Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T13:17:59.450Z Has data issue: false hasContentIssue false

Treating Socially Phobic Youth with CBT: Differential Outcomes and Treatment Considerations

Published online by Cambridge University Press:  01 July 2008

Sarah A. Crawley*
Affiliation:
Temple University, Philadelphia, USA
Rinad S. Beidas
Affiliation:
Temple University, Philadelphia, USA
Courtney L. Benjamin
Affiliation:
Temple University, Philadelphia, USA
Erin Martin
Affiliation:
Temple University, Philadelphia, USA
Philip C. Kendall
Affiliation:
Temple University, Philadelphia, USA
*
Reprint requests to Sarah Crawley, Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, Pennsylvania 19122, USA. E-mail: sarah.crawley@temple.edu

Abstract

Social phobia (SP) is characterized by a fear of one or more social or performance situations. Studies of comorbidity in SP youth find anxiety and affective disorders co-occurring. The present study examined children with primary SP and compared them to children with primary Separation Anxiety Disorder (SAD) or Generalized Anxiety Disorder (GAD) prior to treatment and in response to treatment. The groups differed significantly on self-, parent- and teacher-rated pretreatment measures. Additionally, the two groups showed differential treatment outcomes. When the SP youth with comorbid Affective Disorder were excluded in treatment outcome analyses, there were non significant differences, indicating that comorbid affective disorders likely contributed to differential treatment outcome. Results are discussed in terms of treatment recommendations for socially phobic youth.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. (1991). Integrative Guide for the 1991 CBCL/4-18, YSR, and TRF. Burlington, VT: University of Vermont.Google Scholar
Achenbach, T. and Edelbrock, C. (1986). Manual for the TRF and the Child Behavior Profile. Burlington, VT: University of Vermont.Google Scholar
Achenbach, T. and Edelbrock, C. (1991). Manual for the CBCL and 1991 Profile. Burlington, VT: University of Vermont.Google Scholar
Albano, A. M., Chorpita, B. and Barlow, D. (1996). Childhood anxiety disorders. In Mash, E. J. and Barkley, R. A. (Eds.), Child Psychopathology (pp. 196241). New York: Guilford Press.Google Scholar
Aschenbrand, S. G., Angelosante, A. G. and Kendall, P. C. (2005). Discriminant validity and clinical utility of the CBCL with anxiety disordered youth. Journal of Clinical Child and Adolescent Psychology, 34, 735746.CrossRefGoogle ScholarPubMed
Barmish, A. J. and Kendall, P. C. (2005). Should parents be co-clients in cognitive-behavioral therapy for anxious youth? Journal of Clinical Child and Adolescent Psychology, 34, 569581.CrossRefGoogle ScholarPubMed
Barrett, P., Dadds, M. and Rapee, R. (1996). Family treatment of childhood anxiety: a controlled trial. Journal of Consulting and Clinical Psychology, 64, 333342.CrossRefGoogle ScholarPubMed
Beidel, D. C., Turner, S. M. and Morris, T. L. (1999). Physiological, cognitive, and behavioral aspects of social anxiety. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 643650.CrossRefGoogle Scholar
Bell-Dolan, D. and Brazeal, T. J. (1993). Separation anxiety disorder, overanxious disorder, and school refusal. Child and Adolescent Psychiatric Clinics of North America, 2, 563580.CrossRefGoogle Scholar
Brady, E. and Kendall, P. C. (1992). Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin, 111, 244255.CrossRefGoogle ScholarPubMed
Cartwright-Hatton, S., Roberts, C., Chitsabesan, P., Fothergill, C. and Harrington, R. (2004). Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. British Journal of Clinical Psychology, 43, 421436.CrossRefGoogle ScholarPubMed
Chavira, D. A., Stein, M. B., Bailey, K. and Stein, M. T. (2004). Comorbidity of generalized social anxiety disorder and depression in a pediatric primary care sample. Journal of Affective Disorders, 80, 163171.CrossRefGoogle Scholar
Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weering, R. and Curry, J. (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 930959.CrossRefGoogle ScholarPubMed
Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A. and Worthman, C. M. (1996). The Great Smoky Mountains Study of Youth: goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry, 53, 11291136.CrossRefGoogle ScholarPubMed
Essau, C. A., Conradt, J. and Petermann, F. (1999). Frequency and comorbidity of social phobia and social fears in adolescents. Behaviour Research and Therapy, 37, 831843.CrossRefGoogle ScholarPubMed
Hofflich, S. A., Hughes, A. A. and Kendall, P. C. (2006). Somatic complaints and childhood anxiety disorders. International Journal of Clinical and Health Psychology, 6, 229242.Google Scholar
Howard, B., Chu, B., Krain, A., Marrs-Garcia, A. and Kendall, P. (2000). Cognitive-Behavioral Family Therapy for Anxious Children: therapist manual. Ardmore, PA: Workbook Publishing.Google Scholar
Kazdin, A., French, N., Unis, A., Esveldt-Dawson, K. and Sherick, R. (1983). Hopelessness, depression, and suicidal intent among inpatient children. Journal of Consulting and Clinical Psychology, 51, 504510.CrossRefGoogle ScholarPubMed
Kendall, P. C. (1994). Treating anxiety disorders in children: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100110.CrossRefGoogle ScholarPubMed
