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ObjectiveCommonly-used youth anxiety measures may not comprehensively capture fears, worries, and experiences related to the pervasive impact of the COVID-19 pandemic. This study described the development of the Fear of Illness and Virus Evaluation (FIVE) scales and validated the caregiver-report version.MethodAfter initial development, feedback was obtained from clinicians and researchers, who provided suggestions on item content/wording, reviewed edits, and provided support for the updated FIVE's content and face validity. Factor structure, measurement invariance, and psychometric properties were analyzed using data from a multi-site, longitudinal study of COVID-19-related effects on family functioning with 1599 caregivers from the United States and Canada.ResultsConfirmatory factor analyses indicated a hierarchical five-factor structure best fit the data, resulting in a 31-item measure with four lower-order subscales: (1) Fears about Contamination and Illness; (2) Fears about Social Distancing, (3) Avoidance Behaviors, and (4) Mitigation Behaviors, and a higher-order factor, (5) Total Fears, indicated by the two fear-related lower-order subscales. Measurement invariance by country of residence, child age, and child sex was found. All subscales demonstrated strong internal consistency, appropriate item-scale discrimination, and no floor or ceiling effects. The Total Fears subscale demonstrated appropriate test-retest reliability. Concurrent validity supported by strong correlation with a youth anxiety measure.DiscussionThe FIVE provides a psychometrically-sound measure of COVID-19-related fears and behaviors in youth in a caregiver-report format. Future research is necessary to evaluate correlates and longitudinal symptom patterns captured by the FIVE caregiver-report, as well as the validity and reliability of a youth self-report version of the FIVE.

Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient treatments for these conditions before they become chronic and resistant to change. We developed and pilot-tested the Pain and Trauma Intensive Outpatient Treatment (PATRIOT) Program, a brief, intensive (3 weeks, six sessions) integrated chronic pain and PTSD treatment. An overview and session-by-session outline of the PATRIOT Program is provided, followed by results from the first pilot evaluation of the PATRIOT Program's feasibility, acceptability, and preliminary efficacy in a sample of eight participating Veterans with comorbid chronic pain and PTSD. There were no treatment dropouts. At post-treatment, there were significant reductions in PTSD symptoms based on the Clinician-Administered Assessment of PTSD (CAPS). Pain and catastrophic thinking also decreased from pre- to post-treatment. With continued investigations and support, the PATRIOT Program may offer a brief, cost-effective, and more easily accessible treatment option for individuals who could benefit from learning skills to manage pain and PTSD more effectively. [ABSTRACT FROM AUTHOR]

Anxiety disorders are commonly occurring among children and are associated with increased risk for poor educational outcomes. However, little is known about the specific supports and accommodations provided to anxious children in schools. This study examines reports of school functioning and school-based supports and accommodations among a sample of 51 anxious youth and their mothers seeking treatment at an outpatient clinic. Children and their mothers reported significant anxiety-related impairment in school functioning, particularly for older children. Children identified as needing special education and related services (through Individualized Education Program [IEP] and 504 plans) more often received anxiety-related supports and accommodations at school than their peers who did not receive IEP/504 services. However, these accommodations were not always well matched to child needs and, in some cases, might facilitate avoidance of anxiety. Results suggest that some children with anxiety disorders receive supports in schools that may be inconsistent with evidence-based clinical practices. School-based mental health providers can be in an important position to facilitate coordinated care for youth with anxiety disorders.

This study compared the relative efficacy of intensive versus weekly panic control treatment (PCT) for adolescent panic disorder with agoraphobia (PDA). Twenty-six adolescents participated in weekly sessions and 25 received intensive treatment involving daily sessions. Both groups demonstrated significant and comparable reductions in panic disorder severity and general anxiety symptoms, which maintained over time. Participants receiving weekly treatment showed significant decreases in depressive symptoms, whereas those in the intensive program reported no change. Findings support the efficacy of the intensive approach for adolescent PDA, but suggest that adolescents receiving intensive treatment may benefit from a brief course of additional weekly sessions. (Contains 2 tables and 1 figure.)

A number of studies have demonstrated the efficacy of brief cognitive-behavioral interventions for treating childhood nighttime fears. The purpose of the present study is to determine whether behavior changes could be initiated and maintained with home monitoring and reinforcement alone. Sixteen children, ages 6 to 11, with severe, disruptive nighttime fears were assigned to either a group receiving only reinforcement and home monitoring or a group receiving reinforcement and home monitoring plus an additional skills component. Results reveal that both groups show a significant reduction in the intensity and frequency of nighttime fears. However, only the group receiving the full treatment package maintained these gains over time. (Contains 4 tables and 3 figures.)

