Examination of risk exposure models during COVID-19 in relation to youth life satisfaction and internalizing symptoms

This study examined mediation of a negative COVID-impact on the relationship between risk exposure, and life satisfaction and internalizing symptoms in youth (aged 9-18). Four operationalizations of risk exposure were applied; an Additive versus a Cumulative Risk Model (ARM and CRM), risk clusters and the most salient risk factors. Results showed that a stronger negative COVID-impact is related to lower life satisfaction, more internalizing symptoms and higher additive and cumulative risk. ARM and CRM's effect on lower life satisfaction is mediated through negative COVID-impact, though not for internalizing symptoms. Clusters of risk factors and risk factors within clusters significantly related to a stronger negative COVID-impact are the clusters 'Individual factors' (low self-control), 'Parenting' (negative mother-child interaction and low parental responsiveness), 'Maternal mental health' and 'Demographic factors' (low SES and high paternal education). From all significant risk factors, low self-control, low parental responsiveness, negative mother-child interaction and low SES were most salient

The Relation of Severity and Comorbidity to Treatment Outcome with Cognitive Behavioral Therapy for Childhood Anxiety Disorders

The present study investigated the impact of comorbidity over and above the impact of symptom severity on treatment outcome of Cognitive Behavioral Therapy for children with anxiety disorders. Children (aged 8–12, n = 124) diagnosed with an anxiety disorder were treated with a short-term CBT protocol. Severity was assessed with a composite measure of parent-reported behavior problems. Two approaches to comorbidity were examined; “total comorbidity” which differentiated anxiety disordered children with (n = 69) or without (n = 55) a co-occurring disorder and “non-anxiety comorbidity’ which differentiated anxious children with (n = 22) or without a non-anxiety comorbid disorder (n = 102). Treatment outcome was assessed in terms of Recovery, represented by post-treatment diagnostic status, and Reliable Change, a score reflecting changes in pre- to post-treatment symptom levels. Severity contributed to the prediction of (no) Recovery and (more) Reliable Change in parent-reported internalizing and externalizing symptoms and self-reported depressive symptoms. Total and non-anxiety comorbidity added to the prediction of diagnostic recovery. Non-anxiety comorbidity added to the prediction of Reliable Change in parent reported measures by acting as a suppressor variable. Non-anxiety comorbidity operated as a strong predictor that explained all of the variance associated with severity for self-reported depressive symptoms. The results support the need for further research on mechanisms by which treatment gains in children with higher symptom severity and non-anxiety comorbidity can be achieved

The Role of Perspective Taking and Self-Control in a Preventive Intervention Targeting Childhood Disruptive Behavior

Publisher Copyright: © 2021, The Author(s).Prevention studies typically focus on outcome variables such as reductions in problem behavior, rather than targeted factors (e.g., cognitions), or the relation between change in targeted factors and outcomes. Therefore, the current study examined the effect of a targeted prevention program for childhood disruptive behavior on targeted factors (i.e., perspective taking and self-control) and associations between change in targeted factors and outcomes (i.e., aspects of disruptive behavior). The sample consisted of 173 children (Mage = 10.2 years) who were randomly assigned to an intervention condition (n = 70) or waitlist control condition (n = 103). Assessment took place at pre-, post- and follow-up measurements. For ethical considerations, follow-up data was not available for children on the waitlist. Findings revealed a direct intervention effect on self-control. From pre-test to follow-up, children who received the intervention improved in perspective taking and self-control. Moreover, improvements in self-control were associated with and predicted reductions in teacher-reported symptoms of oppositional defiant disorder. No associations were found between changes in perspective taking and disruptive behavior. These findings suggest that self-control may be an important target factor in reducing childhood disruptive behavior in targeted prevention.Peer reviewe

Examining the relation between the therapeutic alliance, treatment adherence, and outcome of cognitive behavioral therapy for children with anxiety disorders

Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for youths diagnosed with anxiety disorders. Trained observers rated tapes of therapy sessions for treatment adherence and child-therapist alliance in a sample of 52 children (aged 8 to 12) with anxiety disorders. Self-reported child anxiety was assessed at pre-, mid-, and posttreatment; parent-reported child internalizing symptoms was assessed at pre- and posttreatment. The results showed high levels of treatment adherence and child-therapist alliance in both CBT programs. Neither treatment adherence nor child-therapist alliance predicted traditional measurements of child outcomes in the present study, but a relation between alliance and outcome was found using a more precise estimation of the true pre-post differences. Implications of these findings for expanding our understanding of how treatment processes relate to child outcome in CBT for children with anxiety disorders are discusse

Parenting and parental anxiety and depression as predictors of treatment outcome for childhood anxiety disorders: has the role of fathers been underestimated?

A substantial percentage of children with anxiety disorders do not respond adequately to Cognitive Behavioral Therapy (CBT). Examination of parental factors related to treatment outcome could contribute to a further understanding of treatment outcome responses. This study investigated the predictive value of paternal and maternal emotional warmth, rejection, overprotection, anxiety, and depression for CBT outcome in clinic-referred anxious children (ages 8-12). Levels of maternal emotional warmth, paternal rejection and anxiety, and depressive symptoms predicted treatment success and failure. A higher level of maternal emotional warmth was associated with a less favorable treatment outcome. Higher levels of paternal rejection, anxiety, and depressive symptoms were consistently associated with a less favorable treatment outcom

No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trial

The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n = 37), Social Phobia (n = 22) or Specific Phobia (n = 16) were randomly assigned to individual (n = 65) or group (n = 62) treatment. Analyses were conducted separately for the intent-to-treat sample and the sample of children who completed treatment. Analyses included chi-square comparisons and regression analyses with treatment format as a predictor. Forty-eight percent of the children in the individual versus 41% in the group treatment were free of any anxiety disorder at post-treatment; 62% versus 54% were free of their primary anxiety disorder. Regression analyses showed no significant difference in outcome between individual and group treatment. Children improved in both conditions. Choice between treatments could be based on pragmatic considerations such as therapeutic resources, referral rates, and the preference of the parents and the chil

Examination of risk exposure models during COVID-19 in relation to youth life satisfaction and internalizing symptoms

This study examined mediation of a negative COVID-impact on the relationship between risk exposure, and life satisfaction and internalizing symptoms in youth (aged 9-18). Four operationalizations of risk exposure were applied; an Additive versus a Cumulative Risk Model (ARM and CRM), risk clusters and the most salient risk factors. Results showed that a stronger negative COVID-impact is related to lower life satisfaction, more internalizing symptoms and higher additive and cumulative risk. ARM and CRM's effect on lower life satisfaction is mediated through negative COVID-impact, though not for internalizing symptoms. Clusters of risk factors and risk factors within clusters significantly related to a stronger negative COVID-impact are the clusters 'Individual factors' (low self-control), 'Parenting' (negative mother-child interaction and low parental responsiveness), 'Maternal mental health' and 'Demographic factors' (low SES and high paternal education). From all significant risk factors, low self-control, low parental responsiveness, negative mother-child interaction and low SES were most salient