Cognitive Behavioral Therapy for 4- to 7-Year-Old Children With Anxiety Disorders: A Randomized Clinical Trial
Objective: To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years. Method: Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% Euro...
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| Veröffentlicht in: | Journal of consulting and clinical psychology 2010-08, Vol.78 (4), p.498-510 |
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| creator | Hirshfeld-Becker, Dina R Masek, Bruce Henin, Aude Blakely, Lauren Raezer Pollock-Wurman, Rachel A McQuade, Julia DePetrillo, Lillian Briesch, Jacquelyn Ollendick, Thomas H Rosenbaum, Jerrold F Biederman, Joseph |
| description | Objective:
To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.
Method:
Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (
n
= 34) or a 6-month wait-list condition (
n
= 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires. Analysis: Chi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.
Results:
The response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) among 57 completers was 69% versus 32% (CBT vs. controls),
p
< .01; intent-to-treat: 59% vs. 30%,
p
= .016. Treated children showed a significantly greater decrease in anxiety disorders (effect size [
ES
] = .55) and increase in parent-rated coping (
ES
= .69) than controls, as well as significantly better CGI improvement on social phobia/avoidant disorder (
ES
= .95), separation anxiety disorder (
ES
= .82), and specific phobia (
ES
= .78), but not on generalized anxiety disorder. Results on the Child Behavior Checklist Internalizing scale were not significant and were limited by low return rates. Treatment response was unrelated to age or parental anxiety but was negatively predicted by behavioral inhibition. Gains were maintained at 1-year follow-up.
Conclusions:
Results suggest that developmentally modified parent-child CBT may show promise in 4- to 7-year-old children. |
| doi_str_mv | 10.1037/a0019055 |
| format | Article |
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To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.
Method:
Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (
n
= 34) or a 6-month wait-list condition (
n
= 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires. Analysis: Chi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.
Results:
The response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) among 57 completers was 69% versus 32% (CBT vs. controls),
p
< .01; intent-to-treat: 59% vs. 30%,
p
= .016. Treated children showed a significantly greater decrease in anxiety disorders (effect size [
ES
] = .55) and increase in parent-rated coping (
ES
= .69) than controls, as well as significantly better CGI improvement on social phobia/avoidant disorder (
ES
= .95), separation anxiety disorder (
ES
= .82), and specific phobia (
ES
= .78), but not on generalized anxiety disorder. Results on the Child Behavior Checklist Internalizing scale were not significant and were limited by low return rates. Treatment response was unrelated to age or parental anxiety but was negatively predicted by behavioral inhibition. Gains were maintained at 1-year follow-up.
Conclusions:
Results suggest that developmentally modified parent-child CBT may show promise in 4- to 7-year-old children.</description><identifier>ISSN: 0022-006X</identifier><identifier>EISSN: 1939-2117</identifier><identifier>DOI: 10.1037/a0019055</identifier><identifier>PMID: 20658807</identifier><identifier>CODEN: JCLPBC</identifier><language>eng</language><publisher>Washington, DC: American Psychological Association</publisher><subject>Anxiety ; Anxiety Disorders ; Anxiety Disorders - diagnosis ; Anxiety Disorders - psychology ; Anxiety Disorders - therapy ; Anxiety, Separation - diagnosis ; Anxiety, Separation - psychology ; Anxiety, Separation - therapy ; Behavior Modification ; Behavior therapy. Cognitive therapy ; Behavioral Inhibition ; Biological and medical sciences ; Check Lists ; Child ; Child Behavior ; Child Behavior Checklist ; Child psychology ; Child, Preschool ; Children ; Clinical Trials ; Cognitive Behavior Therapy ; Cognitive behaviour therapy ; Cognitive Restructuring ; Cognitive therapy ; Cognitive Therapy - methods ; Coping ; Counseling Effectiveness ; Counseling Techniques ; Developmentally Appropriate Practices ; Fear ; Female ; Follow-Up Studies ; Human ; Humans ; Inhibition ; Intervention ; Interviews ; Male ; Medical sciences ; Outcomes of Treatment ; Parents ; Personality Assessment - statistics & numerical data ; Phobic Disorders - diagnosis ; Phobic Disorders - psychology ; Phobic Disorders - therapy ; Preschool Students ; Psychology. Psychoanalysis. Psychiatry ; Psychometrics ; Psychopathology. Psychiatry ; Questionnaires ; Separation Anxiety ; Symptoms (Individual Disorders) ; Treatments ; Young Children</subject><ispartof>Journal of consulting and clinical psychology, 2010-08, Vol.78 (4), p.498-510</ispartof><rights>2010 American Psychological Association</rights><rights>2015 INIST-CNRS</rights><rights>(PsycINFO Database Record (c) 2010 APA, all rights reserved).