scholarly journals Reflective Functioning in Children and Adolescents With and Without an Anxiety Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Valérie Chevalier ◽  
Valérie Simard ◽  
Julie Achim ◽  
Pamela Burmester ◽  
Thalie Beaulieu-Tremblay
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Internalizing Symptoms ◽  
Reflective Functioning ◽  
Mental States ◽  
Maternal Attachment ◽  
Clinical Samples ◽  
Psychiatric Clinic ◽  
Clinical Group

Reflective functioning (RF), meaning the capacity to interpret mental states (intentions, emotions, thoughts, desires, and beliefs) underlying one’s own and others’ behaviors, may help understand the dysfunctional self-regulation associated with anxiety disorders. However, research on anxiety and RF in clinical samples is scarce. This study aimed to assess whether mothers’ and youths’ RF was associated with youths’ (a) anxiety disorders and symptoms and (b) internalizing symptoms. Another goal was to explore whether RF predicted anxiety and internalizing symptoms beyond the more commonly established effect of attachment. Canadian children and adolescents aged between 8 and 16years, and their mothers were recruited in an outpatient psychiatric clinic (clinical group with a diagnosed anxiety disorder, n=30, mean age=11.5±2.8years) and in the general population (non-clinical group, n=23, mean age=11.5±2.1years). The Child Attachment Interview was used to assess youths’ attachment along with three dimensions of RF (global, regarding self, regarding others). Mothers’ attachment and RF were assessed with the Adult Attachment Interview. Children’s and adolescents’ anxiety and internalizing symptoms were measured with the Behavior Assessment Scale for Children, second version. The clinical and non-clinical groups did not differ in mothers’ or youths’ RF. However, in the overall sample, youths’ RF regarding themselves and maternal attachment preoccupation were associated with internalizing symptoms. Sequential regression analyses revealed that higher RF regarding self predicted a higher level of self-reported internalizing symptoms, beyond the effect of maternal attachment (β=0.43, p<0.05). This study’s finding suggests that clinically anxious children and adolescents have adequate RF. We propose that the sustained hypervigilance and apprehension associated with anxiety make anxious youths sensitive to their own and others’ mental states. Our findings suggest that psychotherapeutic treatments for anxiety should make use of patients’ RF abilities to help them make sense of their symptoms and thus reduce them.

scholarly journals Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

2005 ◽  
Vol 63 (2b) ◽  
pp. 407-409 ◽  
Author(s):  
Isabella Souza ◽  
Maria Antônia Pinheiro ◽  
Paulo Mattos
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Clinical Sample ◽  
Structured Interview ◽  
Separation Anxiety Disorder ◽  
Clinical Samples ◽  
Hyperactivity Disorder

OBJECTIVE: To evaluate the prevalence of anxiety disorders in a clinical referred sample of children and adolescents with attention deficit/hyperactivity disorder (ADHD). METHOD: 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. RESULTS: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disorder. CONCLUSION: Children and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.

scholarly journals Frequency and Correlates of Fathers' Accommodation in Pediatric Anxiety Disorders

2021 ◽  
Author(s):  
Ena Alcan ◽  
Tess Anderson ◽  
Eli R. Lebowitz
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Internalizing Symptoms ◽  
Child Anxiety ◽  
Externalizing Symptoms ◽  
Treatment Seeking ◽  
Family Routines ◽  
Pediatric Anxiety ◽  
Pediatric Anxiety Disorders

AbstractPrevious studies investigating family accommodation (FA) in pediatric anxiety disorders have primarily relied on mothers' reports, while data on FA by fathers remains scarce. We examined the frequency and correlates of fathers' FA of anxious children and compared fathers’ and mothers’ reports of FA. Participants were 69 parents of treatment-seeking children and adolescents with a primary anxiety disorder. FA was highly prevalent amongst fathers, with the majority of fathers participating in symptom-related behaviors and modifying family routines due to child anxiety. Fathers' accommodation levels were significantly correlated with fathers' reports of child internalizing symptoms, child externalizing symptoms, and fathers' own anxiety symptoms. Fathers’ and mothers’ reports of FA were moderately correlated, whereas their reports of their respective distress related to the need to accommodate were only weakly correlated. Fathers reported a significantly lower frequency of FA than did mothers. These findings highlight the importance of obtaining reports from both fathers and mothers when assessing FA. Results are particularly relevant to family-focused and parent-based interventions designed to address and reduce FA amongst parents of clinically anxious children.

