Theoretical models specify that anxiety aggregates in families. Research confirmed maternal anxiety as a predictor of childhood anxiety; however, very little evidence exists in support of paternal anxiety's role in child anxiety as well as about potentially reciprocal relationships between parental and child anxiety. The parent-child anxiety transmission mechanisms are also not fully understood; the majority of previous research focuses on the child's acquisition of anxiety symptoms from a parent via cognitive processes. Recent integrative theoretical models propose that child emotion regulation processes might be involved in parent-child anxiety transmission. The current dissertation aimed to address these gaps in literature. Both studies utilized data from over 800 mothers, 400 fathers, and their children drawn from the longitudinal NICHD Study of Early Childcare and Youth Development. Measures of maternal anxiety, paternal anxiety, child anxiety, and child emotion dysregulation were collected over a nine-year period when children were between the ages of 6 and 15 years. Study I provided evidence of significant indirect effects from parental anxiety to child anxiety through child emotion dysregulation for both mother-child and the father-child relationships. Child emotion dysregulation was non-significant in the father-child path of a family model, despite significant direct effects. The results provide evidence for child emotion dysregulation as an underlying process of parent-child anxiety transmission. Study II provided evidence of significant bidirectional predictive links of maternal anxiety and child anxiety across ages 6, 8, 10, and 15 years tested in a mother-child cross-lagged path model. Significant predictive paths from paternal anxiety to child anxiety were found from ages 6 to 8 and a significant predictive path from child anxiety to paternal anxiety was found from age 10 to age 15 in a father-child cross-lagged model. Additional tests of family models confirmed that there were unique effects of both maternal and paternal anxiety on child anxiety over time. The results show the long-term impact of both maternal anxiety and paternal anxiety on child anxiety as well as child anxiety's reciprocal effects on parental anxiety. Both studies demonstrate the importance of both mothers and fathers in childhood anxiety etiology. / Doctor of Philosophy / Research has shown that anxiety might run in families, and that parental and child anxieties might reinforce each other. In research, most attention is paid to mothers and how their anxiety influences child anxiety, including how children learn their anxious experiencing from their mothers. Very little research has been dedicated to studying fathers and how their anxiety might impact their children. The current two studies of this dissertation wanted to better understand how maternal and paternal anxiety shape child anxiety over the years. Study I tested whether the way how children regulate their emotions is influenced by parental anxiety and whether it contributes to their own anxiety. The evidence shows both mother and father anxiety influence children's regulation of their emotions, and in turn, this contributes to child anxiety. Therefore, how children control their emotions impacts how parental anxiety shapes child anxiety. Study II tested whether parental anxiety influences child anxiety consistently over time as children become adolescents. Study II also tested whether child anxiety contributes to parental anxiety over the years. Results showed that maternal and child anxiety consistently foretold each other when children were at 8, 10, and 15 years old. The results for fathers were more complicated and showed that father anxiety likely influences child anxiety when children are younger, while child anxiety influences paternal anxiety when children are older, during their teenage years. Both studies highlighted showed the importance of both mother and father anxiety to better understand child anxiety.

