Psychiatry Research EG

Globally, current epidemiological data have reported that up to 20% of children and adolescents have a disabling psychiatric disorder [1]. Moreover, there is mounting evidence that many, if not most, lifetime psychiatric disorders will first appear in childhood or adolescence [2]. Anxiety disorders are the most common psychiatric disorders that occur in children and adolescents, followed by disruptive behavior disorders and mood disorders [3–8]. Most of these disorders are associated with severe burden and high distress for the children and their families, and lead to substantial functional, academic, and emotional impairments [9,10]. In addition, there is evidence that childhood disorders tend to continue into adolescence and adulthood if left untreated with a chronic and unremitting course [11,12]. Therefore, research into understanding, identification, and early intervention of childhood and adolescent disorders is essential, and this relies on the existence and development of feasible assessment tools [13]. Self-report instruments assessing childhood and adolescent disorders are frequently used in a wide variety of clinical and research settings, with fear, anxiety, and depression being the main areas of focus [14]. Metaanalytic reviews indicate that the majority of commonly used measures such as the Revised Children’s Manifest Anxiety Scale [15] and the Child Behavior Check List [16] are limited in their ability to discriminate between clinical disorders, and they are moderately sensitive to treatment change [17]. A notable feature of commonly used instruments is the general lack of assessments of cognitive features of psychopathology, such as self-statements/cognitive thoughts, cognitive errors, or schemas. [14]. Cognition is presumed to play a critical role in the onset and maintenance of anxiety disorders [18]. The Children’s Automatic Thoughts Scale (CATS) [13] was previously developed to assess automatic thoughts in young people across a broad spectrum of negative emotions, including internalizing and externalizing problems. The CATS consists of 40 items of self-statements covering a range of emotional content. In contrast to previous measures, the CATS was constructed with children and adolescents at each stage, from initial item generation, to testing and validation [19]. Confirmatory factor analysis of the CATS in a community sample revealed four distinct first-order factors (physical threat, social threat, personal failure, and hostility) and one high-order factor reflecting negative beliefs [13]. This factor structure was replicated in two other studies [14,20]. Previous research has shown that the CATS possesses good internal consistency, with values greater than 0.85 for all subscales, and satisfactory test–retest stability, with a test–retest correlation of 0.91 for the CATS total score [13]. In addition, initial investigations found that the CATS effectively discriminated between control and clinical children and adolescents, and was effective in discriminating between clinical subgroups on the relevant subscales [13]. Finally, the CATS has also been shown to be sensitive to treatment change [14,21]. Thus, the CATS has shown promise as a reliable and valid measure of negative automatic thoughts across both internalizing and externalizing problems in young people [22]. The majority of evaluation instruments developed for medical research originate from developed western countries and are based on the concepts, formats, norms, and expectations that are prevalent in these countries [23]. In the majority of cases, translation and transcultural adaptation of already-existing scales is carried out, as it is a more practical procedure than developing an original scale and also allows results from different countries to be compared [24]. To the best of our knowledge, there is no instrument in the Arabic language and validated for the Arab population to assess automatic thoughts in young people across a broad spectrum of emotional disorders. Assessment is usually carried out either by global appreciation (patient and doctor’s appreciations) or by the use of invalidated Arabic-translated tools.