Anxiety Problems In Children Research Articles

Family Centered Care Berhubungan dengan Kecemasan Anak Usia Prasekolah yang Menjalani Hospitalisasi di UPTD RSUD Jend. Ahmad Yani Metro

Being sick and being hospitalized is a major crisis for children, while children still have limited coping mechanisms to deal with problems so that children easily experience anxiety about undergoing hospitalization, this condition can affect the immune response and impact the length of the healing process. Efforts that can be made by health workers, especially nurses, to reduce the level of anxiety in children is through family centered care. The aim of this research is to determine the relationship between family centered care and anxiety in preschool aged children undergoing hospitalization. Research design is a correlation study, cross-sectional design. The population in this study were preschool children undergoing hospitalization. The sample used was 58 people. Data analysis in this study was carried out using the Somer's d test.The research results showed that the distribution of family centered care was mostly in the good category (55.2%), and the majority of preschool aged children undergoing hospitalization experienced mild anxiety (62.1%). The results of the analysis show that there is a relationship between family centered care and anxiety in preschool aged children undergoing hospitalization (p-value = 0.001). The correlation coefficient obtained was r 0.413, the direction of the correlation was positive with the strength of the relationship being in the medium category, meaning that the better the family centered care, the anxiety symptoms of pre-school aged children undergoing hospitalization would decrease. It is hoped that family centered care can be implemented optimally to help overcome anxiety problems in children undergoing hospitalization.

Digitally augmented, parent-led CBT versus treatment as usual for child anxiety problems in child mental health services in England and Northern Ireland: a pragmatic, non-inferiority, clinical effectiveness and cost-effectiveness randomised controlled trial

Anxiety problems are common in children, yet few affected children access evidence-based treatment. Digitally augmented psychological therapies bring potential to increase availability of effective help for children with mental health problems. This study aimed to establish whether therapist-supported, digitally augmented, parent-led cognitive behavioural therapy (CBT) could increase the efficiency of treatment without compromising clinical effectiveness and acceptability. We conducted a pragmatic, unblinded, two-arm, multisite, randomised controlled non-inferiority trial to evaluate the clinical effectiveness and cost-effectiveness of therapist-supported, parent-led CBT using the Online Support and Intervention (OSI) for child anxiety platform compared with treatment as usual for child (aged 5-12 years) anxiety problems in 34 Child and Adolescent Mental Health Services in England and Northern Ireland. We examined acceptability of OSI plus therapist support via qualitative interviews. Participants were randomly assigned (1:1) to OSI plus therapist support or treatment as usual, minimised by child age, gender, service type, and baseline child anxiety interference. Outcomes were assessed at week 14 and week 26 after randomisation. The primary clinical outcome was parent-reported interference caused by child anxiety at week 26 assessment, using the Child Anxiety Impact Scale-parent report (CAIS-P). The primary measure of health economic effect was quality-adjusted life-years (QALYs). Outcome analyses were conducted blind in the intention-to-treat (ITT) population with a standardised non-inferiority margin of 0·33 for clinical analyses. The trial was registered with ISRCTN, 12890382. Between Dec 5, 2020, and Aug 3, 2022, 706 families (706 children and their parents or carers) were referred to the study information. 444 families were enrolled. Parents reported 255 (58%) child participants' gender to be female, 184 (41%) male, three (<1%) other, and one (<1%) preferred not to report their child's gender. 400 (90%) children were White and the mean age was 9·20 years (SD 1·79). 85% of families for whom clinicians provided information in the treatment as usual group received CBT. OSI plus therapist support was non-inferior for parent-reported anxiety interference on the CAIS-P (SMD 0·01, 95% CI -0·15 to 0·17; p<0·0001) and all secondary outcomes. The mean difference in QALYs across trial arms approximated to zero, and OSI plus therapist support was associated with lower costs than treatment as usual. OSI plus therapist support was likely to be cost effective under certain scenarios, but uncertainty was high. OSI plus therapist support acceptability was good. No serious adverse events were reported. Digitally augmented intervention brought promising savings without compromising outcomes and as such presents a valuable tool for increasing access to psychological therapies and meeting the demand for treatment of child anxiety problems. Department for Health and Social Care and United Kingdom Research and Innovation Research Grant, National Institute for Health and Care (NIHR) Research Policy Research Programme, Oxford and Thames Valley NIHR Applied Research Collaboration, Oxford Health NIHR Biomedical Research Centre.

