Long-Term Outcomes of Youth Treated for an Anxiety Disorder: A Critical Review

Pediatric anxiety disorders are common, disabling, and chronic conditions. Efforts over the past two decades have focused on developing and testing effective treatments. Short-term efficacy of both Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors has been established. Data are emerging on the long-term (i.e., 2 years or longer) effectiveness of these treatments, but this literature has yet to be adequately synthesized. This study presents a systematic and critical qualitative review of published long-term follow-up (LTFU) studies of youth treated for an anxiety disorder. A comprehensive search of several databases identified 21 published reports (representing 15 LTFU cohorts of treated youth) meeting specified inclusion criteria. LTFU assessments occurred a mean of 5.85 years after initial treatment (range 2–19 years). Diagnostic rates at LTFU and predictors (e.g., demographic, baseline child clinical variables, treatment type) of outcomes at LTFU were also examined. A discussion of the limitations of this literature is provided to qualify interpretations of findings and to inform future studies. Findings can aid clinicians and families in making treatment decisions and setting reasonable expectations for the long-term prognosis after treatment for anxiety.     

Maternal Control Behavior and Locus of Control: Examining Mechanisms in the Relation Between Maternal Anxiety Disorders and Anxiety Symptomatology in Children

This study tested components of a proposed model of child anxiety and examined the mediational roles of (1) maternal control behavior, (2) maternal external locus of control, and (3) child external locus of control in the association between maternal and child anxiety. Thirty-eight clinically anxious mothers and 37 nonanxious mothers participated along with one of their children aged 6 to 14 (52.0% female; 78.7% Caucasian). Path analysis indicated that the overall model fit the data very well. Analyses also indicated that child external locus of control mediated the associations between (1) maternal and child anxiety and (2) maternal control behavior and child anxiety. Maternal anxiety was not related to maternal control behavior and maternal external locus of control was not associated with child anxiety. Findings are discussed in the context of theoretical models (e.g., Chorpita and Barlow 1998) regarding the transmission of maternal anxiety to their children and the specific roles of maternal behavior and child locus of control.     

Thirty years on – a large anti‐Flynn effect/ (II): 13‐ and 14‐year‐olds. Piagetian tests of formal operations norms 1976–2006/7

Background Shayer, Ginsburg, and Coe (2007) showed that children leaving primary school in Y6 entered secondary school with much lower levels of understanding of the physical conservations than in 1976. It seemed desirable to investigate cognitive development in the first three years of secondary education. Aims By using two Piagetian tests of formal operations, one of which had been used in the 1976 CSMS survey, the performance of Y8 and Y9 pupils would be compared with the survey results published in 1978. Sample Eight schools were selected as willing to test their Y9 or Y8 classes on either the Pendulum (in 2007) or the Equilibrium in the Balance tests (in 2006), giving 39 classes on which to make the comparison with 1976 performance. Method Regression of the pupils' class mean on each formal test on either the class's 2004 MidYIS or nferCAT standardized scores, and computing the regression at IQ = 100 allows comparison with that found in 1976. Results On Equilibrium in the Balance the Y8 pupils were down on the proportion at the early formal level or above by ?0.61 standard deviations (SD) for boys and ?0.63 SD for girls on the 1976 results. On the Pendulum the Y9 boys were down by ?0.49 SD and the girls by ?0.48 SD on the proportion at the early formal level or above. Conclusion The negative Flynn‐effect found on Volume & Heaviness for Y7 pupils is paralleled by a similar negative effect on attainment of formal operations by Y8 and Y9, compared with 1976. Yet at the same time the proportion of pupils using the top level of concrete operational thinking has increased on both tests. It seems that there has been a change either in general societal pressures on the individual or in the style of teaching in schools – or both – favouring a lower level of processing of reality.     

Headache and sensation seeking

According to the cognitive theory of sensation seeking, headache sufferers were predicted to score lower than controls on Zuckerman's Sensation Seeking Scale. 26 subjects who experienced chronic headaches scored significantly lower than a group of 26 controls. The relationships between the Sensation Seeking Scale and a number of personality tests are described. Replication of the findings on this scale with headache patients is encouraged as well as exploration of other personality dimensions which show significant relations with sensation seeking.     

Differential effectiveness of two classification procedures on the Bem Sex Role Inventory

Two procedures-a simple median split and a difference/median split method-were used to classify 102 male and 129 female college students into masculine, feminine, androgynous, and undifferentiated sex role orientations on the basis of their Bern Sex Role Inventory scores. Differences in classification occurred among nearly one-third of the subjects, and as expected, the difference/median split procedure was more successful in predicting sex-role ideology. Using this procedure, masculine-typed females were found to be most profeminist in their attitudes, while low masculinity females were most conservative. No significant differences were obtained for the male groups using either procedure. Future research with the BSRI and related sex-role measures should employ similar comparisons to determine the relative validity of the two procedures.     

Perceived numerosity as a function of item size

In a sample of 48 subjects, there was a significant inverse relation between item size and estimation of numerosity. This result was shown to be consistent with Gestalt theory. According to this approach, the components of good figures appear more numerous, and smaller items produce better figures.     

Measurement of visual cluster

The cluster continuum is described, along with how to measure degree of cluster and how to generate stimuli that vary along the continuum. Five experiments were performed on cluster discrimination and rating, numerosity estimation, pattern discriminability, and random generation. Difference thresholds were obtained for discrimination between random and clustered patterns, and ratings exhibited a power function with respect to cluster values of the stimuli. Numerosity estimates decreased with increasing degree of cluster, and random patterns were easier to discriminate than clustered ones. When subjects were asked to arrange items so that they appeared random, they erred on the side of regularity. The cluster continuum was discussed in relation to the distribution of living organisms and to the ecological approach of Gibson. The cluster metric was compared with the measures used in the study of response organization in free recall.     

Scaffolding emotions and evolving language

We suggest that, in animals, the core-affect system is linked to partially assimilated behavioral dispositions that act as developmental scaffolds for the ontogenetic construction of emotions. We also propose that in humans the evolution of language altered the control of emotions, leading to categories that can be adequately captured only by emotion-words.