Faculty Database Psychology and Neuroscience Arts & Sciences Duke University |
||
HOME > Arts & Sciences > pn > Faculty | Search Help Login |
| Publications of Scott N. Compton :chronological combined listing:%% Journal Articles @article{fds369781, Author = {Sabatos-DeVito, M and Rardin, BP and Paisley, E and Major, ST and Stoute, C and Murias, M and Compton, SN and Davlantis, KS and Dawson, G}, Title = {1.23 THE UTILITY OF OBJECTIVE MEASURES OF SOCIAL COMMUNICATION DEFICITS IN YOUNG CHILDREN WITH AUTISM SPECTRUM DISORDER}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {55}, Number = {10}, Pages = {S107-S107}, Publisher = {Elsevier BV}, Year = {2016}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jaac.2016.09.024}, Doi = {10.1016/j.jaac.2016.09.024}, Key = {fds369781} } @article{fds369778, Author = {Sakolsky, D and Compton, SN and Pine, DS}, Title = {11.0 Results From the Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS)}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {56}, Number = {10}, Pages = {S317-S318}, Publisher = {Elsevier BV}, Year = {2017}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jaac.2017.07.637}, Doi = {10.1016/j.jaac.2017.07.637}, Key = {fds369778} } @article{fds302629, Author = {Piacentini, J and Bennett, S and Compton, SN and Kendall, PC and Birmaher, B and Albano, AM and March, J and Sherrill, J and Sakolsky, D and Ginsburg, G and Rynn, M and Bergman, RL and Gosch, E and Waslick, B and Iyengar, S and McCracken, J and Walkup, J}, Title = {24- and 36-week outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {53}, Number = {3}, Pages = {297-310}, Year = {2014}, Month = {March}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2013.11.010}, Abstract = {OBJECTIVE: We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). METHOD: CAMS youth (N = 488; 74% ≤ 12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. RESULTS: The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. CONCLUSIONS: COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials.gov. Unique identifier: NCT00052078.}, Doi = {10.1016/j.jaac.2013.11.010}, Key = {fds302629} } @article{fds369779, Author = {Harstad, S and Compton, SN and Villabo, MA}, Title = {6.67 Cognitive-Behavioral Therapy (CBT) for Children With Anxiety Disorder: Do the Therapists’ Adherence and Competence Matter?}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {56}, Number = {10}, Pages = {S300-S300}, Publisher = {Elsevier BV}, Year = {2017}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jaac.2017.09.412}, Doi = {10.1016/j.jaac.2017.09.412}, Key = {fds369779} } @article{fds369782, Author = {Strawn, JR and Dobson, ET and Mills, JA and Cornwall, GJ and Sakolsky, DJ and Birmaher, B and Compton, SN and Piacentini, J and McCracken, JT and Ginsburg, GS and Kendall, PC and Walkup, JT and Albano, AM and Rynn, MA}, Title = {6.80 PLACEBO RESPONSE IN PEDIATRIC ANXIETY DISORDERS: RESULTS FROM THE CHILD AND ADOLESCENT ANXIETY MULTIMODAL STUDY}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {55}, Number = {10}, Pages = {S230-S230}, Publisher = {Elsevier BV}, Year = {2016}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jaac.2016.09.399}, Doi = {10.1016/j.jaac.2016.09.399}, Key = {fds369782} } @article{fds357862, Author = {Dawson, G and Sun, JM and Baker, J and Carpenter, K and Compton, S and Deaver, M and Franz, L and Heilbron, N and Herold, B and Horrigan, J and Howard, J and Kosinski, A and Major, S and Murias, M and Page, K and Prasad, VK and Sabatos-DeVito, M and Sanfilippo, F and Sikich, L and Simmons, R and Song, A and Vermeer, S and Waters-Pick, B and Troy, J and Kurtzberg, J}, Title = {A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder.}, Journal = {J Pediatr}, Volume = {222}, Pages = {164-173.e5}, Year = {2020}, Month = {July}, url = {http://dx.doi.org/10.1016/j.jpeds.2020.03.011}, Abstract = {OBJECTIVE: To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD). STUDY DESIGN: This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo (n = 61) and were evaluated at 6 months postinfusion. RESULTS: CB infusion was safe and well tolerated. Analysis of the entire sample showed no evidence that CB was associated with improvements in the primary outcome, social communication (Vineland Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes, autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary (Expressive One-Word Picture Vocabulary Test). There was also no overall evidence of differential effects by type of CB infused. In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale, but the OR for improvement was not significant. Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power. CONCLUSIONS: Overall, a single infusion of CB was not associated with improved socialization skills or reduced autism symptoms. More research is warranted to determine whether CB infusion is an effective treatment for some children with ASD.}, Doi = {10.1016/j.jpeds.2020.03.011}, Key = {fds357862} } @article{fds271487, Author = {Lewin, AB and Murphy, TK and Storch, EA and Conelea, CA and Woods, DW and Scahill, LD and Compton, SN and Zinner, SH and Budman, CL and Walkup, JT}, Title = {A phenomenological investigation of women with Tourette or other chronic tic disorders.}, Journal = {Compr Psychiatry}, Volume = {53}, Number = {5}, Pages = {525-534}, Year = {2012}, Month = {July}, ISSN = {0010-440X}, url = {http://dx.doi.org/10.1016/j.comppsych.2011.07.004}, Abstract = {There are little data concerning clinical characteristics of women with Tourette disorder and chronic tic disorders in the extant literature and what is available mostly focuses on treatment-seeking individuals. The present research was conducted to provide a phenomenological characterization of tic disorders among 185 adult women with tic disorders. In addition to providing a descriptive overview of specific tic symptoms, tic severity, self-reported history of other psychiatric conditions, and impairment/lifestyle impact due to tics, this study compares 185 women and 275 men between 18 and 79 years old with tic disorders (who completed an identical battery of measures) based on demographic, social/economic status indicators, psychiatric variables (comorbidity, family psychiatric history, symptom presentation), adaptive functioning/quality of life, and impairment variables among a nonclinical adult sample. Finally, this research examines the relationship between tic severity and impairment indicators among women with tics. Sixty-eight percent of women in our sample reported severe motor tics and 40% reported severe phonic tics. Our exploratory data suggest that a sizeable number of adult women with persistent tics are suffering from psychiatric comorbidity and psychosocial consequences such as underachievement and social distress. Tic severity in women may be associated with lifestyle interference as well as with symptoms of depression and anxiety, and such symptoms may be more common among women with tics than in men with tics.}, Doi = {10.1016/j.comppsych.2011.07.004}, Key = {fds271487} } @article{fds271457, Author = {Beidas, RS and Lindhiem, O and Brodman, DM and Swan, A and Carper, M and Cummings, C and Kendall, PC and Albano, AM and Rynn, M and Piacentini, J and McCracken, J and Compton, SN and March, J and Walkup, J and Ginsburg, G and Keeton, CP and Birmaher, B and Sakolsky, D and Sherrill, J}, Title = {A probabilistic and individualized approach for predicting treatment gains: an extension and application to anxiety disordered youth.}, Journal = {Behav Ther}, Volume = {45}, Number = {1}, Pages = {126-136}, Year = {2014}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/j.beth.2013.05.001}, Abstract = {The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry.}, Doi = {10.1016/j.beth.2013.05.001}, Key = {fds271457} } @article{fds349363, Author = {Pistorello, J and Jobes, DA and Gallop, R and Compton, SN and Locey, NS and Au, JS and Noose, SK and Walloch, JC and Johnson, J and Young, M and Dickens, Y and Chatham, P and Jeffcoat, T}, Title = {A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students.}, Journal = {Arch Suicide Res}, Volume = {25}, Number = {4}, Pages = {765-789}, Year = {2021}, url = {http://dx.doi.org/10.1080/13811118.2020.1749742}, Abstract = {This randomized controlled trial compared the Collaborative Assessment and Management of Suicidality (CAMS) and Treatment as Usual (TAU) for suicidal college students within a feasibility trial. Sixty-two suicidal college students were randomized to CAMS (n = 33) or TAU (n = 29). We hypothesized that those receiving CAMS would show more improvement in suicide-related measures, and effects would be moderated by borderline personality disorder (BPD), prior suicide attempts, and age. Both treatment groups showed improvements in all outcome variables; CAMS had a significantly higher impact on depression and suicidal ideation when measured weekly during care and was more likely than TAU to decrease hopelessness among students with fewer BPD features, no suicide attempt history, and older age. Conversely, TAU did better for students with BPD features and history of multiple suicide attempts.