84 results on '"Rapee, Ronald M."'
Search Results
2. Barriers to Universal Mental Health Screening in Schools: The Perspective of School Psychologists
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Burns, John R. and Rapee, Ronald M.
- Abstract
Many young people with mental disorders are not identified until some years after the first onset of symptoms and then frequently do not receive professional intervention. One promising strategy to better identify these young people is mental health screening in schools. Despite a growing literature on the benefits of school-based screening, it remains a relatively uncommon practice and little is known about the practices of those schools that do screen. Moreover, the barriers that prevent schools from screening are not well understood. This study reports on the perceptions of school psychologists about universal mental health screening in schools regarding the prevalence of screening; the practices within schools that do screen; and the perceived barriers to implementing screening. Results indicated that screening remains uncommon, with only 14.8% of school psychologists working in schools that screened in the previous 12 months. The most significant barriers to screening related to being adequately resourced to implement programs, and particularly concerns about how to follow-up students identified as being at-risk. Despite this, school psychologists endorse the potential benefit of screening and report being likely to run screening programs if perceived barriers could be reduced.
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- 2022
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3. Testing a Concurrent Model of Social Anxiety in Preadolescence
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Rapee, Ronald M., Forbes, Miriam K., Oar, Ella L., Richardson, Cele E., Johnco, Carly J., Magson, Natasha R., and Fardouly, Jasmine
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Social anxiety is a common mental disorder with an average age of onset in early adolescence. Current theories focus largely on risk factors that are present from early in life, but reasons for onset of the disorder as youth move into adolescence are rarely discussed. We recently proposed a model of the onset of certain mental disorders during the adolescent years based on characteristics of adolescent development. While this model will require longitudinal testing, the current article establishes concurrent associations between relevant variables in a cohort of 528 preadolescents (M[subscript age] = 11.2 years) at baseline. Youth with social anxiety disorder differed significantly from other youth on measures of social comparison (including physical appearance comparisons, self-rated attractiveness, and negative peer comparisons on social media) as well as positive peer connections (including self-reported school belonging, number of friends, victimization, and peer affiliation). A structural equation model showed that symptom levels of social anxiety were directly related to social comparisons and peer connections, as well as indirectly associated with pubertal development and social comparisons. This pattern was not moderated by sex of youth.
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- 2020
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4. Linking Mother--Child Discrepancies to Behavioral Observations of Children's Anxiety
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van Doorn, Marleen M. E. M., Bodden, Denise, Jansen, Mélou, Rapee, Ronald M., and Granic, Isabela
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Background: Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear. Objective: The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother-child agreement for anxiety subtypes, and by exploring mother-child discrepancies in relation to independent observer ratings of behavioral anxiety. Method: The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7-13 years. Mother-child dyads were observed during an anxiety-provoking task and independent observers rated children's observed anxiety. Results: The findings indicated a high level of mother-child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother-child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children's observed anxious voice was negatively associated with child-reported panic disorder. Conclusions: The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.
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- 2018
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5. A Systematic Review and Meta-Analysis of Impairment and Quality of Life in Children and Adolescents with Anxiety Disorders
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Dickson, Sophie J., Oar, Ella L., Kangas, Maria, Johnco, Carly J., Lavell, Cassie H., Seaton, Ashleigh H., McLellan, Lauren F., Wuthrich, Viviana M., and Rapee, Ronald M.
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- 2024
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6. Effect of Comorbidity on Treatment of Anxious Children and Adolescents: Results from a Large, Combined Sample
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Rapee, Ronald M., Lyneham, Heidi J., and Hudson, Jennifer L.
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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.)
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- 2013
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7. Annual Research Review: Conceptualising Functional Impairment in Children and Adolescents
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Rapee, Ronald M., Bogels, Susan M., and van der Sluis, Cathy M.
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Functional impairment is a key factor in the clinical importance of mental health problems in children. Yet, the nature of impairment and criteria for defining and assessing impairment in childhood disorders has been surprisingly overlooked in much of the literature. The current article examines the extant literature on the conceptualisation, nature and assessment of impairment in childhood disorders. Relations between diagnostic symptoms and functional impairment are discussed together with the influence of impairment on diagnostic decisions and prevalence rates. Several factors influencing impairment in childhood such as culture, development and gender are considered. This article concludes with a discussion of the utility of separating judgements of impairment from specific diagnoses, which is proposed for consideration in the forthcoming DSM-5.
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- 2012
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8. Conceptual Relations between Anxiety Disorder and Fearful Temperament
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Rapee, Ronald M. and Coplan, Robert J.
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Fearful temperaments have been identified as a major risk factor for anxiety disorders. However, descriptions of fearful temperament and several forms of anxiety disorder show strong similarities. This raises the question whether these terms may simply refer to different aspects of the same underlying construct. The current review examines evidence for the overlap and distinction between these constructs. Although strong conclusions cannot be drawn from the extant literature, the bulk of the evidence appears to support a distinction between them.
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- 2010
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9. Cognitive-Behavioral Treatment versus an Active Control for Children and Adolescents with Anxiety Disorders: A Randomized Trial
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Hudson, Jennifer L., Rapee, Ronald M., and Deveney, Charise
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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.
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- 2009
10. Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version
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Lyneham, Heidi J., Abbott, Maree J., and Rapee, Ronald M.
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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.)
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- 2007
11. Bibliotherapy for Children with Anxiety Disorders Using Written Materials for Parents: A Randomized Controlled Trial
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Rapee, Ronald M., Abbott, Maree J., and Lyneham, Heidi J.
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The current trial examined the value of modifying empirically validated treatment for childhood anxiety for application via written materials for parents of anxious children. Two hundred sixty-seven clinically anxious children ages 6-12 years and their parents were randomly allocated to standard group treatment, wait list, or a bibliotherapy version of treatment for childhood anxiety. In general, parent bibliotherapy demonstrated benefit for children relative to wait list but was not as efficacious as standard group treatment. Relative to wait list, use of written materials for parents with no therapist contact resulted in around 15% more children being free of an anxiety disorder diagnosis after 12 and 24 weeks. These results have implications for the dissemination and efficient delivery of empirically validated treatment for childhood anxiety.
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- 2006
12. Treating Anxiety Disorders in a School Setting
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McLoone, Jordana, Hudson, Jennifer L., and Rapee, Ronald M.
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Anxiety disorders are among the most prevalent childhood psychological disorders. In addition to causing acute distress to the child, parent and school staff, anxiety disorders may also have a significant impact on a child's educational and social development and persist chronically into adulthood. Recent work has begun to identify the school as an important setting for both the treatment and prevention of anxiety disorders in children. This paper begins with a description of several prevalent anxiety disorders and their presentation in a school setting. It then describes some of the more common assessment tools designed specifically for the assessment of anxiety in children, as well as some of the advantages and limitations different methods of assessment offer. Three school-based treatment programs are reviewed; Cool Kids, Friends and Skills for Social and Academic Success (SASS). Both Cool Kids and Friends are suitable for the treatment of anxiety disorders broadly; whereas the SASS has been included in the review as an example of a program designed specifically for social phobia. Several practical issues such as universal versus targeted delivery, parental involvement and implementation are also discussed.
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- 2006
13. Attachment, Behavioral Inhibition, and Anxiety in Preschool Children.
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Shamir-Essakow, Galia, Ungerer, Judy A., and Rapee, Ronald M.
