ABSTRACT
This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7-17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078).
Subject(s)
Adaptation, Psychological , Anxiety Disorders/therapy , Cognitive Behavioral Therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Sertraline/therapeutic use , Adolescent , Anxiety Disorders/drug therapy , Anxiety Disorders/psychology , Child , Combined Modality Therapy , Female , Health Status , Humans , Male , Symptom Assessment , Treatment OutcomeABSTRACT
We developed and evaluated a brief (8-session) version of cognitive-behavioral therapy (BCBT) for anxiety disorders in youth ages 6 to 13. This report describes the design and development of the BCBT program and intervention materials (therapist treatment manual and child treatment workbook) and an initial evaluation of child treatment outcomes. Twenty-six children who met diagnostic criteria for a principal anxiety diagnosis of separation anxiety disorder, generalized anxiety disorder, and/or social phobia were enrolled. Results suggest that BCBT is a feasible, acceptable, and beneficial treatment for anxious youth. Future research is needed to examine the relative efficacy of BCBT and CBT for child anxiety in a randomized controlled trial.
ABSTRACT
BACKGROUND: Subjective Units of Distress Scale (SUDS) ratings are commonly used during exposure tasks in cognitive behavioral treatment (CBT) for anxiety. AIMS: The present study examined patterns and predictors of SUDS in a sample of anxiety-disordered youth. METHOD: Youth (N = 99) aged 7 to 14 (M = 10.4, SD = 1.8) were treated with CBT for social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Analyses were conducted using hierarchical linear modeling. RESULTS: Child's peak SUDS and magnitude of change in SUDS significantly increased between sessions. Higher child self-reported pretreatment total Multidimensional Anxiety Scale for Children (MASC) score predicted greater change in SUDS within the first exposure session. Primary GAD diagnosis predicted less increase in change in SUDS between sessions. CONCLUSIONS: Results suggest that higher pretreatment total MASC scores are associated with increased first exposure within-session habituation. Additionally, youth with a principal diagnosis of GAD experienced less between-session habituation, perhaps because they may have required more imaginal than in-vivo exposures.
Subject(s)
Anxiety Disorders/psychology , Anxiety Disorders/therapy , Anxiety, Separation/psychology , Anxiety, Separation/therapy , Arousal , Cognitive Behavioral Therapy/methods , Depressive Disorder/psychology , Depressive Disorder/therapy , Family Therapy/methods , Fear , Implosive Therapy/methods , Pain Measurement , Personality Inventory/statistics & numerical data , Phobic Disorders/psychology , Phobic Disorders/therapy , Adolescent , Anxiety Disorders/diagnosis , Anxiety, Separation/diagnosis , Child , Depressive Disorder/diagnosis , Female , Habituation, Psychophysiologic , Humans , Imagination , Linear Models , Male , Patient Education as Topic , Personality Assessment/statistics & numerical data , Phobic Disorders/diagnosis , Psychometrics , Social SupportABSTRACT
The effect of 5% CO pretreatments prior to vacuum packaging of beef striploin steaks (Longissimus thoracis et lumborum, LTL) on quality attributes, primarily colour stability was investigated. The aim was to determine the optimum pretreatment that would induce the desirable red colour, while allowing discoloration to occur by the end of a 28-day display period (2°C), so as to not mask spoilage. A range of pretreatment exposure times (1, 3, 5, 7, 9, 15 and 24h) were applied to steaks using a gas mixture of 5% CO, 60% CO2 and 35% N2. The 5h CO pretreatment exposure time achieved the desirable colour and discoloration reached unacceptable levels (a*=12, C*=16) by the use-by date (28days), thus ensuring consumers' of a reliable visual indication of freshness and addressing concerns about safety. The 5% CO pretreatment had no negative effect on microbiological safety, lipid oxidation, cooking loss and WBSF measurements at the end of storage (P>0.05).