</rights><rights>2010, American Psychological Association</rights><rights>Copyright American Psychological Association Aug 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a484t-613aeda65b551403bcfd3618d6d62b45ad377433ac5035298df503c251cf392c3</citedby><orcidid>0000-0001-9278-3345</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,30999,31000</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ892065$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23087826$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20658807$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>La Greca, Annette M</contributor><creatorcontrib>Hirshfeld-Becker, Dina R</creatorcontrib><creatorcontrib>Masek, Bruce</creatorcontrib><creatorcontrib>Henin, Aude</creatorcontrib><creatorcontrib>Blakely, Lauren Raezer</creatorcontrib><creatorcontrib>Pollock-Wurman, Rachel A</creatorcontrib><creatorcontrib>McQuade, Julia</creatorcontrib><creatorcontrib>DePetrillo, Lillian</creatorcontrib><creatorcontrib>Briesch, Jacquelyn</creatorcontrib><creatorcontrib>Ollendick, Thomas H</creatorcontrib><creatorcontrib>Rosenbaum, Jerrold F</creatorcontrib><creatorcontrib>Biederman, Joseph</creatorcontrib><title>Cognitive Behavioral Therapy for 4- to 7-Year-Old Children With Anxiety Disorders: A Randomized Clinical Trial</title><title>Journal of consulting and clinical psychology</title><addtitle>J Consult Clin Psychol</addtitle><description>Objective:
To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.
Method:
Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (
n
= 34) or a 6-month wait-list condition (
n
= 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires. Analysis: Chi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.
Results:
The response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) among 57 completers was 69% versus 32% (CBT vs. controls),
p
< .01; intent-to-treat: 59% vs. 30%,
p
= .016. Treated children showed a significantly greater decrease in anxiety disorders (effect size [
ES
] = .55) and increase in parent-rated coping (
ES
= .69) than controls, as well as significantly better CGI improvement on social phobia/avoidant disorder (
ES
= .95), separation anxiety disorder (
ES
= .82), and specific phobia (
ES
= .78), but not on generalized anxiety disorder. Results on the Child Behavior Checklist Internalizing scale were not significant and were limited by low return rates. Treatment response was unrelated to age or parental anxiety but was negatively predicted by behavioral inhibition. Gains were maintained at 1-year follow-up.
Conclusions:
Results suggest that developmentally modified parent-child CBT may show promise in 4- to 7-year-old children.</description><subject>Anxiety</subject><subject>Anxiety Disorders</subject><subject>Anxiety Disorders - diagnosis</subject><subject>Anxiety Disorders - psychology</subject><subject>Anxiety Disorders - therapy</subject><subject>Anxiety, Separation - diagnosis</subject><subject>Anxiety, Separation - psychology</subject><subject>Anxiety, Separation - therapy</subject><subject>Behavior Modification</subject><subject>Behavior therapy. Cognitive therapy</subject><subject>Behavioral Inhibition</subject><subject>Biological and medical sciences</subject><subject>Check Lists</subject><subject>Child</subject><subject>Child Behavior</subject><subject>Child Behavior Checklist</subject><subject>Child psychology</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical Trials</subject><subject>Cognitive Behavior Therapy</subject><subject>Cognitive behaviour therapy</subject><subject>Cognitive Restructuring</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - methods</subject><subject>Coping</subject><subject>Counseling Effectiveness</subject><subject>Counseling Techniques</subject><subject>Developmentally Appropriate Practices</subject><subject>Fear</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Human</subject><subject>Humans</subject><subject>Inhibition</subject><subject>Intervention</subject><subject>Interviews</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Outcomes