The Cool Kids as a School-Based Universal Prevention and Early Intervention Program for Anxiety: Results of a Pilot Study

The efficacy of the Cool Kids program has been consistently demonstrated both within Australia and internationally, but limited data are available on the use of Cool Kids as a universal program. The purpose of the study is to evaluate Cool Kids as a universal program for preventing childhood anxiety in the school context. There were 73 Italian children (35 boys and 36 girls, ages 10–13 years) attending the last year of primary school and the first year of middle school who participated in an active intervention based on a school adaptation of the Cool Kids protocol. Results of t-test analyses highlighted a downward trend of anxiety symptoms, especially in total anxiety, somatic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia at post-treatment assessed by children. Even the score of depression symptoms, measured as a second outcome measure, decreased after the treatment. This study contributes to the evidence base for the Cool Kids program as a universal program for preventing childhood anxiety in the school context. Although these preliminary results show some promise, their replication in future research is necessary given current study limitations.

Prenatal predictors of childhood anxiety disorders: An exploratory study of the role of attachment organization

Childhood anxiety disorders (CAD) are a common childhood mental disorder and understanding early developmental pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by infant attachment status. To address this question, this exploratory study draws on 190 women recruited in early pregnancy and followed together with their children until 4 years of age. Early life stress is operationalized as maternal depression measured using the Structured Clinical Interview for the DSM, Childhood Trauma Questionnaire, Parenting Stress Index, and antenatal maternal hair cortisol concentrations. Infant cortisol reactivity was measured at 12 months together with the Strange Situation Procedure and CAD assessed at 4 years of age using the Preschool Age Psychiatric Assessment. There was no direct association between attachment classification and CAD. Furthermore, infant cortisol reactivity neither mediated nor attachment moderated the association of early life stress predictors and CAD. However, only for infants with organized attachment classifications, higher maternal antenatal depression, and hair cortisol were associated with a higher risk of CAD.

CBT for Childhood Anxiety: Reviewing the State of Personalised Intervention Research

This article presents a mini-review of the state of personalised intervention research in the field of child and adolescent anxiety. We evaluated narrative, systematic and meta-analytic reviews of key research methodologies and how they relate to current approaches for personalising CBT, specifically. Preliminary evidence of predictors (severity of primary disorder, social anxiety disorder (SoAD), comorbid depression, parental psychopathology, parental involvement and duration of treatment), moderators (type of primary disorder) and mediators (self-talk, coping, problem-solving and comorbid symptoms) of CBT outcomes provides content for several personalised approaches to treatment. Finally, we present a novel conceptual model depicting the state of personalised intervention research in childhood anxiety and propose a research agenda for continued progress.

Personalized Assessment of Anxiety and Avoidance in Children and Their Parents—Development and Evaluation of the Anxiety and Avoidance Scale for Children

In treating childhood anxiety disorders, therapists use highly individualized anxiety hierarchies to assess anxiety-eliciting situations and to personalize treatment. In contrast, psychometric assessment of anxiety symptoms in children usually consists of standardized questionnaires, assessing either total anxiety or disorder-specific symptom scores, prioritizing comparability over individual information. To account for interindividual differences, the Anxiety and Avoidance Scale for Children (AVAC) was developed, following a precise, personalized, assessment approach. In responding to the questionnaire, children and parents identify the most anxiety-eliciting situations before starting treatment, and rate them for anxiety and avoidance. Ratings are repeated over the course of treatment. The aim of this study is to introduce the new questionnaire and present first data on psychometric properties. The AVAC was administered to 389 children with separation anxiety disorder (N = 148), social anxiety disorder (N = 110) or specific phobia (N = 131) aged 8 to 16 and their parents, along with other measures of anxiety and psychopathology before and after cognitive behavioral treatment. Results showed adequate to good test-retest reliability. The AVAC items correlated significantly with established anxiety questionnaires, indicating convergent construct validity. Regarding divergent construct validity, the AVAC showed only small correlations with externalizing symptoms, demonstrating its precision in measuring anxiety and avoidance. The questionnaire was also sensitive to change after treatment, with medium to large effects in the reduction of anxiety and avoidance. The present analyses suggest that the new personalized assessment approach with the AVAC is a reliable and valid assessment of individualized anxiety and avoidance, as well as change in those constructs over the course of CBT treatment.

