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Background: Hurricane Harvey struck southeast Texas in August 2017 resulting in widespread destruction and significant emotional distress. Objective: We examined the effectiveness of a transdiagnostic psychotherapeutic intervention delivered to youth with emotional disorders in a large, community health system following this hurricane. Methods: One hundred forty-nine youth aged 5 to 17 years with a history of hurricane exposure and emotional difficulties received an average of 6.4 (SD = 3.4) psychotherapy sessions using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents. Youth-caregiver dyads completed measures of disaster exposure and impact at baseline as well as anxiety and depression at baseline and each therapy session. Symptom severity and level of functioning were rated by the clinician. Latent growth curve modeling was used to examine symptom change over time. Results: Children and adolescents began treatment with moderate levels of anxiety and depressive symptoms, symptom severity, and difficulties in daily functioning. Anxiety and depressive symptoms and symptom severity declined significantly over the treatment period. Clinician ratings of functionality evidenced significant improvement over time. Older age was correlated with more depressive symptoms at baseline and superior functioning at baseline with fewer completed treatment sessions. Conclusion: In this naturalistic, community-based effectiveness study we found significant improvement on measures of anxiety, depression, symptom severity, and daily functioning. Findings suggest that a transdiagnostic intervention may be effective for addressing a range of emotional concerns in the aftermath of a natural disaster. These results can be used to inform and refine evidence-based interventions that improve the mental health and wellbeing of disaster-exposed youth.

Angelman Syndrome (AS) is a neurodevelopmental disorder most commonly caused by the impaired expression of the maternal UBE3A gene on chromosome 15. Though anxiety has been identified as a frequently present characteristic in AS, there are limited studies examining anxiety in this population. Studies of anxiety in other neurodevelopmental disorders have found disorder specific symptoms of anxiety and age specific displays of anxiety symptoms. However, there is a consistent challenge in identifying anxiety in people with neurodevelopmental disorders given the lack of measurement instruments specifically designed for this population. Given the limited information about AS and anxiety, the aims of the current project were to (a) examine symptoms of anxiety in children with AS and (b) determine the correlates of anxiety in children with AS. Participants included 42 adult caregivers of youth with AS in the AS Natural History study who completed the Developmental Behavior Checklist (DBC). The results found that 26% of the sample demonstrated elevated symptoms of anxiety and established a relationship between elevated anxiety in youth with AS and higher levels of irritability, hyperactivity, self-absorbed behaviors, and disruptive/antisocial behaviors. Findings from this research provide a foundation for tailoring evidence-based assessments and treatments for youth with AS and anxiety.

Anxiety/obsessive-compulsive disorders are common among youth with autism spectrum disorder (ASD). Two versions of cognitive behavior therapy (CBT) are effective, with some advantage for a personalized, adapted version. This study evaluated predictors and moderators of standard CBT and adapted CBT. Youth (N = 167) ages 7-13 were randomized to standard or adapted CBT, or treatment-as-usual. Age, IQ, ASD severity, and emotional-behavioral symptom severity were examined. More severe internalizing and emotional-behavioral problems predicted poorer treatment outcomes especially in standard versus personalized CBT. Elevated repetitive behaviors and restricted interests predicted poorer treatment outcomes across treatments, though youth with "moderate" repetitive behaviors and restricted interested experienced poorer outcomes only in standard but not personalized CBT. Externalizing symptoms directly predicted treatment outcomes. Older age predicted improved outcomes in adapted but not standard CBT. Findings highlight the need for further treatment refinements and the value in adapting treatment for youth with more complex presentations.

Introduction: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families. Methods: Focused interviews were conducted with 20 youth with misophonia (ages 10–17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted. Results: A number of themes were identified, which included internalizing and externalizing cognitive behavioral processes at the individual level (e.g., hypervigilance, anticipatory anxiety, escape, automatic negative attributions), secondary emotional and functional consequences (e.g., negative perception of self, guilt, anxiety, depression, emotional exhaustion, concentration difficulties at school), as well as significant impacts to school, social life, and particularly to family life (e.g., conflict/tension, anger and resentment, family accommodation). These themes are integrated in a proposed theoretical model. Discussion: Misophonia is characterized by several transdiagnostic cognitive behavioral processes, including avoidance, maladaptive cognitions, emotional reactivity, and family communication difficulties, as well as significant functional impairment. Developing treatments that target these processes has the potential to help youth overcome misophonia and improve the quality of life of youth and their families. [ABSTRACT FROM AUTHOR]

Objective: Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation. Methods: The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment‐seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver‐child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed. Results: Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8−13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably. Conclusion: Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence‐based treatment development. [ABSTRACT FROM AUTHOR]

Brief exposure to traumatic memories using script‐driven imagery (SDI) has been proposed as a promising treatment for posttraumatic stress disorder (PTSD). This study investigated the effect of SDI plus active versus sham deep transcranial magnetic stimulation (TMS) in a secondary analysis of a randomized controlled trial for adults with PTSD (N = 134). Linguistic features of scripts and self‐reported distress during a 12‐session deep TMS treatment protocol were examined as they related to (a) baseline PTSD symptom severity, (b) trauma characteristics, and (c) treatment outcomes. Linguistic Inquiry and Word Count (LIWC) software was used to analyze the following linguistic features of SDIs: negative emotion, authenticity, and cognitive processing. More use of negative emotion words was associated with less severe self‐reported and clinician‐rated baseline PTSD symptom severity, r = ‐.18, p =.038. LIWC features did not differ based on index trauma type, range: F(3, 125) = 0.29–0.49, ps =.688–.831. Between‐session reductions in self‐reported distress across SDI trials predicted PTSD symptom improvement across both conditions at 5‐week, B = ‐15.68, p =.010, and 9‐week endpoints, B = ‐16.38, p =.011. Initial self‐reported distress and linguistic features were not associated with treatment outcomes. The findings suggest that individuals with PTSD who experience between‐session habituation to SDI‐related distress are likely to experience a corresponding improvement in PTSD symptoms. [ABSTRACT FROM AUTHOR]