The feasibility and validity of a daily diary for the assessment of anxiety in children

doi:10.1016/S0005-7894(05)80342-9

Behavior Therapy

Volume 22, Issue 4, Autumn 1991, Pages 505-517

https://doi.org/10.1016/S0005-7894(05)80342-9 Get rights and content

The use of a daily diary to assess the range and frequency of anxious events in young children was examined. The results indicated that although further modifications in procedure may be necessary to address the child's maturational age, self-monitoring is a feasible assessment strategy for use with anxious children. Furthermore, the findings that anxious children report significantly more emotional distress and more negative behaviors such as crying, somatic complaints or behavioral avoidance provide some initial validity for the use of this assessment format. The results are discussed in terms of the utility and validity of a diary format and its ability to enhance our clinical understanding of childhood anxiety disorders.

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Pegasys-VR™ (Wong Sarver et al., 2014) was developed to address the two components of SET-C that were difficult to implement in clinical practice settings: (a) the use of friendly, outgoing peers to assist in peer generalization sessions, and (b) assigning homework that was dependent upon parental cooperation. The initial version used a virtual school environment and six characters/avatars, a principal, classroom teacher, gym teacher, and three same-age peers, which represented classmates identified by children with SAD as typically creating distress when they are engaged in social interactions—that is, children perceived as socially popular, academically talented or bullying (Beidel et al., 1991). The initial version focused on four social skill areas (greetings and initiating conversations, maintaining conversations through asking open-ended questions, giving and receiving compliments, and assertiveness; see Wong Sarver et al., 2014, for details).
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One method that may address these limitations is the use of a parent-report daily diary. Several researchers have examined parental daily diary reports of anxiety in anxious and healthy comparison school-age children and adolescents, typically to characterize the phenomenology of anxiety in older youth or assess the impact of an intervention (Allen, Blatter-Meunier, Ursprung, & Schneider, 2010; Beidel, Neal, & Lederer, 1991; Beidel, Turner, & Morris, 1999; Beidel, Turner, & Morris, 2000; Eisen, Raleigh, & Neuhoff, 2008). These studies demonstrated the feasibility of daily assessment of children’s anxiety.
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Using Self-Monitoring: Implementation of Collaborative Empiricism in Cognitive-Behavioral Therapy
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Conceptualization and evaluation of the psychometric properties of self-monitoring are discussed by Jackson (1999), but key points are worth noting. First, reliability is often demonstrated in self-monitoring procedures with retest stability, particularly for traits such as anxiety (Beidel et al., 1991; Silverman & Ollendick, 2005) and eating disorder attitudes and urges (Tasca et al., 2009). Reliability of specific behaviors that are expected to fluctuate over time pose more difficulty, and clinicians and investigators may look to whether similar behaviors consistently elicit similar responses.
Self-monitoring is an important clinical technique used in cognitive-behavioral therapy. It is frequently used for homework assignments in the context of comprehensive treatments. A description of self-monitoring and practical considerations is presented, followed by an examination of self-monitoring as a means to facilitate collaborative empiricism in therapy. It may foster collaboration between therapist and client in collecting and reviewing essential data, inform treatment planning, and enhance the client's sense of agency. A clinical case example is included to provide an emphasis on clinical application. We conclude by noting potential mechanisms for facilitating change through the use of self-monitoring. Continued examination of applied clinical practice, including strategies such as self-monitoring, is needed to further our understanding of the mechanisms of therapeutic change.
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For purposes of the present study, the overall RCMAS-total, RCMAS-Phy, and RCMAS-W/O subscales were used as treatment outcome measures to determine end-state functioning status (to be discussed). Although child participants were largely responsible for reporting the frequency of separation-anxious events per day, this process was made a family endeavor to enhance accuracy and reliability (Beidel, Neal, & Lederer, 1991). Parents, however, were fully responsible for recording these events via daily diaries (DD; Eisen & Silverman, 1998; see Eisen & Schaefer, 2005).
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Quantitative and qualitative research approaches to assess student well-being
