Dental anxiety: prevalence and evaluation of psychometric properties of a scale

Aim: To estimate the reliability and validity of the Dental Anxiety Scale (DAS) and identify the prevalence and the effect of the socio-demographic characteristics of dental anxiety, in a sample of 212 adults. Methods: The psychometric sensitivity of the scale was assessed. A confirmatory factor analysis was performed, and the convergent validity and internal consistency were determined. The prevalence of anxiety was estimated, and the effect of socio-demographic variables on anxiety was assessed using structural equation modelling. Results: The participants’ mean age was 33.5 (SD = 15.6) years, and 62.3% were female. There was an adequate factorial adjustment of the scale in this sample. The convergent validity and internal consistency were adequate in the one-factor model. Regarding two-factor model, there was a high correlation (r) among the factors, which jeopardized the discriminant validity. A total of 47.6% of the participants (IC95% = 40.9 - 54.4) presented low levels of anxiety, 32.5% (IC95% = 26.2 - 38.9) moderate levels, and 12.3% (IC95% = 7.8 - 16.7) exacerbated levels. There was a non-significant effect of gender, age and education on the anxiety levels of this sample. Conclusion: We concluded that the one-factor model presented better psychometric qualities, that anxiety was highly prevalent and there was no significant effect of the demographic variables on anxiety, in this sample

Social phobia in obsessive-compulsive disorder: Prevalence and correlates

Background: Social Phobia (SP) is an anxiety disorder that frequently co-occurs with obsessive-compulsive disorder (OCD); however, studies that evaluate clinical factors associated with this specific comorbidity are rare. The aim was to estimate the prevalence of SP in a large multicenter sample of OCD patients and compare the characteristics of individuals with and without SP. Method: A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV Axis I Disorders. Univariate analyses were followed by logistic regression. Results: Lifetime prevalence of SP was 34.6% (N=346). The following variables remained associated with SP comorbidity after logistic regression: male sex, lower socioeconomic status, body dysmorphic disorder, specific phobia, dysthymia, generalized anxiety disorder, agoraphobia, Tourette syndrome and binge eating disorder. Limitations: The cross-sectional design does not permit the inference of causal relationships; some retrospective information may have been subject to recall bias; all patients were being treated in tertiary services, therefore generalization of the results to other samples of OCD sufferers should be cautious. Despite the large sample size, some hypotheses may not have been confirmed due to the small number of cases with these characteristics (type 2 error). Conclusion: SP is frequent among OCD patients and co-occurs with other disorders that have common phenomenological features. These findings have important implications for clinical practice, indicating the need for broader treatment approaches for individuals with this profile. (C) 2012 Elsevier B.V. All rights reserved.

Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.

General and specific components of depression and anxiety in an adolescent population

Background Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety. Methods An exploratory factor analysis (EFA) and a bifactor modelling approach were used to separate a general distress continuum from more specific sub-domains of depression and anxiety in an adolescent community sample (n = 1159, age 14). The Mood and Feelings Questionnaire and the Revised Children's Manifest Anxiety Scale were used. Results A three-factor confirmatory factor analysis is reported which identified a) mood and social-cognitive symptoms of depression, b) worrying symptoms, and c) somatic and information-processing symptoms as distinct yet closely related constructs. Subsequent bifactor modelling supported a general distress factor which accounted for the communality of the depression and anxiety items. Specific factors for hopelessness-suicidal thoughts and restlessness-fatigue indicated distinct psychopathological constructs which account for unique information over and above the general distress factor. The general distress factor and the hopelessness-suicidal factor were more severe in females but the restlessness-fatigue factor worse in males. Measurement precision of the general distress factor was higher and spanned a wider range of the population than any of the three first-order factors. Conclusions The general distress factor provides the most reliable target for epidemiological analysis but specific factors may help to refine valid phenotype dimensions for aetiological research and assist in prognostic modelling of future psychiatric episodes.