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This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3-4 years who were assessed for behavioral inhibition and mother-child attachment (using the Strange Situation procedure). DSM-IV criteria were used to assess childhood anxiety disorders. Insecure attachment and behavioral inhibition were both independently associated with child anxiety, even after controlling for the effect of maternal anxiety. Maternal anxiety was also associated with child anxiety. This study identified both constitutional and environmental factors associated with the expression of anxiety in young children. Furthermore, the highest levels of anxiety were shown by children who were behaviorally inhibited and insecurely attached and whose mothers were also anxious.KEY WORDS: mother-child attachment; behavioral inhibition; childhood anxiety.
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- 2005
14. Agreement between Telephone and In-Person Delivery of a Structured Interview for Anxiety Disorders in Children.
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Lyneham, Heidi J. and Rapee, Ronald M.
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Objective: The current study determined the viability of using the telephone to facilitate assessment of children using the Anxiety Disorders Interview Schedule for children for DSM-IV (ADIS-C-IV). Method: Diagnoses established during telephone administration of the ADIS-C-IV-Parent version were compared with diagnoses obtained during standard administration of the ADIS-C-IV using both Child and Parent versions. Seventy-three children and their parents participated in counterbalanced, repeated assessments. Results: The level of agreement between telephone and standard administration for principal diagnosis ([kappa] = 0.86), individual anxiety disorders ([kappa] = 0.63-0.86), and other disorders ([kappa] = 0.79-0.91) were in the good to excellent range. Additionally, agreement on overall suitability for an anxiety treatment program was excellent ([kappa] = 0.97). Conclusions: The data indicate that telephone administration of the ADIS-C-IV is a valid way to differentiate children who have anxiety disorders from those who have no disorder or other disorders, providing a less resource-demanding alternative to face-to-face assessment. J. Am. Acad. Child Adolesc. Psychiatry, 2005;44(3):274-282. Key Words: child anxiety, telephone assessment, structured interview.
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- 2005
15. Understanding Selective Mutism: A Comprehensive Guide to Assessment and Treatment
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Milic, Maria Ivanka, Carl, Talia, Rapee, Ronald M., and Matson, Johnny L., Series Editor
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- 2023
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16. Group Based Cognitive Behavioural Therapy for Anxiety in Children with Autism Spectrum Disorder: A Randomised Controlled Trial in a General Child Psychiatric Hospital Setting
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Kilburn, Tina R., Sørensen, Merete J., Thastum, Mikael, Rapee, Ronald M., Rask, Charlotte U., Arendt, Kristian B., Carlsen, Anders H., and Thomsen, Per H.
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- 2023
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17. Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis
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Dickson, Sophie J., Kuhnert, Rebecca-Lee, Lavell, Cassie H., and Rapee, Ronald M.
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- 2022
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18. Minimising young children’s anxiety through schools (MY-CATS): protocol for a cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of an online parent-led intervention compared with usual school practice for young children identified as at risk for anxiety disorders
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Reardon, Tessa, Dodd, Helen, Hill, Claire, Jasper, Bec, Lawrence, Peter J., Morgan, Fran, Rapee, Ronald M., Ukoumunne, Obioha C., Violato, Mara, Davey, Emily, Halliday, Gemma, Jones, Benjamin, Martineau, Lindsey, McCall, Amy, Niekamp, Natascha, Placzek, Anna, Potts, Ruth, Weisser, Tamatha, and Creswell, Cathy
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- 2022
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19. The Brief Evaluation of Adolescents and Children Online (BEACON): Psychometric development of a mental health screening measure for school students.
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Rapee, Ronald M., Kuhnert, Rebecca, Spence, Susan H., Bowsher, Ian, Burns, John, Coen, Jennifer, Dixon, Julie, Kotselas, Pauline, Lourey, Catherine, McLellan, Lauren F., Mihalopoulos, Cathrine, Peters, Lorna, Prendergast, Traci, Roos, Tiffany, Thomas, Danielle, and Wuthrich, Viviana
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MENTAL health screening , *CLASSICAL test theory , *ITEM response theory , *COMPULSIVE eating , *PSYCHOMETRICS , *MENTAL illness , *SCHOOL absenteeism - Abstract
This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]
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- 2024
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20. The Role of Self-reports and Behavioral Measures of Interpretation Biases in Children with Varying Levels of Anxiety
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Klein, Anke M., Flokstra, Emmelie, van Niekerk, Rianne, Klein, Steven, Rapee, Ronald M., Hudson, Jennifer L., Bögels, Susan M., Becker, Eni S., and Rinck, Mike
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- 2018
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21. The Italian version of the Preschool Anxiety Scale-Revised (PAS-R): factor structure and psychometric properties.
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Caputi, Marcella, Bazzoli, Erika, Forresi, Barbara, Grazioli, Silvia, Rapee, Ronald M, and Scaini, Simona
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PSYCHOMETRICS ,SEPARATION anxiety ,SOCIAL anxiety ,FACTOR structure ,CHILD Behavior Checklist ,ANXIETY ,CONFIRMATORY factor analysis - Abstract
This study assessed the psychometric properties of the Italian version of the Preschool Anxiety Scale-Revised (PAS-R), a parent-reported measure of their preschool child's anxiety symptoms. The participants were mothers of 279 Italian preschoolers (age 2–7 years, M = 4.5 years). According to information criteria derived from a confirmatory factor analysis, the four originally identified factors (generalized anxiety, social anxiety, separation anxiety, specific fears) provided the best fit to the data. Reliability was excellent for the total score and acceptable for the subscales. PAS-R total score showed moderate correlation with internalizing subscales of the Strengths and Difficulties Questionnaire (SDQ) and of the Child Behavior Checklist and weak correlation with the externalizing subscale of the SDQ, demonstrating convergent and concurrent validity, respectively. Test–retest reliability of the PAS-R was good after 1 month. The results suggest good psychometric properties of the Italian PAS-R, although its factor structure needs further investigation with different samples. [ABSTRACT FROM AUTHOR]
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- 2024
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22. Rationale and design for cognitive behavioral therapy for anxiety disorders in children with autism spectrum disorder: a study protocol of a randomized controlled trial
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Kilburn, Tina R., Sørensen, Merete Juul, Thastum, Mikael, Rapee, Ronald M., Rask, Charlotte Ulrikka, Arendt, Kristian Bech, and Thomsen, Per Hove
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- 2018
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23. Combining CBT and sertraline does not enhance outcomes for anxious youth: a double-blind randomised controlled trial.
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Hudson, Jennifer L., McLellan, Lauren F., Eapen, Valsamma, Rapee, Ronald M., Wuthrich, Viviana, and Lyneham, Heidi J.
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ANXIETY disorders treatment ,DRUG efficacy ,PARENT attitudes ,HEALTH outcome assessment ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,PLACEBOS ,SEVERITY of illness index ,BLIND experiment ,RESEARCH funding ,COMBINED modality therapy ,STATISTICAL sampling ,COGNITIVE therapy ,SERTRALINE ,PHARMACODYNAMICS ,CHILDREN ,ADOLESCENCE - Abstract
Background: Anxiety disorders are the most prevalent mental disorder in children and young people. Developing effective therapy for these children is critical to reduce mental disorders across the lifespan. The study aimed to evaluate the efficacy of combining cognitive behavioural therapy (CBT) and sertraline (SERT) in the treatment of anxiety in youth, using a double-blind randomised control trial design. Methods: Ninety-nine youth (ages 7–15 years) with an anxiety disorder were randomly allocated to either individual (CBT) and SERT or individual CBT and pill placebo and assessed again immediately and 6 months after treatment. Results: There were no significant differences between conditions in remission of primary anxiety disorder or all anxiety disorders. Furthermore, there were no significant differences in rates of change in diagnostic severity, parent-reported anxiety symptoms, child-reported anxiety symptoms or life interference due to anxiety. Conclusions: The efficacy of CBT for children and adolescents with anxiety disorders is not significantly enhanced by combination with a short-term course of anti-depressants over and above the combined effects of pill placebo. [ABSTRACT FROM AUTHOR]
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- 2023
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24. Prediction of clinical anxious and depressive problems in mid childhood amongst temperamentally inhibited preschool children: a population study.
