Disorders - Anxiety Disorders
Bernstein, G. A., Bernat, D. H., Victor, A. M., Layne,
A. E.
Objective: To follow 61 participants (7-
11 years old) from a study that compared three school-based interventions for anxious children: group cognitive-behavioral therapy (CBT) for
children, group CBT for children plus parent training, and no-treatment control to determine whether posttreatment benefits are sustained
longitudinally. Method: Parent, child, and clinician report measures of child anxiety were completed at 3, 6, and 12 months posttreatment.
Semistructured diagnostic interviews were administered at 6- and 12-month follow-ups. For initial analyses, the group CBT and group CBT plus parent
training conditions were collapsed into one group and compared to control. When significant results were found, each active treatment group was
compared to control. Results: Across several measures, the collapsed CBT group sustained significant improvement in anxiety severity and impairment
across a 12-month period compared to control. There were no significant differences between the three groups on remission of baseline anxiety
disorders or incidence of new anxiety disorders during the follow-up. Several parent-report measures at 3 and 6 months posttreatment suggested that
group CBT for children plus parent training provided additional benefit over the group CBT for children when each was compared to the control group.
Conclusions: School-based CBT appears effective in decreasing anxiety symptoms up to 12 months posttreatment for anxious children. copyright2008 by
the American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent
Psychiatry., 47(9) : 1039-1047
- Year: 2008
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Bodden, D. H. M., Bogels, S. M., Nauta, M. H., DeHaan, E., Ringrose, J., Appelboom, C., Brinkman, A. G., Appelboom-Geerts, K. C. M. M. J.
Objective: The
efficacy and partial effectiveness of child-focused versus family-focused cognitive-behavioral therapy (CBT) for clinically anxious youths was
evaluated, in particular in relation to parental anxiety disorders and child's age. Method: Clinically referred children with anxiety disorders (N =
128) and their parents were randomly assigned to child or family CBT and evaluated at pretreatment, posttreatment, and 3-month follow-up. Twenty-five
families were measured before and after a 2- to 3-month waitlist period. Results: None of the waitlisted children recovered from their anxiety
disorders. In contrast, 41% of the treated children no longer met criteria for any anxiety disorder after CBT, and 52% demonstrated continued
improvement at the 3-month follow-up. Significantly more children were free of anxiety disorders (53%) in the child CBT condition compared with
family CBT condition (28%) at posttreatment, whereas at 3-month follow-up, the superior effect of child CBT was no longer significant. Similar
results were obtained from the questionnaire measures. Both child and family CBT were less effective if parents had an anxiety disorder themselves.
On some of the measures, child CBT was superior if parents had anxiety disorders themselves, whereas family CBT was superior if parents had no
anxiety disorders. Finally, younger children had better outcomes than older children, regardless of the treatment condition. Conclusions: Overall,
child CBT seems slightly more beneficial than family CBT. Because this study was conducted in a clinical setting with clinically referred children,
results indicate partial effectiveness for child CBT. (copyright)2008 by the American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 47(12) : 1384-
1394
- Year: 2008
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
OBrien, F., Olden, N., Migone, M., Dooley, B. Atkins, L., Ganter, K., Bates, A.
Objectives: This study evaluated
the effectiveness of group cognitive behavioural therapy (GCBT) for the treatment of anxiety disorders in children over an initial period of 12 weeks
and to one-month follow-up. Parents of the children receiving GCBT participated in adjunctive psycho-education sessions and the effect of these
sessions on parental anxiety was also evaluated. Methods: Participants were 12 children, six male and six female, aged between 11 and 15 years who
were attending a child mental health service. Participants were interviewed with their parents and anxiety symptoms assessed, using the following
measures: Anxiety Disorder Interview Schedule - revised, the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the
Coopersmith Self-Esteem Inventory and the Child Behaviour Checklist. Parental anxiety levels were assessed using the Depression, Anxiety and Stress
Scale. The 12 children were randomly assigned into two age- and sex-matched groups. While the first group received therapy, the second group acted as
a treatment-as-usual control (TAU) group. The second group began group cognitive behavioural therapy after the 10-week waiting period. All
participants and their parents provided structured feedback on the intervention. Results: Group cognitive behavioural therapy was significantly
effective in reducing both child-reported depressive symptoms, and anxiety on the physiological, worry and total anxiety subscales of the Revised
Children's Manifest Anxiety Scale. There were associated significant increases in the childrens' subjective levels of general and total self-
esteem, that relating to their self-confidence with peers and when engaging in social and academic pursuits. Diagnosis of anxiety disorder reduced by
an average of 67% immediately post-treatment, and by 72% by the onemonth follow-up period. Parents reported significant reductions in their
children's levels of internalising symptoms, thought and attention problems. However, parents reported no significantly positive changes in their
own levels of depression, anxiety and stress symptoms. Conclusions: Group cognitive-behavioural therapy is a useful and clinically effective
intervention for the treatment of anxiety disorder in children. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Irish Journal of Psychological Medicine, 24(1) : 5-
12
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Chu, Brian C., Harrison, Tara L.
