Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: prevalence and characterization

Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID). Anxiety and social withdrawal are considered core features of the FXS phenotype, yet there is limited diagnostic evidence of the prevalence of formal anxiety disorders in FXS. This study assessed the prevalence of anxiety disorders in a sample of 58 males and 39 females with FXS (ages 5.0–33.3 years). Participants’ parents completed the Anxiety Disorders Interview Schedule (ADIS-IV), a clinical interview based on DSM-IV criteria, and the Anxiety Depression and Mood Scale (ADAMS), a psychiatric disorders screening instrument normed in ID. We conducted cognitive (IQ) and autism (AUT) assessments and surveyed medication use. Despite a high rate of psychopharmacological treatment, 86.2% of males and 76.9% of females met criteria for an anxiety disorder, with social phobia and specific phobia the most commonly diagnosed. Proband status, gender, and IQ were not significantly related to any anxiety disorders, however significantly higher rates of a few anxiety disorders were found in older age and AUT groups. Significant correlations between ADIS diagnoses and ADAMS scores provided cross-validation of instruments, indicating that the ADIS is suitable for use in FXS. A greater percentage of our sample met criteria for most anxiety disorders than has been reported in other ID groups or the general population. The rate of anxiety compared to general ID suggests that the FMR1 full mutation confers an especially high risk for these disorders, regardless of factors commonly associated with FXS clinical involvement. A thorough clinical assessment and treatment of anxiety should be included in the FXS standard of care

Treating a Child With Anxiety and Attention-Deficit/Hyperactivity Disorder? Don\u27t Rule Out Cognitive-Behavioral Therapy.

Anxiety disorders (ADs) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common psychiatric disorders in youth and approximately 25% of those with an AD have comorbid ADHD.Children with AD and ADHD evidence greater impairment than those with either disorder alone, making them a particularly vulnerable population in need of effective treatment.Although a strong evidence base supports the efficacy of cognitive-behavioral therapy (CBT) for treating anxiety in children,there is little information to guide practitioners on how to best treat those dually diagnosed with an AD and ADHD. Questions have arisen as to whether the cognitive, attentional, and behavioral impairments associated with ADHD interfere with the ability of these children to benefit from CBT for anxiety.Does the distractibility and overactivity characteristic of ADHD inhibit, perhaps differentially, the ability of these children to effectively engage in CBT for anxiety (eg, psychoeducation, cognitive restructuring, therapeutic exposure)

Clinical case presentation: The case of Sandra

Presents the case of Sandra, a composite of several individuals who have presented with anxiety problems. The contributors to this volume discuss their therapeutic orientation, their specific treatment model, and the clinical skills and attributes that are most essential to their therapeutic approach. Then, they address issues in Sandra\u27s case from their perspective: assessment, conceptualization, therapeutic relationship, and treatment implementation and outcome. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter

Comparison of treatment approaches

Presents an overview comparing the treatment approaches to anxiety disorder in the case of Sandra as described in this volume (see record 200304404-000). The defining characteristics of each of the psychotherapy models are presented, including the following: cognitive-behavioral therapy, problem-solving therapy, acceptance and commitment therapy, contextual family therapy, Adlerian therapy, context-centered therapy, interpersonal psychotherapy, person-centered therapy, supportive-expressive therapy, psychodynamic psychotherapy, and psychopharmacological treatments. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter

Comparative treatments for anxiety disorders

Anxiety disorders are costly, common and debilitating, and often present challenging problems to the caseloads of practicing clinicians. This volume compares and contrasts various models of and treatment approaches to anxiety disorders. Each contributor, an experienced clinician, analyzes the same case and presents a thorough description of the model. Detailed descriptions of therapists\u27 skills and attributes, assessment plans, treatment goals, intervention strategies, common pitfalls and mechanisms of change are included. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (cover

Anxiety disorders: An overview

Presents an overview of the characteristics of anxiety and anxiety disorders. In the first section, the authors describe the basic characteristics of anxiety and discuss several issues in distinguishing between anxiety as a normal response and anxiety as a disordered response. The second section presents a brief review of the DSM-IV classification scheme for anxiety disorders. These include panic disorder, panic disorder with agoraphobia, specific phobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, acute stress disorder, and anxiety disorder not otherwise specified. The final section addresses mental and physical substrate factors, triggering factors, and maintenance factors in anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter

Anxiety disorders: An overview

Presents an overview of the characteristics of anxiety and anxiety disorders. In the first section, the authors describe the basic characteristics of anxiety and discuss several issues in distinguishing between anxiety as a normal response and anxiety as a disordered response. The second section presents a brief review of the DSM-IV classification scheme for anxiety disorders. These include panic disorder, panic disorder with agoraphobia, specific phobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, acute stress disorder, and anxiety disorder not otherwise specified. The final section addresses mental and physical substrate factors, triggering factors, and maintenance factors in anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter

Anxiety disorders : a practitioner s guide to comparative treatments/ Ditomasso

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