Anxiety Disorders In Children Research Articles

The state of psychological treatments for social anxiety disorder in children and adolescents: An Umbrella Review

Social Anxiety Disorder (SAD) is a very common disorder in childhood and adolescence. Many studies have examined various types of Cognitive Behavioral Therapy (CBT), meaning there is a need for a study exploring the efficacy of CBT. The objectives of this study are to determine what treatments and factors can improve treatment outcomes for SAD. We performed an umbrella review of the effectiveness of psychological interventions in treating SAD in children and adolescents. Nine databases were searched using a combination of keywords. Risk of bias was assessed using AMSTAR-2. Six systematic reviews and meta-analysis were selected and reported. All of those studies assessed the efficacy of CBT in children and adolescents with SAD, demonstrating its short- and long-term effectiveness. The components that seem to be most effective are exposure in any modality and social skills training. Other considerations to take into account are addressed in the discussion.

Comparison of Efficacy of Child Cognitive – Behavioral Therapy (CCBT) Versus Family Cognitive – Behavioral Therapy (FCBT) and Mother - Child Attachment Intervention in Reduction of Separation Anxiety Disorder in Children between 7-12 Years Old

Objective: The purpose of this study was to compare and evaluate the effectiveness of child-based cognitive-behavioral therapy (CCBT), family-based cognitive-behavioral therapy (FCBT) and mother-child attachment intervention in reducing separation anxiety in children aged 7 to 12 years. Methods and Materials: The method of this semi-experimental study was pre-test-post-test with a control group and a three-month follow-up. For this purpose, 48 children with separation anxiety disorder were selected by purposive sampling and were divided into four groups of 12 people. The first group received child-based cognitive behavioral therapy, the second group received family-based cognitive behavioral therapy, the third group received mother-child attachment intervention, and the control group did not receive any intervention. The measurement tools of this research include the semi-structured diagnostic interview of mood disorders and schizophrenia for children and adolescents (K-SADS-PL) and Separation Anxiety Scale (Parental Form). The data were analyzed using mixed variance analysis with repeated measurement and Bonferroni's post hoc test. Findings: The findings show that child-centered cognitive-behavioral therapy has been more successful in reducing separation anxiety compared to family-centered cognitive-behavioral therapy and mother-child attachment-centered intervention. Also, family-centered cognitive-behavioral therapy has been more effective in reducing children's separation anxiety compared to mother-child attachment-centered intervention (P<0.05). Conclusion: The results of the present study show that the therapeutic methods used can be effective in the treatment of separation anxiety disorder by psychologists and psychiatrists.

Impact of Childhood Trauma and Adult Separation Anxiety Disorder on Quality of Life in Individuals with Schizophrenia.

Childhood trauma and anxiety disorders are common in individuals with schizophrenia. This study aimed to investigate the effects of childhood trauma and adult separation anxiety disorder on the quality of life of individuals with schizophrenia. This cross-sectional study included 111 individuals with schizophrenia and 85 control subjects. The separation anxiety symptom inventory (SASI), adult separation anxiety questionnaire (ASAQ), Positive and Negative Syndrome Scale (PANSS), childhood trauma questionnaire (CTQ), and World Health Organization quality of life questionnaire (WHOQoL-BREF) were administered to the participants. More individuals with schizophrenia than control subjects were unemployed and single (p<0.05). Individuals with schizophrenia scored significantly higher on the SASI, ASAQ, and CTQ (p<0.05), whereas the control subjects scored significantly higher on the WHOQoL-BREF (p<0.05). ASAQ scores had mild positive correlations with total PANSS and PANSS subscale scores, and moderate positive correlations with total CTQ, CTQ emotional subscale scores, and CTQ physical abuse subscale scores. A negative moderate correlation was found between ASAQ and total WHOQoL-BREF scores. Mediation analysis revealed that CTQ scores significantly affected total WHOQoL-BREF and ASAQ scores. The model pathway for ASAQ scores showed a significant direct and indirect effect of CTQ on the total WHOQoL-BREF scores. Childhood trauma predicts adult separation anxiety disorder, which partially mediates the impact of childhood trauma on quality of life in individuals with schizophrenia. Therapeutic interventions for adult separation anxiety disorder in individuals with schizophrenia and a history of childhood trauma may help increase their quality of life.

