Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-03T02:14:38.544Z Has data issue: false hasContentIssue false

Effects of a parent training programme for the treatment of young children with separation anxiety disorder

Published online by Cambridge University Press:  21 November 2017

Sandra Mayer-Brien
Affiliation:
Département de psychologie, Université de Montréal, Case postale 6128, Succursale Centre-Ville, Montréal (Québec), Canada, H3C 3J7
Lyse Turgeon*
Affiliation:
École de psychoéducation, Université de Montréal, Case postale 6128, Succursale Centre-Ville, Montréal (Québec), Canada, H3C 3J7
Marc J. Lanovaz
Affiliation:
École de psychoéducation, Université de Montréal, Case postale 6128, Succursale Centre-Ville, Montréal (Québec), Canada, H3C 3J7
*
*Author for correspondence: Lyse Turgeon, École de psychoéducation, Université de Montréal, Case postale 6128, Succursale Centre-Ville, Montréal (Québec)CANADAH3C 3J7 (E-mail: [email protected]).

Abstract

Cognitive behavioural therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children. However, the majority of studies conducted to date have included heterogeneous samples of children combining social anxiety disorder, generalized anxiety disorder and separation anxiety disorder (SAD) together. Few studies have examined the efficacy of CBT to specifically treat SAD. Moreover, research on the impact of CBT for SAD in children younger than 7 years old has been very limited. To address these issues, we examined the effects of a CBT parent training programme with six children with SAD aged between 4 and 7 years using a non-concurrent multiple baseline design. Parents completed semi-structured interviews, questionnaires and daily diaries to assess their child's anxiety symptoms, parental practices and parental stress. Results indicated that five of six children no longer met the criteria for SAD diagnosis after treatment and at 3-month follow-up. Moreover, the daily diaries showed that four of six children presented a systematic favourable change of the total weekly frequency of SAD symptoms. Finally, four mothers reported a decrease in overprotection, but we observed no changes in parental stress.

Type
Original Research Report
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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

Recommended follow-up reading

Eisen, AR, Sussman, JM, Schmidt, T, Mason, L, Hausler, LA, Hashim, R (2011). Separation anxiety disorder. In Handbook of Child and Adolescent Anxiety disorders (ed. McKay, D. and Storch, E. A.), pp. 245259. doi: 10.1007/978-1-4419-7784-7_17 CrossRefGoogle Scholar

