Looking to the future of research in pediatric anxiety disorders

March, John S.

doi:10.1002/da.20754

Cited by 15 publications

(9 citation statements)

References 104 publications

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“…As the field moves towards examination of these cognitive and physiological markers of anxiety in order to directly target these processes with translational, novel, and personalized intervention (March, 2011), it is critical to understand the respective and interactive contributions of autonomic arousal and cognitive bias to anxiety. We conducted this study in order to begin answering the question: does cognitive bias moderate the relationship between anxiety disorder status and sympathetic arousal in youth?…”

Section: Cognitive Bias and Autonomic Arousal: Interactive Processes?mentioning

confidence: 99%

Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth

Rozenman¹,

Vreeland²,

Piacentini³

2017

Journal of Anxiety Disorders

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Cognitive bias and physiological arousal are two putative markers that may underlie youth anxiety. However, data on relationships between cognitive bias and arousal are limited, and typically do not include behavioral measurement of these constructs in order to tap real-time processes. We aimed to examine the relationship between performance-based cognitive bias and sympathetic arousal during stress in clinically anxious and typically-developing youth. The sample included children and adolescents ages 9 to 17 (Mean age = 13.18, SD = 2.60) who either met diagnostic criteria for primary generalized anxiety, social phobia, or separation anxiety (N=24) or healthy controls who had no history of psychopathology (N=22). Youth completed performance-based measures of attention and interpretation bias. Electrodermal activity was assessed while youth participated in the Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum, Jobst, & Wustmans, 1997). A mixed models analysis indicated significant linear and non-linear changes in skin conductance, with similar slopes for both groups. Interpretation bias, but not attention bias, moderated the relationship between group status and sympathetic arousal during the TSST-C. Arousal trajectories did not differ for anxious and healthy control youth who exhibited high levels of threat interpretation bias. However, for youth who exhibited moderate and low levels of interpretation bias, the anxious group demonstrated greater arousal slopes than healthy control youth. Results provide initial evidence that the relationship between anxiety status and physiological arousal during stress may be moderated by level of interpretation bias for threat. These findings may implicate interpretation bias as a marker of sympathetic reactivity in youth. Implications for future research and limitations are discussed.

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Section: Cognitive Bias and Autonomic Arousal: Interactive Processes?mentioning

confidence: 99%

Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth

Rozenman¹,

Vreeland²,

Piacentini³

2017

Journal of Anxiety Disorders

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“…Anxiety disorders are associated with substantial impairment for youth across social, academic, and home domains [2, 3], and confer significant risk for future medical and psychiatric illness [2, 4, 5]. Experts have called for clarification of the biobehavioral markers and mechanisms underlying pediatric anxiety [6, 7] to improve illness classification and intervention efforts.…”

Section: Introductionmentioning

confidence: 99%

Autonomic arousal in anxious and typically developing youth during a stressor involving error feedback

Rozenman¹,

Sturm²,

McCracken³

et al. 2017

Eur Child Adolesc Psychiatry

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Anxiety has been proposed to influence psychophysiological reactivity in children and adolescents. However, the extant empirical literature has not always found physiological reactivity to be associated with anxiety in youth. Further, most investigations have not examined psychophysiological reactivity in real time over the course of acute stress. To test the impact of anxiety disorder status on autonomic arousal in youth, we compared youth with primary anxiety disorders (N = 24) to typically developing (TD) youth (N = 22) on heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA) during an acute stressor in which youth received error-related feedback. We also conducted exploratory analyses on youth performance during the task. Youth ages 9–17 participated in the arithmetic portion of the Trier Social Stress Test for Children (Buske-Kirschbaum et al., Psychosom 59:419–426, 1997), during which time they received consecutive, standardized feedback that they made calculation errors. Results indicated that, compared to their TD counterparts, the anxious group demonstrated elevated HR and suppressed HRV during initial provision of error feedback and during the recovery period. No group differences were found for RSA. Additionally, overall TD youth made a greater proportion of errors than anxious youth. Clinically, these findings may provide preliminary support for anxious youth exhibiting physiological reactivity in response to receipt of error-related feedback, and may have implications for understanding biological processes during stress. This work underscores the need for further study of when and how anxiety may influence autonomic reactivity over the course of stress.

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“…Therefore, it would be useful to examine the effects of AMP in addition to standard care in such real‐world clinical settings where youth anxiety is especially severe. As many youths who receive CBT and pharmacotherapy are not treated to remission, the National Institute of Mental Health called for augmentation treatments for psychotherapy and pharmacotherapy . Similarly, recent reviews of CBM have emphasized the need for research investigating the potential augmentation effects of CBM in conjunction with traditional CBT and/or pharma‐cotherapy.…”

Section: Introductionmentioning

confidence: 99%

Augmentation of Youth Cognitive Behavioral and Pharmacological Interventions With Attention Modification: A Preliminary Investigation

et al. 2013

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Background Recent research suggests the efficacy of attention modification programs (AMP) in treating adult anxiety [1]. Though some research supports the success of AMP treatment in anxious youths [2, 3], to date no study has examined the efficacy of AMP as an adjunctive treatment to other psychosocial and pharmacological interventions for anxious youths within the community. Methods In the current study we examined the efficacy of AMP as an adjunctive treatment to standard care at a residential anxiety treatment facility. Adolescents (N = 42) completed either an active (attention modification program, AMP; n = 21) or a control (attention control condition, ACC; n = 21) condition, in addition to the facility's standard treatment protocol, which included cognitive behavioral therapy with or without medication. Results While anxiety symptoms decreased for participants across both groups, participants in the AMP group experienced a significantly greater decrease in anxiety symptoms from point of intake to point of discharge, in comparison to participants in the ACC group. Conclusions These results suggest that AMP is an effective adjunctive treatment to the standard treatments of choice for anxiety disorders, and may hold promise for improving treatment response in highly anxious youths.

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Looking to the future of research in pediatric anxiety disorders

Cited by 15 publications

References 104 publications

Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth

Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth

Autonomic arousal in anxious and typically developing youth during a stressor involving error feedback

Augmentation of Youth Cognitive Behavioral and Pharmacological Interventions With Attention Modification: A Preliminary Investigation

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