of Treatment</subject><subject>Parents</subject><subject>Personality Assessment - statistics & numerical data</subject><subject>Phobic Disorders - diagnosis</subject><subject>Phobic Disorders - psychology</subject><subject>Phobic Disorders - therapy</subject><subject>Preschool Students</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychometrics</subject><subject>Psychopathology. Psychiatry</subject><subject>Questionnaires</subject><subject>Separation Anxiety</subject><subject>Symptoms (Individual Disorders)</subject><subject>Treatments</subject><subject>Young Children</subject><issn>0022-006X</issn><issn>1939-2117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqF0V1rFDEUBuAgil2r4A8QCcWiIKMn35nLuv1QKRShol6FbJJxU2ZnxmSmdP99U3dbUUSvEjgPb8h5EXpK4A0Bpt5aAFKDEPfQjNSsrigh6j6aAVBaAcivO-hRzhdQlATxEO1QkEJrUDP0ad5_7-IYLwN-F5b2MvbJtvh8GZId1rjpE-YVHnusqm_Bpuqs9Xi-jK1PocNf4rjEB91VDOMaH8bcJx9SfoweNLbN4cn23EWfj4_O5--r07OTD_OD08pyzcdKEmaDt1IshCAc2MI1nkmivfSSLriwninFGbNOABO01r4pF0cFcQ2rqWO76OUmd0j9jynk0axidqFtbRf6KRulKFVQc_p_ycr7VNa6yL0_5EU_pa58wyguhWBM838jQWqhKRT0aoNc6nNOoTFDiiub1oaAuenM3HZW6PNt3rRYBX8Hb0sqYH8LbHa2bZLtXMy_HAOtNJXFPdu4kKK7Gx991PVNVBm_3oztYM2Q186mMbo2ZDelUudonBuM0oYb_nMVL_6uf2fXTt2-7Q</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Hirshfeld-Becker, Dina R</creator><creator>Masek, Bruce</creator><creator>Henin, Aude</creator><creator>Blakely, Lauren Raezer</creator><creator>Pollock-Wurman, Rachel A</creator><creator>McQuade, Julia</creator><creator>DePetrillo, Lillian</creator><creator>Briesch, Jacquelyn</creator><creator>Ollendick, Thomas H</creator><creator>Rosenbaum, Jerrold F</creator><creator>Biederman, Joseph</creator><general>American Psychological Association</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7RZ</scope><scope>PSYQQ</scope><scope>7QJ</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9278-3345</orcidid></search><sort><creationdate>20100801</creationdate><title>Cognitive Behavioral Therapy for 4- to 7-Year-Old Children With Anxiety Disorders</title><author>Hirshfeld-Becker, Dina R ; Masek, Bruce ; Henin, Aude ; Blakely, Lauren Raezer ; Pollock-Wurman, Rachel A ; McQuade, Julia ; DePetrillo, Lillian ; Briesch, Jacquelyn ; Ollendick, Thomas H ; Rosenbaum, Jerrold F ; Biederman, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a484t-613aeda65b551403bcfd3618d6d62b45ad377433ac5035298df503c251cf392c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Anxiety</topic><topic>Anxiety Disorders</topic><topic>Anxiety Disorders - diagnosis</topic><topic>Anxiety Disorders - psychology</topic><topic>Anxiety Disorders - therapy</topic><topic>Anxiety, Separation - diagnosis</topic><topic>Anxiety, Separation - psychology</topic><topic>Anxiety, Separation - therapy</topic><topic>Behavior Modification</topic><topic>Behavior therapy. Cognitive therapy</topic><topic>Behavioral Inhibition</topic><topic>Biological and medical sciences</topic><topic>Check Lists</topic><topic>Child</topic><topic>Child Behavior</topic><topic>Child Behavior Checklist</topic><topic>Child psychology</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical Trials</topic><topic>Cognitive Behavior Therapy</topic><topic>Cognitive behaviour therapy</topic><topic>Cognitive Restructuring</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - methods</topic><topic>Coping</topic><topic>Counseling Effectiveness</topic><topic>Counseling Techniques</topic><topic>Developmentally Appropriate Practices</topic><topic>Fear</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Human</topic><topic>Humans</topic><topic>Inhibition</topic><topic>Intervention</topic><topic>Interviews</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Outcomes of Treatment</topic><topic>Parents</topic><topic>Personality Assessment - statistics & numerical data</topic><topic>Phobic Disorders - diagnosis</topic><topic>Phobic Disorders - psychology</topic><topic>Phobic Disorders - therapy</topic><topic>Preschool Students</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychometrics</topic><topic>Psychopathology. Psychiatry</topic><topic>Questionnaires</topic><topic>Separation Anxiety</topic><topic>Symptoms (Individual Disorders)</topic><topic>Treatments</topic><topic>Young Children</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirshfeld-Becker, Dina R</creatorcontrib><creatorcontrib>Masek, Bruce</creatorcontrib><creatorcontrib>Henin, Aude</creatorcontrib><creatorcontrib>Blakely, Lauren