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The authors describe social validity assessment of mindfulness education and practices among high school students (N = 84) participating in a 10-week instructional program. The participants rated their satisfaction with and acceptance of several program components, content areas, and outcomes, as well as their engagement in specific mindfulness practices. Nearly all of the participants rated the program favorably, reported many beneficial effects, and anticipated future use of mindfulness in their lives. They did not routinely perform voluntary formal guided meditations beyond the classroom but did engage in informal mindfulness practices preceding certain activities (e.g., preparing for a test, athletic competition, performance event) and going to sleep at night. The authors discuss these findings and the implications for designing school-based mindfulness education programs.

This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The sample included families of 147 preadolescents and adolescents (56.6 % female; 89.8 % Caucasian), 11-18 years old (M = 13.64, SD = 1.98) assigned a principal diagnosis of an anxiety or depressive disorder. When controlling for age and concurrent anxiety symptoms, regression analyses revealed that for boys, both father- and mother-rated family cohesion predicted depressive symptoms. For girls, mother-rated family expressiveness and conflict predicted depressive symptoms. Youth anxiety symptoms were not significantly associated with any family relationship variables, controlling for concurrent depressive symptoms. Findings suggest that parent-rated family relationship factors may be more related to youth depressive than anxiety symptoms in this clinical sample. In addition, family cohesion, as perceived by parents, may be more related to boys' depression, whereas expressiveness and conflict (as rated by mothers) may be more related to girls' depression. Clinical implications and recommendations for future research are discussed.

This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening positive (n = 22) and negative (n = 23) for panic symptoms on the ANS completed follow-up phone interviews assessing fit with DSM-IV criteria for panic disorder, self-reported anxiety and depression symptom severity, anxiety-related correlates, and functional impairment. A two-question version of the ANS demonstrated excellent sensitivity (Se = 1.00), but lower specificity (Sp = 0.47) for PD diagnostic status. Three-question and five-question versions modestly improved specificity (Sp = 0.57 and 0.65, respectively). In addition, screen-positive participants reported higher panic symptoms, anxiety sensitivity, and functional impairment, relative to screen-negative participants. Preliminary results suggest the ANS may be a valid screening tool for PD among adolescents, while simultaneously being brief and easy to score. Replication with larger samples is recommended as one related future research endeavor.

Objective: In research with community samples, children with chronic physical illnesses have shown elevated anxiety and depressive symptoms, compared to healthy peers. Less is known about whether physical illnesses are associated with elevated internalizing symptoms even among children referred for mental health treatment-a pattern that would indicate distinctive treatment needs among physically ill children receiving mental health care. We investigated the relationship between chronic physical illness and internalizing symptomatology among children enrolling in outpatient mental health treatment.Method: A total of 262 treatment-seeking children ages 7-15 and their caregivers completed a demographic questionnaire, Child Behavior Checklist, and Youth Self-Report during a pre-treatment assessment. Physical illnesses were identified through caregiver report.Results: There was no overall association between the presence/absence of chronic physical illness and parent- or child-reported symptoms. However, number of chronic physical illnesses was related to parent- and child-reported affective symptoms. Children with two or more chronic physical illnesses had more severe depressive symptoms than those with fewer physical illnesses.Conclusion: Having multiple chronic illnesses may elevate children's risk of depression symptomatology, even in comparison to other children seeking mental health care. This suggests a need to identify factors that may exacerbate depression symptoms in physically ill children who are initiating therapy and to determine whether different or more intensive services may be helpful for this group. The findings suggest the potential utility of screening for depression in youth with chronic physical illnesses, as well as addressing mental and physical health concerns during treatment. [ABSTRACT FROM AUTHOR]

