A Parent–Child Interactional Model of Social Anxiety Disorder in Youth

In this paper, one of the most common disorders of childhood and adolescence, social anxiety disorder (SAD), is examined to illustrate the complex and delicate interplay between parent and child factors that can result in normal development gone awry. Our parent–child model of SAD posits a host of variables that converge to occasion the onset and maintenance of this disorder. Specifically, five risk factors—temperamental characteristics of the child, parental anxiety, attachment processes in the parent–child dyad, information processing biases, and parenting practices—will be highlighted. While it is acknowledged that other factors including genetic influences and peer relationships may also be important, they are simply not the focus of this paper. Within these constraints, the implications of our parent–child interaction model for prevention, treatment, research, and practice will be explored.     

Diagnosing Oppositional Defiant Disorder Using the Anxiety Disorders Interview Schedule for DSM-IV: Parent Version and the Diagnostic Interview Schedule for Children

The purpose of this study was to determine whether the Anxiety Disorders Interview Schedule for DSM–IV: Parent Version (ADIS–P) is a valid diagnostic tool for the assessment of Oppositional Defiant Disorder (ODD) in youth. Although there is considerable evidence that the ADIS–P is effective in diagnosing anxiety disorders in youth, no studies have yet examined its validity in assessing ODD. In contrast, a number of studies support the Diagnostic Interview Schedule for Children–Version IV (DISC–IV) as a reliable and valid tool in the assessment of ODD. In the present study, the ADIS–P and DISC–IV ODD modules were administered in a counterbalanced order to the parents of a clinical sample of 106 children between 7 and 14?years of age referred for the treatment of ODD. It was hypothesized that the ODD module of the ADIS–P would be valid as determined by its concurrent and convergent validity with the DISC–IV, the Behavior Assessment System for Children (BASC) Aggression and Conduct Problems scales, and the Disruptive Behavior Disorders rating scale (DBD). Results demonstrated that ADIS–P ODD diagnoses had moderate agreement with DISC–IV ODD diagnoses (κ?=?.46, p?<?.001) and that Pearson correlations of ADIS symptom counts with questionnaire scales were similar in magnitude with correlations of DISC–IV symptom counts with the same questionnaires. Overall, findings suggest that clinicians and researchers can use the ADIS–P as an empirically-supported diagnostic interview for assessing children’s oppositional problems.     

Intellectual Ability and Achievement in Anxiety-Disordered Children: A Clarification and Extension of the Literature

Intellectual and achievement deficits associated with childhood anxiety disorders are of considerable controversy. Part of this controversy and inconsistency in findings appears related to methodological differences in studies: anxiety disorders are defined as occurring anywhere in the diagnostic profile (e.g., primary, secondary, or tertiary) in some studies whereas in other studies anxiety disorders are defined only when primary (excluding secondary or tertiary disorders). Results in the present study broadly parallel findings from the previous studies when the procedures inherent to each study are replicated. Through careful diagnostic assignment, it is shown that anxiety disorders are no more impairing than other psychiatric disorders in the present study. However, when compared to referred children without significant psychopathology, children with anxiety disorders show statistically and clinically significant impairment. Subsequent analyses do not suggest inattention mediates this effect. Discussion emphasizes the need to assess for and consider comorbidity in understanding these differences. A portion of these findings were presented at the 40th annual meetings of the Association for Cognitive and Behavioral Therapies (2006).     

Attention Problems as a Mediator of the Relation between Executive Function and Social Problems in a Child and Adolescent Outpatient Sample

Social functioning is critical for the successful navigation of everyday life for children, adolescents, and adults. Recent theories have postulated a neuropsychological basis for social functioning with particularly strong links with the executive functioning (EF) system. The current study examined attention problems as a mediator between EF (e.g., working memory, planning, and response inhibition) and social functioning in a child and adolescent outpatient sample. Participants were 218 children ages 6–16 (M = 10.23; SD = 2.52; 68.8 % males) who were referred to an outpatient clinic for psychoeducational assessment. Bias-corrected bootstrapping mediation analyses were used to examine the hypothesized models. The effects of working memory and planning (but not response inhibition) on social problems were mediated by attention problems in both teacher- and mother-reported models. These findings also held up in cross-source models (e.g., mother-reported attention problems as a mediator in a model predicting teacher-reported social problems). These findings have implications for dimensional models of social functioning and conceptual models for specific clinical populations (e.g., attention-deficit/hyperactivity disorder).     