Effects of Problem Solving Therapy in Substance Use Disorder in Adolescents.

In this study, it was aimed to examine the effects of problem solving therapy, which is a cognitive behavioral method, on adolescents diagnosed with alcohol and substance use disorder. A semi-structured interview and intelligence test were administered to adolescents with diagnosis of substance use disorder to identify comorbidities. 46 adolescents who met the inclusion criteria were divided into two groups. Problem solving therapy was applied to the first group for 5 weeks, once a week, while the other group continued their routine controls in the center. Beck Depression Inventory, Screen for Child Anxiety Disorders, Revised Social Problem Solving Inventory, Addiction Profile Index and Treatment Motivation Questionnaire were administered to the groups at the beginning of the study and at the end of the 5th week and the results were analyzed. Sociodemographic and substance use characteristics, comorbid psychopathologies and scale mean scores of the groups in the first evaluation were found to be similar to each other. Although the depression and anxiety scores decreased significantly in both groups, no significant difference was found between the groups. Problemsolving skills and treatment motivation increased in the therapy group and decreased in the control group. The difference between groups was found to be significant (p=0.045, 0.037 for problem solving and treatment motivation respectively). While the severity of addiction decreased in therapy group, it increased in control group, but the difference was not significant. This study is important in that it shows that psychosocial interventions strengthen the treatment of substance use disorder in adolescents. In our country, no other study was evaluating the effects of the intervention methods in addicted adolescents was found. Future studies with larger sample sizes and where the long-term results of substance use disorder are evaluated are needed.

PROBLEMS OF PSYCHOLOGICAL SCIENTISIC TEXTS MACHINE TRANSLATION ON THE MATERIAL OF AN INFORMATIONAL BROCHURE

The article is devoted to the analysis of the psychological scientific text machine translation (from the English language to the Russian one). On the material of the Russian machine translation of an informational brochure, potential difficulties were identified. The author points out the mistakes in machine translation and offers ways to solve them. A particular attention is paid to the translation of special terminology of the psychological semantic field.&#x0D; Background. Machine translation programs are often used as a way of getting texts translation. On the one hand, it is an available inexpensive way to get a quick translation. On the other hand, there is no guarantee of translation adequacy. The basis of quality translation analysis was a machine translation of scientific text.&#x0D; Purpose. On the basis of the text made by the machine translation program some mistakes are revealed and analyzed, some ways to solve them are offered. Special attention is paid to the translation of terms in the field of psychology.&#x0D; Materials and methods. The research material was a machine translation of the brochure “Anxiety Disorders in Children” written by the American Anxiety Disorders Association (the translation is from English into Russian). The translation was made with the help of the online program Google Translator.&#x0D; Results. Scientific texts on psychology have become popular in the world, but as the analysis showed, their translation is still difficult for online translation programs. Machine translation is not the way to get an equivalent text, but it does make the translation process easier. At the same time, an interpreter should spend time on further text editing. One type of mistakes is connected with the translation of terms. Besides there are mistakes caused by the difference between the grammatical structures of the original language and the translation language, such as the voice constructions, special word orders and set phrases.

Increasing the Efficiency of Diagnostic Interviews for Childhood Anxiety Disorders Through Joint Child-Parent Administration

Increasing the Efficiency of Diagnostic Interviews for Childhood Anxiety Disorders Through Joint Child-Parent Administration

Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study.

The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7years. The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.

Staging the bipolar disorders: Are early stages too early a stage for intervention?

Staging the bipolar disorders: Are early stages too early a stage for intervention?

Pediatric anxiety and daily fine particulate matter: A longitudinal study.

Daily variations in ambient fine particulate matter (PM2.5) could contribute to the morbidity of anxiety disorders in children and adolescents, but has not yet been studied longitudinally at a daily level. We tested this association using repeated weekly measures of anxiety symptom severity in a group of 23 adolescents with generalized anxiety disorder. After estimating ambient PM2.5 concentrations using a validated model, we found that increased concentrations were significantly associated with increased anxiety symptom severity and frequency two, three, and four days later. PM2.5 may be a novel, modifiable exposure that could inform population level interventions to decrease psychiatric morbidity.

Childhood temperamental, emotional, and behavioral characteristics associated with mood and anxiety disorders in adolescence: A prospective study.

