Using structural equation modeling, the authors evaluated the hypothesis that the relation between marital adjustment and children's behavior problems is mediated by child-rearing disagreements, whose effects are mediated by parents' overreactive discipline. In a community sample, fully or partially mediated models of internalizing and externalizing behavior problems of 3- to 7-year-old boys (N = 99) and girls (N = 104) were supported for mothers and fathers in 7 of 8 cases. Child-rearing disagreements always mediated the relation of marital adjustment and child behavior problems, and overreactive discipline was a final mediator in 3 cases. More variance was accounted for in mothers' than fathers' ratings. For mothers' ratings, the most variance was accounted for in boys' externalizing and girls' internalizing behavior problems.

Pediatric anxiety disorders are prevalent, chronic, and often lead to significant impaired functioning that impacts both short- and long-term outcomes for children and adolescents. Treatment options include pharmacotherapy and psychosocial interventions. This presentation will review treatment advances specifically for pharmacotherapy. Current research supports serotonin reuptake inhibitors as the medication class to be the first-line treatment option for pediatric anxiety disorders. Available evidence for the efficacy of other classes of medications will be reviewed, along with the available approaches to manage partial responders and nonresponders. The risks and benefits of pharmacotherapy will also be reviewed. In addition, recent research has shown the potential promise of novel agents that act upon other neural systems implicated in the development of pediatric anxiety disorders. Novel compounds that affect the glutamate system will be discussed.

Objective-Children of depressed and/or anxious parents are at increased risk for developing psychiatric disorders. Little research has focused on screening parents bringing their children for psychiatric evaluation, and few studies have included fathers or Hispanic children. This study aimed to: 1) identify current symptom rates in parents bringing their children for evaluation and 2) determine if parental symptoms were associated with children's symptoms, diagnoses, and functioning.Method-The sample included 801 mothers, 182 fathers, and 848 children (ages 6-18). The majority were Hispanic (55.66%) who attended a child and adolescent psychiatric evaluation service. Parent and child symptoms were assessed via parental reports. Children's diagnoses and functioning were determined by clinicians. Multiple regression analyses were used to determine if severity of parental symptoms was associated with clinical child variables adjusting for child and parent demographic variables.Results-18.80% of mothers and 18.42% of fathers reported elevated internalizing symptoms. Maternal symptoms were significantly associated with problems in children's functioning and children's anxiety, depression and oppositional/conduct diagnoses; but not attention deficithyperactivity disorder. Adjusting for parental and child demographics had a reduction on the effect of maternal symptoms on child depression. Paternal symptoms and functioning were positively associated with children's diagnoses, but smaller and not significant. Both parents' symptoms were significantly associated with children's internalizing and externalizing symptoms. However, these significant effects were not moderated by marital status or child ethnicity. Unit 24, New York, N.Y. 10032, Phone: 212-543-6824, Fax: 212-543-6660, vidairh@childpsych.columbia.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or the National Institutes of Health. Conclusions-This study highlights the importance of screening parents when their children receive a psychiatric evaluation. It supports the development of mental health services that addresses psychiatric needs of the entire family within one clinical setting. Keywords parent screening; child psychiatric evaluationChildren and adolescents whose parents suffer from depression and anxiety are at high risk for developing their own psychiatric symptoms and disorders. Top-down studies assessing offspring of parents with lifetime symptoms as compared to non-symptomatic ...

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The process of terminating cognitive-behavioral therapy (CBT) with families has been largely neglected in the literature, with the limited research focused on premature termination. This article describes the natural termination process in CBT with children, adolescents, and their parents. Based on existing theories, we describe a cognitive-behavioral model for: (a) initiating and engaging in discussion of termination, (b) processing the termination of treatment and the therapeutic relationship, (c) key aspects of the termination process in the final session, and (d) the very end of the final session (saying goodbye). For each of the 4 components, we review relevant theories, provide clinical exchanges to demonstrate techniques, and provide related research support. (PsycINFO Database Record