In the literature, a well-known effective program in reducing children’s anxiety symptoms is the ‘Coping Cat’ program (Kendall, 1994). However, effectiveness studies of parental education program have been relatively limited. Parenting factors are important as the risk for anxiety disorders appears particularly high in the offspring of anxious parents (McClure, Brennan, Hammen, & Le Brocque, 2001). Further parenting styles such as over-involvement and criticism was found to play a significant role in the development and maintenance of childhood anxiety (Gar, & Hudson, 2008). Therefore, this study adopted the ‘Coping Cat’ treatment program and delivered exclusively to parents of 14 children with anxiety symptoms of ages 6-11. The intervention group consisted of 6 2-hours group sessions of 4 to 7 parents. Psychological questionnaires were administered to parents during pre and post treatment. The outcome measures were compared with another 14 parents who did not receive the parental education program. Self-reported questionnaires were administered, including Parenting Stress Scale (PSS), Alabama Parenting Questionnaire (APQ), Coping Self-Efficacy Scale (CSE 13), Brief COPE and Screen for Child Anxiety Related Disorders (SCARED), to assess parental stress, parental styles, parental stress-coping styles and indirect effect on children’s anxiety symptoms. Repeated-measures ANOVA and paired sample t-tests was computed to evaluate the effects of the parental program. Results suggested that the intervention group showed significantly reduction in parents and children’s levels of stress and anxiety symptoms. It also demonstrated significant decrease of child’s separation anxiety symptoms and school avoidance behaviours after intervention. Moreover, significant reduced level of negative parental practices and increased practices of positive stress-coping strategies were found at post-treatment. Furthermore, perceived efficacy in stopping unpleasant emotions and thoughts as well as getting support from friends and family had improved. Additionally, the reduced stress symptoms among participants in the intervention group were negatively correlated with the increased use of humour coping strategies. Likewise, the reduced level of anxiety symptoms at post-treatment was positively correlated with the reduced practices of negative and ineffective discipline. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Previous research had demonstrated cognitive biases towards threatening stimuli in anxious individuals, such as in attention, interpretation and memory. The present study aimed to examine the differences in memory-related information processing between anxious and nonanxious children and the effectiveness of a Cognitive-Bias Modification (CBM) based positive training in altering these differences. The study adopted a directed forgetting paradigm, where children with anxiety disorders (N=12) and healthy controls (N=12) were asked to either forget or remember word lists comprised of words of negative or positive valence, and were later asked to recall and recognize target words. The CBM training was subsequently administered, in which subjects were trained to endorse positive interpretations to ambiguous situations, followed by a similar directed forgetting task for post-training assessment. Results revealed that the CBM training was effective in reducing the hypervigilance towards negative words in anxious children, as well as reducing recall of negative words in all subjects. Clinical implications and limitations of the study were discussed. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Thesis (M. Soc. Sc.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 27-31).

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Thesis (M. Soc. Sc.)--University of Hong Kong, 2008. / Includes bibliographical references (p.33-37).