Childhood anxiety disorders are often considered gateway disorders: having an anxiety disorder in youth is associated with a higher likelihood of developing a related psychological disorder in adulthood. Successfully treating youth with anxiety disorders may reduce the likelihood of subsequent anxiety, depressive, and substance use disorders later in life. This study evaluates follow-up outcomes associated with treatment for childhood anxiety by comparing successfully and unsuccessfully treated participants 16 years after the completion of treatment. A sample of 66 youth (ages 7 to 14 at time of initial study treatment, ages 18 to 32 at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56) years prior participated in the present follow-up evaluation that included self-report measures and a diagnostic interview conducted to assess anxiety, depression, and substance misuse. Results indicate that, relative to those who respond successfully to CBT intervention for an anxiety disorder in childhood, those who were less responsive to CBT for childhood anxiety had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. The present study is the first to assess the 16-year follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. / Psychology

Objective: This study examined (a) the distribution of physical symptoms in youth with specific primary anxiety disorders (i.e. separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and social phobia [SP]) and (b) their response to treatment with cognitive-behavioral therapy (CBT; 14 sessions of CBT over the course of 12 weeks), medication, combination therapy (CBT + medication), or pill placebo in a sample. Method: Anxiety disordered youth (N = 488, age 7-17) who met criteria for a primary diagnosis of GAD, SAD, and/or SP as part of the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al. 2008) were included in this study. The sample was diverse and included children with comorbid secondary diagnoses. Results: The most common somatic complaints were headache, stomach pain or aches, feeling drowsy or too sleepy, head cold or sniffles, and sleeplessness. The distribution of these complaints did not differ across diagnostic groups. The number and severity of physical symptoms decreased over the course of treatment. Treatment condition, including placebo, was unrelated to the number and severity of physical symptoms posttreatment. Conclusions: Treatment of anxiety leads to a decrease in the number and severity of physical symptoms experienced in anxiety-disordered youth, irrespective of treatment type. / Psychology

Recent theoretical developments both within and outside the clinical literature have stressed the complex interactions between biological and environmental risk in relation to psychopathology development. They have also highlighted the importance of cognitive dimensions, especially those related to control perceptions, in the developmental path towards anxiety and mood disorders in children. Few studies have investigated these cognitive dimensions in relation to risk and protective factors. In light of these considerations, the present study evaluated structural models investigating the relationship of perceived control and competence to child temperamental risk, parent personal risk, family environmental risk and anxious and depressed feelings. It was hypothesised that temperamental, and psychological risk in relationship to family environment would be mediated by the cognitive dimensions of perceived control and competence. It was further hypothesised that family environment, would mediate the relationship between child temperamental risk and anxious and depressed feelings. A school sample of 293 New Zealand children aged between 8 and 11 and their parents was assessed using a cross-sectional design. Overall results indicated that in the face of temperamental and family adversity, feeling in control of emotions and social interactions and feeling socially competent afforded children protection from anxious or depressed feelings. In addition, a sensitive, accepting family environment was seen to protect a temperamentally vulnerable child from distressed feelings. In contrast, distress was more likely to occur when a temperamentally vulnerable child lived in a family characterised by parental psychological control and conflict than one characterised by less cohesion and parental rejection. Results also indicated that, in terms of cognitive features, perceptions of social competence were particularly important in protecting a child from having anxious or depressed feelings. These findings are discussed in relationship to Barlow's and other recent integrated aetiological theories of distress disorder. Findings are also considered in relation to implications for identification, intervention and prevention strategies for distressed children in both clinical and school populations. Further results, limitations and proposals for future research are also discussed.

The present dissertation consists of three empirical studies on children and adolescents presenting with various specific phobias in Stockholm, Sweden and in Virginia, USA. The overall aim was to contribute to our understanding of childhood fears, anxiety and phobias and to evaluate the efficacy and portability of a one-session treatment of specific phobias in youth. Study I tested the dimensionality of the Parental Bonding Instrument, across three generations and for two countries, and examined if parenting behaviors of indifference and overprotection were associated with more anxiety problems in children. The results showed that the four-factor representation of parental behavior provided an adequate fit for the instrument across informants. Perceived overprotection was associated with significantly more anxiety symptoms and comorbid diagnosis in children. Study II explored parent-child agreement on a diagnostic screening instrument for youths. The results indicated that children scoring high on motivation at treatment entry had generally stronger parent-child agreement on co-occurring diagnoses and severity ratings. Parents reported overall more diagnoses for their children, and parents who themselves qualified for a diagnosis seemed more tuned in to their children’s problematic behavior. Study III compared a one-session treatment with an education-supportive treatment condition, and a wait-list control condition for children presenting with various types of specific phobias. The results showed that both treatment conditions were superior to the wait-list control condition and that one-session exposure treatment was superior to education-supportive treatment on several measures. Treatment effects were maintained at a 6-month follow-up. Overall, the above findings suggest that the one-session treatment is portable and effective in treating a variety of specific phobias in children and adolescents.