Features Of Anxiety And Attention In Elementary School Students Of The Russian North

A child’s body in the contemporary educational process with innovative programs and electronic devices, along with insufficient motor activity, against the background of low reserve capacity in the North, experiences the psychoemotional stress. The objective of our study was to investigate the anxiety and attention in elementary school students in the northern cities of Magadan Oblast. The study was conducted on elementary school students (9.9±0.05 years of age) in the regional center of Magadan and the remote town of Magadan Oblast, Susuman. Group I consisted of 108 Magadan school students, whereas Group II included 82 Susuman school students. Methods — we used the methodology of multidimensional assessment of childhood anxiety (MACA). To investigate the function of attention, we used the method of proofreading modified by V.N. Amatuni. Results — the number of anxious children was 42% in Magadan and 26% in Susuman. Magadan children were significantly more anxious than their Susuman peers on five of ten scales: in connection with the evaluation by others (M±SE: p=0.013; Me [Q1; Q3]: p<0.05); in their relationships with teachers (p=0.003; p<0.01); in terms of their learning success (p=0.016; p<0.05); in situations of knowledge testing (p=0.022; p<0.05); and they also exhibited an increase in their autonomic reactivity associated with anxiety (p=0.040; p<0.05). It was revealed as well that the neurodynamic characteristics of attention were better in the group of Susuman children. Conclusion — It can be assumed that elementary school students in small remote towns are less at risk of school maladjustment and are more efficient than their peers living in larger cities, where anxiety is higher, which complicates the learning process.

A Curiosity About Links Between Adventure Playgrounds, Loose Parts, Playwork Approach, a State of "Flow" and Children’s Wellbeing

Over the past century there has been a documented rise in childhood anxiety and depression (Gray, 2011; Twenge, 2001). This increase largely correlates to the significant decrease in the amount of time children have to play freely (Gray, 2013). The suggested reason for this is a decrease in free time and play creating a strong external locus of control, the result of which has been shown to cause increases in childhood anxiety and depression (April, Dharani, & Peter, 2012; Gray, 2013). This paper records a practitioner’s musings on the links between aspects of playwork practice and children’s wellbeing. It considers Csikszentmihalyi (2008) concept of a state of flow and the development of an internal locus of control and the opportunities afforded children in an adventure playground wedded to playwork theory and practice.

Childhood anxious/withdrawn behaviour and later anxiety disorder: a network outcome analysis of a population cohort

Background Several previous studies have identified a continuity between childhood anxiety/withdrawal and anxiety disorder (AD) in later life. However, not all children with anxiety/withdrawal problems will experience an AD in later life. Previous studies have shown that the severity of childhood anxiety/withdrawal accounts for some of the variability in AD outcomes. However, no studies to date have investigated how variation in features of anxiety/withdrawal may relate to continuity prognoses. The present research addresses this gap. Methods Data were gathered as part of the Christchurch Health and Development Study, a 40-year population birth cohort of 1265 children born in Christchurch, New Zealand. Fifteen childhood anxiety/withdrawal items were measured at 7–9 years and AD outcomes were measured at various interviews from 15 to 40 years. Six network models were estimated. Two models estimated the network structure of childhood anxiety/withdrawal items independently for males and females. Four models estimated childhood anxiety/withdrawal items predicting adolescent AD (14–21 years) and adult AD (21–40 years) in both males and females. Results Approximately 40% of participants met the diagnostic criteria for an AD during both the adolescent (14–21 years) and adult (21–40 years) outcome periods. Outcome networks showed that items measuring social and emotional anxious/withdrawn behaviours most frequently predicted AD outcomes. Items measuring situation-based fears and authority figure-specific anxious/withdrawn behaviour did not consistently predict AD outcomes. This applied across both the male and female subsamples. Conclusions Social and emotional anxious/withdrawn behaviours in middle childhood appear to carry increased risk for AD outcomes in both adolescence and adulthood.