Anxiety Disorders In Children Research Articles

Recent advances in understanding neural correlates of anxiety disorders in children and adolescents.

Anxiety disorders are some of the most common psychiatric diagnoses in children and adolescents, but attempts to improve outcome prediction and treatment have stalled. This review highlights recent findings on neural indices related to fear and anxiety that provide novel directions for attempts to create such improvements. Stimuli capable of provoking fear engage many brain regions, including the amygdala, medial prefrontal cortex, hippocampus, and bed nucleus of the stria terminalis. Studies in rodents suggest that sustained, low-level threats are particularly likely to engage the bed nucleus of the stria terminalis, which appears to malfunction in anxiety disorders. However, anxiety disorders, like most mental illnesses, appear less likely to arise from alterations in isolated brain regions than in distributed brain circuitry. Findings from large-scale studies of brain connectivity may reveal signs of such broadly distributed dysfunction, though available studies report small effect sizes. Finally, we review novel approaches with promise for using such large-scale data to detect clinically relevant, broadly distributed circuitry dysfunction. Recent work maps neural circuitry related to fear and anxiety. This circuitry may malfunction in anxiety disorders. Integrating findings from animal studies, big datasets, and novel analytical approaches may generate clinically relevant insights based on this recent work.

Non-violent resistance and family accommodation: A trans-diagnostic solution to a highly prevalent problem.

The goal of this study is to integrate two areas in recent clinical theory, research, and practice: family accommodation and non-violent resistance (NVR). Family accommodation describes changes that family members make to their own behavior, to help their relative who is dealing with psychopathology to avoid or alleviate distress related to the disorder. Rapidly growing research on family accommodation has established its high prevalence and negative impact across disorders and the life span. NVR is a trans-diagnostic treatment approach that helps parents to cope with child externalizing, internalizing, and other problems in non-escalatory ways. This study reviews empirical research on family accommodation and NVR, and argues that the anchoring function of NVR, a central concept reflecting the stabilization of the parent-child relationship, may provide a uniquely suited framework for reducing family accommodation across disorders and development. The study discusses how the anchoring function may be applied to promote accommodation reduction through a detailed description of SPACE (Supportive Parenting for Anxious Childhood Emotions), an NVR-informed treatment for childhood anxiety and obsessive-compulsive disorder.

Efficacy of psychological interventions for selective mutism in children: A meta-analysis of randomized controlled trials.

Selective mutism is a rare childhood anxiety disorder characterized by a consistent failure to speak in certain social situations where speech is expected, despite fluent speech in other situations. The purpose of this meta-analysis was to investigate the efficacy of psychological interventions for selective mutism in randomized controlled trials (RCTs). Five RCTs with a total of 233 participants were analysed using a random-effects model. A quality assessment of the included studies revealed that psychometrically sound measures and treatment manuals were used across all studies. The results of the analyses showed psychological interventions to be more effective than no treatment, with the overall weighted effect size of g = 0.87, indicating a large mean treatment effect. This effect did not significantly differ with whether only selective mutism specific or nonselective mutism specific measures were included in the analysis. These findings provide support for the efficacy of psychological treatment for selective mutism. Future research could examine the effects of the successful treatments identified in this meta-analysis when compared with a psychological placebo or another bona fide treatment.

Prevalence and course of anxiety disorders and symptoms from preschool to adolescence: a 6-wave community study.

The rate of various anxiety disorders in early childhood and whether they continue into middle childhood or adolescence is not known. We therefore report on the prevalence and stability of DSM-5-defined anxiety disorders and their symptoms, capturing the period from preschool to adolescence. By means of interviewer-based clinical interviews, anxiety was measured in a sample of Norwegian children at six measurement points from age 4 to 14 (n = 1,041). To adjust for time-invariant factors, we applied random intercept cross-lagged panel models (RI-CLPMs) capturing within-person changes. Nearly 10% (95% CI = 7.29, 12.63) had an anxiety disorder at some timepoint. Specific phobia was the most prevalent disorder in early and middle childhood, whereas generalized anxiety disorder (GAD) increased in prevalence and became the most common anxiety disorder at age 14 (4.51%, 95% CI = 2.78, 6.23). When time-invariant confounding was adjusted for, homotypic continuity in anxiety symptoms typically first emerged in late middle childhood or adolescence. Even so, such within-person analyses revealed a heterotypic path from increased number of early childhood symptoms of specific phobia to increased number of GAD symptoms in middle childhood (B = .41, 95% CI = .06, .75). Increased separation anxiety in middle childhood predicted increased symptoms of GAD in adolescence (B = .38, 95% CI = .14, .62), and vice versa (B = .05, 95% CI = .00, .09). Only minor gender differences were revealed. Anxiety disorders are prevalent in childhood. In early childhood, anxiety symptoms generally do not predict later anxiety symptoms. In middle childhood, however, such symptoms are less likely to vanish, indicating this developmental period to be particularly important for preventive and treatment efforts.

