Publications by authors named "Anthony Puliafico"

Importance: Serotonin reuptake inhibitors (SRIs) are the only medications approved for obsessive-compulsive disorder (OCD), yet most patients taking SRIs exhibit significant symptoms. Adding exposure/response prevention (EX/RP) therapy improves symptoms, but it is unknown whether patients maintain wellness after discontinuing SRIs.

Objective: To assess whether patients with OCD who are taking SRIs and have attained wellness after EX/RP augmentation can discontinue their SRI with noninferior outcomes compared with those who continue their SRI therapy.

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Despite recent advances in the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care, and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary efficacy of a family-based behavioral parenting intervention (i.e.

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Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission.

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Anxiety disorders are one of the most prevalent and impairing classes of mental health difficulties affecting young children. Though the vast majority of supported programs for child anxiety focus on youth ages 7 years and up, preliminary support has emerged for exposure-based adaptations of parent-coaching interventions, i.e.

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Although efficacious psychological treatments for internalizing disorders are now well established for school-aged children, until recently there have regrettably been limited empirical efforts to clarify indicated psychological intervention methods for the treatment of mood and anxiety disorders presenting in early childhood. Young children lack many of the developmental capacities required to effectively participate in established treatments for mood and anxiety problems presenting in older children, making simple downward extensions of these treatments for the management of preschool internalizing problems misguided. In recent years, a number of research groups have successfully adapted and modified parent-child interaction therapy (PCIT), originally developed to treat externalizing problems in young children, to treat various early internalizing problems with a set of neighboring protocols.

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Anxiety disorders are prevalent in children 7 years and younger; however, these children generally do not possess developmental skills required in cognitive behavior treatment. Recent efforts have adapted parent-child interaction therapy (PCIT), originally developed for disruptive and noncompliant behavior, for young children with anxiety. This article reviews the principles underlying PCIT and the rationale for adapting it to target anxiety symptoms.

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As many as 9% of preschoolers suffer from an anxiety disorder, and earlier onset of disorder is associated with more intractable forms of psychopathology in later life. At present there is a relative dearth of empirical work examining the development of evidence-based treatments for anxiety disorders presenting in early childhood. Building on previous work supporting extensions of PCIT for separation anxiety disorder, the present study examines the preliminary feasibility and efficacy of an anxiety-based modification of PCIT (The CALM Program; Coaching Approach behavior and Leading by Modeling) for the treatment of youth between the ages of three and eight presenting with separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, and/or specific phobias (N=9; M(age)=5.

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Background: Generalized Anxiety Disorder (GAD) in youth is characterized by excessive worry across domains for ≥ 6 months, an inability to stop worrying, and at least one physiological symptom. This study examined the multiple domains that optimally distinguish (1) GAD youth from nonanxiety-disordered youth and (2) GAD youth from other anxiety-disordered youth.

Methods: Receiver operating characteristic analyses examined a sample of youth (N=180) aged 7-13 (M=10.

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Pediatric anxiety disorders are prevalent, chronic, and often lead to significant impaired functioning that impacts both short- and long-term outcomes for children and adolescents. Treatment options include pharmacotherapy and psychosocial interventions. This presentation will review treatment advances specifically for pharmacotherapy.

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The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention (FESA; N = 39). Children in FCBT engaged in exposure tasks in Sessions 9-16, whereas FESA participants did not.

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The present study evaluated the utility of parent- and child-reported social fears for reaching a diagnosis of social phobia in youth. The diagnostic utility of (a) the number of fears and (b) specific feared social situations was examined. The sample included 140 youth and their parents: youth diagnosed with social phobia (n=50), youth diagnosed with generalized anxiety disorder or separation anxiety disorder but not social phobia (n=49), and youth without an anxiety disorder (n=41).

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We evaluated the utility of Anxiety scales for the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). The scales (CBCL-A; TRF-A) were examined using mothers and teachers of anxiety-disordered (AD; 157 mothers, 70 teachers) and non-anxiety-disordered (NAD; 100 mothers, 17 teachers) children. Separate samples of parents and teachers of AD (mothers=145, fathers=120, teachers=137) and NAD (mothers=35, fathers=29, teachers=27) children cross-validated the original findings.

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The research literature suggests that children and adolescents suffering from anxiety disorders experience cognitive distortions that magnify their perceived level of threat in the environment. Of these distortions, an attentional bias toward threat-related information has received the most theoretical and empirical consideration. A large volume of research suggests that anxiety-disordered youth selectively allocate their attention toward threat-related information.

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