The authors describe social validity assessment of mindfulness education and practices among high school students (N = 84) participating in a 10-week instructional program. The participants rated their satisfaction with and acceptance of several program components, content areas, and outcomes, as well as their engagement in specific mindfulness practices. Nearly all of the participants rated the program favorably, reported many beneficial effects, and anticipated future use of mindfulness in their lives. They did not routinely perform voluntary formal guided meditations beyond the classroom but did engage in informal mindfulness practices preceding certain activities (e.g., preparing for a test, athletic competition, performance event) and going to sleep at night. The authors discuss these findings and the implications for designing school-based mindfulness education programs. [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD) is frequently comorbid with bipolar disorder (BD), yet frontline pharmacological interventions for SAD are often contraindicated for individuals with BD. We present a case report of a 29-year-old male with Bipolar I Disorder who received cognitive-behavioral therapy (CBT) for SAD, followed by CBT and interpersonal therapy (IPT) for SAD. The patient completed standardized self-report measures of social anxiety and depressive symptoms throughout treatment and at 1-month and 3-month follow-ups. The greatest social anxiety symptom improvement occurred during the CBT phase, and the patient experienced small but additional benefit with the incorporation of IPT techniques. Although not a direct target of treatment, the patient’s depressive symptoms remained subthreshold throughout treatment. Finally, the patient reported significantly higher quality of life at 1-month and 3-month follow-ups, compared with a reference group of BD outpatients. Findings offer preliminary support for the integration of CBT and IPT in treating comorbid SAD among individuals with BD. Clinical implications and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

There is a high degree of comorbidity between anxiety and depressive disorders among treatment-seeking adolescents. Comorbid youth often present with greater diagnostic severity, worse social functioning, and more severe anxiety and depressive symptoms, compared with anxiety-disordered youth without depression. However, the degree to which these populations may differ in underlying affect and emotion regulation (ER) is largely unknown. This study compared 44 anxiety-disordered adolescents (ages 12-18 years) with a comorbid depressive disorder (ANX + DEP) and 32 anxiety-disordered adolescents without a comorbid depressive disorder (ANX) on several clinical and emotion-related variables. Results indicated that ANX + DEP adolescents were assigned higher clinician-rated diagnostic severity ratings, and reported greater functional impairment and more severe social anxiety and depressive symptoms, compared with ANX adolescents. In addition, ANX + DEP adolescents demonstrated higher levels of negative affect, lower levels of positive affect, and poorer self-reported and parent-reported ER. Implications for assessment and treatment, as well as directions for future research, are discussed. [ABSTRACT FROM PUBLISHER]

The frequent co-occurrence of anxiety disorders and autism spectrum disorders (ASD) in youth has spurred study of intervention practices for this population. As anxiety disorders in the absence of ASD are effectively treated using cognitive-behavioral therapy (CBT) protocols, an initial step in evaluating treatments for comorbid youth has necessarily centered on adaptation of CBT. One primary limitation of this research, to date, is that interventions for adolescents with anxiety disorders and ASD have not been systematically tested. In this study, 20 adolescents (90% male) with ASD and a comorbid anxiety disorder, between ages 11 and 14 years (M = 12.2 years, SD = 1.11 years), participated in an open trial of modified CBT targeting anxiety with ASD. Findings demonstrated significant reductions in anxiety severity, as assessed by clinician and parent ratings, from baseline to post-treatment. In addition, reductions in parent-rated externalizing symptoms were observed. Gains were maintained at a 1-month follow-up. [ABSTRACT FROM PUBLISHER]

The frequent co-occurrence of anxiety disorders and autism spectrum disorders (ASD) in youth has spurred study of intervention practices for this population. As anxiety disorders in the absence of ASD are effectively treated using cognitive-behavioral therapy (CBT) protocols, an initial step in evaluating treatments for comorbid youth has necessarily centered on adaptation of CBT. One primary limitation of this research, to date, is that interventions for adolescents with anxiety disorders and ASD have not been systematically tested. In this study, 20 adolescents (90% male) with ASD and a comorbid anxiety disorder, between ages 11 and 14 years (M = 12.2 years, SD = 1.11 years), participated in an open trial of modified CBT targeting anxiety with ASD. Findings demonstrated significant reductions in anxiety severity, as assessed by clinician and parent ratings, from baseline to post-treatment. In addition, reductions in parent-rated externalizing symptoms were observed. Gains were maintained at a 1-month follow-up. [ABSTRACT FROM AUTHOR]