The commonalities between anxiety and depression have been discussed before, but few have delineated the potentially different
mechanisms through which treatments work for these populations. The current study conducted a comprehensive review of child and adolescent randomized
clinical trials that tested cognitive-behavioral therapy (CBT) for anxiety or depression. All studies were required to have assessed both treatment
outcomes and at least one theory-specific process target, including behavioral, physiological, cognitive, and coping variables. Using a meta-analytic
approach, CBT demonstrated positive treatment gains across anxiety, depression, and general functioning outcomes. CBT for anxiety also produced
moderate to large effects across behavioral, physiological, cognitive, and coping processes, with behavioral targets demonstrating potentially the
greatest change. CBT for depression produced small effects for cognitive processes but nonsignificant effects for behavioral and coping variables.
Findings were generally consistent with CB theory but suggest potentially different mediators in the treatment of anxiety and depression. Results are
discussed in terms of implications for mechanisms research, theories of change, and treatment development.
Clinical Child & Family Psychology Review, 10(4) : 352-
72
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Cukrowicz, K. C., Joiner Jr, T. E.
This research was designed to examine the efficacy of a brief cognitive-behavioral psychoeducation model as an
intervention for depressive and anxious symptoms, based on the Cognitive-Behavioral Analysis System of Psychotherapy (CBASP). One hundred fifty two
participants were randomly assigned to the control and prevention groups. These participants completed symptom ratings of depression and anxiety at
baseline, and again eight weeks later. Multivariate Analysis of Covariance (MANCOVA) revealed a significant effect of group, with the intervention
group showing lower symptom scores at the follow-up session. The implications of this study include the development of the CBASP method as a
computer-based prevention and intervention strategy. copyright 2007 Springer Science+Business Media, LLC.
Cognitive Therapy & Research., 31(5) : 677-693
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
deGroot, J., Cobham, V., Leong, J., McDermott, B.
Objective: The aim of the present study
was to compare the relative effectiveness of group and individual formats of a family-focused cognitive-behavioural intervention, for the treatment
of childhood anxiety disorders. Method: Twenty-nine clinically anxious children aged between 7 and 12 years were randomly allocated to either
individual cognitive-behaviour therapy (ICBT) or group cognitive-behaviour therapy (GCBT). Results: At post-treatment assessment 57% of children in
the ICBT condition no longer met criteria for any anxiety disorder, compared to 47% of children in the GCBT condition. At 3 month follow up these
improvements were retained with some weakening. By the 6 month follow up 50% of children in the ICBT compared to 53% of children in the GCBT
condition were anxiety diagnosis free. In terms of questionnaire data, no significant differences were detected between the ICBT and GCBT conditions
at any of the follow-up points. However, a significant treatment effect for time was found, with both self-reports and parent reports indicating a
significant reduction over time in anxiety symptoms. Conclusion: Overall, results suggest that children with anxiety disorders appear to improve
following a family-focused cognitive behavioural intervention, regardless of individual or group administration. The interpretation and potential
clinical implications of these findings are discussed, together with the limitations of this study and suggestions for future research.
Australian & New Zealand Journal of Psychiatry., 41(12) : 990-997
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Creswell, Cathy, Cartwright-Hatton, Sam
Anxiety of childhood is a common and serious
condition. The past decade has seen an increase in treatment-focussed research, with recent trials tending to give greater attention to parents in
the treatment process. This review examines the efficacy of family-based cognitive behaviour therapy and attempts to delineate some of the factors
that might have an impact on its efficacy. The choice and timing of outcome measure, age and gender of the child, level of parental anxiety, severity
and type of child anxiety and treatment format and content are scrutinised. The main conclusions are necessarily tentative, but it seems likely that
Family Cognitive Behaviour Therapy (FCBT) is superior to no treatment, and, for some outcome measures, also superior to Child Cognitive Behaviour
Therapy (CCBT). Where FCBT is successful, the results are consistently maintained at follow-up. It appears that where a parent is anxious, and this
is not addressed, outcomes are less good. However, for children of anxious parents, FCBT is probably more effective than CCBT. What is most clear is
that large, well-designed studies, examining these factors alone and in combination, are now needed. [References: 82]
Clinical Child & Family Psychology Review, 10(3) : 232-
52
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Compton, S. N., Kratochvil, C. J., March, J. S.
