Thesis (M.A.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains vii, 69 p. Includes abstract. Includes bibliographical references (p. 37-45).

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Florida, 1984. / Description based on print version record. Typescript. Vita. Includes bibliographical references (leaves 266-276).

Children and parents suffer from anxiety at high rates, but little is known regarding the role of family accommodation in the relationship between parent anxiety and child anxiety. Family accommodation is the process by which families accommodate patient symptoms by providing reassurance or by modifying family routines to avoid anxiety producing situations, which is in direct opposition to clinical therapeutics, like Cognitive Behavioral Therapy (CBT), which focus on confronting rather than accommodating symptoms. It is important to identify family variables that are relevant to understanding the role of the parent in their child's anxiety, and family accommodation is promising because it has been implicated in impairment, symptom severity, and poor treatment outcomes in children and adults with obsessive-compulsive disorder. However, less is known about family accommodation and anxiety. Therefore, the purpose of the present study was to explore the possibility that family accommodation might mediate the relationship between parent anxiety and child anxiety by using survey methodology to acquire data from 85 parents via community and clinical sampling. Measures included "The Family Accommodation Scale Anxiety," "The State Trait Anxiety Inventory for Adults," and "The Screen for Child Anxiety Related Emotional Disorders." Multiple regression analyses revealed that family accommodation fully mediated the relationship between parent anxiety and child anxiety, as evidenced by a statistically significant Sobel test of mediation and by a reduction in the parent anxiety child anxiety relationship from significant to non-significant. This study fills an important gap in the literature by providing empirical evidence that family accommodation plays an important role in mediating the relationship between parent anxiety and child anxiety. Implications include the potential for development of effective interventions for child anxiety by including focused treatment components designed to reduce and eliminate family accommodation. / text

Generalized Anxiety Disorder (GAD) is one of the most common and impairing childhood anxiety disorders, impacting over 10% of children with an average age of onset at 8.5 years. GAD in childhood increases the risk for developing additional anxiety and depressive disorders, academic and social difficulties, and, if left untreated, continuity into adulthood. While treatments incorporating mindfulness techniques have been shown to be efficacious among adults, relatively few studies have examined the efficacy of these techniques in the treatment of children. Mindfulness skills may be able to target maladaptive cognitive patterns by teaching children more flexible ways of thinking and viewing the world and providing children additional coping skills that may positively impact their overall functioning long-term. The aim of the present study was to develop and provide preliminary evaluation of a mindfulness-based intervention for GAD in school-aged children. Four children aged 9 to 12 with a principal diagnosis of GAD completed an open trial pilot phase of a 6-session individual format mindfulness intervention. Each session emphasized mindful awareness of breath, body, and thoughts, and involved child and parent participation. An additional twelve children were randomized to either an immediate treatment (n = 6) or a waitlist (i.e., delayed treatment; n = 6) condition during the course of a randomized waitlist-controlled clinical trial. Measures were administered at pre-waitlist (if applicable), post-waitlist/pre-treatment, post-treatment, and eight weeks following treatment to assess overall program satisfaction and changes in symptoms and diagnosis. Overall, treatment dropout was low, and families reported high satisfaction with treatment. Relative to waitlist, children in the immediate treatment group evidenced significant difference in mean change scores on Clinical Global Improvement Severity score and Child Behavioral Checklist Internalizing and Anxiety Problems scales. Effect size statistics indicated very large effect sizes between the waitlist and immediate treatment groups for change in GAD Clinical Severity Rating, child self-report of worries, and mindfulness ability, despite non-statistical significance. Overall, the intervention demonstrated feasibility, acceptability, and preliminary evidence of potential efficacy even in this small pilot study. Effect size estimates suggest a larger randomized clinical trial is warranted to fully evaluate treatment efficacy.