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Bayer, Jordana K., Prendergast, Luke A., Brown, Amy, Bretherton, Lesley, Hiscock, Harriet, Nelson-Lowe, Margaret, Gilbertson, Tamsyn, Noone, Kate, Bischof, Natalie, Beechey, Cassima, Muliadi, Fenny, Mihalopoulos, Cathrine, and Rapee, Ronald M.
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MENTAL depression risk factors ,ADVERSE childhood experiences ,EMOTIONAL trauma ,INTERVIEWING ,RISK assessment ,PARENTING ,TEMPERAMENT ,RESEARCH funding ,HEALTH ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,ANXIETY ,SOCIODEMOGRAPHIC factors ,LONGITUDINAL method ,PARENTS ,PSYCHOLOGICAL distress ,CHILDREN - Abstract
Shy/inhibited young children are at risk for internalising difficulties; however, for many, this temperamental style does not result in mental health problems. This study followed a population-based sample of temperamentally inhibited preschool children into mid childhood to explore the aetiology of clinical-level anxious and depressive problems. Amongst inhibited preschool children, we aimed to predict each of clinical child anxiety and depressive problems in mid childhood from a broad range of potential risks (demographics, traumatic events and broader recent stressors, parents' well-being, and parenting practices). This study is based on data from a wider population trial of Cool Little Kids that recruited a representative sample of inhibited preschool children enrolled in their year before starting school. In 2011–2012, an inhibition screen was universally distributed to parents of children in their year before school (age 4 years) across eight diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited preschoolers (78% uptake, 545/703) who were followed to mid childhood (three annual waves 2015–2017, age 7–10 years) with 84% retention (456/545). Parents completed questionnaires spanning child ages 4–10 years, along with diagnostic interviews for child anxiety. Children also completed questionnaires in mid childhood. The questionnaires encompassed a variety of potential risks including sociodemographics, traumatic events, recent life stressors, parent wellbeing and parenting practices. In mid childhood, 57% (246/430) of inhibited preschoolers had a clinical level of anxiety problems while 22% (95/432) had depressive problems (by one or more sources). The aetiology analyses highlighted parent distress and parenting practices (overinvolved/protective, harsh discipline) as key predictors of inhibited preschoolers' internalising problems by mid childhood. Some high-risk families may not have participated. Child depression was not assessed with a diagnostic interview. The measures did not include every possible risk factor. The findings lend support to parenting programs for shy/inhibited young children that aim to prevent the development of anxiety and depression as they grow. [ABSTRACT FROM AUTHOR]
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- 2023
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25. Burden and preference-based quality of life associated with bullying in children.
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Le, Long Khanh-Dao, Chatterton, Mary Lou, Rapee, Ronald M., Fitzpatrick, Sally, Bussey, Kay, Hudson, Jennie, Hunt, Caroline, Cross, Donna, Magnus, Anne, and Mihalopoulos, Cathrine
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BULLYING prevention ,CONFIDENCE intervals ,HEALTH status indicators ,CRIME victims ,QUALITY of life ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,VICTIMS ,DATA analysis software ,SOCIODEMOGRAPHIC factors ,QUALITY-adjusted life years ,PARENTS ,CHILDREN - Abstract
The objectives of this study are to assess the association between childhood bullying and preference-based health-related quality of life (QoL) in Australian school children and their parents and estimate quality-adjusted life years (QALYs) associated with bullying chronicity. Children aged 8–10 years completed the child health utilities (CHU-9D), while parents completed the Australian quality of life (AQoL-8D). Children were grouped into four categories of bullying involvement (no bullying, victim, perpetrator, or both perpetrator and victim) based on the Revised Olweus Bully/Victim Questionnaire. Parental data were compared across two bullying involvement groups (bullying vs. no bullying). QALYs were calculated for children over two years and comparisons made based on the number of assessments where bullying was reported (baseline, 1- and 2-year follow up). Children who were involved in bullying (victims and/or perpetrators) reported statistically significantly lower mean utility scores compared to children who were not involved in bullying. Parents whose child was involved in bullying had significantly lower mean utility scores compared to parents of children not involved with bullying. There appeared to be a dose–response relationship, with higher QALY losses associated with increasing frequency of reported bullying. Bullying among Australian school children was associated with significantly lower preference-based QoL for themselves and their parents. This study also confirmed the significant burden of disease for bullying among children measured by an incremental decrease in QALY with an increasing chronicity of bullying over time. [ABSTRACT FROM AUTHOR]
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- 2023
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26. Assessment of Maternally Reported Life Events in Children and Adolescents: A Comparison of Interview and Checklist Methods
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Allen, Jennifer L., Rapee, Ronald M., and Sandberg, Seija
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- 2012
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27. The Structure of Negative Self-Statements in Children and Adolescents: A Confirmatory Factor-Analytic Approach
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Schniering, Carolyn A. and Rapee, Ronald M.
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- 2004
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28. Follow‐up of the Cool Little Kids translational trial into middle childhood.
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Bayer, Jordana K., Brown, Amy, Prendergast, Luke A., Bretherton, Lesley, Hiscock, Harriet, Mihalopoulos, Cathrine, Nelson‐Lowe, Margaret, Gilbertson, Tamsyn, Noone, Kate, Bischof, Natalie, Beechey, Cassima, Muliadi, Fenny, and Rapee, Ronald M.
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PARENT attitudes ,BASHFULNESS ,CHILD behavior ,TRANSITIONAL programs (Education) ,RANDOMIZED controlled trials ,MENTAL depression ,ANXIETY disorders ,STATISTICAL sampling ,LONGITUDINAL method ,CHILDREN - Abstract
Background: Public health advocates have highlighted internalising problems as a leading cause of global burden of disease. Internalising problems (anxiety/depression) affect up to 20% of school‐age children and can impact peer relations, school engagement and later employment and mortality. This translational trial aimed to determine whether a selective/indicated parenting group programme to prevent internalising distress in shy/inhibited preschool children had sustained effects in middle childhood. Translational design aspects were a brief parent‐report screening tool for child inhibition offered universally across the population via preschools in the year before school, followed by an invitation to parents of all inhibited children to attend the parenting programme at venues in their local community. Methods: Design of the study was a randomised controlled trial. The setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited four‐year‐old children of which 456 (84%) were retained during middle childhood (age of seven to 10 years). Early intervention was the Cool Little Kids parenting group programme, and control was 'usual care' access to available support services in the community. Primary outcomes were child anxiety and depression symptoms (parent and child report) and DSM‐IV anxiety disorders (assessor masked). Secondary outcomes were parenting practices and parent mental health. Results: There was no significant difference in anxiety disorders between the intervention and control group during the three annual follow‐ups of the cohort in middle childhood (2015 43% vs. 41%, 2016 40% vs. 36%, 2017 27% vs. 30%, respectively; p's >.05). There were also no significant differences in child anxiety or depression symptoms (by child or parent report), parenting practices or parent mental health, between the intervention and control group during middle childhood. However, a priori interaction tests suggested that for children with anxious parents, early intervention attenuated risk for middle childhood internalising problems. Conclusions: An issue for population translation is low levels of parent engagement in preventive interventions. Initial effects of the Cool Little Kids parenting group programme in reducing shy/inhibited preschool children's internalising distress at school entry dissipated over time, perhaps due to low engagement. Future translational research on early prevention of internalising problems could benefit from screening preschool children in the population at higher risk (combining temperamental inhibition and parent distress) and incorporating motivational techniques to facilitate family engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. [ABSTRACT FROM AUTHOR]
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- 2022
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29. Research Review: Recommendations for reporting on treatment trials for child and adolescent anxiety disorders – an international consensus statement.
