Childhood anxiety and depression

Question 1

Most common disorder for children

Answer 1

ADHD, then anxiety

Question 2

most important element of CBT for children

Answer 2

exposure therapy and rapport building

Question 3

fear v anxiety

Answer 3

fear is accurate perception of danger and context appropriate safety seeking behaviours
anxiety is fear response in absence of real threat

Question 4

normal developmental fears in infancy

Answer 4

strangers, loud noises

Question 5

normal developmental fears in early childhood

Answer 5

separation, monsters, darkness

Question 6

normal fears in middle childhood

Answer 6

real-world dangers, injury, new challenges

Question 7

normal fears in adolescence

Answer 7

social status, performance, health

Question 8

when normal fears become ADs

Answer 8

Significant distress
Duration
Interference

Question 9

biggest MI predictor in kids

Answer 9

specific phobia

Question 10

immediate consequences of anxiety in kids

Answer 10

Co-occurring anxiety & mood disorders
Less liked by other children
Poorer social competence or confidence with social engagement with other children
Limited mastery via reduced exposure to various activities
Somatic complaints: headache; gastro/abdominal pain

Question 11

factors contributing to anxious /depressed child

Answer 11

biological: heritability and temperament (anxious parents 7x more likely to have anxious child) (temperament and behavioural inhibition indicators at 21 mo)
contextual: social/family (life events, parental interaction)
learning: pathways to fear; conditioning, modelling, information pathway to learning
psychological: cognitive style, esteem, coping

Question 12

best parenting style

Answer 12

authoritative
high warmth and control

Question 13

parenting factors

Answer 13

parental anxiety: modelling, information giving
parenting style: overprotection, overinvolvement, warmth, rejection
parental expectations
parental thinking style

Question 14

attention bias

Answer 14

hypervigilance for threat stimuli
rapid attention directed either towards or away from threat
in anxiety, attentional vigilance for threat facilitates avoidance of threat

Question 15

interpretation bias

Answer 15

overestimate danger, underestimate coping ability

Question 16

treatment of ADs

Answer 16

Assessment and Evaluation Tools
Cognitive-Behavioural Therapy
Psychoeducation and externalising symptoms / disorder
Monitoring symptomatology and ranking fear’s – developing a Step Plan
Relaxation & Breathing Training
Systematic Desensitisation
Exposure Therapy and Response Prevention
Social skills / problem solving skills
Involvement of parents and family
Pharmacological Treatments
Balanced Life – relapse prevention

Question 17

indicator of no treatment response

Answer 17

no improvements at 6 session mark

Question 18

treatment of depression

Answer 18

Psychotherapies
CBT
IPT
Psychopharmacology
SSRI
Continuation and maintenance

Question 19

CBT for depression

Answer 19

psychoeducation
behavioural activation
social/interpersonal functioning
cognitive therapy
problem solving skills
family relationships

Question 20

variables predicting stable remission

Answer 20

male, younger age, no social phobia, better global and family functioning, fewer negative life events

Question 21

from CAMS to CAMELS: moderators, predictors, mediators

Answer 21

no moderators of response
predictors of remission: absence of socphob, absence of comorbid internalising disorder, lower severity, younger age
mediators of change : anxious self talk, coping in anxiety provoking situations

Question 22

Structure of CBT Programs for Anxiety

Answer 22

Vary in intensity – Low to High
Individual or group
Homework activities for each session
booster sessions
parent sessions
developmentally sensitive approaches
Flexibility within fidelity

Question 23

FEAR plan

Answer 23

F = feeling frightened (recognize the fear),
E = Expecting bad things to happen (recognize the fearful self-talk),
A = attitudes and actions that will help (developing & using coping skills) and
R = results and rewards (self-evaluation and self-reward).

Question 24

BRAVE program

Answer 24

body signs
relax
activate helpful thoughts
victory over fears
enjoy yourself

Question 25

why it is important to involve parents

Answer 25

Possible parental psychopathology
Possible negative family interactions
Display less time with their children:
Listening to their children’s solutions
Discussion of positive consequences
Reinforcement of proactive plans
Monitoring or mentoring supportive friendships
Forming an “expert” team
Extensive educational support
Parental and child anxiety management
Reduction of family involvement in the symptoms
Family support of E/RP
Problem-solving skills training
Co-therapist, collaborator in treatment

Question 26

benefits of participating for parents

Answer 26

Self awareness
Stress management strategies
Modelling of positive coping behaviours
Enhancement of family teamwork
Awareness of child’s fears; “at risk” times
Awareness of child’s coping / problem solving
Reinforcement for approach behaviours
Helping their children/youth form support networks

Question 27

relaxation for anxiety

Answer 27

awareness and monitoring (feelings thermometer)
diaphragmatic breathing
body scan
pmr
visualisation
exervise
quiet time doing enjoyable activities

Question 28

exposure step plan

Answer 28

develop fear hierarchy
approach difficult situations and fears
setting specific goals
breaking a problem into small achievable steps

Question 29

E/RP

Answer 29

monitor symptoms
develop step plans
start with goal (step 1)
then come to step 1 and develop small steps to practice
be flexible
start with one step plan and add slep plans once the child has had some maste
give options in case the step is too hard
practice in session and plan for between session exposure
plan rewards
work toward the child and parent being able to plan exposure steps themselves
get evidence of success

Question 30

exposure common mistakes

Answer 30

going too fast
not going far enough
not eliciting enough anxiety
distraction during exposure
providing reasssurance
doing imaginal when you could do in vivo
not using behavioural experiments to challenge beliefs- threat and coping

Question 31

exposure- enhancing outcomes

Answer 31

violate expectancies- mismatch between expectancy and outcome (after exposure)
vary hierarchy and context
use retrieval cues
compound exposure, deepened extinction
affect labelling

Question 32

coping strategies beyond exposure

Answer 32

address functionality and teach independence and mastery of routine tasks
learning from others (positive role models)
social support networks
social skills training
communication styles
problem solving plans