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Anxiety affects 10% of all children and disrupts educational, socio-emotional development and overall functioning of the child and family. Research has shown that parenting factors (i.e. intrusiveness, negativity, distorted cognitions) contribute to the development and maintenance of childhood anxiety. Recent studies have therefore investigated if the treatment effect of traditional cognitive behavioural therapy may be enhanced by adding a parental component. However, randomised controlled trials have not shown unequivocal support for this assumption. The results are inconsistent and ambiguous. This article investigates possible reasons for this inconsistency and in particular differences in methodology and the theoretical relevance of the applied parental components are highlighted as possible contributory factors. Another factor is that treatment effect is mainly measured by change in the child's diagnostic status rather than changes in parental or family functioning.

Citation: Esbjørn BH, Sømhovd MJ, Turnstedt C, Reinholdt-Dunne ML (2012) Assessing the Revised Child Anxiety and Depression Scale (RCADS) in a National Sample of Danish Youth Aged 8–16 Years. PLoS ONE 7(5): e37339. doi:10.1371/journal.pone.0037339, Early identification of anxiety among youth is required to prevent them from going unrecognised and untreated by mental health professionals. A precise identification of the young person's primary difficulty is also required to guide treatment programs. Availability of a valid and easily administrable assessment tool is crucial for identifying youth suffering from anxiety disorders. The purpose of the present study was therefore to examine the psychometric properties of the Danish version of the Revised Children's Anxiety and Depression Scale (RCADS). A total of 667 youth from community schools (4(th) through 9(th) grade) across Denmark participated in the study. The psychometric properties of the RCADS-(DAN) resembled those reported in US and Europe. Within scale reliability was excellent with Chronbach's alpha of 96. All subscales also showed good to excellent internal reliability. The study provides convincing evidence that the RCADS-(DAN) is a valid assessment tool for screening anxiety in Danish youth.

Aim To determine if adolescents who are born very preterm (<32wks; of gestation) and/or with very low birthweight (VLBW; <1500g) have a higher risk of experiencing clinically significant anxiety problems. Method We used a systematic review and meta-analysis. We searched the databases ISI Web of Knowledge, PubMed, PsycNET, Educational Resources Information Center (ERIC), Latin American and Caribbean Literature on the Health Sciences (LILACS), and Virtual Health Library (VHL) with equivalent search expressions (from the databases inception to June 2011). Also, we screened reference lists of identified articles. We selected casecontrol studies of adolescents 11 to 20 years old who were very preterm/VLBW and had a matched reference group born at term with normal birthweight that reported a validated anxiety outcome measure. For data extraction, two authors independently reviewed titles, abstracts, and full articles identified through the searches. Subsequently two authors independently extracted data. Results We included six studies with 1519 adolescents (787 very preterm/VLBW, 732 comparisons). The general risk of developing clinically significant anxiety problems was nearly doubled (p<0.05) in the very preterm/VLBW population (OR 2.27, 95% confidence interval 1.154.47). The overall prevalences were 9.9% in the very preterm/VLBW group and 5.5% in the comparison group. Interpretation Those born very preterm/VLBW have an increased risk of developing clinically significant anxiety problems in adolescence.

Although fathers have been shown to contribute uniquely to the development of psychopathology in children, they continue to be ignored in research and clinical work. Knowledge about the impact of involving fathers in their child’s treatment – for the child, couple and the family as a whole - is still sparse. The aim of this study was to explore parents’ experiences of having fathers involved in the treatment of their child. Parents, whose children had received cognitive behavioural therapy for an anxiety disorder, were interviewed about this topic. The participating parents had all been involved in the treatment of their child. Interpretative phenomenological analysis (IPA) was used to analyze the data in this study. Three higher order themes and 11 subthemes emerged from the six interview accounts. The three higher order themes were as follows: Strengthening the family system, empowerment of parents, and impact on partner relationship. Results indicated that parents’ experiences of the involvement of fathers to be beneficial not only on the child’s treatment but also on other aspects of family life. The parents reported that the family as a whole benefitted from the treatment and that the relationship between the parents was strengthened. A model was created to conceptualize these results.

Esbjørn, B. H., Breinholst, S., Reinholdt-Dunne, M. L., & Leth, I. (2011). The effect of parental involvement in CBT of anxious children: Preliminary results from a RCT study. Poster accepted for the Association for Behavioral and Cognitive Therapies, Toronto, Canada.

Hvorfor udvikler nogle børn angst, mens andre børn kan møde verden uden angst? På trods af at angst er en naturlig og adaptiv del af ethvert barns udvikling, risikerer ca. 10 % af alle børn at udvikle en angstlidelse. Angsten bliver en lidelse, når den forstyrrer et barn i at udvikle sig gennem deltagelse i et alderssvarende børneliv. Gennem de seneste årtier er forskere i stigende grad begyndt at undersøge, hvilke faktorer der har indflydelse på udviklingen og vedligeholdelsen af angst. På baggrund af et udviklingspsykopatologisk perspektiv har man udviklet modeller, der søger at indfange kompleksiteten i angstlidelserne. Heri indgår barnets genetiske dispositioner, det tidlige samspil med forældre, negative livsbegivenheder, emotionsregulering, indre kognitive mekanismer som opmærksomhedsbias og fortolkning af omverdenen samt aktuelle familiemønstre. I artiklen gives et kort review af de væsentligste risikofaktorer, som man via forskning ved er særlig betydningsfulde for udvikling og vedligeholdelse af angst i barndommen, og det diskuteres, hvilke implikationer denne viden bør få for behandling af børn med angst.

