Psychometric Validation of the Revised Child Anxiety and Depression Scales-Parent Version (RCADS-P) in Children Evaluated for ADHD

Validation of a Chinese Version of the Digital Stress Scale and Development of a Short Form Based on Item Response Theory Among Chinese College Students

Purpose

In 2021, Hall et al developed the Digital Stress Scale (DSS), but its psychometric characteristics were only tested using classical test theory (CTT). In this study, we use item response theory (IRT) and CTT to develop and verify a Chinese version of the DSS and its short version, which can improve the reliability and effectiveness of the digital stress measurement tool for Chinese college students.

Methods

In this study, we developed a Chinese version of the DSS (DSS-C) and recruited 1506 Chinese college students as participants to analyze its psychometric characteristics based on CTT and item response theory methods. First, we used CTT, including common method bias, construct validity, criterion-related validity, internal consistency, test-retest reliability and measurement invariance. Then, we adopted the IRT approach to examine the item parameters, item characteristics, item information, differential item function, test information, and test reliability of the DSS-C. Finally, a short form (DSS-C-S) was constructed, and the psychometric characteristics of the DSS-C-S were examined.

Results

(1) The five-factor structure of the DSS-C was verified. The DSS-C shows good internal reliability, test-retest reliability, criterion-related validity and measurement invariance between urban college students and rural college students. (2) All 24 items had reasonable discrimination parameters and location parameters and were DIF-free by gender. Except for Items 4 and 10, all the other items had high information and measurement reliability at medium θ levels. (3) Compared with the DSS-C, the 22-item short form also has good reliability and validity and maintains sufficient measurement accuracy while reducing items of poor quality.

Conclusion

Both the DSS-C and the DSS-C-S have good psychometric characteristics and are accurate and effective tools for measuring the digital stress of Chinese college students.

In-person victimization, cyber victimization, and polyvictimization in relation to internalizing symptoms and self-esteem in adolescents with attention-deficit/hyperactivity disorder

BACKGROUND

There is mixed evidence for whether in-person victimization and cyber victimization are differentially linked to internalizing symptoms and self-esteem among adolescents with attention-deficit/hyperactivity disorder (ADHD). The goals of the present study were to (1) evaluate in-person victimization and cyber victimization in relation to internalizing symptoms (i.e., anxiety and depression) and self-esteem and (2) examine differences in internalizing symptoms and self-esteem between in-person victimization, cyber victimization, and polyvictimization (i.e., both in-person victimization and cyber victimization).

METHODS

Participants were 78 adolescents (ages 13-17 years) diagnosed with ADHD who completed ratings of in-person victimization, cyber victimization, anxiety, depression, and self-esteem. Parents completed ratings of their adolescent's anxiety and depression.

RESULTS

Adolescents with ADHD reported experiencing higher rates of in-person victimization (64%) than cyber victimization (23%) in the last 30 days. In addition, 22% reported that they experienced polyvictimization. In-person victimization was associated with higher adolescent-reported anxiety symptoms, whereas cyber victimization was associated with higher parent-reported depressive symptoms; both were associated with lower adolescent-reported self-esteem. Adolescents who reported polyvictimization reported the highest anxiety and depressive symptoms and the lowest self-esteem.

CONCLUSIONS

Approximately one quarter of adolescents with ADHD report experiencing polyvictimization in the past month. Findings indicate that in-person victimization and cyber victimization are each uniquely associated with lower self-esteem and differentially associated with co-occurring internalizing symptoms among adolescents with ADHD. Polyvictimization is especially linked to higher internalizing symptoms and lower self-esteem. Longitudinal studies are needed to better understand the directionality of these associations.