Trajectories and risk factors for anxiety and depression in children and adolescents with cancer: A 1-year follow-up.

BACKGROUNDThere is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed to longitudinally assess the trajectories and risk factors for anxiety and depressive symptoms and disorders in children and adolescents with cancer.METHODSChildren and adolescents with cancer and their parents completed the Patient‐Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety Module and were interviewed by the semi‐structured Affective and Anxiety Modules of the Kiddie Schedule for Affective Disorders and Schizophrenia for School‐Age Children (K‐SADS), at 4 time points, 1, 4, 7, and 12 months following the diagnosis of cancer.RESULTSOf the 99 patients enrolled, 48% met criteria for anxiety and/or depressive disorders at least once during the follow‐up period. There was a significant decrease in PROMIS pediatric and parent anxiety and depression scores (all p's < 0.01) and in the rate of depressive disorders over time (p = 0.02), while rates of anxiety disorders remained stable. Anxiety PROMIS pediatric and parent scores at baseline, having brain tumors and being in the acute treatment phase significantly predicted the presences of anxiety disorders at endpoint.CONCLUSIONSOur results highlight the importance of screening for anxiety and disorders in children with cancer, especially among those with brain tumors and at the acute phase of treatment.

Evaluating the association of adverse childhood experiences, mood and anxiety disorders, and suicidal ideation among behavioral health patients at a large federally qualified health center.

Although numerous studies have examined the relationship between adverse childhood experiences (ACEs) and suicide, research is needed that studies the effects of specific ACEs, including subclasses of ACEs, independent of the effect of other ACEs. We explored the relationship between ACEs and suicidal ideation (SI) with special attention to patterns according to generation cohort (millennials: 22–37 years old, generation X: 38–53 years old, and baby boomers: 54–72 years old), and assessed the extent to which mood and anxiety disorders account for the relationship between ACEs and suicidal ideation. Patients in behavioral healthcare services of a large federally qualified health center (n = 4,392) were assessed at baseline on ACEs, SI, and mood and anxiety disorders. Logistic regression modeling was used to examine the data. Emotional neglect was the strongest predictor of SI among Millennials (OR = 1.59), Generation X (OR = 1.81), and Baby Boomers (OR = 1.88) after controlling for mood and anxiety disorders, race/ethnicity, and gender. Findings suggest ACEs predict an increased likelihood of having SI over and above the influence of mood and anxiety disorders, in models adjusted for gender and race/ethnicity. Across generations, the association with suicidal ideation was strongest for any child abuse and neglect, but not for household dysfunction. The observed association of ACEs with suicidal ideation suggests that ACEs should be considered as a risk factor and incorporated into screening assessments for suicidal ideation. Lastly, additional research on the association of ACEs and suicidality in individuals not actively being managed in behavioral healthcare settings is also warranted.

Parents’ Perspectives on Guided Parent-Delivered Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Qualitative Study

Cognitive behavioral therapy (CBT) is an effective treatment for child anxiety disorders. Low-intensity forms of CBT, such as guided parent-delivered CBT (GPD-CBT), have been developed to increase access; however, it is unclear why some children benefit from this treatment and others do not. This qualitative study aimed to increase understanding of parents’ experiences of GPD-CBT and what facilitates and creates barriers to good outcomes. The sample was derived from a sample of families who took part in long-term follow-up assessments (reported in). Data were analyzed using thematic analysis. Two themes containing five subthemes were developed from the data. Theme 1 described factors influencing the experience of GPD-CBT. Theme 2 described perceived outcomes in the child and wider changes within the family. The identification of facilitators and barriers to the success of GPD-CBT could inform and improve future treatment delivery.

Familial Factors in the Development of Social Anxiety Disorder

The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].