Mood and anxiety disorders account for a large share of the global burden of disability. Some studies suggest that early signs may emerge already in childhood. However, there is a lack of well-powered, prospective studies investigating how and when childhood mental traits and trajectories relate to adolescent mood and anxiety disorders. We here examine cross-sectional and longitudinal association between maternally reported temperamental traits, emotional and behavioral problems in childhood (0.5-8 years) and clinical diagnosis of mood or anxiety ("emotional") disorders in adolescence (10-18 years), using the prospective Norwegian Mother, Father and Child Cohort Study (MoBa) of 110,367 children. Logistic regression analyses showed consistent and increasing associations between childhood negative emotionality, behavioral and emotional problems and adolescent diagnosis of emotional disorders, present from 6months of age (negative emotionality). Latent profile analysis incorporating latent growth models identified five developmental profiles of emotional and behavioral problems. A profile of early increasing behavioral and emotional problems with combined symptoms at 8 years (1.3% of sample) was the profile most strongly associated with emotional disorders in adolescence (OR vs. reference: 5.00, 95% CI: 3.70-6.30). We found a consistent and increasing association between negative emotionality, behavioral and emotional problems in early to middle childhood and mood and anxiety disorders in adolescence. A developmental profile coherent with early and increasing disruptive mood dysregulation across childhood was the profile strongest associated with adolescent emotional disorders. Our results highlight the importance of early emotional dysregulation and childhood as a formative period in the development of adolescent mood and anxiety disorders, supporting potential for prevention and early intervention initiatives.

A Self-Efficacy Measure for Use During Exposure in CBT Therapy for Childhood Anxiety Disorders

ABSTRACT Cognitive-behavioral therapy (CBT) with exposure is an effective treatment for childhood anxiety disorders; however, by nature it may involve much discomfort, often rendering engagement during exposure a challenge. An examination of factors related to engagement during exposure in CBT for anxiety is needed; yet, a search of the extant literature found few appropriate assessment tools. Thus, the current study focuses on developing and testing a measure of self-efficacy specific to exposure tasks, a construct likely to contribute to engagement during exposures. Twenty-four parent-child dyads were recruited, and parent, child, and clinician assessments were completed. Analyses revealed significant increases in self-efficacy in tandem with reductions in anxiety symptoms and increases in social and family functioning. Internal consistency was acceptable to excellent across time. Observed effect sizes were promising, warranting greater investigation of the self-efficacy measure. Further investigation into factors contributing to child engagement during exposure in CBT for anxiety is needed.

Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis.

Individuals with autism spectrum disorder (ASD) struggle accessing psychotherapy services for comorbidities, including anxiety-, depressive- and obsessive-compulsive disorders (OCD). Apart from cognitive behavioural therapy (CBT) for anxiety in children with ASD, it is unclear whether psychotherapy is effective for these comorbid disorders.We therefore systematically reviewed any form of psychotherapy for co-occurring symptoms of anxiety, depression and OCD in individuals with ASD.Database searches were conducted until February 2022 using EMBASE, PsycINFO and PubMed. Randomised controlled trials (RCT) were included investigating any form of psychotherapy for symptoms of anxiety, depression and OCD in individuals with ASD. Summary data were extracted, and random-effects meta-analyses were conducted.For CBT 26 RCTs (n = 1251), and for social skills training (SST) 11 RCTs (n = 475) met criteria for inclusion. Pooled effect sizes indicated a moderate reduction of anxiety in children (g = -0.70) and a small reduction of depressive symptoms in adults (g = -0.39). For SST overall effect sizes were small for reduction of anxiety in children (g = -0.35) and adults (g = -0.34) and moderate for reduction of depressive symptoms in children (g = -0.50). Risk of bias was high in 18, moderate in 16 and low in 3 RCTs.Our results provide new and age-specific evidence that: (1) CBT is effective for reducing anxiety in children and to a lesser extent for depressive symptoms in adults with ASD; and (2) social skills interventions are effective for reducing anxiety in children and adults and for depressive symptoms in children with ASD.

Cognitive Behavioral Therapy for Anxiety Disorders in Youth: Efficacy, Moderators, and New Advances in Predicting Outcomes.

