- Email: [email protected]
4.39 Measurement Invariance of the Scared Questionnaire: Examining Parent and Child Report of Anxiety Symptoms
NEW RESEARCH POSTERS 4.38 — 4.40
4.38 PLANNING ABILITY IMPAIRMENT IN CHILDREN AND ADOLESCENTS WITH ANXIETY DISORDER: RESULTS FROM A CONTROLLED TRIAL Camila Luisi Rodrigues, MS, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected]; Carolina da Costa, MD, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected]; Cristiana Castanho A. Rocca, PhD, Institute of Psychiatry of University of S~ ao Paulo, [email protected]; Fernando R. Asbahr, MD, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected] Objectives: A few studies have shown cognitive abnormalities in youngsters with anxiety disorders, particularly impairment in attention and memory processes. The aim of this study was to investigate whether planning ability is compromised in children and adolescents with anxiety disorders. Methods: A sample group of 37 children (ages 7–17 years), diagnosed with at least one anxiety disorder [generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and/or social anxiety; study group], and 34 healthy control subjects were evaluated. The following neuropsychological tests were used: 1) the Tower of Hanoi task (ToH) for the assessment of planning ability; 2) speed processing and problem solving; and 3) the Vocabulary and Matrix Reasoning subtests of the Wechsler Abbreviated Scale of Intelligence (WASI) for measures of the estimated IQ in both groups. The groups were compared with a generalized linear model controlling for age, IQ, and ADHD comorbidity. Results: Compared with the control group, subjects with anxiety disorders made more errors (P ¼ 0.006) and required more time (P ¼ 0.001) to complete the ToH task. Conclusions: Findings from this study suggest that subjects with pediatric anxiety disorder have poorer planning ability than healthy control subjects. Poorer planning ability performances seem to be related to attentional control theory, which suggests that anxiety impairs the efficiency of the inhibition and shifting functions.
AD, COG, NEPSYC
~o de Amparo a Pesquisa do Estado de S~ Supported by Fundac¸ a ao Paulo - S~ ao Paulo Research Foundation Grants 0851632-9 and 2015/17582-8 http://dx.doi.org/10.1016/j.jaac.2017.09.254
4.39 MEASUREMENT INVARIANCE OF THE SCARED QUESTIONNAIRE: EXAMINING PARENT AND CHILD REPORT OF ANXIETY SYMPTOMS Brigid Behrens, BS, National Institute of Mental Health, [email protected]; Caroline Swetlitz, BA, National Institute of Mental Health, [email protected]; Katharina Kircanski, PhD, National Institute of Mental Health, [email protected]; Daniel S. Pine, MD, National Institute of Mental Health, [email protected]; David Pagliaccio, PhD, National Institute of Mental Health, [email protected] Objectives: The Screen for Child Anxiety Related Disorders (SCARED) is a questionnaire measure widely used to assess childhood anxiety based on parent and child report. However, although SCARED is a reliable, valid, and sensitive measure to screen for pediatric anxiety disorders, informant discrepancy can pose clinical and research challenges. Preliminary research suggests partial threshold invariance among respondents but uses moderate sample sizes. By examining measurement invariance of the SCARED between parent–child dyads and between age-groups, the present study aims to explore psychometric factors that may influence informant discrepancies. Methods: Participants included 1,092 parent–child dyads. Child participants (aged 7–18 years) included both treatment-seeking anxious patients and healthy volunteers. We conducted one longitudinal and two multi-group invariance models in Mplus to explore how informant (parent vs. child) and age of the child at completion related to item interpretation. The first model examined parent and child responses, using a longitudinal method to account for the
S242
www.jaacap.org
nonindependence of variables. The second and third model examined parent or child responses in young and older children. Ongoing analyses will examine the test-retest reliability of parent and child report on the SCARED as well. Results: Our results indicated that the SCARED shows strict measurement invariance, as evidenced by small changes in confirmatory factor analysis model fit, suggesting similar factor loadings, thresholds, and residuals across informant, as well as age of the child. Evidence of measurement invariance informs the interpretation of the SCARED, suggesting that it is appropriate to compare values across groups. Conclusions: This suggests that item interpretation is not responsible for the discrepancy between raters. However, because of the prevalence of informant discrepancy, further analyses will examine the test-retest reliability of parent and child respondents. Understanding how informants interpret the latent variables informs the validity of the SCARED measure in both research and clinical settings.
