Effectiveness of exposure-based treatment for childhood anxiety disorders: An open clinical trial to test its relation with indices of emotional processing and inhibitory learning.

Background And Objectives: The current study examined how effectiveness of exposure-based CBT was related to indices of emotional processing and inhibitory learning during exposure exercises.

Methods: Adolescents with anxiety disorder(s) (N = 72; age 11-19; 85% girls) received a group-based, intensive two-week treatment of which effectiveness was indexed by the SCARED and by ratings of anxiety and approach towards individualized goal situations. To index emotional processing, subjective units of distress (SUDs) were used to indicate both initial and final fear level, and absolute, relative, and total dose of fear reduction.

Better together? A randomized controlled microtrial comparing different levels of therapist and parental involvement in exposure-based treatment of childhood specific phobia.

Introduction: Exposure is often limited to homework assignments in routine clinical care. The current study compares minimally-guided (MGE) and parent-guided (PGE) out-session homework formats to the 'golden standard' of therapist-guided in-session exposure with minimally-guided exposure at home (TGE).

Methods: Children with specific phobia (N = 55, age 8-12, 56% girls) participated in a single-blind, randomized controlled microtrial with a four-week baseline-treatment period design.

Treating specific phobia in youth: A randomized controlled microtrial comparing gradual exposure in large steps to exposure in small steps.

Introduction: Exposure may be especially effective when within exercises, there is a strong violation of threat expectancies and much opportunity for fear reduction. Outcomes of exposure may therefore improve when exposure is conducted in large steps (LargeSE) relative to small steps (SmallSE).

Methods: Children and young people with a specific phobia (SP) (N = 50, age 8-17, 64 % girls) participated in a preregistered single-blind, randomized controlled microtrial comparing LargeSE and SmallSE in a four-week baseline-treatment design.

Treating Speech Anxiety in Youth: A Randomized Controlled Microtrial Testing the Efficacy of Exposure Only Versus Exposure Combined With Anxiety Management Strategies.

CBT for anxious youth usually combines anxiety management strategies (AMS) with exposure, with exposure assumed to be critical for treatment success. To limit therapy time while retaining effectiveness, one might optimize CBT by restricting treatment to necessary components. This study tested whether devoting all sessions to exposure is more effective in reducing speech anxiety in youth than devoting half to AMS including cognitive or relaxation strategies and half to exposure.

Therapists' characteristics associated with the (non-)use of exposure in the treatment of anxiety disorders in youth: A survey among Dutch-speaking mental health practitioners.

Introduction: Although there is consensus that exposure is the key ingredient in treating childhood anxiety disorders, several studies in the USA suggest exposure to be underused in clinical practice. Previous research pointed to therapists' beliefs about exposure, their age, experience, caseload, training and theoretical orientation, as well as the level of the therapists' own anxiety as important factors in the underusage of exposure in the treatment of adult anxiety disorders. This study examined what therapist characteristics may be involved in the (non-)use of exposure in treating childhood anxiety disorders.

Disgust- and anxiety-based emotional reasoning in non-clinical fear of vomiting.

Background And Objectives: Emotional reasoning has been described as a dysfunctional tendency to use subjective responses to make erroneous inferences about threatening outcomes in objectively safe situations (e.g., "If I feel anxious/disgusted, there must be danger/risk of becoming ill").

Rate of improvement during and across three treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy, selective serotonin reuptake inhibitor or both combined.

Background: Existing literature on panic disorder (PD) yields no data regarding the differential rates of improvement during Cognitive Behavioral Therapy (CBT), Selective Serotonin Reuptake Inhibitor (SSRI) or both combined (CBT+SSRI).

Method: Patients were randomized to CBT, SSRI or CBT+SSRI which each lasted one year including three months of medication taper. Participating patients kept record of the frequency of panic attacks throughout the full year of treatment.

"If I feel disgusted, I must be getting ill": emotional reasoning in the context of contamination fear.

Patients suffering from anxiety disorders have been shown to infer danger on the basis of their anxiety responses "if I feel anxious, there must be danger." This tendency logically hampers the identification of false alarms and may thus act in a way to confirm the a priori threat value of the feared stimuli/situations. Since disgust is assumed to play a critical role in the persistence of contamination fears in OCD, the question rises whether individuals suffering from fear of contamination perhaps similarly infer danger on the basis of their disgust response: "If I feel disgusted, it must be contagious.

Clinical features, prevalence and psychiatric complaints in subjects with fear of vomiting.

Unlabelled: Specific phobia of vomiting (also known as emetophobia) is a relatively understudied phobia with respect to its aetiology, clinical features and treatment. In this stage, research is mostly based on people with self-reported fear of vomiting. This paper presents a survey on the clinical features of fear of vomiting of individuals.

A randomized trial of cognitive-behavioral therapy or selective serotonin reuptake inhibitor or both combined for panic disorder with or without agoraphobia: treatment results through 1-year follow-up.

Objective: To establish the long-term effectiveness of 3 treatments for DSM-IV panic disorder with or without agoraphobia: cognitive-behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT + SSRI). As a secondary objective, the relationship between treatment outcome and 7 predictor variables was investigated.

Method: Patients were enrolled between April 2001 and September 2003 and were randomly assigned to treatment.

Perceived criticism: associations with perceiver characteristics and interpersonal behaviour.

Perceived Criticism (PC) evolved in the context of Expressed Emotion (EE) research and, like EE, predicts the course of various psychiatric disorders. However, little is known about PC's validity. We examined (in Study 1) to what extent PC reflects the perceiver's current depressive and marital complaints, whether PC measures reciprocal criticism that characterizes dyads rather than individuals, and (in Study 2) whether PC reflects actual interactive behaviour.

Processes of change in cognitive-behavioural treatment of obsessive-compulsive disorder: Current status and some future directions.

The present paper discusses theoretical and methodological issues involved in the processes of change in cognitive-behavioural treatment (CBT) of obsessive-compulsive disorder (OCD). Treatment outcome studies showed that CBT is effective in reducing obsessive-compulsive symptoms. However, why and how CBT works cannot be corroborated by comparing pre- and post-assessment.

Covariation bias for social events and signs of (dis)approval in high and low socially anxious individuals.

In two covariation bias experiments, we investigated whether socially anxious women overestimate the contingency between social events and signs of rejection and/or to underestimate the contingency between social events and approval. Participants were exposed to descriptions of ambiguous or negative social events, situations involving animals, and nature scenes that were randomly paired with disgusting, happy, and neutral faces. Socially anxious participants reported enhanced belongingness between ambiguous events and signs of rejection, together with reduced belongingness between negative events and approval.

An internet-based study on the relation between disgust sensitivity and emetophobia.

In the etiology of disgust-relevant psychopathology, such as emetophobia (fear of vomiting), two factors may be important: disgust propensity, i.e., how quickly the individual experiences disgust, and disgust sensitivity, i.