}, Doi = {10.1080/13811118.2020.1749742}, Key = {fds349363} } @article{fds358055, Author = {Perochon, S and Di Martino and M and Aiello, R and Baker, J and Carpenter, K and Chang, Z and Compton, S and Davis, N and Eichner, B and Espinosa, S and Flowers, J and Franz, L and Gagliano, M and Harris, A and Howard, J and Kollins, SH and Perrin, EM and Raj, P and Spanos, M and Walter, B and Sapiro, G and Dawson, G}, Title = {A scalable computational approach to assessing response to name in toddlers with autism.}, Journal = {J Child Psychol Psychiatry}, Volume = {62}, Number = {9}, Pages = {1120-1131}, Year = {2021}, Month = {September}, url = {http://dx.doi.org/10.1111/jcpp.13381}, Abstract = {BACKGROUND: This study is part of a larger research program focused on developing objective, scalable tools for digital behavioral phenotyping. We evaluated whether a digital app delivered on a smartphone or tablet using computer vision analysis (CVA) can elicit and accurately measure one of the most common early autism symptoms, namely failure to respond to a name call. METHODS: During a pediatric primary care well-child visit, 910 toddlers, 17-37 months old, were administered an app on an iPhone or iPad consisting of brief movies during which the child's name was called three times by an examiner standing behind them. Thirty-seven toddlers were subsequently diagnosed with autism spectrum disorder (ASD). Name calls and children's behavior were recorded by the camera embedded in the device, and children's head turns were coded by both CVA and a human. RESULTS: CVA coding of response to name was found to be comparable to human coding. Based on CVA, children with ASD responded to their name significantly less frequently than children without ASD. CVA also revealed that children with ASD who did orient to their name exhibited a longer latency before turning their head. Combining information about both the frequency and the delay in response to name improved the ability to distinguish toddlers with and without ASD. CONCLUSIONS: A digital app delivered on an iPhone or iPad in real-world settings using computer vision analysis to quantify behavior can reliably detect a key early autism symptom-failure to respond to name. Moreover, the higher resolution offered by CVA identified a delay in head turn in toddlers with ASD who did respond to their name. Digital phenotyping is a promising methodology for early assessment of ASD symptoms.}, Doi = {10.1111/jcpp.13381}, Key = {fds358055} } @article{fds369350, Author = {Perochon, S and Matias Di Martino and J and Carpenter, KLH and Compton, S and Davis, N and Espinosa, S and Franz, L and Rieder, AD and Sullivan, C and Sapiro, G and Dawson, G}, Title = {A tablet-based game for the assessment of visual motor skills in autistic children.}, Journal = {NPJ Digit Med}, Volume = {6}, Number = {1}, Pages = {17}, Year = {2023}, Month = {February}, url = {http://dx.doi.org/10.1038/s41746-023-00762-6}, Abstract = {Increasing evidence suggests that early motor impairments are a common feature of autism. Thus, scalable, quantitative methods for measuring motor behavior in young autistic children are needed. This work presents an engaging and scalable assessment of visual-motor abilities based on a bubble-popping game administered on a tablet. Participants are 233 children ranging from 1.5 to 10 years of age (147 neurotypical children and 86 children diagnosed with autism spectrum disorder [autistic], of which 32 are also diagnosed with co-occurring attention-deficit/hyperactivity disorder [autistic+ADHD]). Computer vision analyses are used to extract several game-based touch features, which are compared across autistic, autistic+ADHD, and neurotypical participants. Results show that younger (1.5-3 years) autistic children pop the bubbles at a lower rate, and their ability to touch the bubble's center is less accurate compared to neurotypical children. When they pop a bubble, their finger lingers for a longer period, and they show more variability in their performance. In older children (3-10-years), consistent with previous research, the presence of co-occurring ADHD is associated with greater motor impairment, reflected in lower accuracy and more variable performance. Several motor features are correlated with standardized assessments of fine motor and cognitive abilities, as evaluated by an independent clinical assessment. These results highlight the potential of touch-based games as an efficient and scalable approach for assessing children's visual-motor skills, which can be part of a broader screening tool for identifying early signs associated with autism.