AD, NIMH Supported by NIMH Intramural Research Program http://dx.doi.org/10.1016/j.jaac.2017.09.255
4.40 THE EFFECT OF SOCIAL AWARENESS ON ANTICIPATED SOCIAL INTERACTIONS IN ANXIOUS AND NON-ANXIOUS YOUTH: A NEUROIMAGING STUDY Quyen B. Do, BS, National Institute of Mental Health, quyen. [email protected]; Brent I. Rappaport, BA, Washington University in St. Louis, [email protected]; Eric E. Nelson, PhD, Nationwide Children’s Hospital, eric.nelson@ nationwidechildrens.org; Johanna M. Jarcho, PhD, Stony Brook University, [email protected]; Daniel S. Pine, MD, National Institute of Mental Health, pined@mail. nih.gov; Ashley R. Smith, PhD, National Institute of Mental Health, [email protected] Objectives: Adolescence is a period of increased emphasis on peer relationships. Social awareness, the ability to detect social cues, is critical in forming and maintaining such relationships. Anxious youth have difficulty processing social cues, often interpreting social interactions as more negative than their healthy peers. These negative biases may lead to avoidance of and/or withdrawal from social interactions. As such, understanding how individual differences in social awareness influence brain response during anticipation of peer interactions may be critical to our understanding of social anxiety. Methods: Both anxious (N ¼ 44) and healthy (N ¼ 45) youths (ages 8–17) completed a computerized social interaction task while undergoing fMRI. Participants were told they would be the “New Kid” at a virtual school and that a purported group of “Other Students” would provide evaluative feedback about a profile and avatar they created at a previous visit. To examine how youth respond to anticipation of different types of social interactions, each Other Student had a reputation for being “nice” (provided 100% positive feedback), “mean” (provided 100% negative feedback), or “unpredictable” (provided 50% positive and 50% negative feedback). The present analysis focused on the anticipatory period before receiving evaluative feedback. We ran a whole-brain, mixed-effects model with social awareness (as measured by the Social Responsiveness Scale) as a continuous, between-subject variable and student reputation as a repeated, within-subjects variable. Results: A whole-brain analysis (P < 0.005) revealed a main effect of social awareness in the anterior insula (41, 1, 1). In particular, when anticipating evaluative feedback, youth with lower levels of social awareness showed less insula activation, whereas insula activation was higher in youth with higher levels of social awareness. Conclusions: The current study suggests a direct relationship between one’s ability to detect social cues and engagement in the insula, a brain region involved in the detection and interpretation of physiological arousal. These preliminary data demonstrate that both levels of social awareness and insula engagement may play important roles in processing potential social interactions during adolescence.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017
4.38 PLANNING ABILITY IMPAIRMENT IN CHILDREN AND ADOLESCENTS WITH ANXIETY DISORDER: RESULTS FROM A CONTROLLED TRIAL Camila Luisi Rodrigues, MS, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected]; Carolina da Costa, MD, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected]; Cristiana Castanho A. Rocca, PhD, Institute of Psychiatry of University of S~ ao Paulo, [email protected]; Fernando R. Asbahr, MD, Faculdade de Medicina da Universidade de S~ ao Paulo, [email protected] Objectives: A few studies have shown cognitive abnormalities in youngsters with anxiety disorders, particularly impairment in attention and memory processes. The aim of this study was to investigate whether planning ability is compromised in children and adolescents with anxiety disorders. Methods: A sample group of 37 children (ages 7–17 years), diagnosed with at least one anxiety disorder [generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and/or social anxiety; study group], and 34 healthy control subjects were evaluated. The following neuropsychological tests were used: 1) the Tower of Hanoi task (ToH) for the assessment of planning ability; 2) speed processing and problem solving; and 3) the Vocabulary and Matrix Reasoning subtests of the Wechsler Abbreviated Scale of Intelligence (WASI) for measures of the estimated IQ in both groups. The groups were compared with a generalized linear model controlling for age, IQ, and ADHD comorbidity. Results: Compared with the control group, subjects with anxiety disorders made more errors (P ¼ 0.006) and required more time (P ¼ 0.001) to complete the ToH task. Conclusions: Findings from this study suggest that subjects with pediatric anxiety disorder have poorer planning ability than healthy control subjects. Poorer planning ability performances seem to be related to attentional control theory, which suggests that anxiety impairs the efficiency of the inhibition and shifting functions.