Anxiety disorders are among the most common psychiatric disturbances in childhood (Costello 2003). Theorists suggest that information-processing biases for emotional information play an important role in the development of anxiety disorders (Kendall & Ronan, 1990), and that development/age affects information-processing biases due to its significant relationship with executive functioning levels and cognitive maturation (Lonigan et al., 2004). The present study aimed to further investigate the relationships between information-processing biases and childhood development. Information-processing bias was assessed using an emotional Stroop paradigm with angry, happy and neutral faces. Trait anxiety was measured using the State-Trait Anxiety Inventory for Children (STAI-C; Spielberger et al., 1983). There were four groups of schoolchildren (N = 67, aged 7 - 14) divided by median splits on trait anxiety (below vs above 31 on STAI-C) and age (below vs above 10.75 years). Results revealed a significant Age x Trait anxiety x Type of emotional face interaction effect on interference scores, indicating an interference effect of angry faces (relative to neutral faces) in younger children with moderate levels of trait anxiety (i.e. 7-10 year-olds with STAI-C > 31). This interference effect was not evident in low trait anxious children, or in older children, irrespective of anxiety levels. There was no interference effect of happy faces. Findings suggest that cognitive maturation (i.e. age) may help moderately anxious children regulate interference for threat-related stimuli. Results are discussed in relation to current cognitive and developmental models of anxiety.

Udgivelsesdato: 13. oktober

Artiklen er et review af international litteratur af forældrenes oplevelser af at få et ekstremt tidligt født barn og en beskrivelse af danske forældres oplevelser af samme situation. Kvalitative data er indhentet ved interviews i forbindelse med en efterundersøgelse af ekstremt tidligt fødte børn i 5-års-alderen og samlet i to vignetter fra tiden på neonatalafdelingen og fra tiden efter udskrivelsen. Resultaterne stemte overens med fund fra udlandet. Temaer fra tiden på neonatalafdelingen var: 1. Fokus på barnets tilstand. 2. Psykiske svingninger. 3. Afhængighed og 4. Gradvis opnåelse af ejerskab af barn. Et særligt fund gældende forældre til ekstremt tidligt fødte børn er, at de foruden belastende oplevelser også oplever at blive knyttet til og afhængige af samværet med personale og øvrige forældre. I tiden efter udskrivelsen var temaerne: 1. Håbet om normaltilstand skuffes. 2. Tab af netværk. 3. Usikkerhed vedr. kompetence som forældre og 4. Forældrenes reaktioner træder frem. Konklusionen er, at forældre til indlagte børn oplever en øget grad af stress, flere psykiske symptomer og ændrede roller som forældre. I perioden efter udskrivelsen og især fra 4. til 5. leveår mindskes graden af bekymring især hos forældre, hvis børn udvikler sig alderssvarende.

A national cohort of extremely low birth weight (ELBW) and/or extremely preterm (EPT) children and a term control group was followed up at the age of 5 years. The primary objective was to investigate whether premature birth had a global impact on cognitive functions or affected specific functions only. Assessment tools were Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), Movement Assessment Battery for Children (M-ABC), and subtests from the Neuropsychological Assessment 4-7 years (NEPSY). The mean Full Scale IQ (FSIQ) and M-ABC score of the index children were 1.1 and 1.2 SDs lower than that of the control children (p <.001). Most WPPSI-R subtests showed medium to large differences between index and control children, suggesting a global impact of premature birth on cognitive functions. For both unadjusted and FSIQ adjusted means, no significant group differences on tests of memory or executive function were observed (p >.1), suggesting little impact of premature birth on these specific functions. In this sample, cognitive difficulties in 5-year-old ELBW and/or EPT children tended to be associated with general intellectual difficulties rather than with specific dysfunctions; however, the implications of this finding are ambiguous due to substantial attrition on the NEPSY subtests.

Udgivelsesdato: 2006/12

A cohort of extremely prematurely born children and matched term controls was assessed at 5 years of age. The parents completed a questionnaire on their behavioral and social development. The purpose was to illuminate whether the children's general intellectual ability and parental sensitivity were associated with behavioral and social development. The index children exhibited more hyperactive behavior and had poorer social skills than the controls. Lower Full Scale IQ (FSIQ) was associated with outward reacting and hyperactive behavior and poorer social skills. Sensitive parenting was associated with less outward reacting and less hyperactive behavior. When controlling for differences in FSIQ and parental sensitivity, the index children persisted to have an increased risk of exhibiting hyperactive behavior but not poorer social skills. The index children with normal intellectual development, however, did not exhibit more behavioral problems or poorer social skills than the control children did.

To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period.

Udgivelsesdato: februar