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Creswell, Cathy, Nauta, Maaike H., Hudson, Jennifer L., March, Sonja, Reardon, Tessa, Arendt, Kristian, Bodden, Denise, Cobham, Vanessa E., Donovan, Caroline, Halldorsson, Brynjar, In‐Albon, Tina, Ishikawa, Shin‐ichi, Johnsen, Daniel Bach, Jolstedt, Maral, Jong, Rachel, Kreuze, Leonie, Mobach, Lynn, Rapee, Ronald M., Spence, Susan H., and Thastum, Mikael
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ANXIETY disorders treatment ,EXPERIMENTAL design ,CONSENSUS (Social sciences) ,CLINICAL trials ,REPORT writing ,HEALTH outcome assessment ,PATIENT-centered care ,MEDICAL care ,MEDICAL protocols ,VALUE-based healthcare ,COMMUNICATION ,QUALITY assurance ,STANDARDS ,CHILDREN ,ADOLESCENCE - Abstract
Background: Anxiety disorders in children and young people are common and bring significant personal and societal costs. Over the last two decades, there has been a substantial increase in research evaluating psychological and pharmacological treatments for anxiety disorders in children and young people and exciting and novel research has continued as the field strives to improve efficacy and effectiveness, and accessibility of interventions. This increase in research brings potential to draw together data across studies to compare treatment approaches and advance understanding of what works, how, and for whom. There are challenges to these efforts due largely to variation in studies' outcome measures and variation in the way study characteristics are reported, making it difficult to compare and/or combine studies, and this is likely to lead to faulty conclusions. Studies particularly vary in their reliance on child, parent, and/or assessor‐based ratings across a range of outcomes, including remission of anxiety diagnosis, symptom reduction, and other domains of functioning (e.g., family relationships, peer relationships). Methods: To address these challenges, we convened a series of international activities that brought together the views of key stakeholders (i.e., researchers, mental health professionals, young people, parents/caregivers) to develop recommendations for outcome measurement to be used in treatment trials for anxiety disorders in children and young people. Results and Conclusions: This article reports the results of these activities and offers recommendations for selection and reporting of outcome measures to (a) guide future research and (b) improve communication of what has been measured and reported. We offer these recommendations to promote international consistency in trial reporting and to enable the field to take full advantage of the great opportunities that come from data sharing going forward. [ABSTRACT FROM AUTHOR]
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- 2021
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30. Genetic variation in the endocannabinoid system and response to Cognitive Behavior Therapy for child anxiety disorders
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Lester, Kathryn J., Coleman, Jonathan R. I., Roberts, Susanna, Keers, Robert, Breen, Gerome, Bögels, Susan, Creswell, Cathy, Hudson, Jennifer L., McKinnon, Anna, Nauta, Maaike, Rapee, Ronald M., Schneider, Silvia, Silverman, Wendy K., Thastum, Mikael, Waite, Polly, Wergeland, Gro Janne H., Eley, Thalia C., and Clinical Psychology and Experimental Psychopathology
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Male ,Adolescent ,Anxiety ,CONDITIONED FEAR ,Polymorphism, Single Nucleotide ,Amidohydrolases ,Receptor, Cannabinoid, CB2 ,Receptor, Cannabinoid, CB1 ,children ,endocannabinoids ,Child ,Children ,Research Articles ,CONTEXTUAL FEAR MEMORY ,Cognitive Behavioral Therapy ,CLINICAL-RESPONSE ,Genetic Variation ,HUMANS ,Fear ,MAJOR DEPRESSION ,EXPOSURE THERAPY ,anxiety ,Anxiety Disorders ,fear extinction ,Treatment Outcome ,EXTINCTION ,Fear extinction ,nervous system ,Cognitive Behavior Therapy ,Female ,CNR1 GENE ,CANNABINOID MODULATION ,CITALOPRAM TREATMENT ,Research Article ,Endocannabinoids - Abstract
Extinction learning is an important mechanism in the successful psychological treatment of anxiety. Individual differences in response and relapse following Cognitive Behavior Therapy may in part be explained by variability in the ease with which fears are extinguished or the vulnerability of these fears to re-emerge. Given the role of the endocannabinoid system in fear extinction, this study investigates whether genetic variation in the endocannabinoid system explains individual differences in response to CBT. Children (N = 1,309) with a primary anxiety disorder diagnosis were recruited. We investigated the relationship between variation in the CNR1, CNR2, and FAAH genes and change in primary anxiety disorder severity between pre- and post-treatment and during the follow-up period in the full sample and a subset with fear-based anxiety disorder diagnoses. Change in symptom severity during active treatment was nominally associated (P
- Published
- 2017
31. Online Assessment of Preschool Anxiety: description and initial validation of a new diagnostic tool.
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Morgan, Amy J., Tamir, Elli, Rapee, Ronald M., Lyneham, Heidi J., McLellan, Lauren F., and Bayer, Jordana K.
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CHILD behavior ,INTERNET ,RESEARCH methodology ,QUESTIONNAIRES ,ANXIETY disorders ,RESEARCH methodology evaluation ,CHILDREN - Abstract
Background: The Online Assessment of Preschool Anxiety (OAPA) is a newly developed measure that assesses anxiety disorders in preschool children aged 3–6 years. This study aimed to explore the OAPA's initial psychometric properties with a particular focus on examining its construct validity, both convergent and discriminant. Method: The OAPA was completed online by a community sample of 319 Australian parents of temperamentally inhibited preschool children (M: 5.3 years). Preliminary diagnoses were automatically generated before assessment reports were reviewed by a psychologist. Construct validity was examined by assessing the degree of agreement between the OAPA and existing valid questionnaire measures that were simultaneously administered online. Results: Nearly half of participants met criteria for a child anxiety disorder according to the OAPA, most commonly social phobia. Findings supported convergent validity with the Revised Preschool Anxiety Scale (an anxiety symptom measure), the Children's Anxiety Life Interference Scale – Preschool Version (a measure of life interference from anxiety), the Emotional Symptoms scale of the Strengths and Difficulties Questionnaire‐Parent Version (a measure of broader internalizing symptoms), as well as an over‐involved/protective parenting scale. Findings also supported initial discriminant validity with the Conduct Problems scale of the Strengths and Difficulties Questionnaire‐Parent Version. Conclusions: Results of this study provide evidence for the OAPA's preliminary construct validity. With further research into the OAPA's reliability (test–retest and interrater) and confirming construct validity, the OAPA may be a useful instrument for use in research settings and clinical practice. [ABSTRACT FROM AUTHOR]
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- 2019
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32. Predicting Temperamentally Inhibited Young Children's Clinical-Level Anxiety and Internalizing Problems from Parenting and Parent Wellbeing: a Population Study.
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Bayer, Jordana K., Morgan, Amy, Prendergast, Luke A., Beatson, Ruth, Gilbertson, Tamsyn, Bretherton, Lesley, Hiscock, Harriet, and Rapee, Ronald M.