Statistical analysis plan for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice: identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i)

BackgroundThe Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i) trial is being conducted to establish whether ‘screening and intervention’, consisting of usual school practice plus a pathway comprising screening, feedback and a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety), bring clinical and health economic benefits compared to usual school practice and assessment only — ‘usual school practice’, for children aged 8–9 years in the following: (1) the ‘target population’, who initially screen positive for anxiety problems according to a two-item parent-report child anxiety questionnaire — iCATS-2, and (2) the ‘total population’, comprising all children in participating classes. This article describes the detailed statistical analysis plan for the trial.Methods and designiCATS-i2i is a definitive, superiority, pragmatic, school-based cluster randomised controlled trial (with internal pilot), with two parallel groups. Schools are randomised 1:1 to receive either screening and intervention or usual school practice. This article describes the following: trial objectives and outcomes; statistical analysis principles, including detailed estimand information necessary for aligning trial objectives, conduct, analyses and interpretation when there are different analysis populations and outcome measures to be considered; and planned main analyses, sensitivity and additional analyses.Trial registrationClinicalTrials.gov ISRCTN76119074. Registered on 4 January 2022

Effectiveness of an online parenting program for childhood anxiety in North Macedonia

Anxiety is considered a basic and adaptive emotion. However, anxiety problems are one of the most prevalent mental health problems, with multiple negative effects and a tendency to worsen with age. The high prevalence rates and their negative consequences accent the importance of developing timely and effective prevention strategies. The aim of the study was to evaluate the effectiveness of an online parenting program in reducing anxiety symptoms in young children in the Republic of North Macedonia. Materials and methods: A controlled randomized controlled study was conducted including parents of children aged 2-9 years old in North Macedonia. Eligible parents were assessed at baseline and post-intervention, using self-report questionnaires on sociodemographic characteristics and childhood anxiety (CBCL anxiety scale, CBCL-A; CBCL anxiety/depression scale, CBCL-AD). Parents were assigned to five group sessions of a parenting program, as the intervention group, or a structured group presentation, as a control group. Results: A total of 288 parents were included in the study. The findings showed significant reductions in childhood anxiety symptoms reported by parents in both the parenting program and the active control condition. However, between-group comparisons showed no significant differences between the two conditions. Conclusions:The study is the first to evaluate the effectiveness of an online group parenting program in reducing anxiety symptoms in young children in North Macedonia. The findings demonstrate that it is possible to achieve a significant change in child anxiety problems, using technology-assisted methods of intervention delivery in the country.

Attachment and comorbid anxiety in ADHD.

Anxiety comorbidity is quite common in children with attention-deficit hyperactivity disorder (ADHD). What is known about the relationship between anxiety, attachment and emotion regulation in such children is still limited. We aimed to investigate the associations between attachment, emotion regulation and comorbid anxiety in children with ADHD. 100 children with ADHD and 100 children without any diagnosis aged 8-13years were included. After the participants were clinically evaluated, Turgay ADHD Scale, Emotion Regulation Checklist, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and Kerns' Security Scale were completed. According to the RCADS-CV scores, ADHD/ANX(+), ADHD/ANX(-), and control groups were formed. The emotional lability/negativity levels were higher in the ADHD groups compared to the non-ADHD controls. Paternal and maternal attachment security levels were lower in the ADHD/ANX(+) group compared to the controls. The regression analysis indicated that higher hyperactivity/impulsivity symptom levels and lower maternal attachment quality were associated with higher anxiety in children with ADHD. These results suggest that focusing on attachment quality and emotion regulation problems may be significant in management of core symptoms and comorbid anxiety problems in children with ADHD.

