No abstract

The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention (FESA; N = 39). Children in FCBT engaged in exposure tasks in Sessions 9-16, whereas FESA participants did not. Alliance growth curves of FCBT and FESA youths were compared to examine the impact of exposure tasks on the shape of the alliance (between-subjects). Within FCBT, the shape of alliance prior to exposure tasks was compared with the shape of alliance following exposure tasks (within-subjects). Therapist, child, mother, and father alliance ratings indicated significant growth in the alliance across treatment sessions. Initial alliance growth was steep and subsequently slowed over time, regardless of the use of exposure tasks. Data did not indicate a rupture in the therapeutic alliance following the introduction of in-session exposures. Results are discussed in relation to the processes, mediators, and ingredients of efficacious interventions as well as in terms of the dissemination of empirically supported treatments.

The authors examined maternal and paternal reports of family functioning and their relationship with child outcomes as well as the association between anxiety and depression in family members and family functioning. Results reveal that maternal and paternal reports of family functioning were both significantly associated with worse child outcomes, including child anxiety disorder (AD) severity, anxiety symptoms, and child global functioning. Maternal and paternal anxiety and depression predicted worse family functioning, whereas child report of anxiety and depression did not. Parents of children with ADs reported significantly worse family functioning and behavior control, but only fathers reported worse problem solving and affective involvement compared with fathers of children with no psychological disorders. Findings from this study suggest that paternal as well as maternal anxiety and depression play a role in worse family functioning in children with ADs and that unhealthier family functioning is associated with worse child outcomes in this population.

This study investigated the psychometric properties of the Positive and Negative Affect Scale for Children (PANAS-C) (Laurent et al. Psychol Asses 1: 326-338, 1999) in a sample of 139 children (ages 7-14 years) diagnosed with a principal anxiety disorder. Results from this study provided support for the convergent validity of the PANAS-C with established measures of childhood anxiety and depression. As predicted, negative affect was significantly associated with measures of anxiety and depression whereas positive affect was associated with depression. However, weaknesses in discriminant validity were found, most notably with regard to social anxiety. Consistent with previous research, social anxiety was significantly associated with low levels of positive affect (PA). Furthermore, results from regression analyses indicated that PA made a significant unique contribution to the prediction of social anxiety as well as depression scores. Findings are discussed with regard to the usefulness of the PANAS-C to differentiate anxiety and depression in children with anxiety disorders.

The present study aimed to examine somatic complaints in children with anxiety disorders compared to non-anxious control children and whether somatic complaints predict poorer academic performance. The sample consisted of 108 children and adolescents (aged 8-14 years) assessed by a structured diagnostic interview: 69 with a principal (i.e., most severe and/or interfering) anxiety disorder diagnosis and 39 non-anxious community controls. Established child and parent report measure of somatic complaints, anxiety, and internalizing symptoms were completed. The participants' primary teacher was used to assess academic performance. Findings indicated that children with anxiety disorders reported more somatic complaints than the non-anxious community controls. Furthermore, a greater frequency of somatic complaints uniquely predicted poorer academic performance beyond that accounted for by anxiety and internalizing symptoms based on both child and parent report measures. Knowledge about somatic complaints in children with anxiety disorders and their relation to academic functioning may allow for early identification and prevent academic problems.