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PARENT-child relationships ,LOW-income parents ,CHILDREN ,POPULATION ,ANXIETY disorders - Abstract
The aim of this study was to explore how some temperamentally inhibited young children and not others in the general population develop anxiety disorders and broader clinical-level internalizing (anxious/depressive) problems, with a focus on the family. A brief screening tool for inhibition was universally distributed to parents of children in their year before starting school across eight socioeconomically diverse government areas in Melbourne, Australia (307 preschool services). Screening identified 11% of all children as inhibited. We invited all parents of inhibited children to participate in a longitudinal prevention study. Participants were 545 parents of inhibited pre-schoolers (78% uptake) of whom 498 (91%) completed assessment one year later and 469 (86%) two years later. Parents completed questionnaires to assess parenting practices, parent wellbeing, and child internalizing problems. Parents also engaged in structured diagnostic interviews to assess child anxiety disorders. During the follow up period close to half of the inhibited young children had anxiety disorders and one in seven had clinical-level internalizing problems, with girls perhaps at higher risk. The family variables significantly predicted inhibited children's anxiety disorders and broader internalizing problems. For child anxiety disorders, overinvolved/protective parenting was particularly important for girls and boys, and poorer parent wellbeing contributed. For child anxious/depressive problems, harsh discipline was a consistent predictor for girls and boys, and poorer parent wellbeing again contributed. These etiological findings support early intervention for temperamentally inhibited young children that focuses on the family environment to prevent the development of mental health problems. [ABSTRACT FROM AUTHOR]
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- 2019
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33. Group-based Cognitive Behavioural Therapy for Anxiety Disorder in Children with Autism Spectrum Disorder: a feasibility study.
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Kilburn, Tina R., Juul Sørensen, Merete, Thastum, Mikael, Rapee, Ronald M., Rask, Charlotte Ulrikka, Bech Arendt, Kristian, and Thomsen, Per Hove
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CHILDREN with autism spectrum disorders ,ANXIETY disorders ,COGNITIVE therapy ,AUTISM spectrum disorders ,PARENT-child relationships ,ANXIETY in children ,ANXIETY treatment ,GROUP psychotherapy - Abstract
Purpose: Autism spectrum disorder (ASD) includes core symptoms that affect general and social development. High risk of developing comorbid disorders such as anxiety is prominent. Up to 60% of children with ASD suffer from anxiety disorders which can negatively influence educational, social and general development together with quality of life. This study is the first to investigate the feasibility of the manualised cognitive behavioural therapy (CBT) group programme 'Cool Kids ASD' for anxiety adapted for children with ASD in a general hospital setting. Methods: Nine children, aged 9–13 years, with ASD and anxiety recruited from a public child psychiatric health clinic were enrolled in the study. Outcome measures were collected from both child and parent pre- and post-treatment and at 3-month follow-up and included scores from a semi-structured anxiety interview, together with questionnaires on anxiety symptoms, life interference, children's automatic thoughts and satisfaction with the programme. Results: Eight out of nine families found the programme useful and would recommend it to other families in a similar situation. Six families attended all 12 sessions in the programme, two missed one session and one family only managed to attend eight sessions. At follow-up, five children were free of all anxiety diagnoses and a further two out of the nine children no longer met the criteria for their primary anxiety diagnosis. Conclusions: This study suggests that the transition of the group programme 'Cool Kids ASD' from University Clinics to standard child psychiatric clinical settings is feasible. Further randomised studies are needed to confirm the efficacy of the programme in a larger sample. [ABSTRACT FROM AUTHOR]
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- 2019
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34. School‐based assessment of mental health risk in children: the preliminary development of the Child RADAR.
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Burns, John R. and Rapee, Ronald M.
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- *
ANXIETY diagnosis , *DIAGNOSIS of mental depression , *PSYCHIATRIC diagnosis , *MENTAL illness risk factors , *ADAPTABILITY (Personality) , *CHILD development , *ELEMENTARY schools , *FACTOR analysis , *MEDICAL screening , *RELIABILITY (Personality trait) , *STUDENT health , *STATISTICAL reliability , *WELL-being , *CHILDREN ,RESEARCH evaluation - Abstract
Background: Screening young people for risk of mental health difficulties in schools is an effective method to facilitate monitoring and early intervention. This study is a preliminary report on the adaptation of the Youth RADAR screening instrument for primary school children. Specifically designed to be used in schools, the Child RADAR assesses a child's balance of risk and protective factors known to be associated with the development of mental health problems. Method: Three hundred and thirty‐nine children drawn from six primary schools across NSW, Australia, completed the alpha version of the Child RADAR in addition to an assessment of depression and anxiety symptoms and subjective well‐being. Results: Confirmatory factor analysis revealed the Child RADAR to have an acceptable factor structure. Reliability for the Total Child RADAR was satisfactory based on both internal consistency (α = .86) and test–retest reliability (r = .85). Convergent validity was demonstrated through significant associations with symptoms of anxiety and depression. Conclusions: The Child RADAR shows preliminary promise as a school‐based screener of mental health risk. Further evaluation is required to demonstrate the generalizability of the instrument across different populations. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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35. Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study
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Hudson, Jennifer L., Keers, Robert, Roberts, Susanna, Coleman, Jonathan R. I., Breen, Gerome, Arendt, Kristian, Bögels, Susan, Cooper, Peter, Creswell, Cathy, Hartman, Catharina, Heiervang, Einar R., Hötzel, Katrin, In-Albon, Tina, Lavallee, Kristen, Lyneham, Heidi J., Marin, Carla E., McKinnon, Anna, Meiser-Stedman, Richard, Morris, Talia, Nauta, Maaike, Rapee, Ronald M., Schneider, Silvia, Schneider, Sophie C., Silverman, Wendy K., Thastum, Mikael, Thirlwall, Kerstin, Waite, Polly, Wergeland, Gro Janne, Lester, Kathryn J., Eley, Thalia C., Clinical Psychology and Experimental Psychopathology, and Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE)
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Male ,Parents ,cognitive-behavioral therapy ,Adolescent ,ANXIETY DISORDERS ,CHILDREN ,CHILDHOOD ANXIETY ,Comorbidity ,Severity of Illness Index ,Cognitive Behavioural Therapy (CBT) ,ADOLESCENTS ,Developmental and Educational Psychology ,Humans ,ANXIOUS YOUTH ,PREDICTORS ,Child ,METAANALYSIS ,treatment ,Cognitive Behavioral Therapy ,TREATMENT ,Prognosis ,Anxiety Disorders ,Psychiatry and Mental health ,predictors ,Logistic Models ,Treatment Outcome ,Phobic Disorders ,Child, Preschool ,TRIAL ,Female ,CAMS - Abstract
OBJECTIVE\ud \ud The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic, and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child's gender, type of anxiety disorder, initial severity and comorbidity, and parents' psychopathology would significantly predict outcome.\ud \ud METHOD\ud \ud A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models. Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these time points.\ud \ud RESULTS\ud \ud Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly predicted response (although not remission) at follow-up.\ud \ud CONCLUSION\ud \ud SoAD, nonanxiety comorbidity, and parental psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes.