Distraction Techniques: Story Telling With Anxiety Problems In Children With Diarrhea

Hospitalization causes anxiety in children and hinders the healing process, distraction techniques: story telling is a nursing action that is able to distract anxiety and is able to create a comfortable environment so that the level of anxiety experienced by children can decrease. Method: This type of research design uses a descriptive design in the form of a case study. The approach used is nursing care which includes assessment, nursing diagnosis, planning, implementation, evaluation and documentation. The case study subjects used were 2 pediatric patients suffering from diarrhea aged 4 years for patient 1 on March 18 2022 and aged 6 years for patient 2 on March 23 2022 who had the same nursing problem, namely anxiety. This research was conducted at Siti Fatimah Regional Hospital, Palembang in 2022. Results: The implementation of nursing in the form of distraction techniques: story telling has an effective effect on reducing the anxiety experienced by pediatric patients during treatment. The results show that the patient's anxiety score has decreased significantly and determine the patient's anxiety level before and after administering the distraction technique. Conclusion: Providing the distraction technique: story telling with anxiety problems was effective in reducing anxiety, there was a significant reduction after using the distraction technique: story telling for three days.

Stress across the Transition from Preschool to School: Association with the Development of Anxiety Symptoms in Children

Children experiencing maladjustment during the transition from preschool to school could further develop internalizing disorders, such as anxiety. Children’s sensitivity to stress is a good indicator of children’s adjustment, but atypical sensitivity, measured by cortisol concentrations, was often linked to later development of anxiety symptoms. Our previous study (PNEC, 2022) showed that most children’s morning cortisol concentrations increased during the first two weeks of kindergarten, and that the adaptation response rate varied between children two months after school entry. The current study aimed to test whether children’s atypical morning cortisol concentration across the transition to kindergarten was associated with an increase in anxiety symptoms 1.5 years later. To model morning cortisol concentrations during the transition, a latent growth model was used (n = 384; one sample for each of the four time-points). Anxiety symptoms were measured twice, before kindergarten entry and in first grade, by parent-report questionnaires. The items were combined using latent variables, one for each time-point. Controlling for pre-transition anxiety symptoms, cortisol level during the first week of school (β = -0.18) predicted anxiety symptoms 1.5 years later. Changes in cortisol levels across the transition did not add to the prediction. This study showed that low morning stress response to a normative environmental stressor was followed by increased levels of anxiety symptoms. Consistent with the stress sensitization hypothesis, this lower stress response is frequently linked to anxiety problems in children who previously experienced adversity; this remains to be examined in this sample.

Hostile interpretation as a transdiagnostic factor for cooccurring anxiety in boys with aggressive behavior problems

AbstractMany children with aggressive behavior problems also suffer from anxiety. This cooccurrence may perhaps be explained by transdiagnostic factors. Identifying these factors seems crucial, as they may be important targets to treat these cooccurring problems effectively. This two‐study paper investigates whether hostile interpretation of others’ intentions is a transdiagnostic factor for cooccurring aggression and anxiety problems, examining two samples of boys in middle childhood. We assessed boys’ aggression and anxiety using teacher‐report in Study 1 (N = 84, Mage = 10.10), and parent‐report in Study 2 (N = 115, Mage = 10.55). In both studies, we assessed hostile interpretation using vignettes describing ambiguous provocations by peers. Both studies revealed a strong association between aggression and anxiety problems, underscoring the necessity to examine factors that can explain this cooccurrence. However, in neither study was this association reduced when we added hostile interpretation to the model, suggesting that hostile interpretation did not function as a transdiagnostic factor in our samples. One possible explanation for these findings is that hostile interpretation predicts both aggression and anxiety problems, but in different children. We, therefore, encourage scholars to conduct more research to explain the high comorbidity of aggression and anxiety problems in children. Future research should also examine hostile interpretation as predictor or transdiagnostic factor for aggression and anxiety problems in more diverse population, including girls and other age groups.

The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta-analysis.

Over a quarter of people have an anxiety disorder at some point in their life, with many first experiencing difficulties during childhood or adolescence. Despite this, gaps still exist in the current evidence base of the multiple consequences of childhood anxiety problems and their costs. A systematic review of Medline, PsycINFO, EconLit and the National Health Service Economic Evaluation Database was conducted for longitudinal and economic studies reporting on the association between childhood anxiety problems and at least one individual-, family- or societal-level outcome or cost. All studies were synthesised narratively. For longitudinal studies, 'effect direction' was used as a common metric, with random effects meta-analysis undertaken where possible. Eighty-three studies met inclusion criteria and were synthesised narratively. We identified 788 separate analyses from the longitudinal studies, which we grouped into 15 overarching outcome domains. Thirteen of the studies were incorporated into 13 meta-analyses, which indicated that childhood anxiety disorders were associated with future anxiety, mood, behaviour and substance disorders. Narrative synthesis also suggested associations between anxiety problems and worse physical health, behaviour, self-harm, eating, relationship, educational, health care, employment, and financial outcomes. 'Effect direction' was conflicting in some domains due to a sparse evidence base. Higher economic costs were identified for the child, their families, healthcare providers and wider society, although evidence was limited and only covered short follow-up periods, up to a maximum of 2years. Total annual societal costs per anxious child were up to £4040 (2021 GBP). Childhood anxiety problems are associated with impaired outcomes in numerous domains, and considerable economic costs, which highlight the need for cost-effective interventions and policies to tackle them. More economic evidence is needed to inform models of the long-term, economic-related, consequences of childhood anxiety problems.

