How serious are common childhood fears?

OBJECTIVE: The present study examined the clinical status of common childhood fears. METHOD: Fears of the 290 children aged 8 to 13 years were assessed and then their severity was explored by means of a structured diagnostic interview measuring anxiety disorders according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM). RESULTS: Childhood fears reflect significant anxiety disorders in a substantial minority (i.e. 22.8%) of the children. CONCLUSIONS: In most children, childhood fears are part of the normal development. However, in some children, these fears reflect serious anxiety problems which interfere with daily routine.     

The Course of Childhood Anxiety Symptoms: Developmental Trajectories and Child-Related Factors in Normal Children

This three-wave longitudinal study explored developmental trajectories for various types of childhood anxiety symptoms (i.e., specific fears, social anxiety, generalized anxiety, and separation anxiety) and examined how these trajectories were associated with several factors thought to be involved in the pathogenesis of anxiety. Parents of a community sample of 224 children aged 4 to 11 years repeatedly completed a standardized questionnaire of anxiety symptoms during a 2-year period. At Time 1, parents also filled out scales for measuring children’s level of behavioral inhibition (BI), internalizing and externalizing symptoms, and prosocial behaviors, while an interview was conducted with children to assess Theory-of-Mind (TOM) ability. Growth Mixture Modeling identified multiple developmental trajectories in childhood anxiety symptoms of which the ‘stable-low’ or ‘stable-medium’ reflected the normative trajectories. Further, multinomial regression analyses indicated that the higher developmental trajectories of anxiety were associated with higher levels of BI and internalizing symptoms at Time 1. In sum, results show heterogeneity in the development of anxiety symptoms and underline the importance of early prevention programs for children at high risk for developing an anxiety disorder.     

How serious are common childhood fears? II. The parent's point of view

In an earlier study [Muris, P., Merckelbach, H., Mayer, B., & Prins, E. (1999). How serious are common childhood fears? Behaviour Research and Therapy, in press.], the severity of common childhood fears was explored by means of a structured child interview measuring specific phobias as defined by the Diagnostic and Statistical Manual of Mental Disorders. It was found that in a substantial minority of the children, specific fears reflect clinically significant phobias. The present study examined further the connection between childhood fears and specific phobias by interviewing children's parents. The Diagnostic Interview Schedule for Children was administered to the parents of 160 children aged 4-12 years. In line with our previous study, results indicate that a sizable proportion of children (i.e. 17.6%) met the full criteria for specific phobia.     

How Can I Help You? Dimensional versus Categorical Distinctions in the Assessment for Child Analysis and Child Psychotherapy

ABSTRACT

This paper describes the process of a psychoanalytically-informed or a psychodynamic diagnostic assessment with children, contrasting it with a DSM-like diagnostic process. The importance of understanding and sensitively addressing the experience of parents when they bring their child to a professional for help is highlighted. The promotion of a psychoanalytic atmosphere, the unique contribution of a child analyst or psychodynamic clinician to the general mental health field, is an approach which promotes the development of a therapeutic alliance. This allows both parents and children to express their underlying issues as openly as possible. In addition to the basic assumptions of psychoanalysis (the ubiquity of unconscious mental activity and the impact of the past on the present/the developmental perspective), several factors are crucial to bear in mind: the importance of understanding the nature of the child’s (and the parent’s) emotions, emotion regulation, development of mental representations of self and other, and their conflicts and defense mechanisms. Potential therapeutic approaches are highlighted, including stressing the need to empirically study how decisions are made by a mental health provider when moving from assessment to treatment recommendation.     

The Rôle of the Acquired Distinctiveness of Cues in the Acquisition of a Motor Skill in Children

The fears of 133 boys and girls aged 7 to 19, classified as educable mentally retarded (EMR), trainable mentally retarded (TMR), and specific learning disabled (SLD), were ascertained through self-report data and compared with those of 106 normal children aged 6 to 12. Similar developmental trends were found in all groups, with younger children reporting more unrealistic fears than older children. When mental age was calculated for the EMR and TMR children, their developmental trends closely approximated those of the normal children. In general, exceptional children were found to have a much wider range and a greater number of fears than normal children. Most fears were found to be realistic, learned, and dependent upon the child's intellectual and maturational level.     