Os transtornos de ansiedade representam uma das formas mais comuns de psicopatologia em crianças e adolescentes e estão associados com prejuízos no funcionamento acadêmico, social e familiar. Porém, permanecem frequentemente subdiagnosticados e subtratados. O bullying escolar é muito comum e está associado com um amplo espectro de problemas psiquiátricos, incluindo sintomas de ansiedade. O principal objetivo desta tese foi examinar a prevalência de bullying em uma grande amostra comunitária de crianças e adolescentes brasileiros e investigar a associação entre bullying e sintomatologia ansiosa de acordo com o DSM-IV. Esse estudo transversal consistiu no preenchimento de um questionário sobre bullying e de sua frequência e de um instrumento auto-aplicativo de triagem para transtornos de ansiedade que é a Screen for Child Anxiety Related Emotional Disorders (SCARED) por 2.353 estudantes entre 9 e 18 anos provenientes de seis escolas pertencentes à área de captação da Unidade Básica de Saúde do Hospital de Clínicas de Porto Alegre. Um total de 22,9% da amostra relatou envolvimento com bullying frequente, como agressor (7,6%), como vítima (5,7%) ou como agressor-vítima (9,6%). Em geral, meninos foram mais envolvidos como agressores e como agressores-vítimas e meninas como vítimas. Nossos achados demonstraram que estudantes envolvidos com bullying, como vítimas ou agressores-vítimas, apresentavam maiores escores na SCARED total e em suas subescalas do que agressores ou do que os estudantes sem envolvimento com bullying. A prevalência do bullying encontrada no nosso estudo está na média quando comparada com estudos prévios na literatura. Vítimas e agressores-vítimas, mas não agressores, são grupos associados com uma sintomatologia ansiosa mais alta. Embora no Brasil as taxas para as prevalências dos transtornos de ansiedade na infância e adolescência sejam substanciais, há uma carência de instrumentos para avaliar os sintomas de ansiedade e constructos relacionados à ansiedade em crianças e adolescentes. Adicionalmente, essa tese avaliou as propriedades psicométricas de duas escalas que são utilizadas na avaliação da ansiedade em crianças e adolescentes. A SCARED é um instrumento auto-aplicativo que foi originalmente desenvolvido como uma ferramenta de triagem para avaliar os transtornos de ansiedade na infância e adolescência de acordo com o DSM-IV. Os resultados encontrados em nosso estudo evidenciam que a SCARED apresenta propriedades psicométricas apropriadas e é um instrumento válido e confiável para avaliar sintomas de ansiedade em jovens no Brasil. O Childhood Anxiety Sensitivity Index (CASI) é o principal instrumento utilizado para avaliar sensibilidade à ansiedade em crianças e adolescentes. A sensibilidade à ansiedade é um constructo temperamental que pode ser conceitualizado como o medo de que sintomas de ansiedade possam ter graves consequências físicas, psicológicas ou sociais para o indivíduo. A sensibilidade à ansiedade está associada com outras medidas de ansiedade, principalmente àquelas que avaliam sintomas relacionados ao transtorno do pânico, e pode ser considerada um fator de risco para o desenvolvimento de sintomas de ansiedade e de transtornos de ansiedade em jovens. Nossos achados demonstraram uma confiabilidade apropriada e evidência de validade convergente entre a CASI e a SCARED em uma subamostra do nosso estudo, sugerindo que a CASI possa ser uma ferramenta útil na avaliação da sensibilidade à ansiedade nessa população. Tendo em vista os limitados recursos em relação à saúde mental e a pouca atenção clínica aos transtornos de ansiedade, acredita-se que tais instrumentos possam 11 se tornar ferramentas úteis na triagem de crianças e adolescentes com sintomas de ansiedade e que poderão necessitar de avaliações adicionais e de tratamento. / Anxiety disorders are one of the most common forms of psychopathology among children and adolescents and are associated with impairments in academic, social, and family functioning. Although very prevalent, the anxiety disorders are often undetected or untreated. School bullying is common and is associated with a broad spectrum of psychiatric problems, including anxiety symptomatology. The main objective of this study was to examine the prevalence of bullying behaviors in a large communitarian sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a self-report questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety Related Emotional Disorders (SCARED) that is also a self-report screening tool for childhood anxiety disorders by 2353 students aged 9-18 years from 6 schools located in the catchment area of the Primary Care Unit from the