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Emotional disorders of anxiety and depression have been recognized as the most prevalent mental disorders in children and adolescents. High rates of co-morbidity between anxiety and depression have been reported in both adults and youths. Clark and Watson (1991) proposed a tripartite model to explain both the overlap and distinctiveness of anxiety and depression. In that model, negative affectivity (NA) is experienced in both anxiety and depression; lack of positive affectivity (PA) is specific to depression; and high physiological hyperarousal (PH) is unique to anxiety. Two decades of research among adults have supported the utility of the tripartite model. However, its applicability to children and adolescents has been studied less, and the results have been controversial. This controversy could be caused by two main issues. First, early youth research on the tripartite components has had to borrow adult measures to represent the tripartite constructs. Second, even after child-specific measures for the tripartite constructs were developed, relatively few studies have examined all three tripartite components together. In particular, PH has received less attention than NA and PA. The present study addresses these issues. First, this study assesses all three components of the tripartite model among Chinese children and adolescents in Hong Kong schools. A deliberate attempt is made to use measures of the tripartite constructs that are specific to children in order to improve the construct validity of the measurements. Finally, special attention is paid to the differential utility of the PH construct. Results partially supported the Clark and Watson’s tripartite model (1991). NA is a common component to both anxiety and depression. However, both PA and PH are also common components to both anxiety and depression. In addition, high correlations were found among anxiety, depression, and PH. These results tend to suggest more intricate relationships among anxiety, depression, and somatic symptoms. To conclude, this study suggests an alternative transdiagnostic approach to the tripartite model, which emphasizes clustering of anxiety, depression, and somatic symptoms. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Research shows that anxiety disorders are common and problematic in children. Treatment studies demonstrate that cognitive-behavioural interventions for children can successfully minimise these problems. Further, when implemented as early intervention or prevention programs, these interventions can prevent the onset of anxiety problems in 7 to 14 year olds and reduce existing levels of anxiety. This type of preventive approach has enormous potential for improving community mental health in a low cost model of service delivery. Yet, to develop this as a viable service model, these programs need to be evaluated under 'real world' conditions as opposed to specialist university clinical teams. In this research, the long-term effectiveness of an ecological model of the prevention of anxiety disorders for children was conducted. In the first study, teachers (N = 17) were trained intensively in the principles of anxiety and the FRIENDS anxiety prevention program (Barrett, Lowry-Webster & Holmes, 1999). Measures were taken of the PROXIMAL effects of training on the knowledge and self-efficacy of participating teachers at two points in time. Compared to teachers in a control group (N= 17) and a group comprised of psychologists regarded as experts in the FRIENDS anxiety program (N= 22), trained teachers demonstrated significant increases in the levels of knowledge and self-efficacy at time two. These increases approached levels exhibited by experts in terms of knowledge, and were not significantly different from experts in their levels of self-efficacy to implement the FRIENDS program following training. This study also explored the quality or fidelity of program implementation by these trained teachers (INTERMEDIATE EFFECTS). Results demonstrated that trained teachers implemented the program with high levels of integrity in accordance with the FRIENDS intervention manual. The second study sought to investigate the outcomes for participating children in terms of actually preventing and reducing existing levels of anxiety. Also of interest was the impact this intervention had on levels of depression. Participants were 594 children aged 10-13 years from 7 schools in Brisbane Australia. Children, and parents reported on children's social, emotional and behavioural characteristics at three-assessment points over 12 months. Results were examined universally (for all children) and for children who scored above the clinical cut-off for anxiety at pre-test. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms regardless of their risk status at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced significant improvements at posttest. The results indicated that intervention gains were maintained over a period of 12 months, as measured by self-reports and diagnostic interviews. Moreover, evidence of a prevention effect was also demonstrated, with a significantly greater percentage of children in the control group progressed to "at risk" or "remained at risk" compared to children in the intervention group. Additionally, 85% of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were diagnosis free in the intervention condition at 12-month follow-up, compared to only 31.2% of children in the control group. Implications of these findings are examined, alongside limitations of the study and directions for future research.

Selective mutism(SM) is a !disorder in which children capable of speech do not speak in certain situations. SM is often related to social phobia (SP); however, the exact relationship between the two conditions is unclear. To obtain a better understanding of the relationship of SM and SP, 8 children with SM, 8 with SP, and 7 typically developing children (ranging in age from 7-13) were compared on measures of physiology(heart rate, skin temperature, and skin conductance responses), and self-report and parent-report measures. The physiological measures were recorded during two social interaction tasks (a role-play task and a reading aloud task). Despite our expectation that children with SM should show higher physiological arousal during these tasks, the results revealed no conclusive physiological differences between the two groups. These finding suggest that the current conceptualization of selective mutism simply as an extreme form of social phobia may be incorrect.