The Treatment of Anxiety in Autism Spectrum Disorder (TAASD) Study: Rationale, Design and Methods.

This paper describes the rationale, design, and methods of the Treatment for Anxiety in Autism Spectrum Disorders study, a three-site randomized controlled trial investigating the relative efficacy of a modular CBT protocol for anxiety in ASD (Behavioral Interventions for Anxiety in Children with Autism) versus standard CBT for pediatric anxiety (the program) and a treatment-as-usual control. The trial is distinct in its scope, its direct comparison of active treatments for anxiety in ASD, and its comprehensive approach to assessing anxiety difficulties in youth with ASD. The trial will evaluate the relative benefits of CBT for children with ASD and investigate potential moderators (ASD severity, anxiety presentation, comorbidity) and mediators of treatment response, essential steps for future dissemination and implementation.

Treatment Concerns and Functional Impairment in Pediatric Anxiety.

Although there are efficacious, evidence-based treatments for anxiety disorders, youth often experience delays in seeking therapy. Myriad reasons may contribute to this lag in treatment initiation, with some youth possessing concerns about therapy. Treatment concerns are broadly characterized by worries/ambivalence about seeking treatment, including concerns about the negative reactions, consequences, and inconvenience of treatment.

Clinical characteristics and predictors of hoarding in children with anxiety disorders.

Objective: This investigation was conducted to describe the clinical of characteristics of anxious children with significant hoarding behavior and to examine the contributions of anxiety, obsessive compulsive, and inattentive and hyperactive/impulsive symptoms in the prediction of hoarding.

Method: One hundred nine children seeking treatment for an anxiety disorder and their parents completed clinician-administered and parent-report measures of emotional and behavioral symptoms, functional impairment, and hoarding symptoms.

Results: Elevated levels of hoarding were reported for 22% of the sample.

Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.

Despite evidence documenting high prevalence of family accommodation in pediatric obsessive-compulsive disorder, examination in other pediatric anxiety disorders is limited. Preliminary evidence suggests that family accommodation is common amongst children with anxiety disorders; however, the impact on clinical presentation and functional impairment has not been addressed. This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model.

A RANDOMIZED CONTROLLED TRIAL IN COMMUNITY MENTAL HEALTH CENTERS OF COMPUTER-ASSISTED COGNITIVE BEHAVIORAL THERAPY VERSUS TREATMENT AS USUAL FOR CHILDREN WITH ANXIETY.

Objective: This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers.

Methods: One hundred children (7-13 years) with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration. Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted CBT treatment responders).

Incidence, clinical correlates and treatment effect of rage in anxious children.

Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined.

Adverse Prenatal, Perinatal and Neonatal Experiences in Children with Anxiety Disorders.

This study examined the incidence of adverse prenatal, perinatal, and neonatal experiences amongst children with anxiety disorders, and the relationship to clinical symptomology and functional impairment in treatment-seeking children (N = 107) with a primary anxiety disorder. Anxious children had higher rates of reported maternal prescription medication use during pregnancy, maternal smoking and illness during pregnancy and neonatal complications (including neonatal intensive care and feeding issues) compared with population base rates and non-affected children. Almost one-third had early problems with sleep.

Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial.

Aims: To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).

Methods: Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU.

Neuropsychological performance across symptom dimensions in pediatric obsessive compulsive disorder.

Background: Few studies have examined neuropsychological functioning among youth with obsessive compulsive disorder (OCD), with inconclusive results. Although methodological differences may contribute to inconsistent findings, clinical factors may also account for differential performance. Symptom dimensions are associated with specific patterns of genetic transmission, comorbidity, and treatment outcome, and may also be uniquely associated with neuropsychological performance.

Mediators and moderators of functional impairment in adults with obsessive-compulsive disorder.

The current study examined correlates, moderators, and mediators of functional impairment in 98 treatment-seeking adults with obsessive-compulsive disorder (OCD). Participants completed or were administered measures assessing obsessive-compulsive symptom severity, functional impairment, resistance against symptoms, interference due to obsessive-compulsive symptoms, depressive symptoms, insight, and anxiety sensitivity. Results indicated that all factors, except insight into symptoms, were significantly correlated with functional impairment.

Consumers' and providers' perceptions of utilizing a computer-assisted cognitive behavioral therapy for childhood anxiety.

Background: Computer-assisted cognitive behavioral therapy (CCBT) programs for childhood anxiety are being developed, although research about factors that contribute to implementation of CCBT in community mental health centers (CMHC) is limited.

Aim: The purpose of this mixed-methods study was to explore consumers' and providers' perceptions of utilizing a CCBT for childhood anxiety in CMHC in an effort to identify factors that may impact implementation of CCBT in CMHC.

Method: Focus groups and interviews occurred with 7 parents, 6 children, 3 therapists, 3 project coordinators and 3 administrators who had participated in CCBT for childhood anxiety.

A Pilot Study of Computer-Assisted Cognitive Behavioral Therapy for Childhood Anxiety in Community Mental Health Centers.

Anxiety disorders among children are common, disabling, and run a chronic course without treatment. Cognitive behavioral therapy (CBT) has shown robust efficacy for childhood anxiety. However, dissemination of CBT into community mental health centers (CMHCs) is limited.