Hospital de Clínicas de Porto Alegre. A total of 22.9% of the sample reported frequent involvement in bullying, as a bully (7.4%), as a victim (5.7%), or as a bully-victim (9.5%). In general, boys were more likely to be involved as bully and as bully-victim, and girls were more likely to be involved as victims. Our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher total scores in SCARED scale, as well as in its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors found in our sample is about average when compared with previous studies described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology. Although prevalence rates of anxiety disorders in Brazilian youth are significant, there is a lack of validated instruments to assess anxiety symptoms and related constructs in children and adolescents. In addition, this study verified the psychometrics properties of two scales that are frequently used in the assessment of anxiety in children and adolescents. The SCARED is a self-report instrument that was originally developed as a screening tool for DSM-IV childhood anxiety disorders. Our study suggested that the SCARED has appropriate psychometric properties and is a useful and reliable instrument to assess anxiety symptoms in Brazilian youth. The Childhood Anxiety Sensitivity Index (CASI) is the principal instrument used to assess anxiety sensitivity in children and adolescents. Anxiety Sensitivity refers to the tendency to fear anxiety-related sensations and is thought to arise from beliefs about their harmful physical, cognitive, or social consequences. Anxiety sensitivity is associated with other anxiety measurements, mainly those evaluating panic symptoms. It is also considered a risk factor for the development of anxious symptomatology and anxiety disorders in youth. Our findings demonstrated an appropriate reliability and evidence of convergent validity in the CASI with the SCARED in a subsample of our study, suggesting that the CASI could be a suitable tool for evaluating anxiety sensitivity in this population. Given the limited mental health resources and the paucity of clinical attention to childhood anxiety disorders in Brazil, these instruments may be a valuable tool for screening Brazilian children and adolescents with anxiety symptoms who may need further assessment and treatment.

Os transtornos de ansiedade representam uma das formas mais comuns de psicopatologia em crianças e adolescentes e estão associados com prejuízos no funcionamento acadêmico, social e familiar. Porém, permanecem frequentemente subdiagnosticados e subtratados. O bullying escolar é muito comum e está associado com um amplo espectro de problemas psiquiátricos, incluindo sintomas de ansiedade. O principal objetivo desta tese foi examinar a prevalência de bullying em uma grande amostra comunitária de crianças e adolescentes brasileiros e investigar a associação entre bullying e sintomatologia ansiosa de acordo com o DSM-IV. Esse estudo transversal consistiu no preenchimento de um questionário sobre bullying e de sua frequência e de um instrumento auto-aplicativo de triagem para transtornos de ansiedade que é a Screen for Child Anxiety Related Emotional Disorders (SCARED) por 2.353 estudantes entre 9 e 18 anos provenientes de seis escolas pertencentes à área de captação da Unidade Básica de Saúde do Hospital de Clínicas de Porto Alegre. Um total de 22,9% da amostra relatou envolvimento com bullying frequente, como agressor (7,6%), como vítima (5,7%) ou como agressor-vítima (9,6%). Em geral, meninos foram mais envolvidos como agressores e como agressores-vítimas e meninas como vítimas. Nossos achados demonstraram que estudantes envolvidos com bullying, como vítimas ou agressores-vítimas, apresentavam maiores escores na SCARED total e em suas subescalas do que agressores ou do que os estudantes sem envolvimento com bullying. A prevalência do bullying encontrada no nosso estudo está na média quando comparada com estudos prévios na literatura. Vítimas e agressores-vítimas, mas não agressores, são grupos associados com uma sintomatologia ansiosa mais alta. Embora no Brasil as taxas para as prevalências dos transtornos de ansiedade na infância e adolescência sejam substanciais, há uma carência de instrumentos para avaliar os sintomas de ansiedade e constructos relacionados à ansiedade em crianças e adolescentes. Adicionalmente, essa tese avaliou as propriedades psicométricas de duas escalas que são utilizadas na avaliação da ansiedade em crianças e adolescentes. A SCARED é um instrumento auto-aplicativo que foi originalmente desenvolvido como uma ferramenta de triagem para avaliar os transtornos de ansiedade na