Family treatment of child anxiety: outcomes, limitations and future directions

Anxiety of childhood is a common and serious condition. The past decade has seen an increase in treatment-focussed research, with recent trials tending to give greater attention to parents in the treatment process. This review examines the efficacy of family-based cognitive behaviour therapy and attempts to delineate some of the factors that might have an impact on its efficacy. The choice and timing of outcome measure, age and gender of the child, level of parental anxiety, severity and type of child anxiety and treatment format and content are scrutinised. The main conclusions are necessarily tentative, but it seems likely that Family Cognitive Behaviour Therapy (FCBT) is superior to no treatment, and, for some outcome measures, also superior to Child Cognitive Behaviour Therapy (CCBT). Where FCBT is successful, the results are consistently maintained at follow-up. It appears that where a parent is anxious, and this is not addressed, outcomes are less good. However, for children of anxious parents, FCBT is probably more effective than CCBT. What is most clear is that large, well-designed studies, examining these factors alone and in combination, are now needed

Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors

<p>Abstract</p> <p>Background</p> <p>Discrepancies between parents and children in their assessment of children's mental health affect the evaluation of need for services and must be taken seriously. This article presents the differences between parents' and children's reports of the children's symptoms and social impairment, based on the results of the Strengths and Difficulties Questionnaire (SDQ). The interrelationship between relational aspects and socio-demographic factors with patterns of disagreement are explored.</p> <p>Methods</p> <p>Differences in the prevalence and means of SDQ symptom and impact scores were obtained from 8,154 primary school children, aged between 10 and 13 years, and their parents. Agreement between matched pairs was measured using Pearson's and Spearman's rho correlations. Socio-demographic variables, communication patterns and parental engagement were analysed as possible correlates of informant discrepancies using bivariate and multivariate logistic regression models.</p> <p>Results</p> <p>In general, although children reported more symptoms, they reported less impact of perceived difficulties than parents. The parents were more consistent in their evaluation of symptoms and impact than were the children. Exploration of highly discrepant subgroups showed that, when children reported the most symptoms and impact, qualitative aspects of the parent-child relationship and family structure seemed to be more powerful predictors of disagreement than were gender of the child and socio-demographic variables. When parents reported the most symptoms and impact, low parental educational level, low income and male gender of the child played an additional role.</p> <p>Conclusions</p> <p>Our findings underline the importance of paying attention to child reports of emotional-behavioural difficulties, particularly when parents do not identify these problems. Considerations on what meaning parent-child discrepancy might have in the context of the parent-child relationship or the family's psychosocial status should be integrated in the overall understanding of the child's situation and subsequent recommendations.</p

Reorganization Energy for Internal Electron Transfer in Multicopper Oxidases.

We have calculated the reorganization energy for the intramolecular electron transfer between the reduced type 1 copper site and the peroxy intermediate of the trinuclear cluster in the multicopper oxidase CueO. The calculations are performed at the combined quantum mechanics and molecular mechanics (QM/MM) level, based on molecular dynamics simulations with tailored potentials for the two copper sites. We obtain a reorganization energy of 91-133 kJ/mol, depending on the theoretical treatment. The two Cu sites contribute by 12 and 22 kJ/mol to this energy, whereas the solvent contribution is 34 kJ/mol. The rest comes from the protein, involving small contributions from many residues. We have also estimated the energy difference between the two electron-transfer states and show that the reduction of the peroxy intermediate is exergonic by 43-87 kJ/mol, depending on the theoretical method. Both the solvent and the protein contribute to this energy difference, especially charged residues close to the two Cu sites. We compare these estimates with energies obtained from QM/MM optimizations and QM calculations in a vacuum and discuss differences between the results obtained at various levels of theory

Relationship between Maternal Clinical Factors and Mother-Reported Child Problems

Maternal depression has been associated with mothers’ elevated reports of child problems. However, it is unclear the extent to which elevations in mother ratings reflect having a depression diagnosis, having any mental illness diagnosis, or having a diagnosis vs. symptom levels. As part of a NIMH-funded, longitudinal study of mothers with serious mental illness ( N =379), we examined the relationship between mother-reported adolescent behavior problems ( N =78) and maternal depression vs. other diagnoses, as well as the effects of depression diagnosis vs. symptom levels. Mothers were recruited from the public mental health system in an urban area, and are primarily African-American and low income. We found that maternal psychiatric symptoms made a unique and significant contribution to explaining the variance in mother-reported child problems, independent of controls (e.g., teacher reports and child demographics), while maternal diagnosis did not. Implications of findings are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44321/1/10597_2005_Article_6425.pd

Illustrationen als Paratext beim Ubersetzen : Mit Beispielen aus einem Werk von O. Preusler

Purpose: The authors tested associations between (a) parent-reported temporary vs. persistent vocabulary delay and (b) parent-reported behavioral/emotional problems in a sample of 5,497 young Dutch children participating in a prospective population-based study. Method: Mothers completed the MacArthur Communicative Development Inventory-Netherlands (Zink & Lejaegere, 2003) at age 18 months and the Language Development Survey (Rescorla, 1989) at age 30 months, with expressive vocabulary delay defined as scores in the lowest 15th age-and gender-specific percentiles. The Child Behavior Checklist (Achenbach & Rescorla, 2000) was completed by mothers when their children were age 18 months and by both parents when their children were age 36 months, from which Internalizing Problems and Externalizing Problems scores were analyzed. Results: All analyses were adjusted for covariates. Expressive vocabulary delay at age 18 months was weakly related to Internalizing Problems scores at age 18 months as well as mother-reported Externalizing and Internalizing Problems scores at age 36 months (the latter for boys only). Expressive vocabulary delay at age 30 months was weakly associated with mother-reported Externalizing and Internalizing Problems scores (the latter for boys only) and father-reported Internalizing Problems scores. Persistent expressive vocabulary delay predicted the highest risk of mother-reported internalizing and externalizing problems at age 36 months. Conclusion: This population-based study showed modest associations between vocabulary delay and behavioral/emotional problems detectable from 18 months onward