Effects of Adversities during Childhood on Anxiety Symptoms in Children and Adolescents: Comparison of Typically Developing Children and Attention-Deficit/ Hyperactivity Disorder Group.

ObjectivesChildhood adversity is a risk factor for anxiety symptoms, but it affects anxiety symptoms in attention-deficit/hyperactivity disorder (ADHD). The current study aimed to examine the association between childhood adversity and anxiety symptoms in participants with and without ADHD.MethodsData were obtained from a school-based epidemiological study of 1017 randomly selected children and adolescents. The ADHD and non-ADHD groups were divided using the Diagnostic Interview Schedule for Children Predictive Scale (DPS). The DPS was also used to assess comorbidities such as anxiety and mood disorders. The childhood adversities were assessed using the Early Trauma Inventory Self Report-Short Form, and the anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Linear and logistic regression models were used to investigate the association between childhood adversity and anxiety in the ADHD and non-ADHD groups with adjustments for age and sex.ResultsThis study found that the ADHD group did not show any significant association between anxiety symptoms and childhood adversities, whereas the non-ADHD group always showed a significant association. In a subgroup analysis of the non-ADHD group, the normal group without any psychiatric disorders assessed with DPS demonstrated a statistically significant association between childhood adversities and anxiety symptoms. These results were consistent with the association between childhood adversities and anxiety disorders assessed using DPS, as shown by logistic regression.ConclusionThe association between anxiety symptoms and childhood adversities statistically disappears in ADHD; ADHD may mask or block the association. Further longitudinal research is necessary to investigate this relationship.

The effect of non‐directive play therapy on reduction of anxiety disorders in young children

AbstractBackgroundThere is strong evidence that non‐directive play therapy, which is also known as child‐centred play, may be useful in reducing anxiety in young children. Non‐directive play is an approach to playing where the child is given ultimate freedom rather than a practitioner impressing ideas on them.ObjectivesThe purpose of this study was to evaluate the efficacy of non‐directive play therapy for anxiety reduction in children.MethodsFor this purpose, 20 elementary students who had been diagnosed as anxious according to the Spence Children's Anxiety Scale (SCAS) were selected through random sampling and were divided into an experimental group and control group. The experimental group participated in 10 sessions of play therapy, and after finishing the sessions, the SCAS questionnaire was implemented again as a post‐test. Analysis of covariance was used to analyse the data.ResultsThe results of the study showed that scores on the anxiety scale reduced significantly in the experimental group.ConclusionsNon‐directive play therapy was useful in reducing children's anxiety, so it may be implicated as an education plan for problematic parent–child relationships. However, more studies are needed to support these results.

Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm.

Children born very preterm (VP) display altered growth in corticolimbic structures compared with full-term peers. Given the association between the cortiocolimbic system and anxiety, this study aimed to compare developmental trajectories of corticolimbic regions in VP children with and without anxiety diagnosis at 13 years. MRI data from 124 VP children were used to calculate whole brain and corticolimbic region volumes at term-equivalent age (TEA), 7 and 13 years. The presence of an anxiety disorder was assessed at 13 years using a structured clinical interview. VP children who met criteria for an anxiety disorder at 13 years (n = 16) displayed altered trajectories for intracranial volume (ICV, p < 0.0001), total brain volume (TBV, p = 0.029), the right amygdala (p = 0.0009) and left hippocampus (p = 0.029) compared with VP children without anxiety (n = 108), with trends in the right hippocampus (p = 0.062) and left medial orbitofrontal cortex (p = 0.079). Altered trajectories predominantly reflected slower growth in early childhood (0-7 years) for ICV (β = -0.461, p = 0.020), TBV (β = -0.503, p = 0.021), left (β = -0.518, p = 0.020) and right hippocampi (β = -0.469, p = 0.020) and left medial orbitofrontal cortex (β = -0.761, p = 0.020) and did not persist after adjusting for TBV and social risk. Region- and time-specific alterations in the development of the corticolimbic system in children born VP may help to explain an increase in anxiety disorders observed in this population.

Evaluation of a parent-led cognitive behaviour therapy programme in routine clinical practice: A controlled trial.