This investigation represents the first randomized controlled trial to evaluate the feasibility and efficacy of Panic Control Treatment for Adolescents (PCT-A). Thirteen adolescents, ages 14 to 17, were randomized to 11 weekly sessions of PCT-A treatment, whereas 13 were randomized to a self-monitoring control group. Results indicate that adolescents receiving immediate PCT-A showed a significant reduction in clinician-rated severity of panic disorder and in self-reported anxiety, anxiety sensitivity, and depression, in comparison to control group participants. These treatment gains were maintained at 3- and 6-month follow-up. Clinical severity of panic continued to improve from post-treatment to 3-month follow-up and then remained stable at 6-month follow-up. In light of study limitations, these findings suggest that cognitive-behavioral treatment for panic disorder in adolescence is a feasible and potentially efficacious intervention for this debilitating condition in youth. (Contains 3 tables and 1 figure.)

This investigation seeks to establish the psychometric properties of an adapted measure of experiential avoidance (EA) in the parenting context by assessing its relation to other parenting constructs and psychosocial correlates of child anxiety in a clinical sample. Participants were 154 children (90 female, 64 male) diagnosed with anxiety disorders and their parents (148 mothers, 119 fathers). The newly developed Parental Acceptance and Action Questionnaire (PAAQ) was administered to parents along with self-report measures of adult experiential avoidance, parental psychopathology, affective expression, and parental control behaviors. A subsample of participants, n = 35, were re-administered the PAAQ to assess temporal stability. Factor analysis of the PAAQ yielded a two-factor solution with factors labeled "Inaction" and "Unwillingness." Temporal stability of the PAAQ was found to be moderate, r = 0.68-0.74. Internal consistency was fair across subscales of the PAAQ, [alpha] = 0.64-0.65. Correlational analysis of the PAAQ and parent-report measures support the criterion validity of the PAAQ, suggesting that the PAAQ correlates with parent-report measures of parental locus of control, affective expression, and controlling parental behaviors as well as child psychopathology symptoms. Finally, the clinical applicability of the PAAQ is indicated by the PAAQ's ability to predict a significant amount of variance in parent- and clinician-rated levels of child anxiety and related psychopathology.

New and innovative ways of implementing cognitive-behavioral therapy (CBT) are required to address the varied needs of youth with anxiety disorders. Brief treatment formats may be useful in assisting teens to return to healthy functioning quickly and can make treatment more accessible for those who may not have local access to providers of CBT. This paper provides information about the implementation of an intensive, 8-day treatment program for panic disorder (with or without agoraphobia) in adolescents. The treatment protocol is described, as are the various areas to consider when implementing an intensive format. Two case examples are provided to detail how the treatment specifically addresses the wide array of symptoms that can present as part of panic disorder with agoraphobia. Within these case descriptions, treatment challenges are highlighted as well as ideas for handling them. Finally, areas for future research are discussed. (Contains 1 table.)

The purpose of the current study was to extend research regarding parent-child agreement in the assessment of anxiety disorders to include youth with obsessive-compulsive disorder (OCD). Ninety-three children and adolescents with OCD (50 female, 43 male), ages 6 to 17 years, and their parents were administered the Anxiety Disorders Interview Schedule for Children. Data were obtained from a review of records of children and their parents seeking services from a university-based research and treatment clinic. Consistent with previous research on the assessment of anxiety disorders in youth, results indicated that parent-child agreement in the assessment of OCD is relatively poor at both the diagnostic and symptom levels. Our findings highlight the importance of multiple informant diagnostic systems in assessing childhood OCD. (Contains 2 tables.)

Separation Anxiety Disorder (SAD) is the most prevalent anxiety disorder experienced by children, and yet empirical treatment studies of SAD in young children are virtually nonexistent. This paper will describe the development and implementation of an innovative treatment for SAD in young children. First, we will highlight the rationale for developing interventions specifically for SAD in young children. Second, we will describe an existing empirically supported treatment, Parent-Child Interaction Therapy (PCIT; Brinkmeyer, M. Y., & Eyberg, S.M., (2003)), that may have particular applicability to very young children with SAD and their parents. We present how results from 10 pilot participants were utilized to modify PCIT to better address the needs of children with SAD and their families. The benefits and challenges of implementing this modified version of PCIT are reviewed, along with potential directions for future research in this area.