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- 2014
36. Linking Mother-Child Discrepancies to Behavioral Observations of Children’s Anxiety.
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van Doorn, Marleen M. E. M., Bodden, Denise, Jansen, Mélou, Rapee, Ronald M., and Granic, Isabela
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ANXIETY diagnosis ,AFFECTIVE disorders ,CHILD behavior ,CONFLICT (Psychology) ,MEDICAL practice ,MEDICAL research ,MOTHER-child relationship ,PSYCHOLOGY of mothers ,PANIC disorders ,SEPARATION anxiety ,TASK performance ,RESEARCH bias ,CHILDREN - Abstract
Background: Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear.Objective: The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother-child agreement for anxiety subtypes, and by exploring mother-child discrepancies in relation to independent observer ratings of behavioral anxiety.Method: The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7-13 years. Mother-child dyads were observed during an anxiety-provoking task and independent observers rated children’s observed anxiety.Results: The findings indicated a high level of mother-child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother-child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children’s observed anxious voice was negatively associated with child-reported panic disorder.Conclusions: The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components. [ABSTRACT FROM AUTHOR]
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- 2018
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37. Prevalence of traumatic events and risk for psychological symptoms among community and at-risk children and adolescents from Bangladesh.
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Deeba, Farah and Rapee, Ronald M.
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- *
ANALYSIS of covariance , *CHI-squared test , *CONFIDENCE intervals , *EXPERIMENTAL design , *RESEARCH methodology , *POST-traumatic stress disorder , *PUBLIC welfare , *QUESTIONNAIRES , *REGRESSION analysis , *RESEARCH funding , *STATISTICAL sampling - Abstract
Background Children from developing countries are more vulnerable to traumatic experiences and more likely to suffer a range of psychological problems than children from developed countries. Method The current paper describes a survey of 1360 children and adolescents from Bangladesh who were selected either from the general community or through a range of social service organizations. Children completed a checklist of traumatic events and questionnaires to assess symptoms of PTSD, anxiety and depression. Results Children from both samples reported high levels of exposure to traumatic events, both via direct experience and indirectly. Direct experiences with intentional, man-made events were more frequently reported by children from support services while trauma from natural disasters was more common among community children. Psychological symptoms were significantly higher within children from social support services. The strongest predictors of psychological symptoms were age, gender, sample source and exposure to man-made direct traumas. Conclusion The results point to the common occurrence of traumatic events and their emotional consequences among children and adolescents from Bangladesh and indicate the need to develop effective and accessible mental health services for Bangladeshi children and adolescents. [ABSTRACT FROM AUTHOR]
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- 2015
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38. Comparing outcomes for children with different anxiety disorders following cognitive behavioural therapy.
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Hudson, Jennifer L., Rapee, Ronald M., Lyneham, Heidi J., McLellan, Lauren F., Wuthrich, Viviana M., and Schniering, Carolyn A.
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- *
ANXIETY in children , *COGNITIVE therapy , *OBSESSIVE-compulsive disorder in children , *FOLLOW-up studies (Medicine) , *HEALTH outcome assessment , *THERAPEUTICS - Abstract
Objective The purpose of this study was to compare treatment outcomes following a group family-based cognitive behavioural therapy for children with different anxiety disorders (social anxiety disorder, separation anxiety disorder, generalised anxiety disorder, specific phobia and obsessive compulsive disorder). Method This study utilised a clinical sample of 842 children and adolescents (aged between 6 and 18 years) and assessed outcome using diagnostic interview, parent-report and child-report. Results Based on diagnostic data and parent-reported symptoms, results revealed that children with a diagnosis of social anxiety disorder experienced a slower rate of change and poorer diagnostic outcomes at post treatment and follow-up than children with other anxiety disorders. Children with GAD showed better response to this broad-based intervention and children with OCD showed better response on one measure. Conclusions This study provides evidence for differential response to broad-based CBT for children, based on type of anxiety diagnoses. [ABSTRACT FROM AUTHOR]
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- 2015
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39. The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children.
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Mihalopoulos, Cathrine, Vos, Theo, Rapee, Ronald M., Pirkis, Jane, Chatterton, Mary Lou, Lee, Yu‐Chen, and Carter, Rob
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ANXIETY disorders ,CLINICAL trials ,COST effectiveness ,MEDICAL care costs ,PRESCHOOLS ,HEALTH outcome assessment ,PARENTING ,PARENTS ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,QUALITATIVE research ,SECONDARY analysis ,RANDOMIZED controlled trials ,PARENTING education ,STATISTICAL models ,DESCRIPTIVE statistics ,PSYCHOEDUCATION ,CHILDREN ,PREVENTION - Abstract
Background Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. Method A cost-utility economic framework, using Disability-Adjusted-Life-Years ( DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio ( ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. Results The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. Conclusions Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken. [ABSTRACT FROM AUTHOR]
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- 2015
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40. Psychometric properties of two measures of childhood internalizing problems in a Bangladeshi sample.
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Deeba, Farah, Rapee, Ronald M., and Prvan, Tania
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COMPETENCY assessment (Law) , *AGE distribution , *ANALYSIS of covariance , *ANALYSIS of variance , *ANXIETY , *ANXIETY in children , *CHI-squared test , *CONFIDENCE intervals , *STATISTICAL correlation , *DEPRESSION in children , *DISCRIMINANT analysis , *FACTOR analysis , *RESEARCH methodology , *MEDICAL cooperation , *MENTAL health , *QUESTIONNAIRES , *RESEARCH , *RESEARCH funding , *STATISTICAL sampling , *SCALE analysis (Psychology) , *SEX distribution , *TRANSLATIONS , *STATISTICAL reliability , *MULTITRAIT multimethod techniques , *RESEARCH methodology evaluation , *PSYCHOLOGICAL vulnerability , *DESCRIPTIVE statistics , *CHILDREN ,RESEARCH evaluation - Abstract
Objectives In order to assist mental health services in developing countries, a key issue is the availability of psychometrically sound, brief, and cost-effective measures that have been tested within the relevant context. The present study was designed to evaluate within a young Bangladeshi population, the psychometric properties of two widely used Western measures of internalizing distress in young people: the short form of the Spence Children's Anxiety Scale and the Short Moods and Feelings Questionnaire. Method The sample included 1,360 children and adolescents aged 9-17 years ( M = 12.3 years, SD = 2.12) recruited from six districts of Bangladesh, including both community and emotionally at-risk participants. A total of 179 children were re-tested on the measures within 3-4 weeks. Results Confirmatory factor analyses showed single-factor structures for both scales in the total sample and in both community and at-risk participants separately. Multiple group analyses across gender and age-group within the at-risk and community samples showed that the single-factor structure was suitable regardless of subgroup. Analyses also indicated acceptable internal consistency, test-retest reliability and construct validity for both scales. Conclusion The two measures show promise as brief, reliable, and valid instruments for the assessment of internalizing distress among young people from Bangla-speaking communities. Practitioner points Positive clinical implications These two measures of internalizing distress in young people showed solid psychometric properties within samples collected from various parts of Bangladesh. The measures can therefore be used to assess anxiety and depression in Bangla-speaking youth., These measures should be of value in both clinical settings and at a community level to assess the need for services., Cautions and limitations Resource limitations did not allow comparison against diagnostic criteria and therefore cut-off scores to indicate clinical status among Bangladeshi youth will require further research. [ABSTRACT FROM AUTHOR]
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- 2015
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41. Community Screening for Preschool Child Inhibition to Offer the 'Cool Little Kids' Anxiety Prevention Programme.
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Beatson, Ruth M., Bayer, Jordana K., Perry, Alexandra, Mathers, Megan, Hiscock, Harriet, Wake, Melissa, Beesley, Kate, and Rapee, Ronald M.