Parent-led cognitive behavioural therapy for child anxiety disorders have garnered a growing evidence base. However, it is unclear how such approaches translate into routine clinical practice. The current study aims to evaluate the effectiveness of an 8-session treatment (From Timid to Tiger) in reducing child anxiety and behavioural difficulties, as well as family accommodation. The parents of 71 children (aged 4-11) were assigned to the treatment or a waitlist control. Parent report measures were completed pre-treatment, at treatment-end, and at 3-month follow-up. Parents assigned to the waitlist were assessed 8weeks after the initial assessment. Findings indicated that parents who attended the group reported significant reductions in child anxiety and behavioural difficulties. In addition, the parents in the treatment group reported a reduction in family accommodation compared to those in the waitlist. The current control trial provides tentative evidence of the use and effectiveness of such parent-led approaches in addressing child anxiety difficulties commonly seen in routine clinical practice. PRACTITIONER POINTS: Parent-led approaches are effective treatments in managing child anxiety difficulties. Very little research to date has assessed the effectiveness of such approaches in routine clinical practice. The From Timid to Tiger program is a brief parent-led CBT intervention. The programme was effective in reducing child anxiety and behavioural difficulties. Parents also reported a reduction in behaviours related to family accommodation. Such programmes show promise and can be used in routine clinical practice.

Quantifying Session Content in the Delivery of Parent Coached Exposure Therapy

ABSTRACT Despite exposure therapy having been identified as the active ingredient in the treatment of childhood anxiety disorders (CADs), available protocols deliver a variety of anxiety management strategies (AMS) in addition to exposure. To increase the effectiveness and efficiency of treatment, Parent Coached Exposure Therapy (PCET): 1) begins exposure early (e.g., session 2 or 3) to increase session time spent on exposure, 2) does not include other AMS, and 3) involves parents at all times. The current manuscript uses audio recordings from a previous pilot study to descriptively quantify the manner in which these key components of PCET are implemented by therapists closely involved in the development of the protocol. Results indicate that implementation of PCET accurately reflected the protocol in that the majority of session time was devoted to exposure activities (.60, s.d. = 0.2), AMS were effectively excluded from treatment (.01, s.d. = .03), and that parents and youth attended almost the entirety of session time together (.98, s.d. = 0.1). These findings suggest that PCET differs meaningfully from traditional CBT for CADs and provides preliminary guidelines for how much time per session to dedicate to in-session exposure work while delivering PCET.

A therapist-guided parent-delivered self-help group for anxiety disorders in children: An effectiveness study

Standard CBT programs for childhood anxiety are costly. Low-intensity self-help treatments may increase access to evidence-based interventions. These interventions are generally promising. We tested the effectiveness of a therapist-guided parent-delivered self-help group intervention based on the “Cool Kids” program at mid-treatment, post-treatment and 6-months follow-up. We enrolled 117 families with children aged 6–12 years. Effect sizes were calculated for mother, father and child reports. Reliable change and change in clinical status were based on mother and child report. We found a significant decrease in both anxiety and depression symptoms. Effect sizes were medium to large for anxiety symptoms following treatment. Mothers reported that 53.8% of the children obtained a reliable change in anxiety symptoms from pre- to post-treatment, and 66.7% from pre- to follow-up. Out of 72.6% children who were classified as having clinical anxiety prior to treatment, 52.9% and 58.8% changed their status to non-clinical at post-treatment and follow-up, respectively. Clinical significant change, involving having achieved both a reliable change and change of status from clinical to non-clinical, was obtained for 49.4% at post-treatment, and 58.8% at follow-up based on mother reports. Our findings indicate that parent-delivered self-help CBT groups may be a valuable asset in improving access to psychological cost-effective evidence-based treatments for anxious children.

553-P: The Type 1 Diabetes High-Fidelity Wraparound (T1D HFW) Program: An Option for the Management of High-Risk Youth?

