The Separation Anxiety Daily Diary: Child Version: Feasibility and Psychometric Properties

This report describes the feasibility and psychometric properties of the child version of the Separation Anxiety Daily Diary (SADD-C) in 125 children (ages 7-14years) from German-speaking areas of Switzerland. Children with separation anxiety disorder (SAD; n=58), "other” anxiety disorders (n=36), and healthy controls (n=31) recorded the frequency of parent-child separations, along with associated anxiety, thoughts, reactions and subsequent parental responses. Compliance rates were modest, consistent with past research on self-report diaries with anxious children. The SADD-C was better at discriminating children with SAD from controls than "other anxious” children. The SADD-C demonstrated good convergent validity with maternal and child self-reported anxiety (Revised Child Manifest Anxiety Scale, Separation Anxiety Inventory) and perceived quality of life (Inventory for Quality of Life in Children and Adolescents). Results provide support for the SADD-C as an acceptable and valid method of assessing child symptoms and parent behavior on separation. Findings are discussed with regard to the clinical utility of the SADD-C and strategies to improve complianc

HPA axis related genes and response to psychological therapies: genetics and epigenetics

Background Hypothalamic–pituitary–adrenal (HPA) axis functioning has been implicated in the development of stress-related psychiatric diagnoses and response to adverse life experiences. This study aimed to investigate the association between genetic and epigenetics in HPA axis and response to cognitive behavior therapy (CBT). Methods Children with anxiety disorders were recruited into the Genes for Treatment project (GxT, N = 1,152). Polymorphisms of FKBP5 and GR were analyzed for association with response to CBT. Percentage DNA methylation at the FKBP5 and GR promoter regions was measured before and after CBT in a subset (n = 98). Linear mixed effect models were used to investigate the relationship between genotype, DNA methylation, and change in primary anxiety disorder severity (treatment response). Results Treatment response was not associated with FKBP5 and GR polymorphisms, or pretreatment percentage DNA methylation. However, change in FKBP5 DNA methylation was nominally significantly associated with treatment response. Participants who demonstrated the greatest reduction in severity decreased in percentage DNA methylation during treatment, whereas those with little/no reduction in severity increased in percentage DNA methylation. This effect was driven by those with one or more FKBP5 risk alleles, with no association seen in those with no FKBP5 risk alleles. No significant association was found between GR methylation and response. Conclusions Allele-specific change in FKBP5 methylation was associated with treatment response. This is the largest study to date investigating the role of HPA axis related genes in response to a psychological therapy. Furthermore, this is the first study to demonstrate that DNA methylation changes may be associated with response to psychological therapies in a genotype-dependent manner

The utility of the SCAS-C/P to detect specific anxiety disorders among clinically anxious children

Questionnaire measures offer a time and cost-effective alternative to full diagnostic assessments for identifying and differentiating between potential anxiety disorders and are commonly used in clinical practice. Little is known, however, about the capacity of questionnaire measures to detect specific anxiety disorders in clinically anxious preadolescent children. This study aimed to establish the ability of the Spence Children’s Anxiety Scale (SCAS) subscales to identify children with specific anxiety disorders in a large clinic-referred sample (N = 1,438) of children aged 7 to 12 years. We examined the capacity of the Separation Anxiety, Social Phobia, Generalized Anxiety, and Physical Injury Fears (phobias) subscales to discriminate between children with and without the target disorder. We also identified optimal cutoff scores on subscales for accurate identification of children with the corresponding disorder, and examined the contribution of child, mother, and father reports. The Separation Anxiety subscale was able to accurately identify children with separation anxiety disorder, and this was replicated across all 3 reporters. Mother- and father-reported Social Phobia subscales also accurately identified children with social anxiety disorder, although child report was only able to accurately detect social anxiety disorder in girls. Using 2 or more reporters improved the sensitivity of the Separation Anxiety and Social Phobia subscales but reduced specificity. The Generalized Anxiety and Physical Injury Fears subscales failed to accurately identify children with the corresponding disorders. These findings have implications for the potential use of mother-, father-, and child-report SCAS subscales to detect specific disorders in preadolescent children in clinical settings

Trennungsangstprogramm für Familien (TAFF) : ein störungsspezifisches, kognitiv-behaviorales Therapieprogramm für Kinder mit Trennungsangst

Separation Anxiety Disorder is one oft the most frequent mental disorders in children. The SAFT treatment manual is an evidence-based cognitive behavioral therapy program for children with separation anxiety. Its first part consists of four weekly sessions with the child and four weekly sessions with the parents. Children and parents receive psychoeducation about anxiety, learn to recognize and reframe irrational beliefs about separation situations, expand their repertoire of coping strategies, and are introduced to the rationale for exposure. The second part of treatment consists of eight weekly family sessions followed by a short parent-only session. During the family sessions, exposure in vivo is planned and practiced. The parent-only portions of the family sessions involve reframing parental irrational beliefs about separation, parenting strategies and practicing parental behavior during exposure. Evaluation data shows that disorder-specific family-based therapy (SAFT) results in improvement compared with waiting list controls

Patterns of family identification and self-congruence in childhood separation anxiety disorder