References

Abidin, RR (1995). Parenting Stress Index: Professional Manual (3rd edition). Odessa, FL: Psychological Assessment Resources.Google Scholar
Achenbach, TM, Rescorla, LA (2001). Manual for the ASEBA School-Age Forms and Profiles. Burlington: University of Vermont, Research Center for Children, Youth and Families.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision). Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edition). Arlington, VA: American Psychiatric Association.Google Scholar
Barlow, DH, Nock M, K, Hersen, M (2009). Single Case Experimental Designs: Strategies for Studying Behavior Change (3rd edition). Boston: MA, Pearson Education.Google Scholar
Barrett, PM, Lowry-Webster, H, Turner, CM (1999). FRIENDS for Children Group Leader Manual. Brisbane, Australia: Australian Academic Press.Google Scholar
Barrett, PM, Rapee, RM, Dadds, MM, Ryan, SM (1996). Family enhancement of cognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology 24, 187203.Google Scholar
Biederman, J, Petty, CR, Hirshfeld-Becker, DR, Henin, A, Faraone, SV, Fraire, M et al. (2007). Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression, Psychiatry Research 143, 245252. doi: 10.1016/j.psychres.2007.02.016 CrossRefGoogle Scholar
Bigras, M, LaFreniere, PJ, Abidin, RR (1996). Indice de stress parental: Manuel francophone en complément à l’édition américaine [Parental Stress Index. French manual to complement the American edition]. New York, NY: Multi-Health Systems.Google Scholar
Blatter-Meunier, J, Schneider, S (2011). Thérapie comportementale-cognitive des troubles émotionnels liés à l'anxiété de séparation. Journal de thérapie comportementale et cognitive 21, 8489. doi: 10.1016/j.jtcc.2011.07.011 Google Scholar
Bögels, SM, Brechman-Toussaint, ML (2006). Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clinical Psychology Review 26, 834856. doi: 10.1016/j.cpr.2005.08.001 CrossRefGoogle ScholarPubMed
Broeren, S, Muris, P (2008). Psychometric evaluation of two new parent-rating scales for measuring anxiety symptoms in young Dutch children. Journal of Anxiety Disorders 22, 949958. doi: 10.1016/j.janxdis.2007.09.008 Google Scholar
Brinkmeyer, MY, Eyberg, SM (2003). Parent–child interaction therapy for oppositional children. In Evidence-Based Psychotherapies for Children and Adolescents (ed. Kazdin, A. E. and Weisz, J. R.), pp. 204223. New York, NY: Guilford Press.Google Scholar
Brumariu, LE, Kerns, KA (2010a). Mother–child attachment patterns and different types of anxiety symptoms: is there specificity of relations? Child Psychiatry and Human Development 41, 663674. doi: 10.1007/s10578-010-0195-0 Google Scholar
Brumariu, LE, Kerns, KA (2010b). Parent–child attachment and internalizing symptoms in childhood and adolescence: a review of empirical findings and future directions. Development and Psychopathology 22, 177203. doi: 10.1017/S0954579409990344 Google Scholar
Carter, AS, Wagmiller, RJ, Gray, SAO, McCarthy, KJ, Horwitz, SM, Briggs-Gowan, MJ (2010). Prevalence of DSM-IV disorders in a representative, healthy birth cohort at school entry: socio-demographic risks and social adaptation. Journal of the American Academy of Child and Adolescent Psychiatry 49, 686698.Google Scholar
Cartwright-Hatton, S, McNally, D, Field, AP, Stewart, R, Laskey, B, Dixon, C et al. (2011). A new parenting-based group intervention for young anxious children: results of a randomized control trial. Journal of the American Academy of Child and Adolescent Psychiatry 50, 242251. e6. doi:10.1016/j.jaac.2010.12.015 CrossRefGoogle Scholar
Chase, RM, Pincus, DB (2011). Sleep-related problems in children and adolescent with anxiety disorders. Behavioral Sleep Medicine 9, 224236. doi: 10.1080/15402002.2011.606768 CrossRefGoogle ScholarPubMed
Choate, ML, Pincus, DB (2001). The Weekly Record of Anxiety at Separation: A Home Monitoring Measure for Parents. Unpublished manuscript, Boston University Center for Anxiety and Related Disorders.Google Scholar
Choate, ML, Pincus, DB, Eyberg, SM, Barlow, DH (2005). Parent–child interaction therapy for treatment of separation anxiety disorder in young children: a pilot study. Cognitive and Behavioral Practice 12, 126135. doi:10.1016/S1077-7229(05)80047-1 Google Scholar