Despite advances in management, many young adolescents with T1D continue to struggle. Psychosocial factors play a major role. The T1D HFW Program is an innovative strategy to improve the adherence to medical regimens, including self-management and self-efficacy in high-risk youth. It is based on HFW, an evidence-based behavioral health concept described as a structured, team-based and individualized process that includes members who have experience either living with or raising a child with T1D. The aim of this pilot study is to test the feasibility and impact of this intervention in youth 11 to 16 years with T1D followed in a large academic diabetes center who are struggling with their management as defined by poor glycemic control and/or repeated emergency room visits and/or hospitalizations. Outcomes include assessment for behavioral, psychosocial and diabetes related measures with validated instruments. Seventeen youth enrolled and participated so far (58% females, 58% Caucasian, 23% African American, mean age 14±1.4 years, T1D duration 7.5±3.5 years, HbA1c at entry 10.3±2.3%, 65% with a deterioration in HbA1c, 45% prior diabetes related hospitalizations). A significant percent (57%) reported at least one traumatic experience including bullying (66%), witnessing violence (50%), physical/emotional abuse (33%). To date, eight families have transitioned out of the program after a mean of 6.5 months with 62.5% showing improvement and 25% no deterioration in HbA1c. Youth scoring positive for moderate depression on the PHQ-9 went from 27% to 9%. 1/3 of youth indicated positive results for generalized anxiety by the Screen for Child Anxiety Disorders (SCARED) with no change upon finishing the program. 60% of caregivers indicated a positive score on the Diabetes Distress Scale at start, which decreased to 20%. The T1D HFW program through personalized plans with identified support systems may be a promising strategy for youth struggling with T1D. Disclosure J. Schreiber: None. A. G. Nevin: None. L. Jones: None. M. W. Payne: None. K. C. Nash: None. R. Muzumdar: None. I. Libman: Advisory Panel; Self; Novo Nordisk. Funding Children’s Hospital of Pittsburgh Foundation

Feasibility and acceptability of an enhanced cognitive behavioural therapy programme for parent\u2013child dyads with anxiety disorders: a mixed-methods pilot trial protocol

BackgroundCognitive behavioural therapy (CBT) is the most widely recognised and efficacious psychological therapy for the treatment of anxiety disorders in children and adults. However, suboptimal remission rates indicate room for improvement in treatments, particularly when both children and their parents have anxiety disorders. Bidirectional transmission and maintenance of anxiety within parent–child dyads could be better targeted by CBT, to improve treatment outcomes for children and parents with anxiety disorders. This study aimed to develop and evaluate the feasibility and acceptability of a concurrent parent–child enhanced CBT intervention that targets the individual’s anxiety disorder(s), as well as the bidirectional factors that influence and maintain anxiety in the dyad.MethodsFeasibility and acceptability of the proposed CBT protocol will be evaluated in an open-label pilot trial of the intervention utilising qualitative and quantitative data collection. Ten parent–child dyad participants (n = 20) with anxiety disorders will be recruited for the proposed intervention. The intervention is based on an empirically supported 10-week CBT programme for anxiety disorders in adults, adapted to be delivered to parent–child dyads concurrently, and to target anxious modelling and overprotective behaviours through joint observational exposures. Intervention feasibility will be explored by pre-post symptom change on a range of clinician- and self-report measures to determine preliminary indications of participants’ intervention response and effect size calculations to estimate sample size for a future definitive randomised controlled trial (RCT). Additional feasibility measures will include recruitment rates, completion rates, and adherence to programme requirements. To explore participant acceptability of the intervention, qualitative interviews will be conducted with five parent–child dyads who complete the intervention (n = 10), along with five parent–child dyads with anxiety symptoms who express interest in the intervention (n = 10). Acceptability measures will include prospective and retrospective quantitative self-report and qualitative interview data.DiscussionThis pilot trial will utilise a mixed-methods design to determine the feasibility and acceptability of delivering an enhanced CBT intervention for the concurrent treatment of parent–child dyads with anxiety disorders. The results of this trial will inform the development and implementation of a future definitive randomised clinical trial to evaluate intervention efficacy.Trial registrationAustralian and New Zealand Clinical Trials Registry, ANZCTR1261900033410. Prospectively registered: pre-results. Registered 04 March 2019.

Investigating the Effect of Implementing a Family-Friendly Program (Based on the MBCT Approach with Parent-Child Interaction) on the Reduction of Parental Anxiety Sensitivity and Separation Anxiety Disorder in Children and Adolescents

This study aimed to investigate the effect of the family-friendly program (FFP) on reducing parental anxiety sensitivity (PAS) and also Separation Anxiety disorders (SAD) in children and adolescents. Subjects in both groups responded to the Screen for Child Anxiety Related Disorder-71 (SCARED-71) (to diagnose separation) and the anxiety sensitivity questionnaire for parents, before intervention (pretest) and immediately after the intervention (posttest). ANCOVA test via SPSS 23 showed that there was a significant difference between the test and control groups in the post-test (p < 0.0001). Teaching FFP affects reducing PAS and also SAD in children and adolescents.

