This is an application for a Mentored Clinical Scientist Development Award with a focus on developing expertise in designing and evaluating early interventions for childhood anxiety disorders. The candidate proposes to build upon her experience studying behavioral inhibition as a risk factor for anxiety disorders by learning to apply this knowledge to benefit children at risk. Anxiety disorders represent the most prevalent category of childhood mental disorder. They have been shown to run in families, with children of parents with anxiety disorders at high risk to develop these disorders themselves. Studies by the candidate and her sponsors have identified behavioral inhibition as a temperamental risk factor for the development of childhood anxiety disorders. Children whose behavioral inhibition remains stable throughout early childhood and whose parents have multiple anxiety disorders appear at greatest risk. The ability to identify young children at high risk affords the opportunity for early intervention. Research Plan: The candidate proposes to refine and test an intervention for behaviorally-inhibited 4.0-5.9-year-old children of parents with panic disorder with agoraphobia to facilitate the children's learning strategies for reducing inhibition and managing anxiety. The twelve- week intervention includes parent-skills training and child anxiety management. It will be tested in a randomized controlled trial with proximal (three-month) and long-term (two-year) follow-up assessment for child behavioral inhibition and psychopathology. Environment: The proposed study will be based at the Massachusetts General Hospital and will complement a program of training and supervised research under the mentorship of Joseph Biederman, MD and co-sponsored by Jerrold F. Rosenbaum, MD, with consultation from experts in the areas of behavioral inhibition, childhood anxiety disorders and intervention research. Career development plan: Training will emphasize skills necessary for designing and evaluating interventions for anxious children and assessing psychological and familial vulnerability factors including child temperament, psychopathology, cognitive risk factors and family interactions. Coursework at the Harvard School of Public Health and tutorials in intervention research design, statistical methods, and methodology for longitudinal follow-up will complement supervision by the consultants. In this manner, the candidate will develop a critical fund of knowledge in childhood anxiety disorders, developmental psychopathology, intervention research, and statistical methodology which will lay the foundation for future independent investigation of intervention strategies for high risk children.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08MH001538-03
Application #
6165118
Study Section
Child/Adolescent Risk and Prevention Review Committee (CAPR)
Program Officer
Hibbs, Euthymia D
Project Start
1998-03-01
Project End
2003-02-28
Budget Start
2000-03-01
Budget End
2001-02-28
Support Year
3
Fiscal Year
2000
Total Cost
$123,931
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02199
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Hirshfeld-Becker, Dina R; Masek, Bruce; Henin, Aude et al. (2008) Cognitive-behavioral intervention with young anxious children. Harv Rev Psychiatry 16:113-25
Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V et al. (2004) Pregnancy complications associated with childhood anxiety disorders. Depress Anxiety 19:152-62
Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V et al. (2004) Lack of association between behavioral inhibition and psychosocial adversity factors in children at risk for anxiety disorders. Am J Psychiatry 161:547-55
Hirshfeld-Becker, Dina R; Biederman, Joseph; Calltharp, Sara et al. (2003) Behavioral inhibition and disinhibition as hypothesized precursors to psychopathology: implications for pediatric bipolar disorder. Biol Psychiatry 53:985-99
Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V et al. (2002) Temperamental correlates of disruptive behavior disorders in young children: preliminary findings. Biol Psychiatry 51:563-74
Hirshfeld-Becker, Dina R; Biederman, Joseph (2002) Rationale and principles for early intervention with young children at risk for anxiety disorders. Clin Child Fam Psychol Rev 5:161-72
Biederman, J; Hirshfeld-Becker, D R; Rosenbaum, J F et al. (2001) Lack of association between parental alcohol or drug addiction and behavioral inhibition in children. Am J Psychiatry 158:1731-3
Biederman, J; Hirshfeld-Becker, D R; Rosenbaum, J F et al. (2001) Further evidence of association between behavioral inhibition and social anxiety in children. Am J Psychiatry 158:1673-9
Rosenbaum, J F; Biederman, J; Hirshfeld-Becker, D R et al. (2000) A controlled study of behavioral inhibition in children of parents with panic disorder and depression. Am J Psychiatry 157:2002-10