limbiks_CACP Revision Notes.docx Flashcards
What did Kessler et al. find about anxiety disorders?
Anxiety disorders are the most commonly experienced mental health disorder across the lifespan.
What percentage of people experience a level of anxiety that could be considered an anxiety disorder at some point in their lifetime?
28.80%
At what age does the median onset of anxiety occur?
11 years old
What did Solmi et al. (2021) find about the median age of onset for anxiety disorders?
The median age of onset for anxiety disorders was around 17 years old.
Which specific anxiety disorders typically onset in childhood?
Separation anxiety and paranoias typically onset in childhood.
Which anxiety disorders typically onset in adulthood?
Panic disorder and GAD typically onset in adulthood.
What is the median age of onset for panic disorder?
26 years old.
What is the median age of onset for GAD?
33 years old.
What were the peaks in the age of onset of AD?
5.5yo and mid-teen years
What did Copeland et al. study?
Impacts of anxiety disorders at 16yo
What were the outcomes for individuals with AD compared to controls?
Worse outcomes in at least one domain
Which AD was associated with poor functioning in all domains?
GAD
What did Sandler et al. (2011) find about parenting?
family-based interventions that target specific parenting behaviours can successful improve some parts of parenting, and also improve a range of long-term child otucomes, including internalising symptoms
What did Hudson et al. (2009) study?
Causal relationships between parental behaviors and child anxiety
What did Hudson et al. (2009) find about mother’s behaviors?
Mothers were more involved when interacting with an anxious child& mothers of children with anxiety showed a smaller decrease in involvement behaviours when interacting with non-anxious children compared to anxious children.
What interactions were observed between mothers and children with anxiety?
Mothers showed a smaller decrease in involvement behaviors when interacting with non-anxious children compared to anxious children.
How did mothers of anxious children behave when interacting with non-clinical children?
They were less negative compared to non-clinical mothers interacting with both anxious and non-anxious children.
What was the effect of child anxious behaviors on mother over-involvement?
Child anxious behaviors influenced mother over-involvement.
Was there a significant direct effect of maternal factors on over-involvement?
No, there was no significant direct maternal effect, but over-involvement was influenced by child behaviors.
What is the limitation of using AI to study parental response to anxious behavior?
Lack of ecological validity
What aspect of parental response was not tested with the researchers’ own children?
Negativity in response to anxiety
What might explain why mothers may be more critical of their own anxious child?
Feel responsibility for their child’s development and growth
What bias could potentially affect the results of the study?
Social desirability bias
What were the scores on the negativity scale generally like?
Very low
What were the recovery rates for the full-guided CBT and brief CBT groups?
34% for full-guided CBT, 39% for brief CBT
What were the recovery rates for the waitlist condition?
11%
What percentage of participants in the full-guided and brief CBT groups no longer met diagnostic criteria for primary anxiety disorder at the 6-month follow-up?
76% for full-guided CBT, 71% for brief CBT
Did therapist experience significantly impact outcomes?
No
What did Platt et al. (2016) examine?
Relationship between stressful life events and anxiety symptoms in children
What were the mediators studied by Platt et al.?
Parenting stress, parental anxious rearing, dysfunctional parent-child interactions
Were children with parents who had an AD included in the study?
No, they were excluded
Is the level of parent anxiety symptoms a significant mediator of the relationship between stressful life events and child anxiety?
No
What is the significant mediator of the relationship between stressful life events and child anxiety?
Parenting stress
What is suggested by the occurrence of stressful life events increasing a parent’s sense of incompetence and conflict?
It influences how they behave towards children
What can be transmitted from parent to child independent of parent psychopathology?
Stress responses
What is an example of mediation in the relationship between child anxiety and stressful life events?
Child-reported anxious rearing style and parent-reported dysfunctional interactions
How do stressful life events contribute to a parent’s dissatisfaction with the relationship?
Increases parent’s dissatisfaction
Was child’s perceived control found to mediate the relationship between parental behaviors and child anxiety?
No
Was child’s perceived control directly related to both stressful life events and child anxiety?
No
What did the study use to assess stressful life events?
Parent report
What did the study suggest about the relationship between parenting behaviors and child’s response to stressful life events?
If parents aren’t warm and encouraging, the relationship may be different
What did Verhoeven et al. (2012) find in their study on perceptions of parenting behaviors and adolescent AD?
Significant association between father’s over-controlling behavior and adolescent AD
According to Verhoeven et al. (2012), which parent could be more important in adolescence?
Father
What did Verhoeven et al. (2012) find regarding perceptions of autonomy granting?
No significant association with adolescent anxiety
According to Verhoeven et al. (2012), which parenting behavior was associated with adolescent anxiety in fathers only?
Rejecting behavior
Did Verhoeven et al. (2012) find consistent associations between parenting behaviors and different diagnoses?
No, contribution of parenting behaviors differ
(2011) - What were the findings regarding perceived parental control and adolescent GAD?
Higher levels of perceived parental control were associated with a greater increase in adolescent GAD.
What did Schwartz et al. find in their longitudinal studies?