Behavioral Sleep Problems in Children and Adolescents

Sleep problems in children and adolescents are common, and they impact multiple domains of child and family functioning. Psychologists have a critical role in the assessment and treatment of sleep problems and are integral to interdisciplinary sleep teams. Certain sleep problems may be related to co-morbid psychological or developmental conditions, and others are considered to be primarily medical, yet behavioral approaches may be applicable. There are also sleep problems considered to be behavioral in etiology (e.g. inadequate sleep hygiene, behavioral insomnia of childhood, nightmares/bad dreams/nighttime fears, delayed sleep phase syndrome, and psychophysiological insomnia). In this article, the assessment of behavioral sleep problems, as well as specific behavioral sleep disorders, and their treatments will be discussed.     

Nighttime fears of children and adolescents: frequency, content, severity, harm expectations, disclosure, and coping behaviours

The present school-based study investigated the nighttime fears of 511 children and adolescents, aged 8-16 years. Participants were assessed using a structured interview about the frequency, content, severity, harm expectations, coping strategies, and disclosure of nighttime fears. Results indicated that nighttime fears are a common experience, with nearly two-thirds (64.2%) of children and adolescents reporting nighttime fears. Fear of intruders/home invasion was the most frequently reported nighttime fear. Females more frequently reported nighttime fears than males (72.9% and 54.6%, respectively) and a greater number of children reported nighttime fears compared to adolescents (79.4% and 48.8%, respectively). Nighttime fears were given moderate severity ratings, and harm expectations were most strongly associated with 'personal security' fears. Respondents reported a variety of coping strategies to manage their nighttime fears with self-control/distraction techniques being the most common. Most respondents reported disclosing their nighttime fear(s) to another person. The clinical implications of these findings and the methodological limitations are discussed.     

Comparing Attention to Socially-Relevant Stimuli in Autism Spectrum Disorder and Developmental Coordination Disorder

Difficulties with social interaction have been reported in both children with an autism spectrum disorder (ASD) and children with developmental coordination disorder (DCD), although these disorders have very different diagnostic characteristics. To date, assessment of social skills in a DCD population has been limited to paper-based assessment or parent report. The present study employed eye tracking methodology to examine how children attend to socially-relevant stimuli, comparing 28 children with DCD, 28 children with ASD and 26 typically-developing (TD) age-matched controls (aged 7–10). Eye movements were recorded while children viewed 30 images, half of which were classed as ‘Individual’ (one person in the scene, direct gaze) and the other half were ‘Social’ (more naturalistic scenes showing an interaction). Children with ASD spent significantly less time looking at the face/eye regions in the images than TD children, but children with DCD performed between the ASD and TD groups in this respect. Children with DCD demonstrated a reduced tendency to follow gaze, in comparison to the ASD group. Our findings confirm that social atypicalities are present in both ASD and to a lesser extent DCD, but follow a different pattern. Future research would benefit from considering the developmental nature of the observed findings and their implications for support.     

Development and Implementation of a Function-Based Clinical Interview to Evaluate Childhood Behavior Problems

The most common reason that children are referred to mental health providers relates to behavior and emotional problems. Without intervention, children with maladaptive behaviors are at risk for poor school performance, interpersonal difficulties, and significant conduct problems later in life. Previous research on the assessment of these problems has focused primarily on caregiver self-report questionnaires, observational coding, and/or diagnostic classification. The behavior literature has far fewer examples of best-practice interview strategies to solicit meaningful clinical information from primary stakeholders. Since caregiver report is essential during initial interviews to better understand his or her child’s presenting issues and given the primary role of assessment is to integrate information into the design of an evidence-based intervention (Barlow et al., 2005), additional published guidance on the content of these clinical interactions is warranted. The following paper outlines an approach to gathering pertinent information from caregivers about their children’s behavior in a way that is germane to treatment planning. In addition, the authors include validity and reliability data to substantiate the interview’s continued use in the clinical setting.     

Fears, worries, and scary dreams in 4- to 12-year-old children: their content, developmental pattern, and origins

Investigated anxiety symptoms in normal school children 4 to 12 years of age (N = 190). The percentages of children reporting fears, worries, and scary dreams were 75.8, 67.4, and 80.5%, respectively, indicating that these anxiety symptoms are quite common among children. Inspection of the developmental pattern of these phenomena revealed that fears and scary dreams were common among 4- to 6-year-olds, became even more prominent in 7- to 9-year-olds, and then decreased in frequency in 10- to 12-year-olds. The developmental course of worry deviated from this pattern. This phenomenon was clearly more prevalent in older children (i.e., 7- to 12-year-olds) than in younger children. Furthermore, although the frequency of certain types of fears, worries, and dreams were found to change across age groups (e.g., the prevalence of fears and scary dreams pertaining to imaginary creatures decreased with age, whereas worry about test performance increased with age), the top intense fears, worries, and scary dreams remained relatively unchanged across age levels. An examination of the origins of these common anxiety phenomena showed that for fears and scary dreams, information was the most commonly reported pathway, whereas for worry, conditioning experiences were more prominent.     