infância e adolescência de acordo com o DSM-IV. Os resultados encontrados em nosso estudo evidenciam que a SCARED apresenta propriedades psicométricas apropriadas e é um instrumento válido e confiável para avaliar sintomas de ansiedade em jovens no Brasil. O Childhood Anxiety Sensitivity Index (CASI) é o principal instrumento utilizado para avaliar sensibilidade à ansiedade em crianças e adolescentes. A sensibilidade à ansiedade é um constructo temperamental que pode ser conceitualizado como o medo de que sintomas de ansiedade possam ter graves consequências físicas, psicológicas ou sociais para o indivíduo. A sensibilidade à ansiedade está associada com outras medidas de ansiedade, principalmente àquelas que avaliam sintomas relacionados ao transtorno do pânico, e pode ser considerada um fator de risco para o desenvolvimento de sintomas de ansiedade e de transtornos de ansiedade em jovens. Nossos achados demonstraram uma confiabilidade apropriada e evidência de validade convergente entre a CASI e a SCARED em uma subamostra do nosso estudo, sugerindo que a CASI possa ser uma ferramenta útil na avaliação da sensibilidade à ansiedade nessa população. Tendo em vista os limitados recursos em relação à saúde mental e a pouca atenção clínica aos transtornos de ansiedade, acredita-se que tais instrumentos possam 11 se tornar ferramentas úteis na triagem de crianças e adolescentes com sintomas de ansiedade e que poderão necessitar de avaliações adicionais e de tratamento. / Anxiety disorders are one of the most common forms of psychopathology among children and adolescents and are associated with impairments in academic, social, and family functioning. Although very prevalent, the anxiety disorders are often undetected or untreated. School bullying is common and is associated with a broad spectrum of psychiatric problems, including anxiety symptomatology. The main objective of this study was to examine the prevalence of bullying behaviors in a large communitarian sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a self-report questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety Related Emotional Disorders (SCARED) that is also a self-report screening tool for childhood anxiety disorders by 2353 students aged 9-18 years from 6 schools located in the catchment area of the Primary Care Unit from the Hospital de Clínicas de Porto Alegre. A total of 22.9% of the sample reported frequent involvement in bullying, as a bully (7.4%), as a victim (5.7%), or as a bully-victim (9.5%). In general, boys were more likely to be involved as bully and as bully-victim, and girls were more likely to be involved as victims. Our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher total scores in SCARED scale, as well as in its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors found in our sample is about average when compared with previous studies described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology. Although prevalence rates of anxiety disorders in Brazilian youth are significant, there is a lack of validated instruments to assess anxiety symptoms and related constructs in children and adolescents. In addition, this study verified the psychometrics properties of two scales that are frequently used in the assessment of anxiety in children and adolescents. The SCARED is a self-report instrument that was originally developed as a screening tool for DSM-IV childhood anxiety disorders. Our study suggested that the SCARED has appropriate psychometric properties and is a useful and reliable instrument to assess anxiety symptoms in Brazilian youth. The Childhood Anxiety Sensitivity Index (CASI) is the principal instrument used to assess anxiety sensitivity in children and adolescents. Anxiety Sensitivity refers to the tendency to fear anxiety-related sensations and is thought to arise from beliefs about their harmful physical, cognitive, or social consequences. Anxiety sensitivity is associated with other anxiety measurements, mainly those evaluating panic symptoms. It is also considered a risk factor for the development of anxious symptomatology and anxiety disorders in youth. Our findings demonstrated an appropriate reliability and evidence of convergent validity in the CASI with the SCARED in a subsample of our study, suggesting that the CASI could be a suitable tool for evaluating anxiety sensitivity in this population. Given the limited mental health resources and the paucity of clinical attention to childhood anxiety disorders in Brazil, these instruments may be a valuable tool for screening Brazilian children and adolescents with anxiety symptoms who may need further assessment and treatment.

