ABSTRACT
OBJECTIVE: To evaluate the efficacy of child and caregiver participation in the cognitive-behavioral treatment of sexually abused children with posttraumatic stress symptoms. METHOD: Thirty-six sexually abused children (aged 5-17 years) were randomly assigned to a child-alone cognitive-behavioral treatment condition, a family cognitive-behavioral treatment condition, or a waiting-list control condition. RESULTS: Compared with controls, children who received treatment exhibited significant improvements in posttraumatic stress disorder symptoms and self-reports of fear and anxiety. Significant improvements also occurred in relation to parent-completed measures and clinician ratings of global functioning. In general, parental involvement did not improve the efficacy of cognitive-behavioral therapy. Maintenance of improvement was evident at a 12-week follow-up assessment. CONCLUSIONS: Cognitive-behavioral treatment was useful, but further research is required on caregiver involvement.
Subject(s)
Child Abuse, Sexual/psychology , Cognitive Behavioral Therapy/methods , Family Therapy/methods , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Adolescent , Analysis of Variance , Chi-Square Distribution , Child , Female , Humans , Imagery, Psychotherapy , Male , Relaxation Therapy , Risk Factors , Treatment OutcomeABSTRACT
Reviews the empirically supported status of behavioral and cognitive-behavioral interventions in the treatment of childhood phobias and anxiety disorders. For childhood phobias, it is concluded that imaginal desensitization, in vivo desensitization, filmed modeling, live modeling, and cognitive-behavioral interventions that use self-instruction training are probably efficacious and that participant modeling and reinforced practice are well established. For anxiety disorders, only cognitive-behavioral procedures with and without family anxiety management (FAM) were found to be probably efficacious. However, much of the support for these procedures comes from analogue studies conducted in research laboratory or school settings, delivered in small-group format and, not infrequently, with nonclinically referred children. Additional research that examines high-strength interventions with clinic-referred children is recommended. Furthermore, research that examines the pathological processes involved in the onset and maintenance of phobic and anxiety disorders as well as the change processes used to treat these disorders is called for.
Subject(s)
Anxiety Disorders/therapy , Psychology, Adolescent/methods , Psychology, Child/methods , Psychotherapy/methods , Adolescent , Behavior Therapy/methods , Behavior Therapy/standards , Child , Child, Preschool , Cognitive Behavioral Therapy/methods , Cognitive Behavioral Therapy/standards , Desensitization, Psychologic , Family Therapy/methods , Fear , Female , Humans , Imagery, Psychotherapy , Infant , Male , Models, Psychological , Parent-Child Relations , Phobic Disorders/therapy , Psychology, Adolescent/standards , Psychology, Child/standards , Psychotherapy/standards , Reproducibility of Results , Role Playing , Treatment Outcome , Video RecordingABSTRACT
BACKGROUND: School-based relaxation training programmes are a popular means of helping children with anxiety problems such as headaches and test anxiety. AIMS: Our major objective is to evaluate the empirical status of school-based relaxation training programmes. CONTENTS: Focusing on progressive muscle relaxation training, we show how this adult training procedure has been modified for use with children. Several training issues are discussed including the questions of live versus recorded instruction and individual versus group instruction. We also discuss the evaluation of relaxation training programmes in school settings, highlighting issues of reliability and validity. CONCLUSIONS: Our review of studies examining the efficacy of school-based relaxation training shows that improvements are usually modest and of dubious clinical or educational significance. Consequently we suggest that when relaxation training is used with school children treatment goals should be more modest or, that if improvements in specific performance areas are sought, then more comprehensive treatment packages be developed which can influence the successful performance of children in target areas and reduce anxiety to normal levels.