scholarly journals Dynamic changes in amygdala activation and functional connectivity in children and adolescents with anxiety disorders

2014 ◽  
Vol 26 (4pt2) ◽  
pp. 1305-1319 ◽  
Author(s):  
Johnna R. Swartz ◽  
K. Luan Phan ◽  
Mike Angstadt ◽  
Kate D. Fitzgerald ◽  
Christopher S. Monk
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Prolonged Exposure ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Initial Exposure ◽  
Amygdala Activation ◽  
Over Time

AbstractAnxiety disorders are associated with abnormalities in amygdala function and prefrontal cortex–amygdala connectivity. The majority of functional magnetic resonance imaging studies have examined mean group differences in amygdala activation or connectivity in children and adolescents with anxiety disorders relative to controls, but emerging evidence suggests that abnormalities in amygdala function are dependent on the timing of the task and may vary across the course of a scanning session. The goal of the present study was to extend our knowledge of the dynamics of amygdala dysfunction by examining whether changes in amygdala activation and connectivity over scanning differ in pediatric anxiety disorder patients relative to typically developing controls during an emotion processing task. Examining changes in activation over time allows for a comparison of how brain function differs during initial exposure to novel stimuli versus more prolonged exposure. Participants included 34 anxiety disorder patients and 19 controls 7 to 19 years old. Participants performed an emotional face-matching task during functional magnetic resonance imaging scanning, and the task was divided into thirds in order to examine change in activation over time. Results demonstrated that patients exhibited an abnormal pattern of amygdala activation characterized by an initially heightened amygdala response relative to controls at the beginning of scanning, followed by significant decreases in activation over time. In addition, controls evidenced greater context-modulated prefrontal cortex–amygdala connectivity during the beginning of scanning relative to patients. These results indicate that differences in emotion processing between the groups vary from initial exposure to novel stimuli relative to more prolonged exposure. Implications are discussed regarding how this pattern of neural activation may relate to altered early-occurring or anticipatory emotion-regulation strategies and maladaptive later-occurring strategies in children and adolescents with anxiety disorders.

scholarly journals Online Attention Bias Modification in Combination With Cognitive-Behavioural Therapy for Children and Adolescents With Anxiety Disorders: A Randomised Controlled Trial

2019 ◽  
Vol 36 (4) ◽  
pp. 200-215 ◽  
Author(s):  
Jasmijn M. de Lijster ◽  
Gwendolyn C. Dieleman ◽  
Elisabeth M.W.J. Utens ◽  
Jan van der Ende ◽  
Tamsin M. Alexander ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Controlled Trial ◽  
Attention Bias ◽  
Behavioural Therapy ◽  
Attention Bias Modification ◽  
Cognitive Behavioural ◽  
Secondary Outcomes ◽  
Bias Modification

AbstractAttention Bias Modification (ABM) targets attention bias (AB) towards threat, which is common in youth with anxiety disorders. Previous clinical trials showed inconsistent results regarding the efficacy of ABM, and few studies have examined the effect of online ABM and its augmented effect with cognitive behavioural therapy (CBT). The aim of the current study was to examine the efficacy of online ABM combined with CBT for children and adolescents with anxiety disorders in a randomised, double-blind, placebo-controlled trial. Children (aged 8–16 years) completed nine online sessions of ABM (n= 28) or online sessions of the Attention Control Condition (ACC;n= 27) over a period of 3 weeks (modified dot-probe task with anxiety disorder-congruent stimuli), followed by CBT. Primary outcomes were clinician-reported anxiety disorder status. Secondary outcomes were patient-reported anxiety and depression symptoms and AB. Results showed a continuous decrease across time in primary and secondary outcomes (ps < .001). However, no differences across time between the ABM and ACC group were found (ps > .50). Baseline AB and age did not moderate treatment effects. Online ABM combined with CBT does not show different efficacy compared with online ACC with CBT for children and adolescents with anxiety disorders.

scholarly journals The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings

2011 ◽  
Vol 33 (2) ◽  
pp. 181-195 ◽  
Author(s):  
Giovanni Abrahão Salum ◽  
Luciano Rassier Isolan ◽  
Vera Lúcia Bosa ◽  
Andrea Goya Tocchetto ◽  
Stefania Pigatto Teche ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Separation Anxiety ◽  
Treatment Phase ◽  
Diagnostic Interview ◽  
Separation Anxiety Disorder ◽  
Design Methods ◽  
Community Screening ◽  
Multidimensional Evaluation