Knowledge, beliefs, risk behaviors, and social skills for HIV/STD prevention in junior college students (grades 11--12) in Bombay, India

1230 year 11 and 12 college students, modal age 16 and 17, in three colleges in Bombay, India, were studied on sexual behaviors or risk of sexual behaviors, beliefs about sex, HIV/STD knowledge, perceived norms regarding sexual behaviors, and the relationships between social skills/anxieties in HIV/STD prevention and actual and anticipated sexual behaviors. A quantitative questionnaire examining HIV/STD risk behaviors, knowledge, attitudes and beliefs, and the AIDS Social Assertiveness Scale (ASAS) were administered to these 1230 college students. Data indicated that 8% of males and 1% of females had had sexual experience, but over one third were not sure at all of being able to abstain from sexual activity with either steady or casual partners. Perceived norms were slanted toward sexual abstinence for the majority of the sample. Knowledge of protective effects of condoms was high, although half of those who had had sex did not use condoms. Logistic regression showed knowledge was higher among males, those who believed it was OK to have sex with a steady partner and that they should not wait until they were older, those who believed that condoms should be used even if the partner is known, and those who believed it was acceptable to have multiple partners. Gender differences in sexual activity and beliefs about sexual activity showed males were less likely to believe in abstaining from sexual activity. The 5 scales of the ASAS were scored and compared on ANOVA on: those who had had sexual experience (HS), those who anticipated being unable to refuse sex (AS), and those who did not anticipate problems in refusing sex (DS). Those in the AS group had greater anxieties about refusing sexual or other risk behaviors than HS and DS groups. There were greater anxieties about dealing with condoms in the AS and DS groups compared with the HS group. Confiding sexual or HIV/STD-related problems to significant others was more anxiety-provoking for the AS group compared with the HS group, and the AS group were more anxious about interactions with people with HIV. Factor analysis produced the same 5 factors as those found in previous studies. Of these, condom interactions and confiding in significant others were most anxiety provoking, and condom interactions most variable based on demographic and attitudinal factors.^ This age group is appropriate for HIV/STD reduction education given the low rate of sexual activity but despite knowledge of the importance of condom use, social skills to apply this knowledge are lacking. Social skills training in sexual negotiations, condom negotiations, and confiding HIV/STD-related concerns to significant others should reduce the risks of Indian college students having unwanted or unprotected sex. ^

Ansiedade em situações de convívio social em idosos

A ansiedade é uma experiência normal em qualquer idade, mas merece uma atenção especial no indivíduo idoso. O idoso tem vivido uma vida social mais intensa como freqüentar cursos, festas ou mesmo lidar com novas tecnologias.Sintomas de ansiedade social podem surgir ou se acentuar nestas situações, prejudicando a integração do indivíduo à sociedade e à família. .A depressão é uma grande preocupação para o idoso. A importância do diagnóstico da doença depressão para diferenciar sintomas depressivos de sentimento de tristeza ou síndrome depressiva .Trata-se de um estudo, do tipo caso-controle investigando ansiedade em situações de convívio social em 61indivíduos com 60 anos de idade ou mais e um grupo de 60 jovens até 35 anos.Responderam um questionário, escalas de ansiedade,fobia social ,esquiva e desconforto, medo de avaliação negativa e depressão.De acordo com os resultados obtidos a ansiedade pode estar relacionada a fatores biológicos, psicológicos e sociais que diagnosticados precocemente podem ser tratados por medicamentos , psicoterapia ou uso da estratégia adequada melhorar a adaptação do idoso.A realidade é que o perfil do idoso mudou e a qualidade de vida também,o que gerou necessidades diferentes,novos desafios. É um assunto que requer maiores estudos com o intuito de apontar estratégias que auxiliem na prevenção ou que aponte fatores que melhorem a adaptação do idoso.(AU)