Chorpita, BF (2007). Modular Cognitive-Behavioral Therapy for Childhood Anxiety Disorders. New York, NY: Guilford Press.Google Scholar
Costa, NM, Weems, CF, Pellerin, K, Dalton, R (2006). Parenting stress and childhood psychopathology: an examination of specificity to internalizing and externalizing symptoms. Journal of Psychopathology and Behavioral Assessment 28, 113122. doi: 10.1007/s10862-006-7489-3 CrossRefGoogle Scholar
de la Barra, F, Vicente, B, Saldivia, S, Melipillan, R (2014). Separation anxiety, social phobia and generalized anxiety disorders in the Chilean epidemiological study of children and adolescents. Journal of Child and Adolescent Behavior 2, 17. doi: 10.4172/jcalb.1000133 Google Scholar
Dumas, JE, LaFreniere, PJ, Capuano, F, Durning, P (1997). Profil Socio-Affectif (PSA): Évaluation des compétences sociales et des difficultés d'adaptation des enfants de 2 ans ½ à 6 ans. Paris, France: Éditions du Centre de Psychologie Appliquée.Google Scholar
Ehrenreich, JT, Santucci, LC, Weiner, CL (2008). Separation anxiety disorder in youth: phenomenology, assessment and treatment. Psichologia Conducta 16, 389412. doi: 10.1901/jaba.2008.16-389.Google Scholar
Eisen, AR, Raleigh, H, Neuhoff, CC (2008). The unique impact of parent training for separation anxiety disorder in children. Behavior Therapy 39, 195206. doi: 10.1016/j.beth.2007.07.004 Google Scholar
Esbjørn, BH, Sømhovd, MJ, Nielsen, SK, Normann, N, Leth, I, Reinholdt-Dunne, M (2014). Parental changes after involvement in their anxious child's cognitive behavior therapy. Journal of Anxiety Disorders 28, 664670. doi: 10.1016/j.janxdis.2014.07.008 Google Scholar
Figueroa, A, Soutullo, C, Ono, Y, Saito, K (2012). Separation anxiety. In IACACAP e-Textbook of Child and Adolescent Mental Health (ed. Rey, J. M.), pp. 1–24. Retrieved from: http://iacapap.org/wp-content/uploads/F.2-SEPARATION-ANXIETY-300812.pdf Google Scholar
Fisher, WW, Kelley, ME, Lomas, JE (2003). Visual aids and structured criteria for improving visual inspection and interpretation of single-case designs, Journal of Applied Behavior Analysis 36, 388406. doi: 10.1901/jaba.2003.36-387 CrossRefGoogle ScholarPubMed
Fabiano, GA (2007). Father participation in behavioral parent training for ADHD: review and recommendations for increasing inclusion and engagement. Journal of Family Psychology 21, 683693.Google Scholar
Franz, L, Angold, A, Copeland, W, Costello, EJ, Towe-Goodman, N, Egger, H (2013). Preschool anxiety disorders in pediatric primary care: prevalence and comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry 52, 12941303. doi: 10.1016/j.jaac.2013.09.008 Google Scholar
Hirshfeld-Becker, DR, Masek, B, Henin, A, Blakely, LR, Pollock-Wurman, RA, McQuade, J et al. (2010). Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial. Journal of Consulting and Clinical Psychology 78, 498510. doi: 10.1037/a0019055 Google Scholar
Hudson, JL, Doyle, AM, Gar, N (2009). Child and maternal influence on parenting behavior in clinically anxious children. Journal of Clinical Child and Adolescent Psychology 38, 256262. doi: 10.1080/15374410802698438 Google Scholar
Jacobson, NS, Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 1219. doi: 10.1037/0022-006X.59.1.12 Google Scholar
Kearny, CA, Sims, KE, Pursell, CR, Tillotson, CA (2003). Separation anxiety disorder in young children: a longitudinal and family analysis. Journal of Clinical Child and Adolescent Psychology 32, 593598.Google Scholar
Last, CG, Francis, K, Hersen, M, Kazdin, AE, Strauss, CC (1987). Separation anxiety and school phobia: a comparison using DSM-III criteria. American Journal of Psychiatry 144, 653657.Google Scholar
Lavigne, JV, LeBailly, SA, Hopkins, J, Gouze, KR, Binns, HJ (2009). The prevalence of ADHD, ODD, depression and anxiety in a community sample of 4-year-olds. Journal of Clinical Child and Adolescent Psychology 38, 315328. doi: 10.1080/15374410902851382 CrossRefGoogle Scholar
Lessard, J (2010). Les pratiques éducatives parentales: Le point de vue des parents et d'un observateur [Parental educative practives. Parents’ and Observers’ point of view]. Doctoral dissertation, University of Montreal. Retrieved from: https://papyrus.bib.umontreal.ca Google Scholar