Ambulante Psychotherapie bei Kindern und Jugendlichen

This paper presents the results of a study of the state of outpatient psychotherapy of children and juveniles in Germany after the PTG came into force. A total of 180 psychotherapists were questioned on certain issues. One result was that patients have to wait 4.5 months for psychotherapy and that every second patient asking for a diagnostic interview and possible treatment was refused.Of those who were given a diagnostic interview 43% were not taken into treatment, although disturbances were diagnosed such as addiction, bodily disabilities with psychic complications, enuresis/encopresis, anorexia nervosa, psychosomatic illnesses, developmental arrests which would normally demand psychotherapeutic treatment. Furthermore only 25% of those children and juveniles who Löcherbach et al. (2000, S.59 f.) considered needing and wanting psychotherapeutic treatment were actually in a G IV psychotherapy.Apart from this the possibility of getting psychotherapy as well as the kind of psychotherapy proved to be dependent on the kind of medical insurance. Differing payments by the insurance companies caused longer waiting times for patients and determined the choice of psychotherapy by the psychotherapists.     

Children's nighttime fears: parent-child ratings of frequency, content, origins, coping behaviors and severity

The present study investigated nighttime fears in normal school children aged 4 to 12 yr (N=176). Children and their parents were interviewed about the frequency, content, origins, coping behaviors and severity of children's nighttime fears. Results showed that 73.3% of the children reported nighttime fears, indicating that these fears are quite prevalent. Inspection of the developmental course of nighttime fears revealed that these fears are common among 4- to 6-year-olds, become even more frequent in 7- to 9-year-olds and then remain relatively stable in 10- to 12-year-olds. Inspection of the origins of nighttime fears revealed that most of the children (i.e., almost 80%) attributed their fear to negative information; conditioning and modeling were endorsed less frequently (25.6% and 13.2%, respectively). A substantial percentage of the children (24.0%) indicated that learning experiences had not played a role in the acquisition of their nighttime fears. Children reported a variety of coping strategies in order to deal with their nighttime fears and generally rated these strategies as helpful in reducing anxiety. Furthermore, children's nighttime fears were associated with moderate levels of anxiety. Moreover, in about 10% of the children, nighttime fears were related to one or more DSM-III-R anxiety disorders. Finally, parental reports of children's nighttime fears substantially deviated from children's reports. Most importantly, parents provided a marked underestimation of the frequency of nighttime fears, at least as reported by their children.     

Developmental considerations in the study of childhood depression

Although a great deal of research has been conducted examining biological and psychological factors related to adult depression, relatively little attention has been given to the study of depression in children. The purpose of the present article is to illustrate the importance of considering normal developmental processes in the study of childhood depression. Epidemiological data, diagnostic issues, and methods of assessment in childhood depression are discussed from a developmental perspective, and the role of developmental issues in both the manifestation of depression and its assessment is outlined. Four major theories of depression—biological, psychoanalytic, behavioral, and cognitive—are presented, and developmental issues are discussed in relation to each theory's formulation of the etiology, maintenance, and treatment of depression. Finally, alternative methodologies for the study of childhood depression are considered, and directions for future research, particularly for investigations examining the relationship between childhood and adult depression, are advanced.     

A methodology for assessing the functions of emerging speech in children with developmental disabilities

An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental disabilities. The purpose of this study was to develop and evaluate an assessment for identifying the elementary functions of vocal speech in children. Participants were 4 children with developmental disabilities, aged 6 years to 12 years, who exhibited at least one distinguishable vocal response (word or phrase) frequently in the natural environment. The assessment focused on three verbal operants delineated by Skinner (mand, tact, and intraverbal). One or more functions were identified for at least one vocal response of each child. Results suggested that this assessment would be useful for (a) evaluating Skinner's theory, (b) guiding decisions about language training for individual children, and (c) studying the nature of expressive language development in children with developmental disabilities.     

