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 inanxiety (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). Understandingpredictors and correlates of treatment response in child anxiety will allow us to: (1) target treatments tochildren most likely to benefit, (2) refine treatments by focusing on components shown to be associated withtreatment response, and (3) develop new treatments tailored to CBT non-responders. We propose that childanxiety disorders, as exemplified by GAD (Rapee, 2002), are associated with a 'vigilance-avoidance' patterncharacterized by problems in monitoring and evaluating emotional information and modifying emotionalreactions. This pattern can be reinforced by controlling and critical parenting behaviors, parentalpsychopathology, and negative interactions with peers. CBT treatments for child anxiety target disruptions inemotion regulation by teaching children skills for identifying and managing negative emotion and providingopportunities to practice these skills during exposures. These skills are then presumed to generalize to socialinteractions in daily life settings outside the clinic, including interactions with parents and peers. Althoughimprovements in affective functioning in the social context are believed to play a role in anxious children'spositive 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 thesocial context and their relationships with parents and peers (1) predict initial and long-term response to CBTtreatment (individually and compared to an active comparison Child Centered treatment) and (2) changeacross the course of treatment. We will rely on two ecologically valid methods for assessing affectivebehaviors in naturalistic contexts: (a) Behavioral Observation and (b) Ecological Momentary Assessment.
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