Objective: This study used confirmatory factor analysis to examine the factor structure for the 10 core WISC–IV subtests in a group of children (N = 812) with ADHD. Method: The study examined oblique four- and five-factor models, higher order models with one general secondary factor and four and five primary factors, and a bifactor model with a general factor and four specific factors. Results: The findings supported all models tested, with the bifactor model being the optimum model. For this model, only the general factor had high explained common variance and omega hierarchical value, and it predicted reading and arithmetic abilities. Conclusion: The findings favor the use of the FSIQ scores of the WISC-IV, but not the subscale index scores.

Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12620000422921; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378317&isReview=true International Registered Report Identifier (IRRID): RR2-10.2196/45040

Social Anxiety Disorder (SAD) is a heterogeneous and distressing problem for many children and youth. This review focuses on the etiology and maintenance of SAD, and examines research findings in several key areas of investigation: genetic or hereditary factors (twin and family studies), temperament characteristics (behavioural inhibition), and parent–child interactions (attachment, parenting styles). It is concluded that genetic influences, behavioural inhibition, and parent–child interactions play significant and interactive roles in the development and maintenance of SAD. Other influences such as peer relationships, social skills deficits, and traumatic experiences are also acknowledged. Ultimately, an understanding of such pathways should facilitate effective early screening and intervention of children at risk for severe social anxiety.

The Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Brief Form (PID-5-BF), is a 25-item self-report questionnaire that measures the severity of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-proposed personality pathology constructs of negative affectivity, detachment, antagonism, disinhibition, and psychoticism. The current study used exploratory factor analysis, exploratory structural equation modeling, and confirmatory factor analysis to examine the support for the theoretically proposed 5-factor model. In total, 502 adults (male = 182, female = 320, age = 18-67 years [M = 28.93, SD = 10.95]) provided ratings for the PID-5-BF. For the theorized 5-factor model, there was support for its factor structure, internal consistency reliabilities (Cronbach's, ordinal alpha, and omega) of the factors, and coefficient of congruence of the factors considering a previous Danish study. The findings also supported a strong general factor for a bifactor model involving a general factor alongside the 5 group factors. Together, the findings support the use of the 5 personality pathology constructs and the total PID-5-BF scores in clinical and research settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).