The Revised Child Anxiety and Depression Scales (RCADS): Psychometric Evaluation in Children Evaluated for ADHD

Co-occurring internalizing symptoms are common and important to assess in children with attention-deficit/hyperactivity disorder (ADHD). One frequently used child self-report measure of internalizing symptoms is the Revised Child Anxiety and Depression Scales (RCADS), yet the psychometric properties of the RCADS remain unexamined in children referred for ADHD specifically. The present study evaluated the RCADS in 117 children (ages 8-12; 66% male) evaluated for suspected ADHD at an ADHD specialty clinic (83% met criteria for ADHD). In addition to the RCADS, children completed measures of social anxiety and depression. Parents completed the RCADS-Parent Version (RCADS-P) in addition to other measures of internalizing and externalizing symptoms. Children and parents both completed a measure of aggression. Factor structure, reliability, and convergent/discriminant validity of the RCADS were examined. Results supported the six-factor structure of the child-report RCADS (Separation Anxiety, Social Phobia, Generalized Anxiety Disorder, Panic Disorder, and Obsessive Compulsive Disorder, Major Depressive Disorder). The RCADS demonstrated adequate reliability as well as convergent and discriminant validity with other child ratings. The total anxiety score on the RCADS also demonstrated convergent and discriminant validity with parent measures, though the depression score on the RCADS did not. Findings provide preliminary psychometric support for the RCADS in children referred for ADHD.

Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms

OBJECTIVE

This study examined nighttime media use in relation to sleep problems and anxiety/depression symptoms in adolescents with attention-deficit/hyperactivity disorder (ADHD).

METHODS

Participants were 81 adolescents (69% male) ages 13-17 with ADHD. Adolescents completed measures assessing pubertal development, nighttime media use, circadian preference, and daytime sleepiness. Both adolescents and parents completed measures of sleep duration, sleep problems, and internalizing symptoms.

RESULTS

When summing across media uses (eg, social networking, playing video games, watching television), the average nighttime media use (after 9:00PM) was 5.31 h. Overall, 63% of adolescents reported obtaining less than 8 h of sleep on school nights, and this percentage rose to 77% for parent-reported sleep duration. Moreover, adolescents obtaining less sleep than recommended had more nighttime media use than those obtaining ≥8 h of nightly sleep. Controlling for age, sex, pubertal development, stimulant medication use, and ADHD symptom severity; nighttime media use was associated with shorter sleep duration and increased sleep problems across both adolescent and parent report. Media use was also associated with greater adolescent-reported anxiety and depression, and marginally associated with eveningness circadian preference and greater daytime sleepiness. In considering specific anxiety dimensions, media use was associated with greater adolescent-reported panic symptoms and parent-reported generalized anxiety disorder symptoms.

CONCLUSIONS

Our findings suggest that nighttime media use may contribute to sleep problems and comorbid internalizing symptoms in adolescents with ADHD, although additional studies are needed to determine causality, potential bidirectional associations, and underlying mechanisms such as using media to (mis)manage negative emotions. Media use is important to assess and monitor and may be a significant intervention target when addressing sleep and internalizing problems, and possible underlying cognitive-emotional processes in adolescents with ADHD.

The impact of comorbid mental health symptoms and sex on sleep functioning in children with ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) display more sleep problems than their peers, but it remains unclear whether comorbid mental health symptoms [i.e., anxiety, depression, oppositional-defiant disorder (ODD)] are uniquely related to sleep functioning. It is also largely unknown whether boys and girls with ADHD differ in their sleep functioning. This study (1) examined whether boys or girls with ADHD differ in their sleep functioning, (2) evaluated comorbid symptoms as uniquely related to sleep functioning domains, and (3) explored whether sex moderated associations between comorbid symptoms and sleep. Participants were 181 children (ages 7-13; 69% male; 82% White) diagnosed with ADHD. Parents completed measures assessing their child's ADHD symptoms, comorbid symptoms, and sleep functioning. Girls had poorer sleep functioning than boys across most sleep functioning domains. Sixty percent of children met cutoff criteria for having sleep problems, though rates differed significantly between girls (75%) and boys (53%). No differences in rates of sleep problems were found between ADHD subtypes/presentations or between younger and older children. In path models including ADHD and comorbid symptom dimensions, anxiety symptoms were uniquely associated with increased bedtime resistance and sleep anxiety, ADHD hyperactive-impulsive symptoms were associated with more night wakings and more parasomnia behaviors, and ODD and depressive symptoms were associated with shorter sleep duration. Depression was also uniquely associated with increased daytime sleepiness and overall sleep problems. Sex did not moderate associations between comorbid symptoms and sleep problems. This study provides important preliminary evidence that girls with ADHD experience more sleep problems than boys with ADHD. Findings also demonstrate that the associations between comorbid symptoms and sleep functioning in children with ADHD vary based on both the specific symptoms and sleep domains examined.