Treatment of Separation, Generalized, and Social Anxiety Disorders in Youths

Mohatt, Justin W.; Bennett, Shannon M.; Walkup, John T.

doi:10.1176/appi.ajp.2014.13101337

Cited by 53 publications

(40 citation statements)

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“…Second, although post-hoc analyses did not reveal that age was a significant moderator, our sample spans a large portion of development and may be underpowered to detect age-related interactions. Second, the sample is heterogeneous with regard to primary diagnoses and only a few participants had primary diagnoses of separation anxiety disorder, though primary diagnoses of social anxiety and GAD did not moderate effects, and the three disorders often co-occur and overlap in symptoms (Mohatt et al, 2014). Finally, although our analysis did not reveal a significant effect of site/scanner as a moderator, the sample was collected and combined from two sites to maximize sample size.…”

Section: Predictors Of Treatment Response In Anxious Youthmentioning

confidence: 87%

“…Separation, social, and generalized anxiety disorder (GAD) are particularly common among youth, with relatively early ages of onset and high rates of co-occurence with each other (Mohatt et al, 2014;Verduin and Kendall, 2003). Although both pharmacological (ie, selective serotonin reuptake inhibitors (SSRIs)) and cognitive behavioral therapy (CBT) are effective in treating pediatric anxiety disorders, approximately 40-45% of youth fail to show significant improvement in symptoms (Mohatt et al, 2014;Walkup et al, 2008), raising the need to identify predictors of treatment response.…”

Section: Introductionmentioning

confidence: 99%

“…This two-site study was modeled after the Child/Adolescent Anxiety Multimodal Study (Compton et al, 2010) in that it included youth across a large span of development (7-19 years) with primary diagnoses of GAD, social anxiety disorder, or separation anxiety disorder, three of the most common anxiety disorders in youth (Compton et al, 2010;Mohatt et al, 2014), treated with either sertraline (ie, SSRI) or psychotherapy (ie, CBT). Prior to beginning treatment, participants completed an fMRI emotional faces task in which brain responses to angry, fearful, and happy faces were measured.…”

Section: Introductionmentioning

confidence: 99%

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Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth

Kujawa

Swain

Hanna

et al. 2015

Neuropsychopharmacol

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Neuroimaging has shown promise as a tool to predict likelihood of treatment response in adult anxiety disorders, with potential implications for clinical decision-making. Despite the relatively high prevalence and emergence of anxiety disorders in youth, very little work has evaluated neural predictors of response to treatment. The goal of the current study was to examine brain function during emotional face processing as a predictor of response to treatment in children and adolescents (age 7-19 years; N = 41) with generalized, social, and/ or separation anxiety disorder. Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), participants completed an emotional faces matching task during functional magnetic resonance imaging (fMRI). Whole brain responses to threatening (ie, angry and fearful) and happy faces were examined as predictors of change in anxiety severity following treatment. Greater activation in inferior and superior frontal gyri, including dorsolateral prefrontal cortex and ventrolateral prefrontal cortex, as well as precentral/postcentral gyri during processing of threatening faces predicted greater response to CBT and SSRI treatment. For processing of happy faces, activation in postcentral gyrus was a significant predictor of treatment response. Post-hoc analyses indicated that effects were not significantly moderated by type of treatment. Findings suggest that greater activation in prefrontal regions involved in appraising and regulating responses to social signals of threat predict better response to SSRI and CBT treatment in anxious youth and that neuroimaging may be a useful tool for predicting how youth will respond to treatment.

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Section: Predictors Of Treatment Response In Anxious Youthmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth

Kujawa

Swain

Hanna

et al. 2015

Neuropsychopharmacol

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“…Les stratégies d'intervention sont nombreuses et comprennent notamment la psychoéducation, la rééducation respiratoire, l'entraînement à la relaxation, l'entraînement à la résolution de problèmes, la restructuration cognitive, l'auto-instruction, l'exposition in vivo graduée aux situations anxiogènes, l'exposition en imagination et l'entraînement aux habiletés sociales (Kendall, 2012). Le traitement est habituellement de courte durée (10-16 semaines); une composante importante a trait à la pratique entre les sessions, sous forme de devoirs ou d'exercices (Mohatt, Bennett et Walkup, 2014). Kendall (1990) est considéré comme un pionnier dans le traitement des troubles anxieux chez les enfants.…”

Section: La Thérapie Cognitivo-comportementale Chez Les Enfants Et Leunclassified

Les programmes préventifs en milieu scolaire auprès des enfants et des adolescents présentant de l’anxiété