The etiology of specific fears and phobias in children: a critique of the non-associative account

The non-associative account of phobic etiology assumes that a number of specific fears (e.g., fear of heights, water, spiders, strangers, and separation) have an evolutionary background and may occur in the absence of learning experiences (e.g., conditioning). By this view, these specific fears pertain to stimuli that once posed a challenge to the survival of our prehistoric ancestors. Accordingly, they would emerge spontaneously during the course of normal development and only in a minority of individuals, these specific fears would persist into adulthood. While the non-associative approach has generated interesting findings, several critical points can be raised. First, it capitalizes on negative findings, i.e., the failure to document learning experiences (e.g., conditioning, modeling) in the history of phobic children. Second, it largely ignores factors that have been found to be crucial for the acquisition of early childhood fears (e.g., the developmental level of the child, stimulus characteristics such as novelty, aversiveness, and unpredictability, and early experience with uncontrollable events). As an alternative to the non-associative account, we briefly describe a multifactorial model of childhood fears and phobias.     

The Social Anxiety Questionnaire for Children: Cross-Cultural Assessment with a New Self-Report Measure

This study describes a series of exploratory and confirmatory factor analyses that were conducted with the 44-item Social Anxiety Questionnaire for Children- 4th version (SAQ-CIV) to identify a reduced set of items that might be used to construct a new abbreviated instrument for measuring social anxiety in children and adolescents. The fourth version of the Social Anxiety Questionnaire for Children (SAQ-CIV) was administered to 12,801 non-clinical participants (ages 9 to 15 years) from 12 Latin American countries and Spain. Exploratory and confirmatory factor analysis supported a 6-factor structure of social anxiety in children, replicating a similar structure to that of adults (Caballo et al. in Behavioral Psychology/Psicología Conductual, 18(1), 5–34, 2010; Caballo et al. in Behavior Therapy, 43(2), 313–328, 2012): 1) Interactions with the opposite sex, 2) Criticism and embarrassment, 3) Speaking in public/Talking to teachers, 4) Assertive expression of annoyance and disgust, 5) Performing in public, and 6) Interactions with strangers. Each of the factors contains 4 items, yielding an abbreviated 24-item instrument, the Social Anxiety Questionnaire for Children (SAQ-C). The present results suggest this is a reliable, valid, and culturally sensitive instrument to assess social anxiety in youth.     

Reactive and Proactive Aggression: Cross-informant Agreement and the Clinical Utility of Different Informants

The current study examined cross-informant agreement and clinical utility of parent and teacher ratings of reactive and proactive aggression (two functions of aggression) in the prediction of aggressive and rule-breaking behavior (two forms of aggressive behavior) in a clinically-heterogeneous referred sample. Reactive and proactive measures were significantly related to one another within informant. Furthermore, the reactive and proactive measures of aggression were significantly related across informants and resulted in differential predictions of emotion-focused aggressive and goal-directed rule-breaking behaviors in home and school settings. Both reactive and proactive functions of aggression predicted aggressive acts that were more emotion-focused, whereas only the proactive function of aggression predicted instrumental acts of aggression. The current findings suggest that setting-specific reports of functions and forms of aggressive behavior are valuable and that it may be premature to abandon the reactive and proactive aggression distinction.

Intensive Treatment of Specific Phobias in Children and Adolescents

One-session treatment (OST), a variant of cognitive-behavioral therapy, combines graduated in vivo exposure, participant modeling, reinforcement, psychoeducation, cognitive challenges, and skills training in an intensive treatment model. Treatment is maximized to one 3-hour session. In this paper, we review the application of OST for specific phobia in youth and highlight practical matters related to OST and its use in a clinical setting. We also briefly review results of treatment outcome studies and suggest future directions for clinical research and practice. We conclude that OST is an efficient and efficacious treatment.