Baryon chiral perturbation theory

We provide a short introduction to the one-nucleon sector of chiral perturbation theory and address the issue of power counting and renormalization. We discuss the infrared regularization and the extended on-mass-shell scheme. Both allow for the inclusion of further degrees of freedom beyond pions and nucleons and the application to higher-loop calculations. As applications we consider the chiral expansion of the nucleon mass to order ${\cal O}(q^6)$ and the inclusion of vector and axial-vector mesons in the calculation of nucleon form factors. Finally, we address the complex-mass scheme for describing unstable particles in effective field theory.Comment: 13 pages, 8 figures, invited talk given at the Third International Conference on Hadron Physics, TROIA'11, 22 - 25 August 2011, Canakkale, Turke

A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders

Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efficacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efficacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety disorder. An electronic search was conducted using the following databases: ASSIA, Cochrane Controlled Trials Register, Current Controlled Trials, Medline, PsycArticles, PsychInfo, and Web of Knowledge. The search terms included “anxiety disorder(s)”, “anxi∗”, “cognitive behavio∗, “CBT”, “child∗”, “children”, “paediatric”, “adolescent(s)”, “adolescence”, “youth” and “young pe∗”. The studies identified from this search were screened against the inclusion and exclusion criteria, and 20 studies were identified as appropriate for inclusion in the current meta-analysis. Pre- and posttreatment (or control period) data were used for analysis. Results: Findings indicated significantly greater odds of anxiety remission from pre- to posttreatment for those engaged in the transdiagnostic CBT intervention compared with those in the control group, with children in the treatment condition 9.15 times more likely to recover from their anxiety diagnosis than children in the control group. Risk of bias was not correlated with study effect sizes. Conclusions: Transdiagnostic CBT seems effective in reducing symptoms of anxiety in children and young people. Further research is required to investigate the efficacy of CBT for children under the age of 6

Preventing family transmission of anxiety: feasibility RCT of a brief intervention for parents

Objectives. Children of anxious parents are at high risk of anxiety disorders themselves. The evidence suggests that this is due to environmental rather than genetic factors. However, we currently do little to reduce this risk of transmission. There is evidence that supporting parenting in those with mental health difficulties can ameliorate this risk. Therefore, the objective of this study was to test the feasibility of a new one-session, group-based, preventive parenting intervention for parents with anxiety disorders. Design. Feasibility Randomised Controlled Trial. Methods. 100 parents with anxiety disorders, recruited from adult mental health services in England (and child aged 3-9 years) were randomised to receive the new intervention (a one-day, group workshop), or to treatment as usual. Children’s anxiety disorder and anxiety symptoms were assessed to 12-months by outcome assessors who were blind to group allocation. Exploratory analyses were conducted on an intention to treat basis, as far as possible. Results. 51 participants were randomized to the intervention condition and 49 to the control condition (82% and 80% followed to 12-months, respectively). The attendance rate was 59%, and the intervention was highly acceptable to parents who received it. The RCT was feasible and 12-month follow-up attrition rates were low. Children whose parents were in the control condition were 16.5% more likely to have an anxiety disorder at follow-up than those in the intervention group. No adverse events were reported. Conclusions. An inexpensive, light-touch, psycho-educational intervention may be useful in breaking the intergenerational cycle of transmission of anxiety disorders. A substantive trial is warranted

Research into anxiety of childhood: playing catch-up (to Olympic standard)

This special issue is the culmination of an ESRC seminar series grant awarded to the authors of this editorial. We named the seminar series CATTS (Child Anxiety, Theory and Treatment Seminars) and it took the form of six highly stimulating, one-day seminars on the subject of child anxiety, with participants from clinical and academic backgrounds and from Great Britain, Europe, the USA and Australia. Most of the authors in this publication, and a sister special issue in Cognitions and Emotion (2008), participated in the CATTS series

No Significant Evidence of Cognitive Biases for Emotional Stimuli in Children At-Risk of Developing Anxiety Disorders.

This paper explores whether the increased vulnerability of children of anxious parents to develop anxiety disorders may be partially explained by these children having increased cognitive biases towards threat compared with children of non-anxious parents. Parents completed questionnaires about their child’s anxiety symptoms. Children aged 5–9 (n = 85) participated in two cognitive bias tasks: 1) an emotion recognition task, and 2) an ambiguous situations questionnaire. For the emotion recognition task, there were no significant differences between at-risk children and children of non-anxious parents in their cognitive bias scores for reaction times or for accuracy in identifying angry or happy facial expressions. In addition, there were no significant differences between at-risk children and children of non-anxious parents in the number of threat interpretations made for the ambiguous situations questionnaire. It is possible that these cognitive biases only become present subsequent to the development of an anxiety disorder, or only in older at-risk children

Adult mental health service engagement with patients who are parents: evidence from 15 English mental health trusts