This review integrates recent systematic reviews and meta-analyses on the efficacy of cognitive behavioral therapy (CBT) for the treatment of anxiety disorders in children and adolescents. To inform personalized approaches to intervention, we also review recent research on moderators and predictors of outcomes. Meta-analyses provide strong support for the efficacy of CBT for youth anxiety disorders, including with preschool-aged children using appropriate modifications. Furthermore, there is evidence that CBT is an effective adjunct treatment to psychopharmacological interventions, and the combination of treatments may be most effective for some youth. There is limited evidence of consistent demographic and clinical moderators of outcomes. Recent work in neuroscience has highlighted novel predictors of treatment outcomes that, with replication, may aid in more personalized approaches to youth anxiety treatment. CBT is efficacious for treating anxiety disorders in youth and lowering recurrence rates. CBT can also be an efficacious adjunct treatment for psychopharmacological interventions. Neuroimaging and psychophysiological measures of threat and motivational processing have shown initial promise in predicting symptom change with CBT, with potential implications for precision medicine.

Childhood Maltreatment in Females Is Associated with Enhanced Fear Acquisition and an Overgeneralization of Fear.

Childhood maltreatment may alter fear neurocircuitry, which results in pathological anxiety and depression. One alteration of fear-related behaviors that has been observed in several psychiatric populations is an overgeneralization of fear. Thus, we examined the association between childhood maltreatment and fear generalization in a non-clinical sample of young adults. Two hundred and ninety-one participants underwent differential fear conditioning in a fear-potentiated startle paradigm. One visual stimulus (CS+), but not another (CS-), was associated with an aversive airblast to the throat (US) during acquisition. The next day, participants were tested for their fear responses to the CS+, CS-, and several generalization stimuli (GS) without the presence of the US. Participants also completed questionnaires that assessed symptoms of childhood maltreatment, anxiety, depression, and post-traumatic stress disorder (PTSD). Participants reporting high childhood maltreatment (n = 71; 23 males, 48 females) exhibited significantly greater anxiety, depression, and symptoms of PTSD than participants reporting low childhood maltreatment (n = 220; 133 males, 87 females). Females reporting high childhood maltreatment demonstrated significantly enhanced fear learning and greater fear generalization, based on their fear-potentiated startle responses. Our findings suggest that childhood maltreatment may sex-dependently influence the development of fear neurocircuitry and result in greater fear generalization in maltreated females.

Anxiety Disorders in Children.

Anxiety disorders are the most common mental health disorders in children with clearly defined and empirically based treatment. However, assessment and treatment pose several obstacles for pediatric providers. A child who may have age-appropriate communication skills will still struggle to accurately report the presence, timing, and severity of symptoms. Reports from parents, caregivers, and teachers are often subjective and can focus on 1 aspect of the child's behavior. Untreated, anxiety disorders have an adverse effect on a child's functioning, and impairments in physical health, academic performance, and social competence can lead to lifelong consequences. Well-validated and rapidly administered screening tools can be used to gather data from schools and other resources to inform the diagnosis, guide treatment recommendations, and track improvements. Limited training on behavioral health diagnosis and fear of "black box warnings" have left many pediatric clinicians reluctant to prescribe medications. There are readily available practice guidelines for these medications, and data documenting the efficacy of these medications for children should encourage their use.

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.

Long-Term Risk for Mood and Anxiety Disorders After Pediatric Traumatic Brain Injury: A Population-Based, Birth Cohort Analysis.

To determine whether exposure to traumatic brain injury (TBI) before 10 years of age is associated with development of a mood or anxiety disorder by 25 years of age, and whether sex or injury severity influences this risk. Olmsted County, Minnesota. A total of 5518 persons born from January 1, 1976, through December 31, 1982. Population-based, birth cohort study. Children sustaining TBI before 10 years of age (index date) were confirmed by manual record review and classified by injury severity using the Mayo Classification System. Each TBI case was age- and sex-matched to 2 referents from the same birth cohort without a history of TBI at the index date. Cox proportional hazards models were fit to compare the risk of a subsequent clinically diagnosed mood or anxiety disorder by 25 years of age between TBI cases and referents. Separate analysis was performed stratified by sex and injury severity. Incidence of mood and anxiety disorders determined through clinical diagnostic codes and manual record review. The study included 562 children (238 females [42.3%] and 324 males [57.7%]) with TBI before 10 years of age (mean [SD] age at TBI: 4.7 [2.8] years). At least 1 mood or anxiety disorder was diagnosed for 115 persons with TBI and 215 referents. No statistically significant association existed between childhood TBI status and anxiety disorder (adjusted hazard ratio [aHR], 1.01 [95% confidence interval (CI), 0.71-1.43]; P = .97) or mood disorder (aHR, 1.16 [95% CI, 0.92-1.47]; P = .21). However, females who sustained TBI had a significantly increased risk of a subsequently diagnosed mood disorder compared with age-matched female referents (aHR, 1.40 [95% CI, 1.04-1.89]; P = .03). This study suggests that isolated TBI before 10 years of age is not significantly associated with an increased risk of anxiety or mood disorder by 25 years of age, though females may be at an increased risk.