AD, COG, NEPSYC
~o de Amparo a Pesquisa do Estado de S~ Supported by Fundac¸ a ao Paulo - S~ ao Paulo Research Foundation Grants 0851632-9 and 2015/17582-8 http://dx.doi.org/10.1016/j.jaac.2017.09.254
4.39 MEASUREMENT INVARIANCE OF THE SCARED QUESTIONNAIRE: EXAMINING PARENT AND CHILD REPORT OF ANXIETY SYMPTOMS Brigid Behrens, BS, National Institute of Mental Health, [email protected]; Caroline Swetlitz, BA, National Institute of Mental Health, [email protected]; Katharina Kircanski, PhD, National Institute of Mental Health, [email protected]; Daniel S. Pine, MD, National Institute of Mental Health, [email protected]; David Pagliaccio, PhD, National Institute of Mental Health, [email protected] Objectives: The Screen for Child Anxiety Related Disorders (SCARED) is a questionnaire measure widely used to assess childhood anxiety based on parent and child report. However, although SCARED is a reliable, valid, and sensitive measure to screen for pediatric anxiety disorders, informant discrepancy can pose clinical and research challenges. Preliminary research suggests partial threshold invariance among respondents but uses moderate sample sizes. By examining measurement invariance of the SCARED between parent–child dyads and between age-groups, the present study aims to explore psychometric factors that may influence informant discrepancies. Methods: Participants included 1,092 parent–child dyads. Child participants (aged 7–18 years) included both treatment-seeking anxious patients and healthy volunteers. We conducted one longitudinal and two multi-group invariance models in Mplus to explore how informant (parent vs. child) and age of the child at completion related to item interpretation. The first model examined parent and child responses, using a longitudinal method to account for the
S242
www.jaacap.org
nonindependence of variables. The second and third model examined parent or child responses in young and older children. Ongoing analyses will examine the test-retest reliability of parent and child report on the SCARED as well. Results: Our results indicated that the SCARED shows strict measurement invariance, as evidenced by small changes in confirmatory factor analysis model fit, suggesting similar factor loadings, thresholds, and residuals across informant, as well as age of the child. Evidence of measurement invariance informs the interpretation of the SCARED, suggesting that it is appropriate to compare values across groups. Conclusions: This suggests that item interpretation is not responsible for the discrepancy between raters. However, because of the prevalence of informant discrepancy, further analyses will examine the test-retest reliability of parent and child respondents. Understanding how informants interpret the latent variables informs the validity of the SCARED measure in both research and clinical settings.
AD, NIMH Supported by NIMH Intramural Research Program http://dx.doi.org/10.1016/j.jaac.2017.09.255
4.40 THE EFFECT OF SOCIAL AWARENESS ON ANTICIPATED SOCIAL INTERACTIONS IN ANXIOUS AND NON-ANXIOUS YOUTH: A NEUROIMAGING STUDY Quyen B. Do, BS, National Institute of Mental Health, quyen. [email protected]; Brent I. Rappaport, BA, Washington University in St. Louis, [email protected]; Eric E. Nelson, PhD, Nationwide Children’s Hospital, eric.nelson@ nationwidechildrens.org; Johanna M. Jarcho, PhD, Stony Brook University, [email protected]; Daniel S. Pine, MD, National Institute of Mental Health, pined@mail. nih.gov; Ashley R. Smith, PhD, National Institute of Mental Health, [email protected] Objectives: Adolescence is a period of increased emphasis on peer relationships. Social awareness, the ability to detect social cues, is critical in forming and maintaining such relationships. Anxious youth have difficulty processing social cues, often interpreting social interactions as more negative than their healthy peers. These negative biases may lead to avoidance of and/or withdrawal from social interactions. As such, understanding how individual differences in social awareness influence brain response during anticipation of peer interactions may be critical to our understanding of social anxiety. Methods: Both anxious (N ¼ 44) and healthy (N ¼ 45) youths (ages 8–17) completed a computerized social interaction task while undergoing fMRI. Participants were told they would be the “New Kid” at a virtual school and that a purported group of “Other Students” would provide evaluative feedback about a profile and avatar they created at a previous visit. To examine how youth respond to anticipation of different types of social interactions, each Other Student had a reputation for being “nice” (provided 100% positive feedback), “mean” (provided 100% negative feedback), or “unpredictable” (provided 50% positive and 50% negative feedback). The present analysis focused on the anticipatory period before receiving evaluative feedback. We ran a whole-brain, mixed-effects model with social awareness (as measured by the Social Responsiveness Scale) as a continuous, between-subject variable and student reputation as a repeated, within-subjects variable. Results: A whole-brain analysis (P < 0.005) revealed a main effect of social awareness in the anterior insula (41, 1, 1). In particular, when anticipating evaluative feedback, youth with lower levels of social awareness showed less insula activation, whereas insula activation was higher in youth with higher levels of social awareness. Conclusions: The current study suggests a direct relationship between one’s ability to detect social cues and engagement in the insula, a brain region involved in the detection and interpretation of physiological arousal. These preliminary data demonstrate that both levels of social awareness and insula engagement may play important roles in processing potential social interactions during adolescence.
J OURNAL
OF THE
AMERICAN A CADEMY OF CHILD & ADOLESCENT P SYCHIATRY VOLUME 56 NUMBER 10S OCTOBER 2017