}, Doi = {10.1038/s41746-023-00762-6}, Key = {fds369350} } @article{fds302620, Author = {Nail, JE and Christofferson, J and Ginsburg, GS and Drake, K and Kendall, PC and McCracken, JT and Birmaher, B and Walkup, JT and Compton, SN and Keeton, C and Sakolsky, D}, Title = {Academic Impairment and Impact of Treatments Among Youth with Anxiety Disorders}, Journal = {Child and Youth Care Forum}, Volume = {44}, Number = {3}, Pages = {327-342}, Publisher = {Springer Nature}, Year = {2015}, Month = {June}, ISSN = {1053-1890}, url = {http://dx.doi.org/10.1007/s10566-014-9290-x}, Abstract = {Background: Global academic difficulties have often been reported in youth with anxiety disorders, however, little is known about the specific academic deficits in this population. Objective: To (a) evaluate the prevalence of seven specific academic impairments in children and adolescents with anxiety disorders, (b) determine whether these impairments are associated with demographic (i.e., race, gender and age) and clinical characteristics (i.e., type of disorder, anxiety severity and global impairment) and (c) examine the impact of anxiety treatments on these impairments. Methods: As part of the Child-Adolescent Anxiety Multimodal Study (a randomized controlled trial), academic impairments, anxiety severity and global impairment were measured in 488 youth (mean age = 10.7 years) with separation, social and/or generalized anxiety disorders. Results: At baseline, 47 % of the sample was rated as impaired on 4 out of 7 items, and nearly 10 % of the sample was rated as academically impaired on 6 out of 7 items. Conversely, 28 % reported no impairment across the 7 items. There were no significant differences in parent-reported academic impairments by race, age or gender. Academic impairment was significantly, positively correlated with anxiety severity and negatively correlated with global functioning. Treatment responders were significantly more likely than non-responders to evidence improvement across all seven specific academic items. Conclusions: Specific academic impairments are prevalent among youth with anxiety disorders. The benefits of evidence-based treatments (i.e., medication/sertraline; CBT/Coping cat) extend beyond symptom relief to include improved academic performance, as perceived by parents, in youth with anxiety disorders.}, Doi = {10.1007/s10566-014-9290-x}, Key = {fds302620} } @article{fds359115, Author = {Babiano-Espinosa, L and Wolters, LH and Weidle, B and Compton, SN and Lydersen, S and Skokauskas, N}, Title = {Acceptability and feasibility of enhanced cognitive behavioral therapy (eCBT) for children and adolescents with obsessive-compulsive disorder.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {15}, Number = {1}, Pages = {47}, Year = {2021}, Month = {September}, url = {http://dx.doi.org/10.1186/s13034-021-00400-7}, Abstract = {INTRODUCTION: Obsessive-compulsive disorder (OCD) is a disabling mental health disorder affecting 1-3% of children and adolescents. Cognitive behavioral therapy (CBT) is recommended as the first-line treatment, but is limited by accessibility, availability, and, in some cases, response to treatment. Enhancement with Internet technologies may mitigate these challenges. METHODS: We developed an enhanced CBT (eCBT) treatment package for children and adolescents with OCD to improve treatment effect as well as user-friendliness. This study aims to explore the feasibility, acceptability, and preliminary effectiveness of the eCBT intervention. The eCBT protocol consists of 10 face-to-face and 12 webcam sessions delivered in 14 weeks. CBT is enhanced by a smartphone application (app) for children and parents to support and monitor treatment, psychoeducative videos, and therapist-guided webcam exposure exercises conducted at home. Assessments were performed at baseline, post-treatment, and at 3- and 6-month follow-up. Primary measures of outcomes were the the Client Satisfaction Questionnaire-8 (CSQ-8) (acceptability), treatment drop-out (feasibility) and the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) (preliminary effectiveness). RESULTS: This paper describes 25 patients with OCD (aged 8-17 years) treated with eCBT. Results indicated that children and parents were satisfied with eCBT, with CSQ-8 mean scores of 27.58 (SD 0.67) and 29.5 (SD 3.74), respectively (range 8-32). No patients dropped out from treatment. We found a mean of 63.8% symptom reduction on the CY-BOCS from baseline to post-treatment. CY-BOCS scores further decreased during 3-month and 6-month follow-up. CONCLUSION: In this explorative study, eCBT for pediatric OCD was a feasible, acceptable intervention demonstrating positive treatment outcomes.