Assessing anger and irritability in children: psychometric evaluation and normative data for the German version of the PROMIS® Parent Proxy Anger Scale

Subclinical, long-term psychological symptoms following sport-related concussion: are athletes more depressed than we think?

INTRODUCTION

In adolescent and collegiate athletes with sport-related concussion (SRC), we sought to evaluate the prevalence and predictors of long-term psychological symptoms.

METHODS

A cohort study was conducted of athletes 12-24-year-old diagnosed with SRC between November 2017 and April 2022. Athletes/proxies were interviewed on psychological symptoms (i.e. anger, anxiety, depression, and stress). Participants who scored ≥75th percentile on one or more PROMIS (Patient-Reported Outcomes Measurement System) measures were operationalized to have subclinical, long-term psychological symptoms. Uni/multivariable regressions were used.

RESULTS

Of 96 participants (60.4% male), the average age was 16.6 ± 2.6 years. The median time from concussion to interview was 286 days (IQR: 247-420). A total of 36.5% athletes demonstrated subclinical, long-term psychological symptoms. Univariate logistic regression revealed significant predictors of these symptoms: history of psychiatric disorder (OR = 7.42 95% CI 1.37,40.09), substance use (OR = 4.65 95% CI 1.15,18.81), new medical diagnosis since concussion (OR = 3.43 95% CI 1.27,9.26), amnesia (OR = 3.42 95% CI 1.02,11.41), other orthopedic injuries since concussion (OR = 3.11 95% CI 1.18,8.21), age (OR = 1.24 95% CI 1.03,1.48), days to return-to-play (OR = 1.02 95% CI 1.00,1.03), and psychiatric medication use (OR = 0.19 95% CI 0.05,0.74). Multivariable model revealed significant predictors: orthopedic injuries (OR = 5.17 95% CI 1.12,24.00) and return-to-play (OR = 1.02 95% CI 1.00,1.04).

CONCLUSIONS

Approximately one in three athletes endorsed long-term psychological symptoms. Predictors of these symptoms included orthopedic injuries and delayed RTP.

The Effectiveness of a Recreational Behavioural Programme in Reducing Anger among Children with Intellectual Disabilities at the Primary Stage

This study aimed to investigate the impact of a recreational behavioural programme on reducing the degree of anger among children with intellectual disabilities (ID) in the primary stage. The study was implemented with 24 children who were randomly divided into two groups: an experimental group (n = 12, age = 10.80 ± 1.03 years, IQ = 63.10 ± 4.43 scores, ASW = 55.50 ± 1.51 scores) and a control group (n = 12, age = 10.80 ± 0.92 years, IQ = 63.00 ± 4.16 scores, ASW = 56.00 ± 1.15 scores). We used the PROMIS anger scale with a modification that was used to measure the degree of anger, and the recreational behavioural programme was implemented three times per week for six weeks. The results of the research showed that the improvement percentages for Anger Triggers (AT), Inner Anger (IA), and External Anger (EA) were 9.73%, 9.04%, and 9.60%, respectively, and the Anger scale as a whole (ASW) rate was 9.46%. r = (0.89-0.91). The experimental group using the recreational behavioural programme also outperformed the control group, as the results indicated a decrease in the intensity of anger in the direction of the experimental group. The differences in the improvement percentages for Anger Triggers (AT) Inner Anger (IA), and External Anger (EA) were 32.97%, 31.03%, and 26.63%, respectively, and the Anger scale as a whole (ASW) rate was 30.09%, r = (0.82-0.86). The results of the study confirmed the effectiveness of the recreational activity programme in developing social interaction among children with intellectual disabilities, which indicates the success of the recreational behavioural programme in reducing the degree of anger among children with IDs. Therefore, the recreational behavioural programme had a positive effect in terms of reducing the degree of anger among children with IDs in the primary stage.

German translation of the PROMIS® pediatric anxiety, anger, depressive symptoms, fatigue, pain interference and peer relationships item banks

BACKGROUND

The present study aimed at the translation and cross-cultural adaptation of six PROMIS^® pediatric self- and proxy- item banks and short forms to universal German: anxiety (ANX), anger (ANG), depressive symptoms (DEP), Fatigue (FAT), pain interference (P) and peer relationships (PR).

METHODS

Using standardized methodology approved by the PROMIS Statistical Center and in line with recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force, two translators for each German-speaking country (Germany, Austria, and Switzerland) commented on and rated the translation difficulty and provided forward translations, followed by a review and reconciliation phase. An independent translator performed back translations, which were reviewed and harmonized. The items were tested in cognitive interviews with 58 children and adolescents from Germany (16), Austria (22), and Switzerland (20) for the self-report and 42 parents and other caregivers (Germany (12), Austria (17), and Switzerland (13)) for the proxy-report.

RESULTS

Translators rated the translation difficulty of most items (95%) as easy or feasible. Pretesting showed that items of the universal German version were understood as they were intended, as only 14 out of 82 items of the self-report and 15 out of 82 items of the proxy-report versions required minor rewording. However, on average German translators rated the items more difficult to translate (M = 1.5, SD = 0.20) than the Austrian (M = 1.3, SD = 0.16) and the Swiss translators (M = 1.2, SD = 0.14) on a three-point Likert scale.

CONCLUSIONS

The translated German short forms are ready for use by researchers and clinicians ( https://www.healthmeasures.net/search-view-measures ).

The DADYS-Screen: Development and Evaluation of a Screening Tool for Affective Dysregulation in Children

Affective dysregulation (AD) in children is characterized by persistent irritability and severe temper outbursts. This study developed and evaluated a screening questionnaire for AD in children. The development included the generation of an initial item pool from existing instruments, a Delphi rating of experts, focus groups with experts and parents, and psychometric analyses of clinical and population-based samples. Based on data of a large community-based study, the final screening questionnaire was developed (n = 771; 49.7 % female; age M = 10.02 years; SD = 1.34) and evaluated (n = 8,974; 48.7 % female; age M = 10.00 years; SD = 1.38) with methods from classical test theory and item response theory. The developed DADYS-Screen (Diagnostic Tool for Affective Dysregulation in Children-Screening Questionnaire) includes 12 items with good psychometric properties and scale characteristics including a good fit to a one-factorial model in comparison to the baseline model, although only a "mediocre" fit according to the root mean square error of approximation (RMSEA). Results could be confirmed using a second and larger data set. Overall, the DADYS-Screen is able to identify children with AD, although it needs further investigation using clinical data.