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Although there is dissimiliarity in theoretical research approaches to subjective well-being and to assessments of well-being, there is agreement regarding the value of well-being, especially among student populations. In the highly structured, achievement-oriented, non-optimal context of a classroom, individual well-being is a necessary pre-condition for learning. Among student populations well-being should not be construed as an achievement enhancer; but, rather, recognized and measured as an educational value of its own. However, it is necessary for the positive bias towards learning at least in highly structured, achievement-orientated, non-optional learning contexts like school [cf. Hascher, T. (2004). Wohlbefinden in der Schule. Münster: Waxmann]. How can it be measured?
Since different research approaches lead to a variety of instruments, the following paper will focus on two ways of assessing well-being in school: a questionnaire on student well-being (N = 2014)¹ and a semi-structured daily diary about relevant emotional situations in school (N = 58, period 3 × 2 weeks). Both methods are introduced and their methodological quality is discussed in terms of reliability, validity and in terms of their usefulness for improving school practice. Furthermore, the research potential of combining quantitative and qualitative data on students’ well-being is addressed.
Assessment of generalized anxiety disorders and worry among children and adolescents
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Les inquiétudes excessives, caractéristiques centrales du Trouble d’anxiété généralisée (TAG), entraînent des conséquences majeures dans le fonctionnement académique, sociale et personnel des enfants et des adolescents (Albano & Hack, 2004). Malgré leur fréquence élevée et les conséquences néfastes qui leur sont associés, les inquiétudes et l’anxiété généralisée sont encore peu étudiées auprès de ces groupes d’âges. Par ailleurs, les cliniciens ont souvent de la difficulté à les évaluer puisque la plupart des instruments disponibles et fréquemment utilisés dans la littérature s’en tiennent à l’évaluation des symptômes physiques de l’anxiété et permettent peu d’évaluer les inquiétudes ou les critères de l’anxiété généralisée. Des outils de mesures spécifiques ont toutefois récemment été développés, notamment auprès des adultes, pour évaluer ces construits. L’objectif de la zzzprésente étude consiste à réaliser une revue critique des instruments présentés dans la littérature pour évaluer le TAG et les inquiétudes des enfants et des adolescents. Les entrevues diagnostics, les questionnaires auto-rapportés et les grilles d’observation furent sélectionnés à partir des banques de données MEDLINE (1986-2006/12) et PsycINFO (1983-2006/12). Les avantages, inconvénients ainsi que les qualités psychométriques des instruments sont discutés. Par ailleurs, lorsque des informations normatives étaient disponibles celles-ci ont été rapportées. Des recommandations sont formulées quant aux recherches futures à effectuer dans le domaine de l’évaluation du Trouble d’anxiété généralisée et des inquiétudes excessives chez les enfants et les adolescents.
Excessive worries, which are the core feature of Generalized Anxiety Disorder (GAD), are associated with serious consequences for children and adolescents. According to Albano and Hack (2004), worry, as well as GAD, affects many dimensions of academic, social and personal functioning among these populations (Albano & Hack, 2004). In spite of the important prevalence of this phenomenon among children and adolescents and their negative consequences, there are still few studies conducted among these age groups. Moreover, few instruments have been developed in order to effectively assess worry and GAD among children and adolescents. Frequently used instruments assess physical symptoms of anxiety and often ignore GAD criteria or worry. The goal of the present study is to review available instruments used in the literature on GAD and worry to assess children and adolescents. Relevant clinical structured interviews, self-report questionnaires and self-observation sheets are selected, identified from MEDLINE (1986-2006/12) and PsycINFO (1983-2006/12) databases. Advantages, inconvenients and psychometric properties of each assessment tool are discussed. Normative data, when available, are also presented. Research and clinical recommendations are suggested in order to better assess GAD and excessive worry among children and adolescents.

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^*: This study was supported in part by NIMH Grants MH43252 and MH18269. The authors wish to thank Karen Trager, M.A., and Jonathan Rubin for their assistance with the data collection and data analytic procedures.

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The feasibility and validity of a daily diary for the assessment of anxiety in children*

Behavior Therapy

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Clinical Psychology Review

Diagnostic and statistical manual of mental disorders

Comorbidity of test anxiety and other anxiety disorders in children

Journal of Abnormal Child Psychology

An investigation of children's fears and their mothers' fears

Journal of Psychopathology and Behavioral Assessment

Principles of behavioral assessment

Baseline adherence as a predictor of dropout in a children's weight-reduction program

Journal of Consulting and Clinical Psychology