometric properties of the 30-item Metacognitions Questionnaire for Children (MCQ-C₃₀; Gerlach, Adam, Marschke, & Melfsen, 2008) in a national sample of 974 children and adolescents (538 girls) ages 9-17 years. Confirmatory factor analysis supported the 5-factor subscale structure and a 2nd-order total scale factor, which corresponds with previous versions of the scale. MCQ-C₃₀ expectedly correlated significantly with anxiety symptoms and worry. Structural equation modeling revealed that both obsessive-compulsive disorder and generalized anxiety disorder symptoms regressed significantly onto the MCQ-C₃₀. We fitted separate models for children and adolescents, and no noticeable differences are suggested between the models. Female gender was, expectedly, associated with increased levels of general metacognitions. This gender effect was mediated by level of anxiety. Overall, the MCQ-C₃₀ exhibited acceptable psychometric properties in our community sample of children ages 9-17 years. Future studies should investigate the psychometric properties of the instrument in clinical samples and samples of younger children.

The impact of attachment security and emotion dysregulation on anxiety in children and adolescents

Theoretical views and empirical findings suggest interrelations among attachment security, emotion dysregulation and anxiety in childhood and adolescence. However, the associations among the three constructs have rarely been investigated in children, and no study has yet addressed these associations in adolescence. The aim of the present study was to test a model of the interrelations among the three factors on a sample of 673 youths (age 9–16), using structural equation modelling. In accordance with theoretical conceptualisations, it was hypothesised that attachment security would relate to anxiety and that emotion dysregulation would help explain the association between attachment security and anxiety. Results showed that more securely attached youths reported less emotion dysregulation and that youths who had fewer emotion regulation difficulties experienced less anxiety. The association between attachment security and anxiety was mediated by emotion dysregulation. The model was confirmed for both children and adolescents. Findings are discussed with respect to theoretical implications, as well as future directions.

Parental changes after involvement in their anxious child's cognitive behavior therapy.

OBJECTIVE Specific parental behaviors and cognitions are associated with child anxiety. Studies informing us of the directionality of the associations are lacking. We investigated the effect of parental involvement in childrens anxiety treatment on parental behaviors and cognitions. METHOD Children (N=54, 7-12 years) and parents were randomly allocated to different treatment groups (involved, not involved). Observed behavior, self-reported behavior and cognitions were assessed separately for mothers and fathers at pre-, posttreatment and follow-up. RESULTS There were no differences over time for self-reported parental efficacy and observed negativity, but self-reported autonomy granting increased for both groups over time. Differential effects were found between groups for observed paternal over-involvement (fathers involved in treatment showed a more rapid decrease) and self-reported maternal autonomy-granting (non-involved mothers showed a greater increase). CONCLUSION Our findings suggest that child anxiety significantly influences parental behaviors and cognitions. Child therapy may successfully change the family system.

The relationship between explicit and implicit attitudes towards drunk driving

Despite downward trends, driving under the influence (DUI) remains one of the most salient traffic safety problems. It is crucial to identify the processes behind a problem behaviour to target the most effective measures to address it. One way of exploring precursors of behaviour is measuring attitudes. All persons hold two types of attitudes, explicit and implicit. Although only one of these (explicit) lays the groundwork for current understandings of DUI, it is imperative to explore both types of attitudes. We explore the relationship between explicit and implicit attitudes towards DUI for the first time in the field. Explicit attitudes (what we say we mean) are measured by a questionnaire. Implicit attitudes (which are introspectively unidentified or inaccurately identified traces of past experience) are measured by the Go/No-go Association Task (GNAT) in a sample of young male drivers (n = 101). The results show a relationship between the two types of attitudes, but not completely in the expected way. Depending whether the amount of alcohol is over or under the legal limit, the relationship between explicit and implicit attitudes varies. We discuss the findings and provide directions for future investigations.

Extremely prematurely born adolescents self-report of anxiety symptoms, and the mothers' reports on their offspring

To compare anxiety symptoms in adolescents born extremely prematurely to term‐born controls.