Childhood-onset anxiety disorders are among the most common problems affecting children and
adolescents, with an estimated prevalence of greater than 10%. Although common, childhood-onset anxiety disorders are not benign. Anxiety in children
and adolescents can range from mild worries to incapacitating symptoms, which can significantly interfere with functioning. Children with anxiety
disorders are at increased risk for later anxiety, depression, illicit drug dependence, educational underachievement, suicide attempts, and
psychiatric hospitalization. Over the past three decades, researchers have investigated a variety of psychopharmacologic agents for the treatment of
these disorders.
Pediatric Annals., 36(9) : 586-598
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)
Levy, K., Hunt, C., Heriot, S.
OBJECTIVE: The aim of the study was to evaluate the effectiveness of an intervention that targeted both
anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. METHOD: The effects of a cognitive-
behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared with a standard cognitive-behavioral therapy
intervention targeting anxiety only. The study was conducted over a period of 2 years, and 69 families were included, with participating children
ranging in age from 8 to 14 years. Intervention effects were evaluated at posttreatment and 3 months following treatment. RESULTS: An intent-to-treat
analysis identified few significant differences between conditions in level of improvement following treatment and at follow-up, with the exception
of parent-reported stress, anxiety, and depression, which improved in the anxiety treatment condition. Both treatment programs led to significant
reductions in parent-reported child externalizing and internalizing problems and child-reported internalizing problems and to improved parenting
practices. CONCLUSIONS: Comorbidity did not appear to significantly affect treatment outcome for anxiety disorders, and combining existing treatments
to address comorbid problems did not enhance treatment effectiveness. Further trials are required to assess the effectiveness of an expanded combined
treatment program that allows adequate time to address both internalizing and externalizing problems. Copyright 2007 copyright American Academy of
Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry., 46(9) : 1111-
1118
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Ishikawa, S.
I., Okajima, I., Matsuoka, H., Sakano, Y.
We conducted a meta-analysis using 20 randomised controlled studies of cognitive behavioural therapy (CBT) for
anxiety disorders in children and adolescents. The mean pre-post effect size was d = 0.94, which was maintained at follow-up. The mean effect size
when comparing the CBT and control group was d = 0.61. Within the CBT group, the mean effect size of university clinics (d = 0.77) was larger than
that of other clinics (d = 0.37). The difference in effect sizes was hardly noticeable when comparing CBT with family or parents and CBT with child
only (d = 0.03). Further studies are required to examine the effectiveness of family CBT versus child CBT. copyright 2007 Association for Child and
Adolescent Mental Health.
Child & Adolescent Mental Health., 12(4) : 164-172
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
In-Albon, T., Schneider, S.
Background: The present study compared the efficacy of psychotherapy for
childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder). Methods: The meta-
analysis included studies that met the basic CONSORT (consolidated standards of reporting trials) criteria. Several outcome variables (e.g. effect
sizes, percentage of recovery) were analyzed using completer and intent-to-treat analyses during post-treatment and follow-up assessment. Twenty-four
studies published by March 2005 were included in this meta-analysis. Results: In all the included studies, the active treatment condition was
cognitive-behavioral. The overall mean effect of treatment was 0.86. No differences in outcome were found between individual and group treatments or
child- and family-focused treatments. Follow-up data demonstrated that treatment gains were maintained up to several years after treatment.
Conclusions: These findings provide evidence that anxiety disorders in children can be treated efficaciously. The gathered data support the clinical
utility of cognitive-behavioral therapy in this regard. Randomized controlled trial studies investigating treatments other than cognitive-behavioral
therapy are missing. Copyright copyright 2007 S. Karger AG.
Psychotherapy & Psychosomatics., 76(1) : 15-24
- Year: 2007
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Panic
Disorder, Social phobia (social anxiety disorder), Specific
Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Reinblatt, S. P., Riddle,
M. A.
Rationale: Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and
academic function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and increasing
empirical evidence helps guide current clinical practice. Objective: To review studies which examine the pharmacological treatment of pediatric
anxiety disorders, including obsessive-compulsive disorder and to summarize treatment implications. Methods: All relevant studies were searched using
MEDLINE and PsycINFO search engines, supplemented by a manual bibliographical search; studies published between 1985 and 2006 that met inclusion
criteria were examined. Results: This article provides a systematic review of the psychopharmacological treatment of pediatric anxiety disorders
based on available empirical evidence, with a focus on randomized controlled trials. General treatment principles and pharmacological management of
specific pediatric anxiety disorders are also reviewed. Conclusion: There is good evidence to support the efficacy of several pharmacological agents
including the selective serotonin reuptake inhibitors to treat pediatric anxiety and obsessive-compulsive disorder, although there are still many
unanswered questions. copyright 2007 Springer-Verlag.
Psychopharmacology., 191(1) : 67-86
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)