Query: anxiety child

title: Influence of trait anxiety, child maltreatment, and adulthood life events on depressive symptoms
abstract: Various personality traits mediate the association between childhood stress and depressive symptoms in adulthood. The aim of this study was to clarify the indirect effects of the experience of child maltreatment on depressive symptoms and appraisal of life events in adulthood through trait anxiety.  A total of 404 participants who were volunteer subjects from the community were studied using the following self administered questionnaire surveys: Patient Health Questionnaire 9, which measures depressive symptoms; State Trait Anxiety Inventory Form Y, which measures trait anxiety; the Child Abuse and Trauma Scale, which measures child maltreatment; and Life Experiences Survey, which measures negative and positive appraisal of adulthood life events.  Structural equation modeling demonstrated that the experience of child maltreatment increased depressive symptoms in adulthood as well as the negative appraisal of life events in adulthood through an increase in trait anxiety. Furthermore, trait anxiety affected depressive symptoms in adulthood through its influence on the negative appraisal of adulthood life events. The following indirect effect was also significant: the experience of child maltreatment increased the negative appraisal of adulthood life events via trait anxiety and subsequently influenced adult depressive symptoms.  The subjects of this study are volunteer subjects from the community including healthy people, and hence the results may not be generalizable to major depressive patients. Recall bias should be considered when interpreting the results. Because this study is a cross sectional study, the causality between the experience of child maltreatment and depression is not clear.  This study suggests that trait anxiety may play a mediating role in the influence of the experience of child maltreatment on depressive symptoms in adulthood and negative appraisal of adulthood life events.

title: Stress and anxiety (child)

title: A Meta Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development.
abstract: Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children.  Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random effects meta analyses were used to derive mean effect sizes and test for potential moderators.  A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) 1.66 (95% CI 1.54 1.79) Effect sizes were stronger for depression (OR 1.79; 95% CI 1.61 1.99) compared to anxiety (OR 1.50; 95% CI 1.36 1.64) Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio demographic risk was heightened.  Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.

title: A Randomized Clinical Trial Comparing Individual Cognitive Behavioral Therapy and Child Centered Therapy for Child Anxiety Disorders
abstract: This study compared individual cognitive behavioral therapy (CBT) and a supportive child centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1 year follow up, as well as on real world measures of emotional functioning. Youth (N 133; ages 9 14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n 90) or CCT (n 43) which served as an active comparison. Treatment response and recovery at posttreatment and 1 year follow up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT) but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT) Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1 year follow up (82.2% for CBT vs. 65.1% for CCT) These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment related gains.

title: Results From the Child/Adolescent Anxiety Multimodal Extended Long Term Study (CAMELS) Primary Anxiety Outcomes.
abstract: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long term Study (CAMELS) Rates of stable anxiety remission (defined rigorously as the absence of all DSM IV TR anxiety disorders across all follow up years) and predictors of anxiety remission across a 4 year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive behavioral therapy (CBT) their combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child and family variables, and interim negative life events.  Data were from 319 youths (age range 10.9 25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or generalized anxiety disorders and enrolled in the multi site Child/Adolescent Anxiety Multimodal Study (CAMS) Participants were assessed annually by independent evaluators using the age appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family functioning, life events, and mental health service use) RESULTS Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely to be in the chronically ill group (odds ratio 2.73; confidence interval 1.14 6.54; p .02) treatment type was not associated with remission status across the follow up. Several variables (eg, male gender) predicted stable remission from anxiety disorders.  Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can help tailor treatments to youth at greatest risk for chronic illness.

title: Parental anxiety, child anxiety and father child interactons a longitudinal, multi method investigation

title: The Relations Between Maternal Prenatal Anxiety or Stress and Child's Early Negative Reactivity or Self Regulation: A Systematic Review
abstract: In the present review, we examine the association between maternal prenatal stress or anxiety and children's early negative reactivity or self regulation. The review includes 32 studies that focus on pregnancy related anxiety, state or trait anxiety, perceived stress, and stressful life events in relation to child's crying, temperament, or behavior during the first 2 years of life. We searched four electronic databases and 32 studies were selected based on the inclusion criteria. Twenty three studies found an association between maternal prenatal anxiety or stress and a child's negative reactivity or self regulation, and typically the effect sizes varied from low to moderate. The association was found regardless of the form of prenatal stress or anxiety and the trimester in which the prenatal stress or anxiety was measured. In conclusion, several forms of prenatal anxiety and stress may increase the risk of emotional and self regulatory difficulties during the first 2 years of life.

title: The Effect of Child Distress on Accommodation of Anxiety: Relations With Maternal Beliefs, Empathy, and Anxiety
abstract: Little is known about the influence of child behaviors on accommodation of anxiety and how accommodation relates to other parent factors. The present study examined the comparative effect of high and low levels of child distress on mother reported accommodation, mother factors in relation to accommodation, and moderators of the relation between accommodation and child distress. Maternal perceptions of accommodation were measured by vignettes depicting youth exhibiting high or low levels of distress in anxiety provoking situations that elicited social anxiety, generalized anxiety, or separation anxiety in a sample of 7 to 17 year old youth with anxiety disorders (N 70, M 11.66, 47.1% male) Findings indicated an effect of child distress on mother reported accommodation of youth anxiety, such that mothers reported more overall accommodation under conditions of high child distress; situation level analyses revealed this effect for social and generalized anxiety situations. Furthermore, an association was found between greater mother reported accommodation and more negative beliefs about their child's experience of anxiety, which held across situations. Maternal empathy moderated the relation between overall accommodation and child distress. Maternal anxiety also moderated the relation between accommodation and child distress, with results varying based on situation type. Findings, consistent with theory, indicate a relation between child distress and mother reported accommodation and suggest that maternal beliefs about anxiety are an important treatment target. High maternal empathy may be related to a greater degree of adaptability in response to child behaviors, whereas maternal anxiety may be linked with less adaptive responses to child behaviors.

title: Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety.
abstract: Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3 8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers' affective states, mothers' ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers' resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e. using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety.

title: Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety
abstract: Anxiety disorders are the most common mental health disorder among children and adolescents. We examined 111 treatment outcome studies testing 204 treatment conditions for child and adolescent anxiety published between 1967 and mid 2013. Studies were selected for inclusion in this review using the PracticeWise Evidence Based Services database. Using guidelines identified by this journal (Southam Gerow Prinstein, 2014) studies were included if they were conducted with children and/or adolescents (ages 1 19) with anxiety and/or avoidance problems. In addition to reviewing the strength of the evidence, the review also examined indicators of effectiveness, common practices across treatment families, and mediators and moderators of treatment outcome. Six treatments reached well established status for child and adolescent anxiety, 8 were identified as probably efficacious, 2 were identified as possibly efficacious, 6 treatments were deemed experimental, and 8 treatments of questionable efficacy emerged. Findings from this review suggest substantial support for cognitive behavioral therapy (CBT) as an effective and appropriate first line treatment for youth with anxiety disorders. Several other treatment approaches emerged as probably efficacious that are not primarily CBT based, suggesting that there are alternative evidence based treatments that practitioners can turn to for children and adolescents who do not respond well to CBT. The review concludes with a discussion of treatments that improve functioning in addition to reducing symptoms, common practices derived from evidence based treatments, mediators and moderators of treatment outcomes, recommendations for best practice, and suggestions for future research.