Lewinsohn, PM, Holm-Denoma, JM, Small, JW, Seeley, JR, (2008). Separation anxiety disorder in childhood as a risk factor for future mental illness. Journal of American Academy of Child and Adolescent Psychiatry 47, 548555. doi: 10.1097/CHI.0b013e31816765e7 Google Scholar
Liber, JM, van Widenfelt, BM, Goedhart, AW, Utens, EMWJ, van der Leeden, AJM, Markus, MT, Treffers, PDA (2008). Parenting and parental anxiety and depression as predictors of treatment outcomes for childhood anxiety disorders. Has the role of fathers been underestimated? Journal of Clinical Child and Adolescent Psychology 37, 747758. doi: 10.1080/15374410802359692 CrossRefGoogle ScholarPubMed
March, S, Spence, SH, Donovan, CL (2009). The efficacy of an internet-based cognitive-behavioral therapy approach to the treatment of child anxiety disorders. Journal of Pediatric Psychology 34, 474487. doi: 10.1093/jpepsy/jsn099 Google Scholar
McLeod, BD, Wood, JJ, Avny, SB (2011). Parenting and child anxiety disorders. In Handbook of Child and Adolescent Anxiety Disorders (ed. McKay, D. and Storch, E. A.), pp. 213228. doi: 10.1007/978-1-4419-7784-7_15 CrossRefGoogle Scholar
Mofrad, S, Abdullah, R, Samah, BA (2009). Perceived parental overprotection and separation anxiety: does specific parental rearing serve as specific risk factor? Asian Social Science 5, 109119.Google Scholar
Mofrad, S, Abdullah, R, Uba, I (2010). Attachment patterns and separation anxiety symptom. Asian Social Science 6, 148153.Google Scholar
Pahl, KM, Barrett, PM, Gullo, MJ (2012). Examining potential risk factors for anxiety in early childhood. Journal of Anxiety Disorders 26, 311320. doi: 10.1016/j.janxdis.2011.12.013 Google Scholar
Pincus, DB, Eyberg, SM, Choate, ML (2005). Adapting Parent–Child Interaction Therapy for young children with separation anxiety disorder. Education and Treatment of Children 28, 163181.Google Scholar
Pincus, DB, Santucci, LC, Ehrenreich, JT, Eyberg, SM (2008). The implementation of Modified Parent–Child Interaction Therapy for youth with separation anxiety disorder. Cognitive and Behavioral Practice 15, 118125. doi: 10.1016/j.cbpra.2007.08.002 Google Scholar
Podell, JL, Kendall, PC (2011). Mothers and fathers in family cognitive-behavioral therapy for anxious youth. Journal of Child and Family Studies 20, 182195. doi: 10.1007/s10826-010-9420-5 Google Scholar
Raleigh, H, Brien, LK, Eisen, AR (2002). Parent Training Treatment Manual for Separation Anxious Children. Unpublished manuscript. Farleigh Dickinson University, Teaneck, NJ.Google Scholar
Reynolds, S, Wilson, C, Austin, J, Hooper, L. (2012). Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. Clinical Psychology Review 32, 251262.Google Scholar
Santucci, LC, Ehrenreich-May, J (2013). A randomized control trial of the Child anxiety multi-day program (CAMP) for separation anxiety disorder. Child Psychiatry and Human Development 44, 439461. doi: 10.1007/s10578-012-0338-6 Google Scholar
Santucci, LC, Ehrenreich, JT, Trosper, SE, Bennett, SM, Pincus, DB (2009). Development and preliminary evaluation of a one-week summer treatment program for separation anxiety disorder. Cognitive and Behavioral Practice 16, 317331. doi: 10.1016/j.cbpra.2008.12.005 CrossRefGoogle Scholar
Schneider, S, Blatter-Meunier, J, Herren, C, Adornetto, C, In-Albon, T, Lavallee, K (2011). Disorder-specific cognitive-behavioral therapy for separation anxiety disorder in young children: a randomized waiting-list-controlled trial. Psychotherapy and Psychosomatics 80, 206215. doi: 10.1159/000323444 Google Scholar
Shear, K, Jin, R, Ruscio, AM, Walters, EE, Kessler, RC (2006). Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication. American Journal of Psychiatry 163, 10741083. doi: 10.1176/appi.ajp.163.6.1074 Google Scholar
Silverman, WK, Albano, AM (1996). The Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions. San Antonio, TX: Psychological Corporation.Google Scholar
Silverman, WK, Pina, AA, Viswesvaran, C (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology 37, 105130.Google Scholar
Silverman, WK, Saavedra, LM, Pina, AA (2001). Test–retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions. Journal of the American Academy of Child and Adolescent Psychiatry 40, 937944. Retrieved from: http://journals.lww.com/jaacap CrossRefGoogle ScholarPubMed
