Objective Examine the efficacy of a parent-augmented One Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. Method A total of 97 youth (ages 6–15, 51.5% female, 84.5% white) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semi-structured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, post-treatment, and 1-month and 6-months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Results Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at post-treatment and 1-month follow up. At 6-month follow up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Conclusions Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted.

The purpose of this paper is to propose a method for empirically investigating diagnostic criteria for personality disorder not otherwise specified (PDNOS). From a large, nonclinical sample of military recruits and undergraduate students who were screened for personality disorders (PDs), 572 completed the Structured Interview for DSM-IV Personality. Data from the interviewed group were used to identify a diagnostic threshold for PDNOS by comparing those who did (n = 88) and did not (n = 484) qualify for a PD diagnosis. For both groups, subjective distress increased and measures of social and occupational functioning decreased as a function of the number of PD criteria met. A classification and regression tree modeling procedure was applied using self-report scores on measures of mood, anxiety, and personality traits to arrive at probabilities for predicting the presence of a PD diagnosis based on the pattern of reported traits present. These probabilities were then used to derive an empirically based diagnostic threshold for PDNOS. In this sample, the most appropriate threshold for a PDNOS diagnosis appears to be the presence of 10 PD criteria for a person who does not qualify for a diagnosis of any other specific form of PD. This definition identified 5.5% of the young adults who were interviewed in this study.

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Social anxiety disorder (SAD) is defined by persistent, irrational anxiety in social situations while generalized anxiety disorder (GAD) is characterized by excessive worry unrelated to any specific situation. These two disorders share some features and are frequently comorbid in children and adults. The current study sought to examine this comorbidity and compare the disorders on a number of dimensions in a clinical sample of children and adolescents. It was hypothesized that SAD would be accompanied by higher levels of social anxiety and behavioral inhibition and lower levels of family expressiveness and social functioning than GAD. GAD was hypothesized to be accompanied by higher levels of worry, physiological symptoms, and anxiety sensitivity and lower levels of school functioning as compared to SAD. Youth with both disorders were hypothesized to function more poorly on all dimensions as compared to either disorder alone. Participants were drawn from a sample of 397 (137 female) youth who underwent psychoeducational assessment. A series of analyses of variance, discriminant function analyses, and factor analyses were performed using the entire sample, and repeated by gender and age group. Results indicated youth with GAD had higher levels of harm avoidance as compared to youth with social anxiety disorder. However, the diagnostic groups did not differ on other features. Moreover, results of factor and discriminant function analyses did not distinguish between the two groups. The pattern of results was similar when examined for gender and age, although some differences emerged. Overall, results suggest SAD and GAD overlap significantly in children, with less overlap in adolescents. This raises questions iii regarding the validity of current child anxiety taxonomies. Future research should further examine this phenomenon, including longitudinal samples and a wider range of diagnoses.iv Acknowledgements

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