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ANXIETY prevention ,ANXIETY disorders ,BASHFULNESS ,MEDICAL screening ,PARENTING ,QUESTIONNAIRES ,RESEARCH funding ,SOCIOECONOMIC factors ,RANDOMIZED controlled trials ,RECEIVER operating characteristic curves ,CHILDREN ,MENTAL illness risk factors - Abstract
Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the context of a trial implementing the Cool Little Kids prevention programme for anxiety disorders. In comparison to the Australian Temperament Project's inhibition scale, we examine the Strengths and Difficulties Questionnaire's (SDQ) ability to screen for inhibited preschool children. Parents of 6307 children aged 3 to 6 years enrolled in preschool programmes from eight socio-economically diverse districts in Melbourne, Australia, first completed the measures of inhibition and SDQ. Parents with inhibited children then enrolled in the Cool Little Kids randomized trial ( n = 545). Of these, 88% provided feedback about inhibition screening. Parents allocated to the intervention also provided feedback on the Cool Little Kids parenting programme. Results demonstrated that parents of preschool children (i) find inhibition screening acceptable, (ii) take up this parenting programme and (iii) report favourable feedback. The SDQ emotional symptoms subscale demonstrated acceptable sensitivity but insufficient specificity to identify inhibited preschool children. Presenting parents with a brief, validated inhibition scale could be a low-cost option for identifying inhibited preschool children in the community to offer early anxiety prevention. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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42. Predicting outcomes following cognitive behaviour therapy in child anxiety disorders: the influence of genetic, demographic and clinical information.
- Author
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Hudson, Jennifer L., Lester, Kathryn J., Lewis, Cathryn M., Tropeano, Maria, Creswell, Cathy, Collier, David A., Cooper, Peter, Lyneham, Heidi J., Morris, Talia, Rapee, Ronald M., Roberts, Susanna, Donald, Jennifer A., and Eley, Thalia C.
- Subjects
ANXIETY disorders treatment ,ALLELES ,CHI-squared test ,COGNITIVE therapy ,CONFIDENCE intervals ,DNA ,ECOLOGY ,EPIDEMIOLOGY ,GENES ,GENETIC polymorphisms ,CLASSIFICATION of mental disorders ,NERVE growth factor ,HEALTH outcome assessment ,POLYMERASE chain reaction ,RESEARCH ,RESEARCH funding ,RISK assessment ,COMORBIDITY ,DATA analysis ,MULTIPLE regression analysis ,TREATMENT effectiveness ,PREDICTIVE tests ,DESCRIPTIVE statistics ,CHILDREN - Abstract
Background Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; 5 HTTLPR and marker rs6330 in Nerve Growth Factor gene; NGF is associated with poorer outcomes following cognitive behaviour therapy ( CBT) for child anxiety disorders. The aim of this study was to explore one potential means of extending the translational reach of G × E data in a way that may be clinically informative. We describe a 'risk-index' approach combining genetic, demographic and clinical data and test its ability to predict diagnostic outcome following CBT in anxious children. Method DNA and clinical data were collected from 384 children with a primary anxiety disorder undergoing CBT. We tested our risk model in five cross-validation training sets. Results In predicting treatment outcome, six variables had a minimum mean beta value of 0.5:5 HTTLPR, NGF rs6330, gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder. A risk index (range 0-8) constructed from these variables had moderate a predictive ability ( AUC = .62-.69) in this study. Children scoring high on this index (5-8) were approximately three times as likely to retain their primary anxiety disorder at follow-up as compared with those children scoring 2 or less. Conclusion Significant genetic, demographic and clinical predictors of outcome following CBT for anxiety-disordered children were identified. Combining these predictors within a risk index could be used to identify which children are less likely to be diagnosis-free following CBT alone and require longer or enhanced treatment. The 'risk-index' approach represents one means of harnessing the translational potential of G × E data. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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43. The development and preliminary validation of a brief scale of emotional distress in young people using combined classical test theory and item response theory approaches: The Brief Emotional Distress Scale for Youth (BEDSY).
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Spence, Susan H. and Rapee, Ronald M.
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CLASSICAL test theory , *ITEM response theory , *PSYCHOLOGICAL distress , *MENTAL illness , *STRUCTURAL equation modeling - Abstract
Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11–17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts. • The BEDSY is a new, brief, self-report scale of emotional distress in young people. • It has promise as a brief screen for identifying emotionally distressed youth in community contexts. • It aims to identify youth who are likely to benefit from early intervention. • The scale has strong internal consistency, good construct validity, and discriminant validity. [ABSTRACT FROM AUTHOR]
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- 2022
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44. Agreement Between Telephone and In-Person Delivery of a Structured Interview for Anxiety Disorders in Children.
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Lyneham, Heidi J. and Rapee, Ronald M.
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ANXIETY , *CHILDREN , *INTERVIEWING , *EMOTIONS , *DIAGNOSIS , *PSYCHOLOGICAL stress - Abstract
Objective: The current study determined the viability of using the telephone to facilitate assessment of children using the Anxiety Disorders Interview Schedule for children for DSM-IV (ADIS-C-IV). Method: Diagnoses established during telephone administration of the ADIS-C-l V-Parent version were compared with diagnoses obtained during standard administration of the AD1S-C-IV using both Child and Parent versions. Seventy-three children and their parents participated in counterbalanced, repeated assessments. Results: The level of agreement between telephone and standard administration for principal diagnosis (K = 0.86), individual anxiety disorders (K = 0.63-0.86), and other disorders (K = 0.79-0.91) were in the good to excellent range. Additionally, agreement on overall suitability for an anxiety treatment program was excellent (K = 0.97). Conclusions: The data indicate that telephone administration of the ADIS-C-IV is a valid way to differentiate children who have anxiety disorders from those who have no disorder or other disorders, providing a less resource- demanding alternative to face-to-face assessment. [ABSTRACT FROM AUTHOR]
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- 2005
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45. The Role of Control in Childhood Anxiety Disorders.
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Weems, Carl F., Silverman, Wendy K., Rapee, Ronald M., and Pina, Armando A.
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ANXIETY ,CHILDREN ,CONTROL (Psychology) ,BEHAVIOR disorders in children ,PSYCHOLOGY - Abstract
This study investigated the role of control beliefs in childhood anxiety disorders. The sample comprised 117 youth aged 9–17 years (86 met diagnostic criteria for an anxiety disorder and the remaining 31 were nonreferred comparison participants). Participants' anxiety levels and their perceptions of control over anxiety-related events (e.g., “things that might be harmful,” “feeling shaky or nervous”) were assessed. Findings indicated that perceived control over anxiety-related events was significantly negatively correlated with self-reported anxiety levels. Moreover, youth with anxiety disorders reported significantly lower perceived control about anxiety than the nonreferred participants. Findings were consistent with theory and suggest that anxiety disorders in youth are associated with beliefs that anxiety is uncontrollable. [ABSTRACT FROM AUTHOR]
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- 2003
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46. Content-specific interpretation biases in clinically anxious children.