Parental Beliefs about Child’s Experience of Anxiety in Saqr Hospital Ras Al-Khaimah, U.A.E

Anxiety is a reaction of an individual to change or a stressful event. Separation anxiety, fear of darkness, stranger anxiety etc., are normal features of development during the initial part of life. However, if it persists and not identified at an early stage can lead to anxiety disorders in children. Parents play an important role in its identification at an early stage and management to protect the child from long term consequences of anxiety disorders. It imposes them to have an appropriate belief about the experience of their child’s anxiety. Cross sectional survey was conducted among 252 parents who visited Saqr hospital for various health care issues. Participants were selected using a convenience sampling technique. Data was collected with the use of a self-reported Parental Belief about child's anxiety questionnaire (PBA-Q). Majority (93.7%) of parents had a moderate level and 5.6% had a highly negative belief about the experience of their child’s anxiety. No significant association was observed between Parental Belief about a child's anxiety and demographic variables like age, gender, education. However, a significant association was observed with the household income of the family. Parents being the primary and most influential caregiver, play a significant role in the emotional health of the children. Findings of the present study strongly recommend regular assessment of parents belief about the experience of anxiety in children and provide guidance to minimize anxiety disorders in children. PBA-Q is a simple tool that can be used in day to day practice.

Anxiety symptoms and their frequencies in albanian children: Differences by age, gender and other variables

IntroductionAnxiety symptoms in childhood represent an important risk factor for developing anxiety disorders in subsequent developmental stages. This study examines the frequency and characteristics of the symptoms of the principal anxiety disorders in children and adolescents using a self-report questionnaire based on the diagnostic categories of the American Psychiatric Association (APA) manual.ObjectivesOur main aim was to have a bigger view of anxiety symptoms spectrum in Albanian children, their frequencies and diferences related to age, gender or other variables.MethodsA cross-sectional, non-interventional study was conducted on 50 children/adolescents aged 8 to 17 years (45% males), frequenting Child/Adolescent Psychiatric Service, who completed the Spence Children’s Anxiety Scale.ResultsMore than one in four of the children and adolescents showed high scores in any anxiety disorder. The anxiety symptoms due to separation were the most frequent in the sample (5.5%), followed by physical fears. Girls scored significantly higher in all disorders (P &lt; .001), except in obsessive-compulsive disorder. Differences were found as regards to age in all disorders, except physical fears, but the effect sizes were only in anxiety due to separation, which decreased with age, and generalized anxiety, which was higher in adolescents than in children.ConclusionsThis study puts emphasizes to the early detection of anxiety symptoms in children, in order to provide the early and effective intervention and prevent the development of anxiety disorders in later life.DisclosureNo significant relationships.

The Effectiveness of a Coping Cat Program on Symptoms of Anxiety Disorders in Primary Schools

Background: Anxiety disorders are the most common disorders in children that affect the psychological and social functioning of the child. Recently, researchers have used the coping cat programs as a way to reduce anxiety disorders. Therefore the current study aimed to investigate the effectiveness of a coping cat program on symptoms of anxiety disorders in primary schools. Materials and Method: This study was performed in a pre-test, post-test compared to the control group. The statistical population included all children aged 8 to 11 years with anxiety disorders in five state primary schools in the second district of Bandar Abbas, Iran in 2019. The sampling using a questionnaire (SCAS), 32 children with anxiety disorders were selected from schools and randomly divided into control (n=16), and experimental (n=16) groups. Members of the experimental group were (CCP) training intervention for 16 sessions, twice a week for 45-minute. The control group did not receive any intervention. The anxiety was assessed one week after intervention by The Spence Children's Anxiety Scale (SCAS) in the control and experimental groups. Data were analyzed by SPSS version 23. Results: The experimental and control groups were homogeneous before intervention. The mean anxiety in the intervention group after the coping cat program including the Separation anxiety disorder (‎3.56±2.09)‎, Panic disorder (‎‎2.12±2.15), Obsessive-compulsive (3.81±2.007)‏‎, physical injury fears (4.06±3.08‏‎) was significantly lower than that in the control group (9.81±3.54), (7±3.07), (9.43±3.28) and (7.37±3.36) respectively (P <0.05). Conclusion: The results showed that (CCP) in 16 sessions by recognizing the symptoms of unwanted anxiety in children and using these symptoms to apply anxiety management strategies leads to a reduction of anxiety disorders in children.