Anxiety disorders in children and adolescents.
Conditions
Interventions
General aspects of the two treatments. Both treatments consist of 1 pre-session with the therapist for assessment purposes, 12 treatment sessions, and 2 follow-up sessions, 1 at 3-month and 1 at 1-yea
and (III) graded exposure-in-vivo by means of a fear hierarchy and reinforcement schedule.
Parents are involved in the individual CBT 4 times: at start of the treatment, to explain the principles of
Sponsors
Academic Hospital Maastricht and University of Maastricht
Eligibility
Inclusion criteria
Inclusion criteria: 1. Children aged 8-18 a. who are referred to one of the in the study participating centres, b. and have one of the following anxiety disorders as their primary diagnosis: separation anxiety disorder, social phobia, generalised anxiety disorder, panic disorder with/without agoraphobia, anxiety disorder not otherwise specified, or simple phobia, form the selected population.
Exclusion criteria
Exclusion criteria: 1. Excluded are children with disorders of the autistic spectrum, a psychotic disorder, attention deficit disorder, and addiction disorders. 2. Children using psychopharmacological medication for their anxiety disorders are guided to stop medication before starting treatment. 3. The parents and siblings need to be willing to participate. 4. In case one of the parents or siblings cannot be motivated to participate, treatment can still be offered, if at least one parent wants to participate.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The treatment that cures most of the referred, anxiety disordered children, is considered as the most effective treatment. Therefore, the percentage of children free from anxiety disorders is the primary outcome variable. Anxiety disorders are assessed by means of the (semi)Structured Anxiety Disorder Interview Schedule (ADIS; Silverman & Albano, 1996). Parents and child are interviewed separately concerning the possible mental disorders of the child, by research assistants with clinical experience, who are blind to the treatment condition of the child. Another operationalisation of cure of child anxiety disorders is by means of a child anxiety questionnaire, filled in by both the anxious child and its parents. The SCARED self- and parent report (Muris et al., 1999) and the STAIC (Spielberger, 1973) are used for this purpose. Finally, fear and avoidance ratings of the child’s 5 target situations is used as an idiosyncratic, illness-specific measure. | — |
Secondary
| Measure | Time frame |
|---|---|
| The following secondary measures are used. The referred child’s general psychopathology, general functioning, and quality of life, is assessed with the Child Behaviour Checklist (CBCL, Achenbach & Edelbrock, 1983) filled in by both parents separately. The degree to which the family benefits from the treatment, in terms of reduction of anxiety and psychopathology, is assessed as follows. By means of a (semi)Structured Anxiety disorder Interview for adulta (ADIS, DiNardo, Brown, & Barlow, 1994), each of the parents’ own mental disorders are assessed, and by means of the ADIS the anxiety disorders of the siblings are measured. In addition, parents’ self-reported anxiety are assessed using the State-Trait Anxiety Inventory (STAI, Spielberger et al., 1973) and the SCARED, and their general psychopathology by the SCL-90 (Arrindell & Ettema, 1983). Siblings also fill out the SCARED and STAIC. Third, the following process measures are included. The functioning of the family is assessed with the Family Functioning Scale (Bloom, 1985), filled in by the referred child and the parents. Two aspects of parental attitudes toward child-rearing, that is, the degree to which parents overprotect their anxious child and discourage independent functioning, are measured by means of a new scale that consists of relevant items of four child rearing questionnaires (EMBU (Bogels et al., 2001), CRPBI (Shaefer & Shaefer), PBI () and MFP scale (Epstein, 1983)), filled in by the referred child and both parents. Such a new scale is made since the reliability of the now existing instruments is poor, probably as a result of too little items for each scale. The new scale is constructed on the basis of factor-analytic research that is currently conducted. In addition, overprotection and autonomy encouragement are measured by a discussion task (see Siqueland et al., 1996). Parents and child engage in a discussion about a) a general hot item, and b) an item related to the fear of the child. The discu | — |
Contacts
Public ContactDenise Bodden
Universiteit Utrecht P.O. Box 80140
Outcome results
None listed