The Management of Anxiety and Depression in Pediatrics.

Anxiety and depression are among the most common psychiatric conditions affecting children and adolescents, and physicians in primary care settings often represent the first point of contact for these patients. Therefore, it is critical to provide these clinicians with an overview of current, evidence-based approaches for treating these conditions in pediatric and adolescent patients. Cognitive behavioral therapy (CBT) is an appropriate and effective first-line intervention for anxiety disorders in children and adolescents. For depressive disorders, treatment guidelines recommend either CBT or interpersonal therapy (IPT) as frontline treatment approaches. Pharmacologically, selective serotonin reuptake inhibitors (SSRIs) represent the most efficacious treatment for anxiety and depressive disorders in young persons. Combination therapies consisting of a psychotherapy plus an SSRI have produced greater therapeutic effects than either treatment alone. In particular, CBT plus sertraline is most effective in those with anxiety, whereas combining CBT or IPT with fluoxetine has been identified as the most effective treatment for depression in this population. Clinically, these combination therapies are especially useful in patients showing an insufficient response to treatment with only an SSRI or psychotherapy. A physician should also recommend lifestyle alterations to aid in the management of anxiety and depression, including diet, exercise, adequate sleep, limiting screen time, and spending time in nature. When used to complement standard treatment approaches, these interventions may provide the patient with additional symptom reduction while decreasing the return of symptoms in the long term.

In the moment social experiences and perceptions of children with social anxiety disorder: A qualitative study.

Childhood social anxiety disorder (SAD) is a common and disabling condition. General forms of cognitive behavioural treatments have demonstrated poorer efficacy for childhood SAD when compared to other childhood anxiety disorders and further understanding of the psychological factors that contribute to the maintenance of childhood SAD is warranted. Examining the social experiences of children with SAD may help to identify relevant psychological factors and increase our understanding of what keeps childhood SAD going. The current study used reflexive thematic analysis to analyse the transcripts of interviews with 12 children aged 8-12 years with SAD who had been interviewed about their 'in the moment' social experiences during a social stress induction task. The interview topic guide included factors hypothesized to maintain SAD in adult cognitive models of the disorder. The interviews revealed both variety and commonalities in the experiences and interpretations of social events in children with SAD, captured in three related main themes: (i) Discomfort being the centre of attention, (ii) (Lack of) awareness of cognitions and (iii) Managing social fears. Findings indicated likely developmental influences on which maintenance mechanisms apply at which point in time. There is variation in the psychological mechanisms that children with SAD endorse and developmental factors are likely to influence when specific mechanisms are relevant. We now need further studies that take a developmentally informed approach to understand the nature of the association between the factors identified in this study and social anxiety in childhood to inform the development of more effective interventions for childhood SAD.

Modular CBT for Childhood Anxiety Disorders: Evaluating Clinical Outcomes and its Predictors.

This study examined clinical outcomes of a modular individual CBT for children with anxiety disorders (AD), and predictors of outcomes, in usual clinical practice. Participants were 106 children with ADs (7-17years), and parents. Assessments were pre-, mid-, post-test, and 10weeks after CBT (follow-up). Predictors (measured pre-treatment) were child characteristics (gender, age, type of AD, comorbid disorders), fathers' and mothers' anxious/depressive symptoms, and parental involvement (based on parents' presence during treatment sessions and the use of a parent module in treatment). At follow-up, 59% (intent-to-treat analyses) to 70% (completer analysis) of the children were free from their primary anxiety disorder. A significant decrease in anxiety symptoms was found. Higher parental involvement was related to lower child anxiety at follow-up, but only for children with comorbid disorders. Findings suggest that it is beneficial to treat anxiety with modular CBT. Future steps involve comparisons of modularized CBT with control conditions.