The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder

To study the mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder (ADHD). Convenience cluster sampling was performed to select 435 eligible children with ADHD from 10 211 students in 10 elementary schools in Kashgar of Xinjiang Uygur Autonomous Region. SNAP-IV Assessment Scale, Emotion Regulation Questionnaire for Children and Adolescents, and Conners Parent Symptoms Questionnaire were used to obtain relevant information. The Spearman correlation analysis and the moderated mediation method were used for data analysis. For the children with ADHD, the score of cognitive reappraisal was negatively correlated with the scores of symptoms and anxiety problems (rs=-0.254 and -0.270 respectively, P<0.001), and the score of symptoms was positively correlated with the score of anxiety problems (rs=0.329, P<0.001). The analysis of mediating effect showed that cognitive reappraisal played a partial mediating role between symptoms and anxiety problems, with a 95% confidence interval of 0.008-0.027, and the mediating effect accounted for 16.10% of the total effect. In addition, sex played a regulatory role in this mediation model (P<0.001). Cognitive reappraisal plays a mediating role between symptoms and anxiety problems in children with ADHD, while sex regulates the relationship of symptoms with cognitive reappraisal and anxiety problems in these children.

The relationship between teachers' day‐to‐day classroom management practices and anxiety in primary school children: A systematic review

AbstractAnxiety problems are common in children and can have profound adverse effects on personal, social and academic life. Almost 40% of anxiety disorders emerge before age 14, making primary schools invaluable settings for prevention and early support of child anxiety. Research indicates that school‐based interventions can be costly and difficult to schedule, school staff lack confidence to deliver them effectively, and outcomes are mixed. One solution may be for school staff to adapt and enhance their day‐to‐day practices to better support children with anxiety. This systematic review aims to summarise what is known about the relationship between teachers' classroom management and anxiety in primary school‐aged children. We searched ASSIA, British Education Index, Education Abstracts, Embase, ERIC, MEDLINE, PsycINFO and Scopus in December 2020 and June 2022, using a predefined strategy. We included studies of any design, published in peer‐reviewed journals at any time, in any language, reporting associations between day‐to‐day classroom management strategies/methods and anxiety/internalising outcomes in children aged 4–11 years, taught in mainstream primary schools. Studies were assessed for quality/risk of bias. We identified eight studies (six quantitative, two qualitative) including 4505 children. We found some evidence that authoritarian, controlling and punitive classrooms may be linked to higher levels of anxiety, although, overall, existing evidence indicates either a weak or no association between classroom management and anxiety. This review highlights a paucity of research in this area. Furthermore, variability in design, measures and quality makes drawing firm conclusions difficult. Recommendations for future research are discussed.Context and ImplicationsRationale for this studyThis review explores what is currently known about the relationship between teachers' day‐to‐day classroom management practices and anxiety in primary school‐aged children.Why the findings matterAnxiety problems are common and often start in the primary years, however there is scant evidence to inform primary school educators on how day‐to‐day classroom practices can be used to better support children with or at risk of anxiety problems.Implications for researchers and practitionersThis review is relevant for primary classroom practitioners, school leaders, education professionals, academics, researchers and policymakers keen to better understand how to support those with or at risk of anxiety. Although overall findings indicate very small associations between teaching styles/practices and anxiety in children, there is very little research to draw on. Research is urgently needed that uses robust designs to focus on whether specific, feasible, day‐to‐day strategies can be used by school staff to effectively manage and minimise children's anxiety problems and, if so, how school staff can best be supported and equipped to deliver them.

Increasing access to evidence-based treatment for child anxiety problems: online parent-led CBT for children identified via schools.