Os transtornos de ansiedade representam uma das formas mais comuns de psicopatologia em crianças e adolescentes e estão associados com prejuízos no funcionamento acadêmico, social e familiar. Porém, permanecem frequentemente subdiagnosticados e subtratados. O bullying escolar é muito comum e está associado com um amplo espectro de problemas psiquiátricos, incluindo sintomas de ansiedade. O principal objetivo desta tese foi examinar a prevalência de bullying em uma grande amostra comunitária de crianças e adolescentes brasileiros e investigar a associação entre bullying e sintomatologia ansiosa de acordo com o DSM-IV. Esse estudo transversal consistiu no preenchimento de um questionário sobre bullying e de sua frequência e de um instrumento auto-aplicativo de triagem para transtornos de ansiedade que é a Screen for Child Anxiety Related Emotional Disorders (SCARED) por 2.353 estudantes entre 9 e 18 anos provenientes de seis escolas pertencentes à área de captação da Unidade Básica de Saúde do Hospital de Clínicas de Porto Alegre. Um total de 22,9% da amostra relatou envolvimento com bullying frequente, como agressor (7,6%), como vítima (5,7%) ou como agressor-vítima (9,6%). Em geral, meninos foram mais envolvidos como agressores e como agressores-vítimas e meninas como vítimas. Nossos achados demonstraram que estudantes envolvidos com bullying, como vítimas ou agressores-vítimas, apresentavam maiores escores na SCARED total e em suas subescalas do que agressores ou do que os estudantes sem envolvimento com bullying. A prevalência do bullying encontrada no nosso estudo está na média quando comparada com estudos prévios na literatura. Vítimas e agressores-vítimas, mas não agressores, são grupos associados com uma sintomatologia ansiosa mais alta. Embora no Brasil as taxas para as prevalências dos transtornos de ansiedade na infância e adolescência sejam substanciais, há uma carência de instrumentos para avaliar os sintomas de ansiedade e constructos relacionados à ansiedade em crianças e adolescentes. Adicionalmente, essa tese avaliou as propriedades psicométricas de duas escalas que são utilizadas na avaliação da ansiedade em crianças e adolescentes. A SCARED é um instrumento auto-aplicativo que foi originalmente desenvolvido como uma ferramenta de triagem para avaliar os transtornos de ansiedade na infância e adolescência de acordo com o DSM-IV. Os resultados encontrados em nosso estudo evidenciam que a SCARED apresenta propriedades psicométricas apropriadas e é um instrumento válido e confiável para avaliar sintomas de ansiedade em jovens no Brasil. O Childhood Anxiety Sensitivity Index (CASI) é o principal instrumento utilizado para avaliar sensibilidade à ansiedade em crianças e adolescentes. A sensibilidade à ansiedade é um constructo temperamental que pode ser conceitualizado como o medo de que sintomas de ansiedade possam ter graves consequências físicas, psicológicas ou sociais para o indivíduo. A sensibilidade à ansiedade está associada com outras medidas de ansiedade, principalmente àquelas que avaliam sintomas relacionados ao transtorno do pânico, e pode ser considerada um fator de risco para o desenvolvimento de sintomas de ansiedade e de transtornos de ansiedade em jovens. Nossos achados demonstraram uma confiabilidade apropriada e evidência de validade convergente entre a CASI e a SCARED em uma subamostra do nosso estudo, sugerindo que a CASI possa ser uma ferramenta útil na avaliação da sensibilidade à ansiedade nessa população. Tendo em vista os limitados recursos em relação à saúde mental e a pouca atenção clínica aos transtornos de ansiedade, acredita-se que tais instrumentos possam 11 se tornar ferramentas úteis na triagem de crianças e adolescentes com sintomas de ansiedade e que poderão necessitar de avaliações adicionais e de tratamento. / Anxiety disorders are one of the most common forms of psychopathology among children and adolescents and are associated with impairments in academic, social, and family functioning. Although very prevalent, the anxiety disorders are often undetected or untreated. School bullying is common and is associated with a broad spectrum of psychiatric problems, including anxiety