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Objective: The purpose of the present study was to evaluate the influence of comorbid disorders on the degree of change and the endpoint of cognitive-behavioral treatment in anxious young people. Method: Data on 750 children 6 to 18 years old were compiled from different samples within one clinic. All children had a primary anxiety disorder and were engaged in a manual-based, 10-session, cognitive-behavioral treatment program. Outcome was determined according to diagnostic status and continuous symptom measurements. Analyses compared results among four groups: no comorbidity, comorbid anxiety disorders, comorbid externalizing disorders, comorbid mood disorders. All analyses were intent-to-treat analyses. Results: Children with comorbid depression were the least likely to be free of their primary anxiety diagnosis at the end of treatment and follow-up. According to child and maternal reports, symptoms of anxiety decreased similarly over time in all groups, but children with comorbid mood disorders scored significantly highest at all time points. Examining the effects of anxiety treatment on comorbid disorders showed that comorbid mood disorders, but not externalizing disorders, decreased significantly over time. Conclusions: The existence of comorbid disorders does not appear to affect the rate or extent of response to cognitive-behavioral treatment for child anxiety. However, comorbidity has a marked influence on the endpoint of treatment. Children with nonanxiety comorbidity and especially with comorbid mood disorders exhibit greater severity at the outset and remain worse after treatment. On the positive side, treatment for anxiety disorders appears to decrease comorbid mood disorders, although it has less effect on comorbid externalizing disorders. (Contains 3 tables.)

Objective: Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this population. Method: Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Results: Using mixed-model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms, automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized treatment was well suited to adolescents with anxiety. Conclusions: The Cool Teens program is efficacious for treatment of adolescent anxiety. Clinical trial registration information-A randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with waist list; http://www.anzctr.org.au; ACTRN12611000508976. (Contains 4 tables and 1 figure.)

The efficacy of early intervention for preschool-aged children at risk of anxiety disorders is investigated. Brief early intervention delivered through parents can reduce anxiety and associated risk and may alter the developmental trajectory of anxiety in some young children.

Specific delivery of cognitive-behavioral skills is more effective in treating childhood anxiety compared to treatment that contains only nonspecific therapy factors. The findings are based on a randomized trial involving 112 children aged 7-16 years.

Objective: The present study determined interrater agreement on diagnoses achieved using the parent and child versions of the Anxiety Disorders Interview Schedule for Children for DSM-IV (ADIS-C/P) and examined informant, age, and gender influences on reliability. Method: Diagnoses established for 153 seven- to 16-year-old children during live administration of the ADIS-C/P were compared to diagnoses identified by a second rater after viewing a video recording of the interviews. Results: When information from both parent and child interviews was used, the level of agreement between raters for principal diagnosis ([kappa] = 0.92) and the individual anxiety disorders ([kappa] = 0.80-1.0) was excellent. Agreement on common comorbid disorders was good ([kappa] = 0.65-0.77). Agreement was also good to excellent when diagnoses were assigned based on separate child or parent interviews, aside from children's report of externalizing disorders. Age and gender did not consistently impact interrater agreement. Conclusions: The data indicate that the present version of the ADIS-C/P provides consistent diagnostic results across different clinicians and indicates improvements in the reliability of diagnoses following criterion changes in DSM-IV. (Contains 4 tables.)

Examines the interrater and parent-child agreement for the major anxiety disorders. Levels of interrater agreement for all major childhood anxiety disorders; Poor parent-child agreement for most diagnostic categories; Reliability of diagnosis of DSM-II-R anxiety disorders using structured interviews.