Anxiety problems are extremely common and have an early age of onset. We previously found, in a study in England, that fewer than 3% of children with an anxiety disorder identified in the community had accessed an evidence-based treatment (Cognitive Behavioural Therapy; CBT). Key ways to increase access to CBT for primary school-aged children with anxiety problems include (a) proactive identification through screening in schools, (b) supporting parents and (c) the provision of brief, accessible interventions (and capitalising on technology to do this). We provided a brief, therapist guided treatment called Online Support and Intervention (OSI) to parents/carers of children identified, through school-based screening, as likely to have anxiety problems. Fifty out of 131 children from 17 Year 4 classes in schools in England screened positive for 'possible anxiety problems' and 42 (84%) of these (and 7 who did not) took up the offer of OSI. We applied quantitative and qualitative approaches to assess children's outcomes and families' experiences of this approach. Inbuilt outcome monitoring indicated session on session improvements throughout the course of treatment, with substantial changes across measures by the final module (e.g. Child Outcome Rating Scale d=0.84; Goal Based Outcomes d=1.52). Parent engagement and satisfaction was high as indicated by quantitative and qualitative assessments, and intervention usage. We provide promising preliminary evidence for the use of OSI as an early intervention for children identified as having anxiety problems through school-based screening.

A randomised controlled trial to compare clinical and cost-effectiveness of an online parent-led treatment for child anxiety problems with usual care in the context of COVID-19 delivered in Child and Adolescent Mental Health Services in the UK (Co-CAT): a study protocol for a randomised controlled trial

BackgroundIn the context of COVID-19, NHS Child and Adolescent Mental Health Services (CAMHS) and other children’s mental health services have faced major challenges in providing psychological treatments that (i) work when delivered remotely and (ii) can be delivered efficiently to manage increases in referrals as social distancing measures have been relaxed. Anxiety problems are a common reason for referral to CAMHS, children with pre-existing anxiety problems are particularly vulnerable in the context of COVID-19, and there were concerns about increases in childhood anxiety as schools reopened. The proposed research will evaluate the clinical and cost-effectiveness of a brief online parent-led cognitive behavioural treatment (CBT) delivered by the OSI (Online Support and Intervention for child anxiety) platform with remote support from a CAMHS therapist compared to ‘COVID-19 treatment as usual’ (C-TAU) in CAMHS and other children’s mental health services throughout the COVID-19 pandemic.MethodsWe will conduct a two-arm, multi-site, randomised controlled non-inferiority trial to evaluate the clinical and cost-effectiveness of OSI with therapist support compared to CAMHS and other child mental health services ‘COVID-19 treatment as usual’ (C-TAU) during the COVID-19 outbreak and to explore parent and therapists’ experiences.DiscussionIf non-inferiority is shown, the research will provide (1) a solution for efficient psychological treatment for child anxiety disorders while social distancing (for the COVID-19 context and future pandemics); (2) an efficient means of treatment delivery as ‘normal service’ resumes to enable CAMHS to cope with the anticipated increase in referrals; and (3) a demonstration of rapid, high-quality evaluation and application of online interventions within NHS CAMHS to drive forward much-needed further digital innovation and evaluation in CAMHS settings. The primary beneficiaries will be children with anxiety disorders and their families, NHS CAMHS teams, and commissioners who will access a potentially effective, cost-effective, and efficient treatment for child anxiety problems.Trial registrationISRCTN ISRCTN12890382. Registered prospectively on 23 October 2020.

Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice

BackgroundSystematically screening for child anxiety problems, and offering and delivering a brief, evidence-based intervention for children who are identified as likely to benefit would minimise common barriers that families experience in accessing treatment. We have developed a short parent-report child anxiety screening questionnaire, and procedures for administering screening questionnaires, sharing screening outcomes with families, and offering and delivering a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety) through schools. This trial aims to evaluate clinical and health economic outcomes for (1) children (aged 8–9) who screen positive for anxiety problems at baseline (target population) and (2) the wider population of all children in participating classes (total population) in schools randomly allocated to receive identification-to-intervention procedures and usual school practice (‘screening and intervention’), compared to assessment and usual school practice only (‘usual school practice’). MethodsThe trial design is a parallel-group, superiority cluster randomised controlled trial, with schools (clusters) randomised to ‘screening and intervention’ or ‘usual school practice’ arms in a 1:1 ratio stratified according to the level of deprivation within the school. We will recruit schools and participants in two phases (a pilot phase (Phase 1) and Phase 2), with progression criteria assessed prior to progressing to Phase 2. In total, the trial will recruit 80 primary/junior schools in England, and 398 children (199 per arm) who screen positive for anxiety problems at baseline (target population). In schools allocated to ‘screening and intervention’: (1) parents/carers will complete a brief parent-report child anxiety screening questionnaire (at baseline) and receive feedback on their child’s screening outcomes (after randomisation), (2) classes will receive a lesson on managing fears and worries and staff will be provided with information about the intervention and (3) parents/carers of children who screen positive for anxiety problems (target population) will be offered OSI. OSI will also be available for any other parents/carers of children in participating classes (total population) who request it. We will collect child-, parent- and teacher-report measures for the target population and total population at baseline (before randomisation), 4 months, 12 months and 24 months post-randomisation. The primary outcome will be the proportion of children who screen positive for anxiety problems at baseline (target population) who screen negative for anxiety problems 12 months post-randomisation.DiscussionThis trial will establish if systematic screening for child anxiety problems, sharing screening outcomes with families and delivering a brief parent-led online intervention through schools is effective and cost-effective.Trial registrationISRCTN registry ISRCTN76119074. Prospectively registered on 4.1.2022.

Comparison of the effectiveness of online supportive parenting intervention (SPACE) and timid to tiger program (FTTT) on childhood anxiety disorders and family accommodation with samples of Iranian parents.

Studies have supported the effectiveness of the From Timid to a Tiger (FTTT) and Supportive Parenting for Anxious Childhood Emotions (SPACE) program in reducing childhood anxiety. This study is the first to compare the effectiveness of the two programs in the treatment of childhood anxiety disorder and reducing family accommodations levels. Parents of children aged 6 to 9 (n = 49, 49% boys) were randomly allocated to either FTTT (n 26) or SPACE (n = 23) groups, and each attended ten online sessions following the manuals of the interventions. Throughout the study, 9 participants dropped out, resulting in a total of 49 participants, and we performed statistical analyses based on data from these 49 participants. The assessment took place pre- and post-treatment and at a ten-week follow-up on parent-rated child anxiety and family accommodation measures. Analyses of variance (repeated measures) and gain scores were conducted to examine the data. The results indicated that both treatments approaches produced significant reductions in outcome measures, and the post-treatment gains of both treatments were maintained at a ten-week follow-up, though when considering the mean differences and effect sizes across the assessment scores and between groups, overall, the FTTT was significantly more effective in reducing child anxiety scores and family accommodation levels. Our results demonstrated that FTTT significantly outperformed the SPACE program in reducing childhood anxiety problems and family accommodation levels.

Genetic Variations in Elements of the Oxytocinergic Pathway are Associated with Attention/Hyperactivity Problems and Anxiety Problems in Childhood.

Genetic alterations related to oxytocin system seem to influence the neurobiology of attention-deficit hyperactivity disorder and anxiety problems leading to greater functional, social and emotional impairment. Here, we analyzed the association of OXTR rs2254298 and CD38 rs6449182 variants with attention/hyperactivity problems and anxiety problems in children. The study enrolled 292 children and adjusted regression model revealed OXTR rs2254298 AA genotype as a risk factor for attention deficit/hyperactivity problems (PR: 2.37; PadjFDR = 0.006), attention problems (PR: 2.71; PadjFDR = 0.003) and anxiety problems (PR: 1.92; PadjFDR = 0.018). CD38 rs6449182 G allele showed as a risk factor for attention deficit/hyperactivity problems (PR: 1.56; PadjFDR = 0.028). Moreover, in silico approach for regulatory roles found markers that influence chromatin accessibility and transcription capacity. Together, these data provide genetic information of oxytocin in developmental and behavioral disorders opening a range of opportunities for future studies that clarify their neurobiology in childhood.

Preventing anxiety in the children of anxious parents - feasibility of a brief, online, group intervention for parents of one- to three-year-olds.

