Therapy for youths with anxiety disorders: a second randomized clinical trial.

Ninety-four children (aged 9-13 years) with anxiety disorders were randomly assigned to cognitive behavioral treatment or waiting-list control. Outcomes were evaluated using diagnostic status, child self-reports, parent and teacher reports, cognitive assessment and behavioral observation: maintenance was examined using 1-year follow-up data. Analyses of dependent measures indicated significant improvements over time, with the majority indicating greater gains for those receiving treatment. Treatment gains returned cases to within nondeviant limits (i.e., normative comparisons) and were maintained at 1-year follow-up. Client age and comorbid status did not moderate outcomes. A preliminary examination of treatment segments suggested that the enactive exposure (when it follows cognitive-educational training) was an active force in beneficial change. Discussion includes suggestions for future research.

Maternal expectations and attributions about coping in anxious children.

This study examined maternal expectations and attributions regarding their child's ability to cope with a stressful situation. Children either met DSM III-R criteria for an Anxiety Disorder or were normal. Results indicated that it was not the perception of threat that differentiated the expectations of mothers in both groups, but rather their expectations for coping, both generally and in terms of specific behavior. Mothers of anxiety-disorder (AD) children expected their children to be more upset, less able to make themselves feel comfortable, and were less confident in their children's abilities to perform task related behavior. In general, maternal expectations for coping appear to reflect the actual lower coping ability of anxious children. Concerning attributions, mothers of AD children made fewer causal distinctions between high and low coping than did mothers of normal control (NC) children. Discussion considers how lowered expectations for coping may relate to protective parenting and how such patterns may unwittingly maintain anxious behavior in children.

Cognitive-behavioral treatments.

The present paper provides an overview of the guiding theory and descriptive features of the cognitive-behavioral approach to psychosocial interventions for youths. Cognitive-behavioral treatment has been applied to various disorders including anxiety, aggression, depression, attention deficit-hyperactivity disorder, pain, and learning disabilities. Research on the nature of these disorders, a description of related treatment strategies, and an illustrative review of treatment outcome data is provided. Discussion focuses on a consideration of familial involvement, developmental factors, and methodological issues (i.e., comorbidity and normative comparisons) that require research attention.