OBJECTIVE: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project. METHOD: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase. RESULTS: A total of 2,457 subjects from the community were screened for anxiety disorders. From those who attended the diagnostic interview, we identified 138 individuals with at least one anxiety disorder (apart from specific phobia) and 102 individuals without any anxiety disorder. Among the anxiety cases, generalized anxiety disorder (n = 95; 68.8%), social anxiety disorder (n = 57; 41.3%) and separation anxiety disorder (n = 49; 35.5%) were the most frequent disorders. CONCLUSION: The PROTAIA Project is a promising research project that can contribute to the knowledge of the relationship between anxiety disorders and anxiety-related phenotypes with several genetic and environmental risk factors.

scholarly journals Relationship between Anxiety Disorders and Anthropometric Indices, Risk Factors, and Symptoms of Cardiovascular Disorder in Children and Adolescents

2021 ◽  
Author(s):  
Nastaran Ahmadi ◽  
Mohammad Hadi Farahzadi ◽  
Mohammad Reza Mohammadi ◽  
Seyed-Ali Mostafavi ◽  
Sedigheh Saadat Moeeini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Demographic Data ◽  
Age Groups ◽  
Cluster Head ◽  
Cardiovascular Disorder ◽  
Cluster Sampling ◽  
Anthropometric Indices

Objective: Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years. Method: In this community-based study, multistage cluster sampling method was used. We randomly selected 1174 children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10- 14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants. Results: A total of 1035 children and adolescents participated in this study. The results showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, and hypertension. According to the results, FBS and LDL are a predictor for anxiety disorders. Conclusion: There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard.

scholarly journals Translation and Adaptation of the Spence Children’s Anxiety Scale (SCAS)-Parent Version at a Tertiary Level Hospital

2018 ◽  
Vol 7 (1) ◽  
pp. 40-45
Author(s):  
B.S. Gurung ◽  
M. Rana ◽  
S. Shakya
Keyword(s):  
Anxiety Disorder ◽  
Internal Consistency ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Clinical Samples ◽  
Clinical Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Metric Properties ◽  
Specificity And Sensitivity

Introduction: The study has examined the psycho-metric properties of the Nepali translation of SCAS-PV in terms of internal consistency and criterion validity Material and Method: Non probability sampling method was used. Participants were selected purposively under two groups of samples called clinical group and non clinical group. Study population of the study was the patient visiting outdoor and inpatient services of Department of Psychiatry and Mental Health, TUTH. Results: Among 200 (clinical= 98 and a non-clinical=102) sample of Nepalese children and adolescents. The specificity and sensitivity of the tool was assessed. Cronbach Alpha for the total scale (α =0.89), panic disorder (α =0.78), physical injury fear (α =0.72) and separation anxiety disorder (α =0.76) were of acceptable to good range. However, internal consistency of generalized anxiety disorder (α =0.67), obsessive compulsive disorder (α =0.59) and social anxiety disorder (α =0.68) were in questionable range. AUC statistic for total scale was in fair range, with optimum cut off score of 19.5 for the total scale with sensitivity of 65.3% and specificity of 64.7%. Conclusion: The study supports the utility of the SCAS-PV as a measure of anxiety symptoms in children. It can be used to directly compare symptom reporting across children in clinical. Because of the psychometric properties of the SCAS-PV that have been demonstrated in community and clinical samples, it is recommended that the SCAS-PV can be used in clinical and research contexts.

scholarly journals The Relationship Between Worry and Dimensions of Anxiety Symptoms in Children and Adolescents

2016 ◽  
Vol 45 (2) ◽  
pp. 124-138 ◽  
Author(s):  
Jonathan Rabner ◽  
Nicholas D. Mian ◽  
David A. Langer ◽  
Jonathan S. Comer ◽  
Donna Pincus
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Regression Model ◽  
Children And Adolescents ◽  
Separation Anxiety ◽  
Child Anxiety ◽  
Age Groups ◽  
Separation Anxiety Disorder ◽  
Older Children ◽  
The Relationship