Ansiedade em situações de convívio social em idosos

A ansiedade é uma experiência normal em qualquer idade, mas merece uma atenção especial no indivíduo idoso. O idoso tem vivido uma vida social mais intensa como freqüentar cursos, festas ou mesmo lidar com novas tecnologias.Sintomas de ansiedade social podem surgir ou se acentuar nestas situações, prejudicando a integração do indivíduo à sociedade e à família. .A depressão é uma grande preocupação para o idoso. A importância do diagnóstico da doença depressão para diferenciar sintomas depressivos de sentimento de tristeza ou síndrome depressiva .Trata-se de um estudo, do tipo caso-controle investigando ansiedade em situações de convívio social em 61indivíduos com 60 anos de idade ou mais e um grupo de 60 jovens até 35 anos.Responderam um questionário, escalas de ansiedade,fobia social ,esquiva e desconforto, medo de avaliação negativa e depressão.De acordo com os resultados obtidos a ansiedade pode estar relacionada a fatores biológicos, psicológicos e sociais que diagnosticados precocemente podem ser tratados por medicamentos , psicoterapia ou uso da estratégia adequada melhorar a adaptação do idoso.A realidade é que o perfil do idoso mudou e a qualidade de vida também,o que gerou necessidades diferentes,novos desafios. É um assunto que requer maiores estudos com o intuito de apontar estratégias que auxiliem na prevenção ou que aponte fatores que melhorem a adaptação do idoso.(AU)

The List of Social Situation Problems: Reliability and validity in an adolescent Spanish-speaking sample

The aim of this study was to analyze the psychometric properties of the Spanish translation of the List of Social Situation Problems (LSSP; S. H. Spence, 1980). The questionnaire was administered to a sample of 388 adolescents between the ages of 12 and 18. Exploratory factor analysis identified four factors: Social Anxiety, Adult Oppositional, Assertiveness, and Making Friends, which accounted for 26.64% of the variance. Internal consistency of the total scale was high (alpha = .86). Correlations between the LSSP and two self-report measures of social anxiety, the Questionnaire about Interpersonal Difficulties for Adolescents (r = .45) and the Social Phobia and Anxiety Inventory (r = .48), were statistically significant. A significant difference was found between LSSP total scores for adolescents with and without social anxiety (d = 1.14), supporting the construct validity of the scale.

A parent-report measure of children's anxiety: psychometric properties and comparison with child-report in a clinic and normal sample

This study examined the psychometric properties of the parent version of the Spence Children's Anxiety Scale (SCAS-P); 484 parents of anxiety disordered children and 261 parents in a normal control group participated in the study. Results of confirmatory factor analysis provided support for six intercorrelated factors, that corresponded with the child self-report as well as with the classification of anxiety disorders by DSM-IV (namely separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, obsessive-compulsive disorder, and fear of physical injuries). A post-hoc model in which generalized anxiety functioned as the higher order factor for the other five factors described the data equally well. The reliability of the subscales was satisfactory to excellent. Evidence was found for both convergent and divergent validity: the measure correlated well with the parent report for internalizing symptoms, and lower with externalizing symptoms. Parent-child agreement ranged from 0.41 to 0.66 in the anxiety-disordered group, and from 0.23 to 0.60 in the control group. The measure differentiated significantly between anxiety-disordered children versus controls, and also between the different anxiety disorders except GAD. The SCAS-P is recommended as a screening instrument for normal children and as a diagnostic instrument in clinical settings. (C) 2003 Elsevier Ltd. All rights reserved.

SINTOMAS MENTAIS E SUPORTE SOCIAL EM PROFISSIONAIS DE ENFERMAGEM

Esta pesquisa investiga a possível correlação entre os níveis de depressão e ansiedade e a percepção de suporte social em profissionais de enfermagem em ambiente hospitalar. Utiliza-se de método descritivo exploratório de caráter quantitativo comparativo. Foram aplicados: A Escala Beck de Depressão BDI total e as subescalas S1 cognitivo-afetiva, S2 somática e de desempenho; o Inventário de Ansiedade BAI (Beck Anxiety Inventory) ; a Escala de Percepção de Suporte Social (EPSS) e questionário sócio-demográfico-clínico em 39 profissionais de enfermagem, auxiliares e técnicos de hospital particular de médio porte. Os dados da BAI revelaram uma freqüência média de 6,10 (DP=5,826) ; a BDI total, média de 7,36 (DP=5,163), com média de 4,31 (DP= 3,764) na subescala cognitivo-afetiva e média de 3,03 (DP= 2,323) na subescala somática e de desempenho. Os dados evidenciam sintomas de ansiedade em 15% dos participantes e depressão em 18%, na faixa de intensidade leve, sem comprometimento funcional significativo. O escore médio fatorial da percepção de suporte social emocional, verificado é de 2,61(DP=0,781), obtendo no suporte prático frequência média de 2,28 (DP=0,686). . Foi verificada uma relação significante positiva (P=0,004) entre os escores das escalas BAI e BDI BDIS1 e BDIS2. Por outro lado, a correlação entre a Percepção de Suporte Social Emocional e o nível de ansiedade verificado pela Escala BAI apresenta uma relação negativa e inversa com BAI e significante (P=0,022), ou seja, enquanto a percepção de suporte emocional aumenta, o escore da escala de ansiedade diminui. Também uma foi verificada uma correlação negativa inversa significante entre a Percepção de Suporte Social Emocional e o nível de depressão verificado pela escala BDI total (P=0,012), e com BDI S1 (P=0,019). A correlação entre a percepção de Suporte Social Prático e o nível de depressão verificado pela Escala BDI Total (P=0,016) e BDI S1(P=0,014) apresenta um relação negativa e inversa, significante , ou seja, enquanto a percepção de suporte social prático aumenta, o escore da escala de depressão diminui. Esses dados apontam para que a percepção de suporte social tenha efeitos mediadores na proteção de saúde, agindo como moderador do impacto negativo de possíveis condições adversas de trabalho do profissional de enfermagem.