}, Doi = {10.1186/s13034-021-00400-7}, Key = {fds359115} } @article{fds347365, Author = {Babiano-Espinosa, L and Wolters, LH and Weidle, B and Op de Beek and V and Pedersen, SA and Compton, S and Skokauskas, N}, Title = {Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review.}, Journal = {Syst Rev}, Volume = {8}, Number = {1}, Pages = {284}, Year = {2019}, Month = {November}, url = {http://dx.doi.org/10.1186/s13643-019-1166-6}, Abstract = {BACKGROUND: Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurring obsessions and compulsions affecting 1-3% of children and adolescents. Current treatment options are limited by accessibility, availability, and quality of care. New technologies provide opportunities to address at least some of these challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitive behavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHOD: We searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articles from 1987 to March 2018. Main inclusion criteria were patients aged 4-18, primary diagnosis of OCD, and iCBT. RESULTS: Of the 2323 unique articles identified during the initial search, six studies with a total of 96 participants met our inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial, and one case series. Four studies reported a significant decrease in OCD severity on the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores for iCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reported high rates of feasibility, and five studies reported good acceptability of iCBT. CONCLUSION: At present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited. Results are promising but need to be confirmed and refined in further research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD4201808587.}, Doi = {10.1186/s13643-019-1166-6}, Key = {fds347365} } @article{fds366145, Author = {Woods, DW and Ely, LJ and Bauer, CC and Twohig, MP and Saunders, SM and Compton, SN and Espil, FM and Neal-Barnett, A and Alexander, JR and Walther, MR and Cahill, SP and Deckersbach, T and Franklin, ME}, Title = {Acceptance-enhanced behavior therapy for trichotillomania in adults: A randomized clinical trial.}, Journal = {Behav Res Ther}, Volume = {158}, Pages = {104187}, Year = {2022}, Month = {November}, url = {http://dx.doi.org/10.1016/j.brat.2022.104187}, Abstract = {Given the limited treatment options for trichotillomania (TTM), or Hair Pulling Disorder, this large randomized clinical trial evaluated the efficacy of acceptance-enhanced behavior therapy for TTM (AEBT-TTM) in reducing TTM severity relative to psychoeducation and supportive therapy (PST). Eighty-five adults (78 women) with TTM received 10 sessions (over 12 weeks) of either AEBT-TTM or PST. Independent evaluators masked to treatment assignment assessed participants at baseline (week 0), midpoint (week 6), and endpoint (week 12). Consistent with a priori hypotheses, 64% of the adults treated with AEBT-TTM were classified as clinical responders at post-treatment relative to 38% treated with PST. Clinical responders were identified by a score of 1 or 2 on the Clinical Global Impressions-Improvement (CGI-I) scale. Relative to the PST group, the AEBT-TTM group demonstrated significantly greater pre-to post-treatment reductions on the self-report Massachusetts General Hospital-Hairpulling Scale (MGH-HS) and the evaluator-rated National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS). There were no significant post-treatment group differences on the Clinical Global Impressions-Severity (CGI-S) scale, or rate of TTM diagnoses. Results suggest AEBT-TTM provides greater treatment benefit than PST. Future research should continue to investigate AEBT-TTM along with mediators and moderators of its efficacy.}, Doi = {10.1016/j.brat.2022.104187}, Key = {fds366145} } @article{fds348089, Author = {Neal-Barnett, A and Woods, DW and Espil, FM and Davis, M and Alexander, JR and Compton, SN and Walther, MR and Twohig, MP and Saunders, SM and Cahill, SP and Franklin, ME}, Title = {Acceptance-enhanced behavior therapy for trichotillomania: Randomized controlled trial rationale, method, and strategies for recruiting minority participants.