GAD and related anxiety disorders in youth are chronic and highly impairing. Cognitive-behavioral therapy (CBT), and other active forms of psychotherapy (e.g. education, support), are associated with reductions in anxiety (Barrett et al 1996;Kendall et al 1997;Last et al 1998;Silverman et al 1999);however, approximately 44% of anxious children treated with CBT do not improve (James et al 2005). Understanding predictors and correlates of treatment response in child anxiety will allow us to: (1) target treatments to children most likely to benefit, (2) refine treatments by focusing on components shown to be associated with treatment response, and (3) develop new treatments tailored to CBT non-responders. We propose that child anxiety disorders, as exemplified by GAD (Rapee, 2002), are associated with a """"""""vigilance-avoidance"""""""" pattern characterized by problems in monitoring and evaluating emotional information and modifying emotional reactions. This pattern can be reinforced by controlling and critical parenting behaviors, parental psychopathology, and negative interactions with peers. CBT treatments for child anxiety target disruptions in emotion regulation by teaching children skills for identifying and managing negative emotion and providing opportunities to practice these skills during exposures. These skills are then presumed to generalize to social interactions in daily life settings outside the clinic, including interactions with parents and peers. Although improvements in affective functioning in the social context are believed to play a role in anxious children's positive response to CBT, research has not yet clearly demonstrated links between children's or parents' affective behaviors and their response to treatment. We will examine how children's emotion regulation in the social context and their relationships with parents and peers (1) predict initial and long-term response to CBT treatment (individually and compared to an active comparison Child Centered treatment) and (2) change across the course of treatment. We will rely on two ecologically valid methods for assessing affective behaviors in naturalistic contexts: (a) Behavioral Observation and (b) Ecological Momentary Assessment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Specialized Center (P50)
Project #
5P50MH080215-03
Application #
8107512
Study Section
Special Emphasis Panel (ZMH1)
Project Start
2010-06-01
Project End
2013-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
3
Fiscal Year
2010
Total Cost
$227,229
Indirect Cost
Name
University of Pittsburgh
Department
Type
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Ricketts, Emily J; Price, Rebecca B; Siegle, Greg J et al. (2018) Vigilant attention to threat, sleep patterns, and anxiety in peripubertal youth. J Child Psychol Psychiatry 59:1309-1322
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Stone, Lindsey B; Mennies, Rebekah J; Waller, Jennifer M et al. (2018) Help me Feel Better! Ecological Momentary Assessment of Anxious Youths' Emotion Regulation with Parents and Peers. J Abnorm Child Psychol :
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Morgan, Judith K; Lee, Grace E; Wright, Aidan G C et al. (2017) Altered Positive Affect in Clinically Anxious Youth: the Role of Social Context and Anxiety Subtype. J Abnorm Child Psychol 45:1461-1472
Price, Rebecca B; Rosen, Dana; Siegle, Greg J et al. (2016) From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures. J Abnorm Psychol 125:267-278
Benoit Allen, Kristy; Silk, Jennifer S; Meller, Suzanne et al. (2016) Parental autonomy granting and child perceived control: effects on the everyday emotional experience of anxious youth. J Child Psychol Psychiatry 57:835-42
Price, Rebecca B; Allen, Kristy Benoit; Silk, Jennifer S et al. (2016) Vigilance in the laboratory predicts avoidance in the real world: A dimensional analysis of neural, behavioral, and ecological momentary data in anxious youth. Dev Cogn Neurosci 19:128-136

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