Raezer</creatorcontrib><creatorcontrib>Pollock-Wurman, Rachel A</creatorcontrib><creatorcontrib>McQuade, Julia</creatorcontrib><creatorcontrib>DePetrillo, Lillian</creatorcontrib><creatorcontrib>Briesch, Jacquelyn</creatorcontrib><creatorcontrib>Ollendick, Thomas H</creatorcontrib><creatorcontrib>Rosenbaum, Jerrold F</creatorcontrib><creatorcontrib>Biederman, Joseph</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Access via APA PsycArticles® (ProQuest)</collection><collection>ProQuest One Psychology</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of consulting and clinical psychology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirshfeld-Becker, Dina R</au><au>Masek, Bruce</au><au>Henin, Aude</au><au>Blakely, Lauren Raezer</au><au>Pollock-Wurman, Rachel A</au><au>McQuade, Julia</au><au>DePetrillo, Lillian</au><au>Briesch, Jacquelyn</au><au>Ollendick, Thomas H</au><au>Rosenbaum, Jerrold F</au><au>Biederman, Joseph</au><au>La Greca, Annette M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ892065</ericid><atitle>Cognitive Behavioral Therapy for 4- to 7-Year-Old Children With Anxiety Disorders: A Randomized Clinical Trial</atitle><jtitle>Journal of consulting and clinical psychology</jtitle><addtitle>J Consult Clin Psychol</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>78</volume><issue>4</issue><spage>498</spage><epage>510</epage><pages>498-510</pages><issn>0022-006X</issn><eissn>1939-2117</eissn><coden>JCLPBC</coden><abstract>Objective:
To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.
Method:
Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (
n
= 34) or a 6-month wait-list condition (
n
= 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires. Analysis: Chi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.
Results:
The response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) among 57 completers was 69% versus 32% (CBT vs. controls),
p
< .01; intent-to-treat: 59% vs. 30%,
p
= .016. Treated children showed a significantly greater decrease in anxiety disorders (effect size [
ES
] = .55) and increase in parent-rated coping (
ES
= .69) than controls, as well as significantly better CGI improvement on social phobia/avoidant disorder (
ES
= .95), separation anxiety disorder (
ES
= .82), and specific phobia (
ES
= .78), but not on generalized anxiety disorder. Results on the Child Behavior Checklist Internalizing scale were not significant and were limited by low return rates. Treatment response was unrelated to age or parental anxiety but was negatively predicted by behavioral inhibition. Gains were maintained at 1-year follow-up.
Conclusions:
Results suggest that developmentally modified parent-child CBT may show promise in 4- to 7-year-old children.</abstract><cop>Washington, DC</cop><pub>American Psychological Association</pub><pmid>20658807</pmid><doi>10.1037/a0019055</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-9278-3345</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of consulting and clinical psychology, 2010-08, Vol.78 (4), p.498-510 |
| issn | 0022-006X 1939-2117 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_772270942 |
| source | MEDLINE; APA PsycARTICLES; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Anxiety Anxiety Disorders Anxiety Disorders - diagnosis Anxiety Disorders - psychology Anxiety Disorders - therapy Anxiety, Separation - diagnosis Anxiety, Separation - psychology Anxiety, Separation - therapy Behavior Modification Behavior therapy. Cognitive therapy Behavioral Inhibition Biological and medical sciences Check Lists Child Child Behavior Child Behavior Checklist Child psychology Child, Preschool Children Clinical Trials Cognitive Behavior Therapy Cognitive behaviour therapy Cognitive Restructuring Cognitive therapy Cognitive Therapy - methods Coping Counseling Effectiveness Counseling Techniques Developmentally Appropriate Practices Fear Female Follow-Up Studies Human Humans Inhibition Intervention Interviews Male Medical sciences Outcomes of Treatment Parents Personality Assessment - statistics & numerical data Phobic Disorders - diagnosis Phobic Disorders - psychology Phobic Disorders - therapy Preschool Students Psychology. Psychoanalysis. Psychiatry Psychometrics Psychopathology. Psychiatry Questionnaires Separation Anxiety Symptoms (Individual Disorders) Treatments Young Children |
| title | Cognitive Behavioral Therapy for 4- to 7-Year-Old Children With Anxiety Disorders: A Randomized Clinical Trial |
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