Background: Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. Aims: The present study aimed to assess the level of worry in children and adolescents and how relationships between worry and symptoms of separation anxiety disorder (SAD) and social anxiety disorder (Soc) may present differently at different ages. Method: 127 children (age 8–12 years) and adolescents (age 13–18 years), diagnosed with any anxiety disorder, presenting at a child anxiety out-patient clinic, completed measures of worry, anxiety and depression. Results: Worry scores did not differ by age group. Soc symptoms were significantly correlated with worry in both age groups; however, SAD symptoms were only significantly correlated with worry in younger participants. After the inclusion of covariates, SAD symptoms but not Soc symptoms remained significant in the regression model with younger children, and Soc symptoms remained significant in the regression model with older children. Conclusions: The finding that worry was comparable in both groups lends support for worry as a stable construct associated with anxiety disorders throughout late childhood and early adolescence.

scholarly journals Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis

2021 ◽  
pp. 000486742110314
Author(s):  
Laura Orlando ◽  
Katarina A Savel ◽  
Sheri Madigan ◽  
Marlena Colasanto ◽  
Daphne J Korczak
Keyword(s):  
Depressive Symptoms ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Dietary Patterns ◽  
Internalizing Symptoms ◽  
Parent Report ◽  
Self Report ◽  
Effect Sizes ◽  
Clinical Samples ◽  
Cross Sectional

Context: Studies of child and adolescent internalizing symptoms and dietary pattern have produced mixed results. Objectives: To quantify the association between dietary patterns and internalizing symptoms, including depression, in children and adolescents. Data sources: Embase, PsycINFO, MEDLINE, Web of Science and Cochrane up to March 2021. Study selection: Observational studies and randomized controlled trials with mean age ⩽ 18 years, reporting associations between diet patterns and internalizing symptoms. Data extraction: Mean effect sizes and 95% confidence intervals were determined under a random-effects model. Results: Twenty-six studies were cross-sectional, 12 were prospective, and 1 used a case-control design. The total number of participants enrolled ranged from 73,726 to 116,546. Healthy dietary patterns were negatively associated with internalizing ( r = –0.07, p < 0.001, 95% confidence interval [–0.12, 0.06]) and depressive symptoms ( r = –0.10, p < 0.001, 95% confidence interval [–0.18, –0.08]). Effect sizes were larger for studies of healthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures, as well as in cross-sectional studies of healthy dietary patterns and depression compared to prospective studies. Unhealthy dietary patterns were positively associated with internalizing ( r = 0.09, p < 0.001, 95% confidence interval [0.06, 0.14]) and depressive symptoms ( r = 0.10, p < 0.01, 95% CI [0.05, 0.17]). Larger effect sizes were observed for studies of unhealthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures. Limitations: A lack of studies including clinical samples and/or physician diagnosis, and a paucity of studies in which anxiety symptoms were the primary mental health outcome. Conclusion: Greater depression and internalizing symptoms are associated with greater unhealthy dietary patterns and with lower healthy dietary intake among children and adolescents.

scholarly journals Cognitive behavioural psychotherapy for anxiety disorders in children and adolescents with particular focus on generalised anxiety disorder

2020 ◽  
Vol 20 (4) ◽  
pp. 274-282
Author(s):  
Anna Meslin-Kuźniak ◽  
◽  
Katarzyna Nowicka-Sauer ◽  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Theoretical Models ◽  
Behavioural Therapy ◽  
Generalised Anxiety Disorder ◽  
Treatment Protocols ◽  
Cognitive Behavioural

The paper presents the issue of anxiety disorders among children and adolescents with particular focus on generalised anxiety disorder and the use of cognitive behavioural psychotherapy in the affected patients. Data on epidemiology, aetiology and diagnosis of anxiety disorders, as well as the specificity and limitations of cognitive behavioural therapy among younger patients are presented. Statistical data show that the group of affected children and adolescents is growing. The diagnosis of generalised anxiety in children and adolescents may take time. It requires careful collection of history and observation of behaviours in different functioning domains. It may happen that symptoms indicative of generalised anxiety disorders are underestimated or missed by adults from the child’s immediate environment. Early and accurate diagnosis is important also because the disorder may give rise to depressive disorders or contribute to suicide attempts. Research shows that cognitive behavioural psychotherapy, often aided by pharmacotherapy, is one of the most effective and popular forms of therapy in children and adolescents with generalised anxiety disorders. The paper describes the theoretical models of the disorder, as well as its implications for psychotherapy and current research trends. Cognitive behavioural therapeutic programs intended for children and adolescents with anxiety disorders are also presented. The literature review shows that studies and protocols devoted exclusively to the treatment of generalised anxiety in children and adolescents are still missing. Therefore, treatment protocols for adults, which are appropriately adjusted to age and cognitive development of the child, are often used, especially for older children.

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