Subject(s)
Goals , Learning/physiology , Relaxation Therapy/education , Students/psychology , Child , Headache/therapy , Humans , Psychology, ChildABSTRACT
Suspension and attachment cultures of Y79 human retinoblastoma cells were treated with all-trans retinoic acid (RA) for up to 10 days to assess its effect on growth and cell-surface expression of immunoglobulin superfamily antigens MHC class I and class II, ICAM-1, NCAM and Thy1. RA up to 10 microM induced growth inhibition, and marked morphological differentiation with extension of prominent processes resembling neurites was seen in attachment cultures. However, above 10 microM RA produced extensive cell death. We also observed increased cell-surface expression of MHC class I, ICAM-1, NCAM and Thy1 on Y79 cells treated with 10 microM over 10 days; constitutive MHC class II expression was not apparent, nor did RA treatment appear to induce Y79 cells to express MHC class immunoreactivity. The up-modulation of cell-adhesion molecules (NCAM, ICAM-1 and Thy1) and immune recognition molecules (NCAM, ICAM-1 and MHC class I), associated with reduced growth and tumour cell differentiation, suggests that RA may have a potential role in regulating the growth and development of retinoblastoma tumours.
Subject(s)
Adjuvants, Immunologic/pharmacology , Antigens, Surface/biosynthesis , Antineoplastic Agents/pharmacology , Eye Neoplasms/immunology , Immunoglobulins/biosynthesis , Retinoblastoma/immunology , Tretinoin/pharmacology , Antigens, Surface/analysis , Antigens, Surface/genetics , Cell Differentiation/drug effects , Dose-Response Relationship, Drug , Eye Neoplasms/metabolism , Eye Neoplasms/pathology , Flow Cytometry , Gene Expression Regulation, Neoplastic/drug effects , Histocompatibility Antigens Class I/analysis , Histocompatibility Antigens Class I/biosynthesis , Histocompatibility Antigens Class I/genetics , Histocompatibility Antigens Class II/analysis , Histocompatibility Antigens Class II/biosynthesis , Histocompatibility Antigens Class II/genetics , Humans , Immunoglobulins/analysis , Immunoglobulins/genetics , Immunohistochemistry , Intercellular Adhesion Molecule-1/analysis , Intercellular Adhesion Molecule-1/biosynthesis , Intercellular Adhesion Molecule-1/genetics , Neural Cell Adhesion Molecules/analysis , Neural Cell Adhesion Molecules/biosynthesis , Neural Cell Adhesion Molecules/genetics , Retinoblastoma/metabolism , Retinoblastoma/pathology , Thy-1 Antigens/analysis , Thy-1 Antigens/biosynthesis , Thy-1 Antigens/genetics , Time Factors , Tumor Cells, CulturedSubject(s)
Behavior Therapy/methods , Child Behavior Disorders/therapy , Child Reactive Disorders/therapy , Desensitization, Psychologic/methods , Emotions , Imagination , Phobic Disorders/therapy , Adaptation, Psychological , Child Reactive Disorders/psychology , Child, Preschool , Humans , Male , Phobic Disorders/psychologyABSTRACT
This review focuses upon the behavioral approach to childhood asthma. Asthma is defined as intermittent, variable, and reversible airways obstruction with a complex multidimensional etiology. The major measures of asthma include physiological, symptomatic, and collateral measures. The behavioral management of childhood asthma has been restricted to relaxation training, systematic desensitization, assertive training, biofeedback, and deconditioning of exercise-induced asthma. The efficacy of such intervention strategies for asthmatic children is in doubt, although the management of asthma-related problems in children appears to be a more promising area of research. The author suggests that the power of intervention programs for asthmatic children may be strengthened by the development of multifaceted treatment programs contingent upon the antecedents and consequences of the individual case. Also, behavior therapy may be of assistance to mild asthmatic children.
Subject(s)
Asthma/therapy , Behavior Therapy/methods , Adolescent , Assertiveness , Asthma/psychology , Asthma, Exercise-Induced/psychology , Biofeedback, Psychology , Child , Child, Preschool , Desensitization, Psychologic , Humans , Psychoanalytic Theory , Relaxation TherapyABSTRACT
Most of the research on biofeedback induced peripheral temperature control is open to serious methodological and theoretical criticisms. In the present research investigation, increase in peripheral (finger) temperature was targeted because of the possible therapeutic implications for the treatment of migraine and Raynaud's disease. Two experiments are reported in which the pretest-posttest control group design was employed to test the power of the variables in biofeedback induced self-control of finger temperature, and the necessity for subjects to engage in somatic manoeuvres. Significant increases in within-session and absolute finger temperature occurred in a test for self-control only for those subjects who had undergoing contingent feedback-somatic activity training conditions. It is suggested that future research should examine the role of mediational strategies in biofeedback-temperature training.