Developmental psychology and mental retardation. Integrating scientific principles with treatment practices

The current debates about "best practices" within mental retardation reflect key unresolved issues about the nature of mental retardation and the goals of treatment programs. The central axiom proposed is that better integration of basic principles about human development with treatment practices for children will yield substantial benefits to individuals and society. To illustrate the format for this proposed integration, three principles have been abstracted from scientific inquiry in human development: (a) targeted environmental prevention, (b) metacognitive conveyance, and (c) ecological dominion. A contextual analysis, using special education as an example of a major treatment setting, indicates that application of these developmental principles is likely to reduce the prevalence of mild retardation (as currently defined), to minimize social and behavioral problems, and to foster improved levels of environmental mastery (adaptive success) for many children with low IQs and cognitive deficiencies. Consistent with these developmental principles, the current construct of mental retardation is judged inadequate, and an alternative diagnostic strategy is proposed. This strategy is based on repeated developmental profiling of a child and his or her biosocial environmental history.     

What we fear most: A developmental advantage for threat-relevant stimuli

Fear is one of our most basic emotions. It is an important social signal and alerts us to when a situation is safe or risky. Interestingly, not all fears are created equal: Several researchers have proposed that humans develop specific fears, such as fear of threatening stimuli, more readily than others. Here we discuss three major theories of fear acquisition, and consider the possibility that some fears are privileged in learning. Second, we review a growing literature that suggests that humans have perceptual biases that quickly draw attention to threatening stimuli in the environment. In particular, we highlight recent developmental work that shows that even infants and young children respond rapidly to the presence of threat well before they acquire any threat-relevant fears. Finally, we argue that such biases may play a causal role in privileging fear learning for certain threats, and we suggest directions for future work that can clarify whether early biases in perception indeed facilitate the development of our most common fears.     

Fear of storms and hurricanes in Antillean and Belgian children

The present study assessed fear of hurricanes in children who had been confronted with this natural event (i.e., Antillean children, n=161). Their fear levels were compared to those of children who are unfamiliar with such an event (i.e., Belgian children, n=185). Antillean children reported significantly higher levels of fear of storms than Belgian children did, thus providing support for the notion that exposure to dangerous events promotes children's fears of those events. Surprisingly, however, Antillean children had lower scores on the 'Hurricanes' item than Belgian children. Plausibly, differences in how children interpreted this item may have accounted for this unexpected finding. That is, ratings of Antillean children were probably based on actual experiences with hurricanes, whereas scores of Belgian children presumably reflected appraisal of threat in case they would be confronted with such an event. Implications of this finding for the assessment of childhood fears are briefly discussed.     

Cognitive-behavioural Analysis and 1 reatment ot Insomnia

Abstract

Insomnia is a condition characterized by subjective complaints of insufficient sleep and poor daytime functioning. Objective measures of sleep and daytime functioning, however, seldom show evidence of a similar degree of dysfunction. Most insomniacs, for example, do not suffer from sleep deprivation or daytime sleepiness. This discrepancy between subjective and objective measures of sleep and daytime functioning suggests that cognitive factors may play a central role in persistent insomnia. In particular, it is argued that fears about insufficient sleep and its adverse daytime consequences tend to interfere with sleep, thereby causing a vicious cycle which serves to maintain the insomnia. It is also argued that perfectionist standards and other dysfunctional beliefs may predispose people to these kinds of fears. Finally, existing models for cognitive-behavioural treatment of insomnia are criticized for being almost exclusively focused on the night-time aspects of insomnia. If insomnia is maintained by various kinds of vicious cycles involving fears, beliefs, and standards with regard to daytime functioning, these daytime aspects of insomnia should receive more attention in cognitive-behavioural treatment.     

The effects of social support on children's eyewitness testimony

Child witnesses often give only short accounts of witnessed events. Part of the reason for this failing centres on the stress present during an interview. The most obvious means of reducing stress in children, through the provision of social support, has typically been neglected in eyewitness research, presumably because of fears over children's excessive suggestibility. Social support is also believed to inhibit children during interviews. However, these fears appear to stem more from general suspicions about children's competencies rather than empirical findings. Studies are described which show that child witnesses express a strong desire for social support, and that support may be provided in a number of different ways, from peers as well as adults. It is argued that social support is one of the most unfairly neglected issues in eyewitness research, and the minimal evidence available suggests that allowing support may have a facilitative effect on task performance, including free-recall memory.