Patterns of identification among family members may differ in families with children with separation anxiety disorder (SAD) as compared with healthy children. However, this has not been explored to date.; The present study examines identification processes in 199 families: 100 families of children with SAD, 43 families of children with other anxiety disorders, and 56 families of nondisordered children, using the Family Identification Test.; Children with SAD and their parents generally identify significantly less with each other and report less desire to be similar to each other than nondisordered children and their parents. Further, children with SAD are less self-congruent than healthy children. There were no significant differences between children with SAD and with other anxiety disorders.; Identification and self-congruence distinguish families of children with SAD from families of healthy children. Future studies should aim to determine the direction of effects over time, as well as to determine the contribution of identification and coherence in explaining SAD after accounting for other factors such as attachment and self-esteem

Maternal daily diary report in the assessment of childhood separation anxiety

The current study evaluated the feasibility and validity of a parent-report measure of separation anxiety, the Separation Anxiety Daily Diary (SADD). Mother and child participants consisted of three groups: 96 children (aged 4–15 years) with separation anxiety disorder, 49 children with ‘‘other’’ anxiety disorders, and 43 healthy controls. The SADD assesses the frequency of anxiety-provoking and non-anxiety-provoking separations, along with associated parental anxiety, thoughts, child behaviors, and corresponding parental reactions. The SADD demonstrated acceptable compliance and convergent validity with hypothesized measures. Substantial improvement in the prediction of diagnostic group membership was shown when SADD items assessing child symptoms were added to information gathered from a separation anxiety symptom questionnaire

Psychometric properties of the Separation Anxiety Daily Diary : child version

This report describes the feasibility and psychometric properties of the child version of the Separation Anxiety Daily Diary (SADD-C) in 125 children (ages 7– 14 years) from German-speaking areas of Switzerland. Children with separation anxiety disorder (SAD; n = 58), ‘‘other’’ anxiety disorders (n = 36), and healthy controls (n = 31) recorded the frequency of parent–child separations, along with associated anxiety, thoughts, reactions and subsequent parental responses. Compliance rates were modest, consistent with past research on self-report diaries with anxious children. The SADD-C was better at discriminating children with SAD from controls than ‘‘other anxious’’ children. The SADD-C demonstrated good convergent validity with maternal and child selfreported anxiety (Revised Child Manifest Anxiety Scale, Separation Anxiety Inventory) and perceived quality of life (Inventory for Quality of Life in Children and Adolescents). Results provide support for the SADD-C as an acceptable and valid method of assessing child symptoms and parent behavior on separation. Findings are discussed with regard to the clinical utility of the SADD-C and strategies to improve compliance

Transgenerational improvements following child anxiety treatment: An exploratory examination.

BACKGROUND:The present study conducted secondary analyses of a randomized controlled trial to examine the transgenerational relationship between cognitive-behavioral therapy for child Separation Anxiety Disorder (SepAD) and the mental health of parents. Symptoms of anxiety and depression were compared before and after child treatment between parents of children treated for SepAD and parents of healthy children, who did not receive any treatment. METHODS:One hundred and seven children aged 4-14 years with SepAD received one of two cognitive behavioral treatment programs for SepAD (TAFF; TrennungsAngstprogramm Für Familien; English: Separation Anxiety Family Therapy or CC; Coping Cat). Their parents (N = 189; 101 mothers and 88 fathers) were assessed at baseline and post-treatment for symptoms of separation anxiety, general anxiety, and depression. A comparison group of parents (N = 74; 42 mothers and 32 fathers) of 45 children without SepAD, who did not receive any treatment, were also assessed. RESULTS:Results indicated a significant interaction effect between group and time on mothers' depression and separation anxiety, indicating that maternal symptoms of depression and separation anxiety improved in the child treatment condition in comparison to mothers of healthy children. There was no significant improvement in parental pathology levels among fathers of children treated for SepAD. CONCLUSIONS:Treatment for child SepAD may have subsequent positive effects on mothers' own levels of separation anxiety and depression, though the mechanisms are yet unknown. Future studies are needed that test the transgenerational effect of child SepAD treatment on parental mental health as the primary research question

The separation anxiety daily diary : child version: feasibility and psychometric properties

This report describes the feasibility and psychometric properties of the child version of the Separation Anxiety Daily Diary (SADD-C) in 125 children (ages 7-14 years) from German-speaking areas of Switzerland. Children with separation anxiety disorder (SAD; n = 58), "other" anxiety disorders (n = 36), and healthy controls (n = 31) recorded the frequency of parent-child separations, along with associated anxiety, thoughts, reactions and subsequent parental responses. Compliance rates were modest, consistent with past research on self-report diaries with anxious children. The SADD-C was better at discriminating children with SAD from controls than "other anxious" children. The SADD-C demonstrated good convergent validity with maternal and child self-reported anxiety (Revised Child Manifest Anxiety Scale, Separation Anxiety Inventory) and perceived quality of life (Inventory for Quality of Life in Children and Adolescents). Results provide support for the SADD-C as an acceptable and valid method of assessing child symptoms and parent behavior on separation. Findings are discussed with regard to the clinical utility of the SADD-C and strategies to improve compliance