Objectives Ascertaining whether mental health service users have children is a clinical requirement in UK health services, and acknowledgement of a patient’s parenting role is necessary to enable engagement with their parenting experience and to facilitate support, both of which are associated with improved outcomes for the parent–child dyad. The current study sought to investigate the practice of mental health practitioners working in UK adult mental health services with regard to the following: Ascertaining whether patients have children; engagement with the parenting role of patients; engagement with the construct of ‘think patient as parent’. Methods Self-report online/paper survey of 1105 multi-disciplinary adult mental health practitioners working in 15 mental health trusts in England. Results A quarter of adult mental health practitioners did not routinely ascertain whether patients had dependent children. Less than half of practitioners engaged with the parenting experience or the potential impact of parental mental health on children. Conclusions The parenting role of patients is not routinely captured by large numbers of practitioners working in adult mental health settings. This is despite it being a mandatory requirement and an integral component of the systematic care of the adult, and preventative care for the offspring. Failure to engage with patients who are parents is a missed opportunity with profound downstream public health implications. The practice deficits identified in this study should be viewed in terms of broader structural failures to address the intergenerational transmission of poor mental health. Practitioner points -Some parents who have mental health difficulties may struggle to provide appropriate and effective care to their children. The parenting role can also exacerbate mental health difficulties. -Identification of dependent children is a mandatory component of adult mental health clinical practice and is necessary to understand a parent’s support needs. -A quarter of adult mental health practitioners are failing to do so. A missed opportunity to engage with the support needs of the parent–child dyad

A new parenting-based group intervention for young anxious children: results of a randomized controlled trial

Objective Despite recent advances, there are still no interventions that have been developed for the specific treatment of young children who have anxiety disorders. This study examined the impact of a new, cognitive–behaviorally based parenting intervention on anxiety symptoms. Method Families of 74 anxious children (aged 9 years or less) took part in a randomized controlled trial, which compared the new 10-session, group-format intervention with a wait-list control condition. Outcome measures included blinded diagnostic interview and self-reports from parents and children. Results Intention-to-treat analyses indicated that children whose parent(s) received the intervention were significantly less anxious at the end of the study than those in the control condition. Specifically, 57% of those receiving the new intervention were free of their primary disorder, compared with 15% in the control condition. Moreover, 32% of treated children were free of any anxiety diagnosis at the end of the treatment period, compared with 6% of those in the control group. Treatment gains were maintained at 12-month follow-up. Conclusions This new parenting-based intervention may represent an advance in the treatment of this previously neglected group. Clinical trial registration information: Anxiety in Young Children: A Randomized Controlled Trial of a New Cognitive-Behaviourally Based Parenting Intervention; http://www.isrctn.org/; ISRCTN12166762

Workplace support for mental health workers who are parents: a feasibility study

Background: Mental health workers are subject to high levels of occupational stress which is associated with poorer health and wellbeing and impaired patient outcomes. For individuals operating in high stress environments, reducing challenge at home, in particular around parenting, has been found to generalize into improvements in the professional domain. The present study sought to investigate the effectiveness and feasibility of brief targeted workplace intervention to support workers in terms of their parental role. Design/Methodology: An uncontrolled evaluation of a series of three-session parenting-focused courses delivered to employees of a large Mental Health Trust. A pre-post-follow-up design was used to investigate effects on outcomes including parenting practice and experience, wellbeing, stress, and occupational self-efficacy. Intervention feasibility and acceptably was also evaluated. Findings: Data from 15 participants who completed measures pre-post indicates the courses were associated with improved parenting practice and experience at a p < 0.005 level. Improvements were reported at 6-month follow up. Participant satisfaction and course acceptability was highly rated by 100% of participants

Non-clinical obsessions in a young adolescent population: Frequency and association with metacognitive variables

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Measuring Metacognition in Cancer: Validation of the Metacognitions Questionnaire 30 (MCQ-30)

Objective The Metacognitions Questionnaire 30 assesses metacognitive beliefs and processes which are central to the metacognitive model of emotional disorder. As recent studies have begun to explore the utility of this model for understanding emotional distress after cancer diagnosis, it is important also to assess the validity of the Metacognitions Questionnaire 30 for use in cancer populations. Methods 229 patients with primary breast or prostate cancer completed the Metacognitions Questionnaire 30 and the Hospital Anxiety and Depression Scale pre-treatment and again 12 months later. The structure and validity of the Metacognitions Questionnaire 30 were assessed using factor analyses and structural equation modelling. Results Confirmatory and exploratory factor analyses provided evidence supporting the validity of the previously published 5-factor structure of the Metacognitions Questionnaire 30. Specifically, both pre-treatment and 12 months later, this solution provided the best fit to the data and all items loaded on their expected factors. Structural equation modelling indicated that two dimensions of metacognition (positive and negative beliefs about worry) were significantly associated with anxiety and depression as predicted, providing further evidence of validity. Conclusions These findings provide initial evidence that the Metacognitions Questionnaire 30 is a valid measure for use in cancer populations