Subject(s)
Carbon Monoxide/pharmacology , Food Packaging/methods , Red Meat/analysis , Animals , Carbon Dioxide , Cattle , Color , Cooking , Lipids/chemistry , Muscle, Skeletal/chemistry , Nitrogen , Oxidation-Reduction , Red Meat/microbiologyABSTRACT
Although hoarding has been associated with several psychological disorders, it is most frequently linked to obsessive-compulsive disorder (OCD). The present study assessed hoarding obsessions and compulsions in 204 individuals with OCD, and evaluated how hoarding was related to obsessive-compulsive symptom severity, psychological comorbidity, and personality as measured by the five-factor model. Results indicated that hoarding in OCD is a dimensional variable that is positively associated with dysphoria, total number of lifetime Axis I disorders, and lifetime histories of bipolar I, PTSD, and body dysmorphic disorder. Hoarding was negatively correlated with the NEO-Personality Inventory-Revised (NEO-PI-R) factor of Conscientiousness and positively associated with the NEO-PI-R factor of Neuroticism. When all personality and psychopathology variables were entered into a regression equation, dysphoria, bipolar II disorder, Conscientiousness, age, and Extraversion emerged as significant predictors of hoarding severity. Recommendations are made for clinicians and for future research.
Subject(s)
Obsessive-Compulsive Disorder/psychology , Personality , Adolescent , Adult , Bipolar Disorder/psychology , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Models, Psychological , Personality Disorders/psychology , Psychiatric Status Rating Scales , Psychometrics , Psychomotor Agitation/psychologyABSTRACT
The Parental Attitudes, Beliefs, and Understanding of Anxiety (PABUA) was developed to assess parental beliefs about their child's anxiety, parents' perceived ability to cope with their child's anxiety and to help their child manage anxious symptoms, and to evaluate parents' understanding of various parenting strategies in response to their child's anxiety. The study evaluated the PABUA in mother-child dyads (N=192) seeking treatment for youth anxiety. Exploratory factor analysis yielded a three-factor solution and identified PABUA scales of Overprotection, Distress, and Approach (with Cronbach's alpha ranging from .67 to .83). Convergent and divergent validity of PABUA scales was supported by the pattern of associations with measures of experiential avoidance, beliefs related to children's anxiety, empathy, trait anxiety, and depressive symptoms; parent-reported family functioning; parent- and youth-reported anxiety severity; and parent-reported functional impairment (n=83). Results provide preliminary support for the PABUA as a measure of parental attitudes and beliefs about anxiety, and future studies that investigate this measure with large and diverse samples are encouraged.
Subject(s)
Anxiety Disorders , Health Knowledge, Attitudes, Practice , Parent-Child Relations , Parents/psychology , Surveys and Questionnaires , Adaptation, Psychological , Adolescent , Adult , Child , Comprehension , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Neurodevelopmental Disorders , PsychometricsABSTRACT
The goals of this study were to examine relationships among symptom categories in obsessive-compulsive disorder (OCD), to establish OCD symptom dimensions by factor- and cluster-analytic analyses, and to explore associations between OCD symptom dimensions and comorbid neuropsychiatric conditions. A total of 317 OCD participants underwent a systematic diagnostic interview using the Structured Clinical Interview for DSM-IV. OCD symptoms assessed by the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (N=169) and by the Thoughts and Behaviors Inventory (N=275) were subjected to factor and cluster analyses. An identical four-factor solution emerged in two different data sets from overlapping samples, in agreement with most smaller factor-analytic studies employing the YBOCS checklist alone. The cluster analysis confirmed the four-factor solution and provided additional information on the similarity among OCD symptom categories at five different levels. OCD symptom dimensions showed specific relationships to comorbid psychiatric disorders: Factor I (aggressive, sexual, religious and somatic obsessions, and checking compulsions) was broadly associated with comorbid anxiety disorders and depression; Factor II (obsessions of symmetry, and repeating, counting and ordering/arranging compulsions) with bipolar disorders and panic disorder/agoraphobia; and Factor III (contamination obsessions and cleaning compulsions) with eating disorders. Factors I and II were associated with early onset OCD. This study encourages the use of cluster analyses as a supplementary method to factor analyses to establish psychiatric symptom dimensions. The frequent co-occurrence of OCD with other psychiatric disorders and the relatively specific association patterns between OCD symptom dimensions and comorbid disorders support the importance of OCD subtyping for treatment, genetic, and other research studies of this heterogeneous disorder.