Kendall, P. C., Flannery-Shroeder, E., Panichelli-Mendel, S., Southam-Gerow, M., Henin, A. and Warman, M. J. (1997). Therapy for youths with anxiety disorders: a second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366380.CrossRefGoogle ScholarPubMed
Kendall, P. C. and Hedtke, K. (2006a). Cognitive-Behavioral Therapy for Anxious Children: therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.Google Scholar
Kendall, P. C. and Hedtke, K. (2006b). Coping Cat Workbook (2nd ed.). Ardmore, PA: Workbook Publishing.Google Scholar
Kendall, P. C., Kortlander, E., Chansky, T. and Brady, E. (1992). Comorbidity of anxiety and depression in youth: treatment implications. Journal of Consulting and Clinical Psychology, 60, 869880.CrossRefGoogle ScholarPubMed
Kendall, P. C., Safford, S., Flannery-Schroeder, E. and Webb, A. (2004). Child anxiety treatment: outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up. Journal of Consulting and Clinical Psychology, 72, 276287.CrossRefGoogle ScholarPubMed
Kessler, R. C., Nelson, C., McGonagale, K., Edlund, M., Frank, R. and Leaf, P. (1996). The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. American Journal of Orthopsychiatry, 66, 1731.CrossRefGoogle ScholarPubMed
Kovacs, M. (1981). Rating scales to assess depression in school aged children. Acta Paedopsychiatrica, 46, 305315.Google ScholarPubMed
Kovacs, M. (1992). Children's Depression Inventory (CDI) Manual. North Tonawanda, NY: Multi-Health Systems.Google Scholar
LaGreca, A. M. and Lopez, N. (1998). Social anxiety among adolescents: linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26, 8394.CrossRefGoogle Scholar
Last, C. L., Perrin, S., Hersen, M. and Kazdin, A. E. (1992). DSM-III-R anxiety disorders in children: sociodemographic and clinical characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 10701076.CrossRefGoogle ScholarPubMed
March, J. S. and Albano, A. (1998). New developments in assessing pediatric anxiety disorders. Advances in Clinical Child Psychology, 20, 213241.CrossRefGoogle Scholar
March, J. S., Parker, J., Sullivan, K., Stallings, P. and Conners, C. (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554565.CrossRefGoogle ScholarPubMed
Nauta, M. H., Scholing, A., Emmelkamp, P. M. G. and Minderaa, R. B. (2003). Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 12701278.CrossRefGoogle Scholar
Pine, D. S. and Grun, J. (1998). Anxiety disorders. In Walsh, T. B. (Ed.), Child Psychopharmacology: review of psychiatry series (pp. 115148). Washington, DC: American Psychiatric Press.Google Scholar
Rao, P. A., Beidel, D. C., Turner, S. M., Ammerman, R. T., Crosby, L. E. and Sallee, F. R. (2007). Social anxiety disorder in childhood and adolescence: descriptive psychopathology. Behaviour Research and Therapy, 45, 11811191.CrossRefGoogle ScholarPubMed
Schorre, B. and Vandvik, I. (2004). Global assessment of psychosocial functioning in child and adolescent psychiatry: a review of three unidimensional scales (CGAS, GAF, GAPD). European Child and Adolescent Psychiatry, 13, 273286.CrossRefGoogle ScholarPubMed
Seligman, L. D., Ollendick, T. H., Langley, A. K. and Baldacci, H. B. (2004). The utility of measures of child and adolescent anxiety: a meta-analytic review of the Revised Children's Anxiety Scale, the State-Trait Anxiety Inventory for Children, and the Child Behavior Checklist. Journal of Clinical Child and Adolescent Psychology, 33, 557565.CrossRefGoogle ScholarPubMed
Shaffer, D., Gould, M., Brasic, J., Ambrosini, P., Fisher, D., Bird, H. and Aluwahlia, S. (1983). A Children's Global Assessment Scale. Archives of General Psychiatry, 40, 12281231.CrossRefGoogle ScholarPubMed
Silverman, W. K. and Albano, A. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. Boulder, CO: Graywind Publications Incorporated.Google Scholar
Silverman, W. K., Saavedra, L. M. and Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: child and parent versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 937944.CrossRefGoogle ScholarPubMed
Southam-Gerow, M. A., Kendall, P. C. and Weersing, V. R. (2001). Examining outcome variability: correlates of treatment response in a child and adolescent anxiety clinic. Journal of Clinical Child Psychology, 30, 422436.CrossRefGoogle Scholar
Spence, S. H., Donovan, C. and Brechman-Toussaint, M. (1999). Social skills, social outcomes, and cognitive features of childhood social phobia. Journal of Abnormal Psychology, 108, 211221.CrossRefGoogle ScholarPubMed
Stein, M. B., Fuetsch, M., Muller, N., Hofler, M., Lieb, R. and Wittchen, H.-U. (2001). Social anxiety disorder and the risk of depression. Archives of General Psychiatry, 58, 251256.CrossRefGoogle ScholarPubMed
Timbremont, B., Braet, C. and Dreessen, L. (2004). Assessing depression in youth: relation between the Children's Depression Inventory and a structured interview. Journal of Clinical Child and Adolescent Psychology, 33, 149157.CrossRefGoogle ScholarPubMed
Wittchen, H.-U., Stein, M. B. and Kessler, R. C. (1999). Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors, and co-morbidity. Psychological Medicine, 29, 309323.CrossRefGoogle Scholar
Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J. and Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. Journal of Clinical Child and Adolescent Psychology, 31, 335342.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.