The evidence suggests an increased risk of developing anxiety problems in children of anxious parents. The current study explored the feasibility and acceptability of an intervention with anxious parents of young children, to inform the possibility of further trials. Participants were recruited through primary and secondary care psychological services and social media. Participants who had a current or recent anxiety disorder and a child aged 12-47 months were included. Assessments of parental and child outcomes occurred at baseline, after the intervention (week-2) and follow-up (week-8). The intervention was delivered in a small group format, in two sessions, one week apart, using videoconferencing. Out of 32 participants, 30 (94%) attended the full intervention. All found the intervention acceptable and reported it as useful and relevant. There was a reduction in parental depression (MD = 2.63, 95%CI 1.01-4.26), anxiety (MD = 3.93, 95%CI 2.49-5.37) and stress (MD = 4.60, 95% CI 3.02-6.18) and increases in parenting confidence. The online group intervention was feasible and acceptable. There were moderate to large effects on parental mental health and no adverse effects on children (decline on outcome measures). This indicates that intervening early in parenting with anxious parents is possible and warrants further investigation to establish prevention efficacy with a larger, controlled trial.

School-based screening for childhood anxiety problems and intervention delivery: a codesign approach

ObjectivesA very small proportion of children with anxiety problems receive evidence-based treatment. Barriers to access include difficulties with problem identification, concerns about stigma and a lack of clarity about how...

Anxiety problems in children and adolescents: a population-based cohort study on incidence and management in Dutch primary care.

BackgroundDue to a large strain on youth mental health care, general practice is suggested as an alternative treatment setting for children and adolescents with anxiety problems. However, research on the current management of these children and adolescents within general practice is scarce.AimTo investigate the incidence of coded anxiety in general practice using the International Classification of Primary Care (ICPC), and GPs’ management of children and adolescents presenting with anxiety problems.Design and settingPopulation-based cohort study using electronic medical records of 51 212 children (aged 0–17 years) in primary care in the Rotterdam region between 1 January 2012 and 31 December 2018.MethodIncidence of ICPC codes for anxiety were calculated, then the characteristics of children and adolescents consulting their GP with anxiety and the GPs’ management were assessed qualitatively using quantitative content analysis.ResultsIncidence of ICPC codes for anxiety in children and adolescents was 5.36 (95% confidence interval [CI] = 5.02 to 5.71) per 1000 person–years. Adolescent females had the highest incidence with 14.01 (95% CI = 12.55 to 15.58) per 1000 person–years. Of the 381 children and adolescents consulting their GP with an initial anxiety problem (median age 13.3 years, 40.4% male), GPs referred 59.3% to mental health care in the first year while 26.5% of children and adolescents were managed by a specialised practice nurse within general practice. Of the 381 children and adolescents, 10.5% received psychiatric medication during the first year, with the trend being for increased prescriptions during adolescence.ConclusionIn general practice children and adolescents frequently received one of two ICPC codes for anxiety, especially adolescent females. Most presenting to their GP with anxiety problems are referred externally or seen by a specialised practice nurse within general practice.

Parsing alcohol-dependent mothers' insensitivity to child distress: Longitudinal links with children's affective and anxiety problems.

Prior work suggests that substance-dependent mothers insensitively respond to their child's emotional needs, which can increase children's risk for psychopathology. However, the mechanisms and processes underlying these associations remain unclarified. Mothers' insensitivity to children's distress is an especially unique predictor of child maladjustment, yet no study has examined whether or how different types of insensitivity to child distress uniquely affect the development of internalizing problems in children of alcohol-dependent mothers. To bridge these gaps, this study examined longitudinal mediational pathways between maternal alcohol dependence symptoms, 2 types of maternal insensitivity to child distress (disengagement and intrusiveness), and 2 types of child internalizing symptoms (affective and anxiety problems) in a majority Black and Latinx sample of young children (Mage = 2.14 years) and their mothers. Results revealed that maternal disengagement mediated associations between maternal alcohol dependence symptoms and child internalizing problems such that alcohol dependence predicted increased disengagement to children's distress, which subsequently predicted increases in children's affective problems. Maternal alcohol dependence symptoms were not associated with intrusiveness to child distress; however, increased intrusiveness predicted later increases in child anxiety problems. Findings support a differentiated approach to studying maternal insensitivity to child distress, specifically indicating that mothers with alcohol dependence symptoms may be more or less likely to display certain types of insensitivity to child distress which may differentially influence children's risk for internalizing problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).