Longitudinal studies disagree with the previous findings.
What did McClure et al. find in their study?
Parental response not associated with adolescent anxiety
What did McClure et al. find regarding maternal anxiety and adolescent perceptions of control?
Maternal anxiety did not predict adolescent perceptions of control
What did Larson et al. find regarding the relationship between maternal anxiety and child anxiety?
Perceived parental control not a mediator of the relationship
What did Larson et al. find regarding the contribution of perceived parental control to adolescent anxiety development?
Perceived parental control does seem to contribute to anxiety development in adolescence
What did the researchers find about emotional states in early adolescence?
Downward shift, more positive than negative emotions
What did the researchers find about reactivity to stressor and positive events?
Heightened reactivity in adolescence
What did the researchers find about anxiety in adolescence?
Linked to cognitive-affective developments
What modifications should be made to treatment to induce engagement earlier on?
Make it more efficient
Why is adolescence considered a period of heightened vulnerability?
Disjunctions between developing brain and behavioural/cognitive systems
What is the relationship between anxiety and cognitive/affective development in adolescence?
Anxiety affects cognitive and affective development
How does adolescent thinking about moral dilemmas change during adolescence?
Becomes more principled
What is the difference between adolescent reasoning about hypothetical dilemmas and real-world problems?
Reasoning about real-world problems is not as good
What is the definition of adolescence?
Begins with puberty and ends when one has assumed adult roles.
What are some common emotional triggers during adolescence?
More time with peers, less with parents, physical changes conflicting with demands of modern society.
What is the motivation for adolescents to seek out and maintain negative emotions?
Desire to achieve emotional states.
What are the physiological changes in response to social evaluation and social rejection?
Increased reactivity in the amygdala
According to Silvers et al. (2012), how effective is re-appraisal in adolescents compared to children and adults?
Less effective
According to Hare et al. (2008), how do adolescents respond to fearful facial expressions compared to children and adults?
Initially exaggerated amygdala response
What did Zimmermann & Iwanski (2014) examine?
Age differences in 7 emotion regulation strategies
What was the association between the exaggerated response and anxiety measures?
Diminished over time
What was the relationship between amygdala and PFC activity?
Inverse
What is a term for short-term treatments?
eating disorders
What does eating disorders view as?
short-term
What is a term for schizophrenia?
bipolar
In what other company are early onset mental health disorders predictive of a range of psychological and social impairments in the long-term?
Lawrence et al
What does meta-analysis of existing studies show?
heterogeneity
What is the average age of a study?
mean age below 19yo
Who conducted a systematic review of the existing data for pre-adolescents aged 5-11yo?
Yap & Jorm
How old are pre-adolescents?
5-11yo
What type of evidence can be classified as?
sound
What was the correlation between modelling of anxiety and child anxiety?
0.3
What was the correlation between modelling of anxiety and child anxiety based on?
cross-sectional studies
What were the correlations between autonomy granting and parental overinvolvement and child anxiety?
0.291 and 0.254
What were the correlations between autonomy granting and parental overinvolvement based on?
cross-sectional data
What can help improve some parts of the world?
family-based interventions that target specific parenting behaviours
What is the reason why parents of children with anxiety are more likely to become overinvolved in their child’s life to try and reduce their
a maladaptive pattern
What is the average age of infants behaviour?
12-14mo
When was the mother rated as more fearful and avoidance of the stranger?
socially anxious
High fear infants were more avoidance in what condition?
socially anxious
What were parents trained to do to provide autonomy?
giving open suggestions and not being directive
What did not affect observed child anxiety during the task?
parental manipulation
When children had high trait anxiety, they were rated as more anxious in controlling conditions than what?
autonomy promoting conditions
What issues did parents try to control for parent self-report on normal autonomy granting?
parental self-report issues
What kind of comments are made when a mother and a child are both anxious?
catastrophising
What group found that there were no significant differences in autonomy promotion or warmth based on parent and child anxiety status?
Creswell et al
What does interacting with a child with an anxiety disorder do?
Measured maternal anxiety behaviours
What type of disorders were mothers with?
anxiety
What was the parent’s status when children are anxious?
anxiety
What is the name of the group that is more likely to model anxiety behaviour to children when they are anxious?
Thirlwall et al
What type of disorder are children with?
anxiety disorder
What type of support did parents receive for the intervention?
therapist
What is not reflective of the child’s experiences?
bias reports
What type of olescence triggers more depression?
AD
Who suggested that the environment changes hugely in the shift to adolescents?
Larson & Ham
What was the number of negative and stressful events in a large US sample of young people and their parents?
10yo to 15yo
What kind of relationships did a significant amount of this increase occur?
peer relationships
Who reported more negative events in a sex effect?
boys
What was found to be the cause of more negative events among boys?
sex effect
Adolescents are more vulnerable to negative effects of life events than what?
pre-adolescents
What group experienced much higher rates of negative affect than younger children in the high stress group?
Mostly bc
How many young people were a victim of bullying?