symptomatology. The main objective of this study was to examine the prevalence of bullying behaviors in a large communitarian sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a self-report questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety Related Emotional Disorders (SCARED) that is also a self-report screening tool for childhood anxiety disorders by 2353 students aged 9-18 years from 6 schools located in the catchment area of the Primary Care Unit from the Hospital de Clínicas de Porto Alegre. A total of 22.9% of the sample reported frequent involvement in bullying, as a bully (7.4%), as a victim (5.7%), or as a bully-victim (9.5%). In general, boys were more likely to be involved as bully and as bully-victim, and girls were more likely to be involved as victims. Our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher total scores in SCARED scale, as well as in its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors found in our sample is about average when compared with previous studies described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology. Although prevalence rates of anxiety disorders in Brazilian youth are significant, there is a lack of validated instruments to assess anxiety symptoms and related constructs in children and adolescents. In addition, this study verified the psychometrics properties of two scales that are frequently used in the assessment of anxiety in children and adolescents. The SCARED is a self-report instrument that was originally developed as a screening tool for DSM-IV childhood anxiety disorders. Our study suggested that the SCARED has appropriate psychometric properties and is a useful and reliable instrument to assess anxiety symptoms in Brazilian youth. The Childhood Anxiety Sensitivity Index (CASI) is the principal instrument used to assess anxiety sensitivity in children and adolescents. Anxiety Sensitivity refers to the tendency to fear anxiety-related sensations and is thought to arise from beliefs about their harmful physical, cognitive, or social consequences. Anxiety sensitivity is associated with other anxiety measurements, mainly those evaluating panic symptoms. It is also considered a risk factor for the development of anxious symptomatology and anxiety disorders in youth. Our findings demonstrated an appropriate reliability and evidence of convergent validity in the CASI with the SCARED in a subsample of our study, suggesting that the CASI could be a suitable tool for evaluating anxiety sensitivity in this population. Given the limited mental health resources and the paucity of clinical attention to childhood anxiety disorders in Brazil, these instruments may be a valuable tool for screening Brazilian children and adolescents with anxiety symptoms who may need further assessment and treatment.

Parent Adaptive Doll Play, a technique in an early stage of development, is designed for use by parents in assisting their young children to cope with the stresses of parental separation/divorce. The effects of technique implementation by parents of three- through six-year-old children were investigated. Data was collected before and after parents received training and implemented the technique over an eight-week period. Parents completed the Child Behavior Rating Scale, Burks' Behavior Rating Scales, the Parenting Stress Index, and the Parental Attitude Scale. Twenty-two parents, reporting marital separation through separation and/or divorce, within 18 months prior to the beginning of the study, and reporting more than 50 percent physical custody of a three- through six-year-old child qualified for participation. Twelve children were experimental subjects and ten were control subjects. To determine differences between groups, a one-way analysis of covariance was performed on each post test variable. Positive differences were calculated in several areas of child behavior by parents of subjects in the experimental group. No significant differences between groups were found in any area of child behavior. The score which most closely approached significance, however, was found in the Burks' Behavior Rating Scale area of poor anger control.

No description available.