Although diminished self-efficacy has been linked to childhood psychopathology, including depression, it has only recently been studied in relation to childhood anxiety disorders. This study examines the relationship between self-efficacy and self-reported anxiety in children who have been referred for an assessment and possible treatment of anxiety symptoms as well as a comparison group of non-referred children. A self-efficacy questionnaire for children and a childhood anxiety measure were administered to a group of children referred for assessment and treatment of a clinical anxiety disorder (n = 50) and a non-referred control group (n = 50). Results indicate that the two samples differed significantly on measures of emotional self-efficacy, but not in terms of self-reported anxiety or other self-efficacy domains. Potential explanations for observed findings are discussed, including the possibility that self-reports of emotional self-efficacy in children may vary by clinical or referral status, amongst those reporting higher levels of anxiety overall.

The purpose of this study was to evaluate the factor structure of the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA). The LSAS-CA was administered to 225 children and adolescents as a component of various clinical studies. In addition, other measures of psychopathology and impairment were administered to a subgroup of the sample. Confirmatory factor analyses of the social interaction and performance subscales for the anxiety and avoidance ratings yielded poor fit indices. Exploratory factor analysis supported a two-factor solution with a higher order factor for the LSAS-CA anxiety and avoidance ratings. Based on item content, factors were named Social and School Performance. The internal consistency of the factors was high and the convergent and divergent validity was supported vis-a-vis correlations with measures of depression and social anxiety, and clinician ratings of impairment and functioning. Findings suggest that the anxiety and avoidance ratings are best explained by a two-factor solution that measures social anxiety and avoidance in social and school performance interactions. This factor structure appears to be a reliable and valid framework for assessing childhood social phobia.

Separation Anxiety Disorder (SAD) is currently the most prevalent, yet most under-researched anxiety disorder in childhood. To date, there have been few studies investigating the efficacy of interventions for young children with SAD. The primary purpose of this paper is to describe the process of tailoring Parent Child Interaction Therapy (PCIT) for young children aged 4-8 with SAD. The paper provides a theoretical rationale for using PCIT to treat young children with SAD. The first randomized clinical trial for young children with SAD is then described. The paper focuses on the process of adapting PCIT to make it most relevant for children with SAD. The specific challenges and rewards of conducting PCIT with anxious children and their parents are presented.

Research suggests that Parent-Child Interaction therapy (PCIT) works to improve the child's behavior by changing the child-parent interaction. PCIT has been effective in treating disruptive behavior in young children. This article describes a pilot study to apply PCIT to the treatment of separation anxiety disorder (SAD). A multiple-baseline design was used with 3 families with a child between the ages of 4 and 8 who had a principal diagnosis of SAD. Following treatment with PCIT, clinically significant change in separation anxiety was observed on all measures. Disruptive behaviors also decreased following treatment. Treatment gains were maintained at a 3-month follow-up interval. These findings suggest that PCIT may be particularly useful for treatment of young children with SAD, the most prevalent yet underresearched anxiety disorder of childhood. The results of this study support research delineating the important contribution of family factors to anxiety in childhood. Several mechanisms are proposed that may account for the dramatic decrease in separation-anxious behaviors seen in children during PCIT, including increased levels of child control, increased social reinforcement of brave behaviors, improved parent-child attachment, and decreased levels of parent anxiety. Results of this study provide promising initial evidence that PCIT may be efficacious for treating young children with SAD. A randomized clinical trial is warranted to further elucidate the efficacy of PCIT for treatment of SAD in young children.

Anxiety disorders are one of the most common psychiatric conditions in youth and can contribute to impairment in social, academic, and family functioning. Cognitive-behavioral therapy (CBT) has been shown to be efficacious in treating youth anxiety disorders; however, for a multitude of reasons, fewer than 20% of adolescents with anxiety disorders receive services for anxiety-related problems. Intensive treatments, which rely on the same traditional components of CBT but are delivered over a shorter period of time or in a fewer number of sessions, may be particularly helpful for anxiety disorders and can offer a number of advantages over standard CBT. Despite emerging evidence supporting the advantages of the intensive approach, there are few established intensive treatment programs for youth with anxiety disorders. Further, no treatment to date has comprehensively targeted the entire spectrum of comorbid adolescent anxiety disorders in a combined intensive and transdiagnostic format, even though non-intensive (i.e., weekly delivered) CBT has been tested using a transdiagnostic approach. We developed an intensive, six-session intervention based on Angelosante and colleagues' 2009 The Adolescent Panic Control Treatment with In-Vivo Exposures (Angelosante et al., 2009) and other empirically-supported treatments for youth to target all anxiety disorders in adolescents. We present a case study on an adolescent with multiple comorbid anxiety and related disorders who received intensive CBT treatment as a way to illustrate the clinical benefit and utility of an intensive, transdiagnostic approach. Findings support the acceptability and feasibility of transdiagnostic treatment of youth anxiety. [ABSTRACT FROM AUTHOR]