1400
What is the reason for the association between ADs and family environment?
those who are vulnerable are more likely to be bullied
What et al. wrote about anxiety in adolescence?
Waite
What are environmental changes Waite et al?
Anxiety in adolescence
What is the focus of the meta-analysis?
adolescence
What is the most well-explored parenting construct in adolescence?
over-involvement
What are the findings based on?
self-report
What is an example of a publication bias in adolescence?
Anxiety in adolescence
Who were more involved and intrusive when completing difficult cognitive tasks?
clinical children and adolescents
What was the difference between age and group interaction?
no significant age by group interaction
What do parents often help to regulate emotions during childhood?
re-appraising
What do parents do to regulate emotions during childhood?
distracting
What is the foundation for emotion regulation abilities?
EFs
When do EFs begin to mature?
early adolescence
How do adolescents react to an anxiety in adolescence?
amber light
What type of peer did the participants manipulate?
a peer of the same age
What was the difference between risk-taking behaviour in adolescents when they were alone?
riskier
What does social exclusion affect during adolescence?
behaviours
What is viewed as a great danger during adolescence?
social exclusion
When does the PFC develop?
adolescence
What is the age of the participant?
the age of the peer
What is the risk taking behaviour of adolescents in the presence of an adolescent?
adult
What review included 88 studies?
Cochrane
What does CBT lead to?
remission of primary anxiety disorder
CBT leads to greater remission of primary anxiety disorder compared to what?
passive control
What type of treatment isn’t as clear as usual?
CBT
What treatment is used to treat anxiety disorders in adolescents?
post-treatment and 3m follow up
How many children were involved in the CAMS trial?
500
What is the name of the trial that included 500 children and adolescents?
CAMS trial
What age group was the CBT outcome poorer for?
older
What was some indication that CBT outcomes were worse for those who were older?
poor
What was associated with ADIS and CGI scores?
Age
Age was associated with what scores?
ADIS and CGI scores
What was not measured by treatment condition?
CBT
What is social anxiety in adolescence?
less responsive
What type of anxiety does CBT affect?
child and adolescent anxiety
What was the difference between age and CBT exposure?
no
What are linked to less positive treatment response to CBT for anxiety?
depression and social anxiety
Differential outcomes based on age could be masked by what?
variation of diagnoses
How many studies of treatments for adolescent anxiety have been evaluated?
55
How old were the participants?
under 19yo
What did studies that didn’t use?
CBT Walkup
What is the largest RCT for anxiety treatment?
CAMS
How long were participants randomly assigned to CBT?
12 weeks
What type of treatment were participants randomly assigned to?
pill placebo
What treatment was associated with greater improvements compared to CBT alone and medication alone?
Combination
What type of treatment did Chu et al use more effectively?
placebo
What did multilevel growth models use?
Measured symptom trajectory
What measured symptom trajectory using?
multilevel growth models
What did adolescents show in early stages compared to children?
elss symptom improvement
When did early adolescence begin?
11yo to 50yo
What was found in the use of emotional regulation strategies?
developmental changes
What is the name of the curve in adaptive emotion regulation and social support seeking?
U-shaped curve
What did sadness and fear show in the use of self-reports?
social desirability and poor introspection
What is the median age of onset of social anxiety disorder?
13yo
How many cases of social anxiety disorder occur before 23yo?
90%
What is the 3rd most common MH disorder?
Social anxiety disorder
What is the prevalence of social anxiety disorder?
11%
What percentage of people with SAD still experience episodes?
50-60%
What do clinic-seeking individuals with SAD achieve at the end of high school?
lower grades
The results of broad-based CBT trials were based on what?
specific diagnoses
What type of disorder was SAD a predictor of poorer outcomes in response to treatments?
social anxiety disorder
What was the post-CBT recovery rate from primary SAD?
35%
What is a combination of cognitive techniques?
cognitive restructuring
What type of exposure did Beidel et et et et et et et et
graded exposure
What does Social effectiveness therapy include?
social skills and exposures
What is more behaviourally based, based on theoretical model that SAD is related to social skill deficits?
social effectiveness therapy
What percentage of SAD recovered from social anxiety over the 12 years from the start of the study?
37%
From what age did adolescents study longitudinally?
14yo until they were 24yo
When was Leary released?
2001
What is related to the idea that people make assumptions about themselves and their social environment?
negative broad unconditional beliefs
What does negative broad unconditional beliefs lead to?
making assumptions about themselves and their social environment
What kind of beliefs lead to them making assumptions about themselves and their social environment?
negative
When was Clark & Wells born?
1995
What does Leigh & Clark believe they are coming across negatively?
safety seeking behaviours
What were some studies based on?
cross-sectional and observation studies
How many questionnaire studies supported negative social attitudes and cognitions?
3
What does Leigh et et et et et et et et et
lack ecological validity
When was an experimental study conducted to investigate the role of negative self-imagery on social anxiety?
2020
What is the role of social anxiety on social anxiety?
negative self-imagery
What does a negative self-image motivate you to engage in more safety Lab study?
lack ecological validity
What motivates you to engage in more safety Lab study?
negative self-image
