Sample Of Anxious Youth Research Articles

Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms.

Parental accommodation contributes to the maintenance of child anxiety and related symptoms. The current study examines the contributions of parent and child factors to parental accommodation in a sample of anxious youth. Sixty-four treatment-seeking youth (6-16 years) and their mothers, as well as a subset of fathers (N = 41) reported on parental accommodation, parental distress and emotion regulation, child psychopathology, child externalizing behaviors, and child intolerance of uncertainty. Parental accommodation was not related to parental distress or emotion regulation. Parents who viewed their child as being more symptomatic (e.g., anxious, externalizing, and intolerant of uncertainty) were more likely to engage in accommodation. For mothers, child anxiety and externalizing symptoms were notable predictors of accommodation. Parent perceptions of child symptomology is an important factor significantly related to accommodation behaviors. This finding can be used to inform programming designed to target parental responses to child anxiety and related disorders.

Multi-informant Expectancies and Treatment Outcomes for Anxiety in Youth.

Expectancies for a favorable treatment outcome have been associated with actual favorable outcomes but have been understudied in youth with anxiety. The current study applied structural equation modeling in a sample of anxious youth (N = 488; 7-17years, M = 10.69, SD = 2.80) to examine whether a multi-informant latent expectancies factor, indicated by youth, parent, and therapist reports, predicted a latent posttreatment anxiety factor, controlling for a latent pretreatment anxiety factor. Both anxiety latent factors were indicated by youth, parent, and independent evaluator (IE) reports. Analyses also examined whether treatment condition (cognitive behavioral therapy, sertraline, combination, pill placebo) moderated the association between expectancies and outcome, and whether this association differed across development. Findings indicated that informant reports loaded similarly onto the latent factors. Results also demonstrated that treatment expectancies were positively associated with outcomes, and that this relationship held across treatment type and age group. Treatment implications and future research directions are discussed.

The Link Between Anxiety Severity and Irritability Among Anxious Youth: Evaluating the Mediating Role of Sleep Problems.

Although recent studies have linked pediatric anxiety to irritability, research has yet to examine the mechanisms through which youth anxiety may be associated with irritability. Importantly, sleep related problems (SRPs) have been associated with both child anxiety and irritability, but research has not considered whether the link between youth anxiety and irritability may be accounted for by SRPs. The present study investigated whether SRPs mediated the relationship between anxiety severity and irritability in a large sample of treatment-seeking anxious youth (N = 435; ages 7-19 years, M = 12.7; 55.1% female). Anxiety severity, SRPs and irritability showed significant pairwise associations, and the indirect effect of youth anxiety severity on irritability, via SRPs, was positive and significant. The present analysis is the first to examine youth anxiety, irritability, and SPRs in a single model in a sample of anxious youth, and provides preliminary evidence that SRPs partially mediate links between child anxiety and irritability.

CLINICAL CONSEQUENCES OF THE REVISED DSM-5 DEFINITION OF AGORAPHOBIA IN TREATMENT-SEEKING ANXIOUS YOUTH

In DSM-5, the agoraphobia core symptom criterion has been revised to require fear about multiple situations from across at least two distinct domains in which escape might be difficult or panic-like symptoms might develop. The present study examined patterns and correlates of the recent change in a sample of anxious youth with symptom presentations consistent with the DSM-IV agoraphobia definition and/or specific phobia (SP) to consider how the recent diagnostic change impacts the prevalence and composition of agoraphobia in children and adolescents. Analyses (N = 151) evaluated impairment and correlates of agoraphobic youth who no longer meet the DSM-5 agoraphobia criteria relative to agoraphobic youth who do meet the new DSM-5 criteria. Secondary analyses compared agoraphobic youth not meeting DSM-5 criteria to SP youth. One-quarter of youth with symptom presentations consistent with the DSM-IV agoraphobia definition no longer met criteria for DSM-5 agoraphobia, but showed comparable severity and impairment across most domains to youth who do meet criteria for DSM-5 agoraphobia. Further, these youth showed higher levels of anxiety sensitivity and internalizing psychopathology relative to youth with SP. A substantial proportion of impaired youth with considerable agoraphobic symptom presentations have been left without a specified anxiety diagnosis by the DSM-5, which may affect their ability to receive and/or get coverage for services and their representation in treatment evaluations. Future DSM iterations may do well to include a "circumscribed" agoraphobia specifier that would characterize presentations of fear or anxiety about multiple situations, but that do not span across at least two distinct situational domains.

Target problem (mis) matching: Predictors and consequences of parent–youth agreement in a sample of anxious youth

Parents and youth often report discrepant target problems upon seeking treatment for youth psychopathology, which can have important impact on therapy processes (e.g., dropout) and treatment outcomes, as entry-level attitudes have been found to be influential in ultimate use and benefit of treatment. The current study examined parent–youth agreement within an anxiety disordered sample by assessing demographic and diagnostic factors that may predict matching, as well as the impact of matching on attrition, treatment outcome, and parental satisfaction. Ninety-five youth with principal anxiety disorders received cognitive–behavioral treatment for anxiety at a university outpatient clinic. Youth and parents independently identified target problems during the pretreatment assessment. Target problems were coded into 25 qualitative categories representing diagnostic, symptom, and functional impairment domains, including diffuse anxiety, social anxiety, academic achievement, oppositional/behavior problems, sleep problems, suicidal ideation, and family functioning. The majority of parent–youth dyads (67.4%) agreed on at least one target problem. Although problems related to diffuse anxiety and social anxiety were reported most frequently, relatively low rates of agreement were found in these domains. Kappa values demonstrated higher levels of agreement for problems with specific fears, school attendance, and panic and lower levels of agreement for difficulties with worry, shame, and self-esteem. Further, youth diagnosed with comorbid externalizing disorders were less likely to agree with their parents on at least one target problem. No effects were found for gender, age, or number of diagnoses in predicting agreement. Target problem agreement did not significantly impact rates of attrition or diagnostic remission, but did predict some measures of parental satisfaction. Results suggest that disagreement on treatment goals exists even within a narrow treatment population and may predict important consumer variables such as satisfaction. Findings emphasize that initial goals disagreement warrants careful assessment and monitoring.

A Preliminary Psychometric Evaluation of a Parent-Report Measure of Child Emotional Awareness and Expression in a Sample of Anxious Youth

Recent conceptualizations of child anxiety disorders have implicated emotion dysregulation in the development, maintenance, and/or exacerbation of these conditions. Assessment of emotion regulation in children often relies upon self-reports, but research suggests a multi-informant approach is optimal in the assessment of youth. The current study evaluates the preliminary psychometric properties of a parent-report adaptation of the Emotion Expression Scale for Children (EESC-P) in a sample of parents (n = 78) seeking treatment for their child’s anxiety disorder (Mchild age = 11.04, SD = 2.96, 46.8 % female). Findings support the internal consistency and predictive validity of the EESC-P. Parent–child concordance was low-to-moderate within a subset of participants whose children completed the EESC. Scores on the EESC-P did not differ as a function of age or gender. Results preliminarily support the use of the EESC-P as part of a multi-informant assessment of emotional awareness in children with anxiety disorders.