SINTOMAS DE BURNOUT EM PROFISSIONAIS DE ENFERMAGEM E SUA CORRELAÇÃO COM REAJUSTAMENTO SOCIAL E CONDIÇÕES DE TRABALHO

O presente estudo teve como principal objetivo correlacionar escalas psicométricas em trabalhadores da área de enfermagem de um Hospital de grande porte do Sudoeste do Paraná. Foram aplicados os seguintes instrumentos: Maslach Burnout Inventory General Survey em suas três dimensões envolvimento pessoal do trabalho, despersonalização e exaustão emocional, os inventários IDATE TRAÇO e IDATE ESTADO, a escala de Reajustamento Social de Holmes e Rahe, além de um Inventário Específico de Eventos de Enfermagem que fora construído de forma experimental para a aplicação na amostra pesquisada. Foram abordados 240 profissionais da área de enfermagem no respectivo ambiente de pesquisa, obtiveram-se um n=192 sujeitos. Como resultados expressivos encontraram-se uma correlação de Pearson entre a Escala de Maslach e suas três dimensões, além do Inventário IDATE ESTADO correlacionado com a Escala de Reajustamento Social. Considerou-se ainda que existiu uma correlação entre o Inventário IDATE ESTADO e um Escore Combinado no programa estatístico empregado na tabulação dos dados coletados. Concluiu-se neste estudo que fatores de reajustamento social podem influenciar positiva ou negativamente em estados de ansiedade em trabalhadores da área de enfermagem hospitalar, considerando ainda as três dimensões avaliadas pelo Maslach Burnout Inventory.

Ansiedade em situações de convívio social em idosos

A ansiedade é uma experiência normal em qualquer idade, mas merece uma atenção especial no indivíduo idoso. O idoso tem vivido uma vida social mais intensa como freqüentar cursos, festas ou mesmo lidar com novas tecnologias.Sintomas de ansiedade social podem surgir ou se acentuar nestas situações, prejudicando a integração do indivíduo à sociedade e à família. .A depressão é uma grande preocupação para o idoso. A importância do diagnóstico da doença depressão para diferenciar sintomas depressivos de sentimento de tristeza ou síndrome depressiva .Trata-se de um estudo, do tipo caso-controle investigando ansiedade em situações de convívio social em 61indivíduos com 60 anos de idade ou mais e um grupo de 60 jovens até 35 anos.Responderam um questionário, escalas de ansiedade,fobia social ,esquiva e desconforto, medo de avaliação negativa e depressão.De acordo com os resultados obtidos a ansiedade pode estar relacionada a fatores biológicos, psicológicos e sociais que diagnosticados precocemente podem ser tratados por medicamentos , psicoterapia ou uso da estratégia adequada melhorar a adaptação do idoso.A realidade é que o perfil do idoso mudou e a qualidade de vida também,o que gerou necessidades diferentes,novos desafios. É um assunto que requer maiores estudos com o intuito de apontar estratégias que auxiliem na prevenção ou que aponte fatores que melhorem a adaptação do idoso.(AU)