- Author
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Klein, Anke M., Rapee, Ronald M., Hudson, Jennifer L., Morris, Talia M., Schneider, Sophie C., Schniering, Carolyn A., Becker, Eni S., and Rinck, Mike
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- *
SEPARATION anxiety , *SOCIAL anxiety , *ANXIETY disorders , *CHILDREN , *MOTHER-child relationship - Abstract
Cognitive theories of anxiety suggest that anxious children interpret negatively only those materials specifically related to the content of their anxiety. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes across different anxiety disorders in children, and most of them focused on social anxiety. Therefore, we examined interpretation bias and its content-specificity in a group of clinically anxious children between the ages of 6–12 years with various anxiety disorders, using an "ambiguous scenarios" task. Children were asked to finish scenarios that were related to either social threat, general threat, or separation threat. In total, 105 clinically anxious children, 21 control children and their mothers were assessed with the ADIS-C/P and the Spence Children's Anxiety Scale. As expected, clinically anxious children provided significantly more negative endings to the scenarios than control children. Within the clinically anxious group, specific interpretation biases were found: Interpretation of scenarios related to social threat, general threat, and separation threat were only predicted by the children's self-reported levels of social anxiety, generalized anxiety, and separation anxiety, respectively. These findings support the content-specificity hypothesis that clinically anxious children display interpretation biases that are specific to fear-relevant stimuli. • Anxious children provided more negative endings to ambiguous scenarios than non-anxious peers. • Anxious children display interpretation biases that are specific to fear-relevant stimuli. • Interpretation related to social threat was only predicted by social anxiety. • Interpretation related to general threat was only predicted by generalized anxiety. • Interpretation related to separation threat was only predicted by separation anxiety. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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47. Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood.
- Author
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Forbes, Miriam K., Rapee, Ronald M., and Krueger, Robert F.
- Subjects
- *
MENTAL illness , *CHILDREN , *ENVIRONMENTAL risk , *CHILD development , *PSYCHOLOGICAL factors , *LIFE course approach - Abstract
This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in life. We review empirical evidence for the existence of the general factor of psychopathology and theories regarding the psychological nature of the factor. We then highlight specific examples of environmental risk factors for general psychopathology and discuss translational implications for the transdiagnostic prevention of psychopathology beginning in early childhood. Ultimately, we propose a developmentally informed and transdiagnostic stepped care approach to intervention in which reduction of general psychopathology in early childhood represents the foundational step for prevention and intervention of subsequent psychopathology. This model heralds three key benefits over the current treatment zeitgeist: (1) Reducing the burden and confusion in healthcare and education systems by providing a coherent and systematic structure for early intervention across a child's development, (2) maximising the breadth of the impact of intervention by focusing on common shared risks across psychopathology, and (3) increasing the efficiency of intervention by corresponding with the development of psychopathology and leveraging the emergence of general psychopathology in early childhood. • There is evidence for a general factor of psychopathology. • This factor captures the shared features common to all mental disorders. • It also highlights opportunities for transdiagnostic prevention of mental illness. • We propose a developmentally informed and stepped care approach to prevention. • In early childhood, the most efficient focus is on targeting the general factor. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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48. Internet-Delivered Parenting Program for Prevention and Early Intervention of Anxiety Problems in Young Children: Randomized Controlled Trial.
- Author
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Morgan, Amy J., Rapee, Ronald M., Salim, Agus, Goharpey, Nahal, Tamir, Elli, McLellan, Lauren F., and Bayer, Jordana K.
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- *
EARLY medical intervention , *ANXIETY , *CHILDREN , *ANXIETY disorders , *NEUROSES , *COMPARATIVE studies , *INTERNET , *RESEARCH methodology , *MEDICAL cooperation , *PARENTING , *PSYCHOLOGY of parents , *PSYCHOLOGICAL tests , *RESEARCH , *TEMPERAMENT , *EARLY intervention (Education) , *EVALUATION research , *RANDOMIZED controlled trials , *HUMAN services programs , *PREVENTION - Abstract
Objective: The Cool Little Kids parenting group program is an effective intervention for preventing anxiety disorders in young children who are at risk because of inhibited temperament. The program has six group sessions delivered by trained psychologists to parents of 3- to 6-year-old children. An online adaptation (Cool Little Kids Online) has been developed to overcome barriers to its wide dissemination in the community. This study tested the efficacy of Cool Little Kids Online in a randomized controlled trial.Method: A total of 433 parents of a child aged 3 to 6 years with an inhibited temperament were randomized to the online parenting program or to a 24-week waitlist. The online program has 8 interactive modules providing strategies that parents can implement with their child to manage their child's avoidant coping, reduce parental overprotection, and encourage child independence. Parents were provided telephone consultation support with a psychologist when requested. Parents completed self-report questionnaires at baseline and at 12 and 24 weeks after baseline.Results: The intervention group showed significantly greater improvement over time in child anxiety symptoms compared to the control group (d = 0.38). The intervention group also showed greater reductions in anxiety life interference (ds = 0.33-0.35) and lower rates of anxiety disorders than the control group (40% versus 54%), but there were minimal effects on broader internalizing symptoms or overprotective parenting.Conclusion: Results provide empirical support for the efficacy of online delivery of the Cool Little Kids program. Online dissemination may improve access to an evidence-based prevention program for child anxiety disorders. Clinical trial registration information-Randomised Controlled Trial of Cool Little Kids Online: A Parenting Program to Prevent Anxiety Problems in Young Children; http://www.anzctr.org.au/; 12615000217505. [ABSTRACT FROM AUTHOR]- Published
- 2017
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49. Forced choice reaction time paradigm in children with separation anxiety disorder, social phobia, and nonanxious controls
- Author
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In-Albon, Tina, Dubi, Kathrin, Rapee, Ronald M., and Schneider, Silvia
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SEPARATION anxiety in children , *SOCIAL phobia , *ANXIETY disorders , *CHOICE (Psychology) , *REACTION time , *CHILD psychology , *HUMAN information processing , *SELF-evaluation - Abstract
Abstract: Cognitive distortions refer to cognitive processes that are biased and therefore yield dysfunctional and maladaptive products (e.g., interpretation bias). Automatic aspects of information processing need to be considered and investigating these aspects requires forms of assessment other than self-report. Studies focussing on the specificity of cognitive biases across different types of anxiety disorders in childhood are rare. Thus, a forced choice reaction time paradigm with picture stimuli was used to assess the interpretation bias in anxious children online. The study investigated disorder-specific interpretation bias in 71 children with separation anxiety disorder (SAD), 31 children with social phobia, and 42 children without mental disorders, aged 5–13 years. Results indicated that children with SAD rated ambiguous separation pictures as significantly more unpleasant and more arousing than nonanxious children. However, no support was found that children with SAD and social phobia interpret ambiguous separation or social pictures in a more negative way than nonanxious children. Furthermore, no group differences were found in reaction times to all picture categories. [Copyright &y& Elsevier]
- Published
- 2009
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50. Threat interpretation in anxious children and their mothers: comparison with nonclinical children and the effects of treatment
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Creswell, Cathy, Schniering, Carolyn A, and Rapee, Ronald M
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- *
ANXIETY , *EMOTIONS , *NEUROSES , *PSYCHOLOGICAL stress - Abstract
Abstract: Interpretation biases towards threat play a prominent role in cognitive theories of anxiety, and have been identified amongst highly anxious adults and children. Little is known, however, about the development of these cognitive biases although family processes have been implicated. The current study investigated the nature of threat interpretation of anxious children and their mothers through (i) comparison of a clinic and non-clinic population, (ii) analysis of individual differences; and (iii) pre- and post-treatment comparisons. Participants were 27 children with a primary anxiety disorder and 33 children from a non-clinic population and their mothers. Children and mothers completed self-report measures of anxiety and indicated their most likely interpretation of ambiguous scenarios. Clinic and non-clinical groups differed significantly on measures of threat interpretation. Furthermore, mothers’ and children''s threat interpretation correlated significantly. Following treatment for child anxiety, both children and their mothers reported a reduction in threat interpretation. [Copyright &y& Elsevier]
- Published
- 2005
- Full Text
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