Simon, E, Dirksen, C, Bögels, S, Bodden, D (2012). Cost-effectiveness of child-focused and parent-focused interventions in a child anxiety prevention program. Journal of Anxiety Disorders 26, 287296.Google Scholar
Smith, AM, Flannery-Schroeder, EC, Gorman, KS, Cook, N (2014). Parent cognitive-behavioral intervention for the treatment of childhood anxiety disorders: a pilot study. Behaviour Research and Therapy 61, 156161.Google Scholar
Spence, SH, Rapee, R (1999). Preschool Anxiety Scale (Parent Report and Teacher version). Retrieved from: http://www.scaswebsite.com/docs/scas-preschool-scale.pdf Google Scholar
Spence, SH, Rapee, R, McDonald, C, Ingram, M (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy 39, 12931316. doi: 10.1016/S0005-7967(00)00098-X Google Scholar
Swoboda, CM, Kratochwill, TR, Levin, JR (2010). Conservative dual-criterion for single-case research: a guide for visual analysis of AB, ABAB, and multiple-baselines designs. (WCER Working Paper no. 2010–13). Retrieved from University of Wisconsin–Madison, Wisconsin Center for Education Research website: http://www.wcer.wisc.edu/publications/workingPapers/papers.php Google Scholar
Thomas, JC, Truax, P (2008). Assessment and analysis of clinically significant change. In Handbook of Research Methods in Abnormal and Clinical Psychology (ed. McKay, D.), pp. 317335. Thousand Oaks, CA: Sage.Google Scholar
Thomasgard, M, Metz, WP, Edelbrock, C, Shonkoff, JP (1995). Parent–child relationship disorders. Part I. Parental overprotection and the development of the Parent Protection Scale. Journal of Developmental and Behavioral Pediatrics 16, 244250.Google Scholar
Turgeon, L, Brousseau, L (2001). Entrevue d’évaluation des troubles anxieux chez les enfants et les adolescents pour le DSM-IV (ADIS-C-P). [Anxiety Disorders Interview Schedule for Children and Adolescents for DSM-IV]. Unpublished manuscript. Fernand-Seguin Research Center, Louis-H. Lafontaine Hospital, Montreal, Canada.Google Scholar
Turgeon, L, Brousseau, L. (2002). Questionnaire sur l'anxiété à l’âge préscolaire [Preschoool Anxiety Questionnaire]. Unpublished manuscript. Fernand-Seguin Research Center, Louis-H. Lafontaine Hospital, Montreal, Canada.Google Scholar
Venet, M, Bigras, M, Normandeau, S (2002). Les qualités psychométriques du PSA-A/The psychometric qualities of the PSA-A [French version of the Socio-Affective Profile]. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement 34, 163167.Google Scholar
Waters, AM, Ford, LA, Wharton, TA, Cobham, VE (2009). Cognitive-behavioural therapy for young children with anxiety disorders: comparison of a child + parent condition versus a parent only condition. Behaviour Research and Therapy 47, 654662. doi: 10.1016/j.brat.2009.04.008 Google Scholar
Webster-Stratton, C (1998). Preventing conduct problems in Head Start children: strengthening parenting competencies. Journal of Consulting and Clinical Psychology 66, 715730.CrossRefGoogle ScholarPubMed
Wood, JJ (2006). Parental intrusiveness and children's separation anxiety in a clinical sample. Child Psychiatry of Human Development 37, 7387.Google Scholar
Wood, JJ, McLeod, BD, Piacentini, JC, Sigman, M (2009). One-year follow-up of family versus child CBT for anxiety disorders: exploring the roles of child age and parental intrusiveness. Child Psychiatry and Human Development 40, 301316. doi: 10.1007/s10578-009-0127-z.CrossRefGoogle ScholarPubMed
Wood, JJ, McLeod, BD, Sigman, M, Hwang, WC, Chu, BC (2003). Parenting and childhood anxiety: theory, empirical findings, and future directions. Journal of Child Psychology and Psychiatry 44, 134151. doi: 10.1111/1469-7610.00106 Google Scholar
Wood, JJ, Piacentini, JC, Bergman, L, McCracken, J, Barrios, V (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Schedule for DSM-IV: Child and Parent versions. Journal of Clinical Child and Adolescent Psychology 31, 335342. doi: 10.1207/S15374424JCCP3103_05 Google Scholar
Wood, JJ, Piacentini, JC, Southam-Gerow, M, Chu, BC, Sigman, M (2006). Family cognitive-behavioral therapy for child anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry 45, 314321.Google Scholar
Submit a response

Comments

No Comments have been published for this article.