Anxiety Disorders: Kingery JN

Ginsburg GS, Kingery JN, Drake KL, Grados MA. · Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, 600 North Wolfe Street/CMSC 340, Baltimore, MD 21287-3325, USA. · J Am Acad Child Adolesc Psychiatry. · Pubmed #18596553 No free full text.

Abstract: OBJECTIVE: To examine predictors of treatment response in pediatric obsessive-compulsive disorder (OCD). METHOD: A literature review of psychotherapy (i.e., cognitive-behavioral therapy) and medication studies for pediatric OCD published from 1985 to 2007 was conducted using several databases. RESULTS: The literature search produced a total of 21 studies (6 cognitive-behavioral therapy, 13 medication, and 2 combination studies) that met specific methodological criteria. Across studies, the following nine predictors were examined: child sex, child age, duration of illness/age at onset, baseline severity of obsessive-compulsive symptoms, type of obsessive-compulsive symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors. Among all of the studies, there was little evidence that sex, age, or duration of illness (age at onset) was associated with treatment response. Baseline severity of obsessive-compulsive symptoms and family dysfunction were associated with poorer response to cognitive-behavioral therapy, whereas comorbid tics and externalizing disorders were associated with poorer response in medication-only studies. CONCLUSIONS: Overall, there are limited data on predictors of treatment response for pediatric OCD. The majority of studies are plagued with methodological limitations and post hoc approaches. Additional research is needed to better delineate the predictors of treatment response in pediatric OCD with the goal of developing individualized treatment approaches.

Kingery JN, Ginsburg GS, Burstein M. · Hobart and William Smith Colleges, Geneva, NY, USA. · Child Psychiatry Hum Dev. · Pubmed #19165593 No free full text.

Abstract: The current study examined the psychometric properties and factor structure of the Multidimensional Anxiety Scale for Children (MASC) among a community sample of 118 African American students (58 females; ages 14-19 years; mean age = 15.79) in an urban, parochial high school. Adolescents completed the MASC and several other self-report measures of anxiety, perceived competence, and symptoms of ADHD. The original MASC total and subscale mean scores were comparable to data reported in previous studies utilizing community samples of youth, though measures of internal consistency were lower. Factor analytic results supported a three factor solution (i.e., social anxiety, physical symptoms, harm avoidance) which accounted for 23.84% of the variance. While there was overlap in the underlying structure of anxiety between the original MASC publication and the current sample, items reflecting separation anxiety did not emerge as a separate factor. As expected, the MASC total score was positively correlated with measures of anxiety and perceived competence but unrelated to measures of hyperactivity. This study represents an important first step toward establishing more comprehensive age, race, and gender norms for the MASC.

Alfano CA, Ginsburg GS, Kingery JN. · Department of Psychiatry, Children's National Medical Center, Washington, DC 20010, USA. · J Am Acad Child Adolesc Psychiatry. · Pubmed #17242626 No free full text.

Abstract: OBJECTIVE: The present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of pharmacological treatment (fluvoxamine versus pill placebo) in reducing SRPs also was examined. METHOD: As part of a large, double-blind, randomized, controlled trial (Research Units on Pediatric Psychopharmacology Anxiety Study Group), clinician and parent reports of SRPs were examined among children and adolescents, ages 6 to 17 years, before and after treatment. RESULTS: Eighty-eight percent of youth experienced at least one SRP, and a majority (55%) experienced three or more. Total SRPs were positively associated with anxiety severity and interference in family functioning. Significantly greater reductions in SRPs were found among children treated with fluvoxamine compared with placebo. CONCLUSIONS: These findings indicate that SRPs are commonly associated with childhood anxiety disorders and suggest a need for the assessment of and attention to these problems in research and clinical settings.