Social and individual influences on eating in preadolescents:the role of friends’ eating behaviours and individual anxiety and depression

Background: Friends are important role models for the formation of social norms and behaviour comparisons, particularly in children. This study examined the similarities between pre-adolescent children’s own eating behaviours with the eating behaviours of those in their friendship group. It also evaluated whether symptoms of anxiety and depression were related to eating behaviours in this age group. Methods: Three hundred and forty three children (mean age 8.75 years) completed questionnaires designed to measure dietary restraint, emotional eating and external eating, as well as general and social anxiety, and symptoms of depression. Children also provided details about their friendship groups. Results: Pre-adolescents’ dietary restraint was positively predicted by the dietary restraint of members of their friendship groups, and their individual levels of anxiety and depression. The levels of general anxiety exhibited by pre-adolescents predicted emotional and external eating behaviours. Younger children were significantly more likely to report higher levels of emotional and external eating than older children, and boys were more likely to report more external eating behaviours than girls. Conclusions: These results suggest that greater dieting behaviours in pre-adolescents are related to their friends’ reports of greater dieting behaviours. In contrast, greater levels of eating governed by emotions, and eating in response to external hunger cues, are related to greater symptoms of anxiety in pre-adolescent children. Such findings underline the importance of friends’ social influences on dieting behaviours in this age group and highlight the value of targeting healthy eating and eating disorder prevention interventions at pre-adolescents.

Salient factors in child molestation: Moral development, social competence, and type of offender

The current study was designed to build on and extend the existing knowledge base of factors that cause, maintain, and influence child molestation. Theorized links among the type of offender and the offender's levels of moral development and social competence in the perpetration of child molestation were investigated. The conceptual framework for the study is based on the cognitive developmental stages of moral development as proposed by Kohlberg, the unified theory, or Four-Preconditions Model, of child molestation as proposed by Finkelhor, and the Information-Processing Model of Social Skills as proposed by McFall. The study sample consisted of 127 adult male child molesters participating in outpatient group therapy. All subjects completed a Self-Report Questionnaire which included questions designed to obtain relevant demographic data, questions similar to those used by the researchers for the Massachusetts Treatment Center: Child Molester Typology 3's social competency dimension, the Defining Issues Test (DIT) short form, the Social Avoidance and Distress Scale (SADS), the Rathus Assertiveness Schedule (RAS), and the Questionnaire Measure of Empathic Tendency (Empathy Scale). Data were analyzed utilizing confirmatory factor analysis, t-tests, and chi-square statistics. Partial support was found for the hypothesis that moral development is a separate but correlated construct from social competence. As predicted, although the actual mean score differences were small, a statistically significant difference was found in the current study between the mean DITP scores of the subject sample and that of the general male population, suggesting that child molesters, as a group, function at a lower level of moral development than does the general male population, and the situational offenders in the study sample demonstrated a statistically significantly higher level of moral development than the preferential offenders. The data did not support the hypothesis that situational offenders will demonstrate lower levels of social competence than preferential offenders. Relatively little significance is placed on this finding, however, because the measure for the social competency variable was likely subject to considerable measurement error in that the items used as indicators were not clearly defined. The last hypothesis, which involved the potential differences in social anxiety, assertion skills, and empathy between the situational and preferential offender types, was not supported by the data. ^

Understanding the cycle of violence: An examination of bully and victim social roles in early childhood

The purpose of this study was to assess the prevalence of bullying and victimization in a metropolitan area. A cross-sectional study with kindergarten (n = 127) and first grade (n = 126) children was conducted in two Miami-Dade County Public Schools and three private schools in the same area. Bullying and victimization behavior and social acceptance were assessed through peer nomination and the mental health outcomes of depression and anxiety were assessed through children's self-report. Teachers and parents also completed a social behavior scale for each child. Three areas of analyses were conducted pertaining to membership classification of social roles and the social acceptance and mental health outcomes associated with those roles, reporter agreement within the social roles, and the psychometric properties of the Childhood Social Behavior Scale. Results showed an overall negative pattern of adjustment for children identified as a member of any of the negative social roles. Also, the results support a new analytic approach to the investigation of social roles. The implication of these findings for early identification, social policy, and effective prevention strategies are discussed. ^