With the current focus on increasing utilization of empirically supported treatments, knowledge of sample differences and similarities has increasing importance. The present study compared anxiety-disordered youth (age 7-13) from (a) five Norwegian service clinics (SC, N = 111) to (b) a university research clinic (RC) in Philadelphia, USA (N = 144) on pre-treatment characteristics measured by the Multidimensional Anxiety Scale for Children, Child Behavior Checklist, Teacher Report Form, Anxiety Disorders Interview Schedule, and Children's Global Assessment Scale (CGAS). SC youth demonstrated higher levels of anxiety based on child- (d = 0.42-1.04) and parent-report (d = 0.53) and conduct problems based on parent-report (d = 0.43) compared to RC youth. SC youth was more functionally impaired on the CGAS (d = 0.97), whereas RC youth evidenced a greater number of diagnoses (d = 0.63). The two samples were equivalent regarding parent-reported symptoms of affective, somatic, attention-deficit/hyperactivity, and oppositional problems. Future directions and clinical implications are discussed.
To compare the effectiveness of individual cognitive-behavioral therapy (ICBT) and group CBT (GCBT) for referred children with anxiety disorders within community mental health clinics.
Children (N = 165; ages 7-13 years) referred to 5 clinics in Norway because of primary separation anxiety disorder (SAD), social anxiety disorder (SOC), or generalized anxiety disorder (GAD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria participated in a randomized clinical trial. Participants were randomized to ICBT, GCBT, or wait list (WL). WL participants were randomized to 1 of the 2 active treatment conditions following the wait period. Primary outcome was loss of principal anxiety disorder over 12 weeks and 2-year follow-up.
Both ICBT and GCBT were superior to WL on all outcomes. In the intent-to-treat analysis, 52% in ICBT, 65% in GCBT, and 14% in WL were treatment responders. Planned pairwise comparisons found no significant differences between ICBT and GCBT. GCBT was superior to ICBT for children diagnosed with SOC. Improvement continued during 2-year follow-up with no significant between-groups differences.
Among anxiety disordered children, both individual and group CBT can be effectively delivered in community clinics. Response rates were similar to those reported in efficacy trials. Although GCBT was more effective than ICBT for children with SOC following treatment, both treatments were comparable at 2-year follow-up. Dropout rates were lower in GCBT than in ICBT, suggesting that GCBT may be better tolerated. Response rates continued to improve over the follow-up period, with low rates of relapse. (PsycINFO Database Record
The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder as opposed to 26.4% who had other principal diagnoses and a secondary anxiety disorder. The national database not only provides a valuable prevalence estimate of anxiety disorders in every-day non-research psychiatric settings, but also highlights the importance of applying standardized screening instruments as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.