Turgeon

Gosselin

2016

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L’objectif de cet article est de décrire les programmes de prévention de l’anxiété en milieu scolaire auprès des enfants et des adolescents. Nous rapportons d’abord quelques données sur l’épidémiologie des troubles anxieux, leurs conséquences et les coûts associés afin d’illustrer la pertinence d’intervenir de manière précoce. La section suivante présente le programme Coping Cat, qui a servi d’inspiration aux programmes de prévention. Nous distinguons ensuite les programmes de prévention en milieu scolaire selon leur nature : universelle, sélective et indiquée. L’accent est mis sur le programme FRIENDS, largement diffusé comme programme de prévention et reconnu par l’Organisation mondiale de la santé. Les résultats montrent de façon générale que les interventions sélectives et indiquées donnent des résultats plus importants, en particulier si elles sont animées par des spécialistes en santé mentale. Cependant, elles comportent certains désavantages, comme le fait de ne pas réussir à rejoindre les enfants qui pourraient le plus en bénéficier. Les programmes de prévention universelle rejoignent pour leur part tous les enfants et ils peuvent être implantés par les enseignantes. Les obstacles liés à l’implantation sont toutefois importants. La dernière partie de l’article contient quelques recommandations destinées à améliorer la prévention des troubles anxieux en milieu scolaire.The objective of this article is to present anxiety prevention programs in schools for children and adolescents. We first present some data on the epidemiology of anxiety disorders, their consequences and associated costs, in order to illustrate the relevance of early intervention. The following section presents the program Coping Cat, which served as inspiration for the prevention programs. We then present the school prevention programs according to their nature: universal, selective and indicated. The accent is on the FRIENDS program, widely distributed as a prevention program and recognized by the World Health Organization. The results generally show that selective and indicated interventions yield more significant results, especially if they are led by mental health specialists. However, there are certain disadvantages, such as not being able to reach the children who could most benefit. Universal prevention programs, however, reach all children and can be implemented by teachers, but there are major obstacles to their application. The last part of the article presents some recommendations for improving the prevention of anxiety disorders in schools.En la prevención y el tratamiento de la ansiedad, los enfoques denominados de la tercera ola basados en la plena consciencia se han vuelto cada vez más actuales. El objetivo de este artículo es presentar las estrategias innovadoras basadas en la consciencia plena del tratamiento y la prevención de la ansiedad entre los niños y los adolescentes, particularmente en el medio escolar. Las principales intervenciones basadas en la plena consciencia en el tratamiento de la ansiedad entre los adultos...

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“…SAD increases the risk for subsequent depressive illness and substance abuse [2]. Early interventions for children and adolescents with anxiety disorders in general are urgently needed to prevent further unfavorable developments [8]. …”

Section: Introductionmentioning

confidence: 99%

Cognitive-Behavioral and Psychodynamic Therapy in Adolescents with Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

Salzer

Stefini

Kronmüller

et al. 2018

Psychother Psychosom

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Background: Although social anxiety disorder (SAD) has an early onset and is frequently found in adolescence, evidence for psychotherapeutic treatments of SAD in adolescents is rather scarce. Within the Social Phobia Psychotherapy Research Network (SOPHO-NET), we examined the efficacy of cognitive-behavioral (CBT) and psychodynamic therapy (PDT) compared to a waiting list (WL) in these patients. Methods: In a multicenter randomized controlled superiority trial, 107 patients, aged 14–20 years, were randomized to CBT (n = 34), PDT (n = 34), or WL (n = 39). Assessments were made at baseline, at the end of treatment, and 6 and 12 months after termination. The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) applied by raters masked to the treatment condition was used as the primary outcome. As secondary outcomes, rates of response and remission and the Social Phobia Anxiety Inventory (SPAI) were used. Results: Both treatments were superior to WL in the LSAS-CA (CBT: p = 0.0112, d = 0.61, 95% CI 0.14–1.08; PDT: p = 0.0261, d = 0.53, 95% CI 0.06–1.00). At the end of treatment, response rates were 66, 54, and 20% for CBT, PDT, and WL. The corresponding remission rates were 47, 34, and 6%, respectively. CBT and PDT were significantly superior to WL regarding remission (CBT: p = 0.0009, h = 1.0; PDT: p = 0.0135, h = 0.74), response (CBT: p = 0.0004, h = 0.97; PDT: p = 0.0056, h = 0.72), and the SPAI (CBT: p = 0.0021, d = 0.75, 95% CI 0.27–1.22; PDT: p = 0.0060, d = 0.66, 95% CI 0.19–1.13). Treatment effects were stable at 6- and 12-month follow-ups. Conclusions: These results are comparable to the large SOPHO-NET trial in adults (n = 495). Early treatments for social anxiety are needed in order to prevent chronic manifestation of SAD.

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Treatment of Separation, Generalized, and Social Anxiety Disorders in Youths

Cited by 53 publications

References 52 publications

Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth

Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth

Les programmes préventifs en milieu scolaire auprès des enfants et des adolescents présentant de l’anxiété

Cognitive-Behavioral and Psychodynamic Therapy in Adolescents with Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

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