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Research supports a relationship between parenting behaviors and anxiety in youth, yet few studies have examined parental accommodation in the context of youth with anxiety disorders other than obsessive-compulsive disorder. Furthermore, little is known about the influence of child behaviors on parental accommodation and how accommodation relates to other parent and child factors. The present study examined the effect of child distress on maternal accommodation and the relationship between maternal accommodation and other parent and child factors in a sample of youth with anxiety disorders aged 7-17 (N = 70, M = 11.66, 47.1% males). Maternal accommodation was measured by vignettes depicting youth exhibiting high or low levels of distress in anxiety-provoking situations that elicited social anxiety, generalized anxiety, or separation anxiety. Results indicated an effect of child distress on accommodation of youth anxiety, such that mothers indicated more accommodation under conditions of high child distress. Furthermore, a relationship was found between greater accommodation and mothers holding more negative beliefs about their child's experience of anxiety. Maternal empathy moderated the relationship between accommodation and child distress, suggesting that mothers high in empathy demonstrate a greater degree of adaptability in response to child behaviors. Maternal anxiety also influenced the relationship between accommodation and child distress, with results varying based on situation type and suggesting that maternal anxiety may be associated with less adaptive responses to child behaviors. Clinical implications for the treatment of anxious youth are discussed and suggestions for future research are offered. / Psychology

BACKGROUND: Preoperative anxiety commonly occurs in young children prior to anesthesia induction. This anxiety is associated with poor post-operative outcomes such as increases in emergence delirium occurrence and post-operative pain. Studies have demonstrated varying effectiveness of interventions such as clowns and video games used to engage and distract children from their anxiety. Anesthesiologists at Lucile Packard Children’s Hospital have designed a new screen-based modality, called the Bedside Entertainment Theatre (BERT), to distract children from their anxiety. OBJECTIVE: The aim of this study is to examine the anxiety-relieving efficacy of BERT against a hand-held electronic tablet, another screen-based form of entertainment used to alleviate preoperative anxiety in children at the hospital. METHODS: Children aged 4-10 undergoing non-emergent outpatient surgery at Lucile Packard Children’s Hospital and their primary caregiver were recruited for the study. Measures were taken at 5 timepoints from children, parents, and clinicians: in the preoperative holding area (T1), at entrance to the OR (T2), at induction (T3), after emergence from anesthesia (T4), and at a 1-week follow up (T5). Primary outcomes were preoperative anxiety, assessed by the modified Yale Preoperative Anxiety Scale (mYPAS) and Child Fear Scale (CFS), and induction compliance, assessed by the Induction Compliance Checklist (ICC). Secondary outcomes were emergence delirium, measured by the Pediatric Anesthesia Emergence Delirium Scale (PAED) and post-operative pain, measured by the Parents’ Post-operative Pain Measure (PPPM) and a Memory Recall Interview. Child covariates were temperament, measured by the Emotionality Activity Sociability Temperament Survey (EAS-TS) and the Children’s Behavior Questionnaire- Very Short Form (CBQ-VSF), and state-trait anxiety, measured by the Child State-Trait Anxiety Inventory (STAIC). Caregiver covariates were state-trait anxiety, measured by the State-Trait Anxiety Inventory (STAI) and caregiver pain catastrophizing about their child, measured by the Pain Catastrophizing Scale- Parent State (PCS-P State). This study is currently ongoing and plans to recruit 60 participants. Parent, child, and clinician satisfaction with usage of either intervention was also assessed. RESULTS: There were no significant differences between mean preoperative anxiety scores of BERT and tablet users at all pre-induction timepoints. There was a significant increase in mean preoperative anxiety scores in BERT users from T1 to T2 and T1 to T3. There was also a significant increase in mean preoperative anxiety scores from T1 to T3 for tablet users. There were no other significant differences in primary and secondary outcomes between interventions. Only post-surgery PCS-P State scores for BERT users correlated with mYPAS scores at T3 (p < 0.05). No other measured covariates correlated with preoperative anxiety scores (p > 0.05). CONCLUSIONS: Although preliminary results do not show differences between the interventions in relieving preoperative anxiety, there may be potential insights gained in how both interventions affect anxiety at different preoperative timepoints. Statistical analysis with the full sample population will be necessary to draw stronger conclusions. / 2018-07-11T00:00:00Z

Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--University of Michigan, 1982.