}, Journal = {Bull Menninger Clin}, Volume = {83}, Number = {4}, Pages = {399-431}, Year = {2019}, url = {http://dx.doi.org/10.1521/bumc_2019_83_04}, Abstract = {Trichotillomania (TTM) involves the chronic pulling out of hair to the point of hair loss or thinning, which continues despite repeated attempts to stop. Behavior therapy is a promising treatment for the condition, but studies have been limited by the lack of a credible control condition, small sample sizes, follow-up periods of short duration, and low participation by underrepresented populations. In the current article, the authors describe the theoretical rationale for an acceptance-enhanced form of behavior therapy for TTM in adults and describe the methodology used to test the efficacy of this intervention against a psychoeducation and supportive control condition. In addition, the authors discuss the importance of and difficulties encountered with enrolling minority participants into TTM research, as well as strategies used to enhance minority recruitment. Finally, the authors discuss the instruments, procedures, and related outcomes of the fidelity measures used in the randomized controlled trial.}, Doi = {10.1521/bumc_2019_83_04}, Key = {fds348089} } @article{fds367348, Author = {Carpenter, KLH and Davis, NO and Spanos, M and Sabatos-DeVito, M and Aiello, R and Baranek, GT and Compton, SN and Egger, HL and Franz, L and Kim, S-J and King, BH and Kolevzon, A and McDougle, CJ and Sanders, K and Veenstra-VanderWeele, J and Sikich, L and Kollins, SH and Dawson, G}, Title = {Adaptive Behavior in Young Autistic Children: Associations with Irritability and ADHD Symptoms.}, Journal = {J Autism Dev Disord}, Year = {2022}, Month = {October}, url = {http://dx.doi.org/10.1007/s10803-022-05753-2}, Abstract = {Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials.}, Doi = {10.1007/s10803-022-05753-2}, Key = {fds367348} } @article{fds302624, Author = {Compton, SN and Rosenfield, D and Hofmann, SG and Smits, JAJ}, Title = {Advances in data analytic methods for evaluating treatment outcome and mechanisms of change: introduction to the special issue.}, Journal = {J Consult Clin Psychol}, Volume = {82}, Number = {5}, Pages = {743-745}, Year = {2014}, Month = {October}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0037795}, Abstract = {This series of articles, which provide an overview of several advanced statistical methods for evaluating treatment outcomes and mechanisms of change, makes up the first research methods-oriented special issue to appear in the Journal of Consulting and Clinical Psychology. Like most active areas of scientific inquiry, the field of biostatistics and quantitative psychology continues to innovate and progress at a remarkable pace. These recent advancements provide researchers with the tools needed to ask and get answers to progressively nuanced and complex questions. It is our hope that the articles included in this special issue will spark an interest among applied researchers to investigate and learn how these and other newer statistical methods might be used to enhance their own line of research.}, Doi = {10.1037/a0037795}, Key = {fds302624} } @article{fds349362, Author = {Kagan, ER and Frank, HE and Norris, LA and Palitz, SA and Chiappini, EA and Knepley, MJ and Crane, ME and Phillips, KE and Ginsburg, GS and Keeton, C and Albano, AM and Piacentini, J and Peris, T and Compton, S and Sakolsky, D and Birmaher, B and Kendall, PC}, Title = {Antidepressant Use in a 3- to 12-Year Follow-up of Anxious Youth: Results from the CAMELS Trial.}, Journal = {Child Psychiatry Hum Dev}, Volume = {52}, Number = {1}, Pages = {41-48}, Year = {2021}, Month = {February}, url = {http://dx.doi.org/10.1007/s10578-020-00983-w}, Abstract = {The current study explored whether patient characteristics predicted patterns of antidepressant use (i.e., never used, single episode of use, or two or more episodes) in a naturalistic follow-up. Participants in the child/adolescent multimodal (CAMS) extended long-term study. (n = 318) indicated medication use over the course of eight follow-up visits, 3-12 years after receiving treatment in CAMS. 40.6% of participants reported never using an antidepressant during follow-up, 41.4% reported a single episode of antidepressant use, and 18.0% reported multiple episodes of antidepressant use. Greater baseline anxiety severity marginally predicted a single episode of antidepressant use; baseline depression severity predicted multiple episodes of use. Reasons for discontinuing antidepressants included perceived ineffectiveness (31.8%), side effects (25.5%), and improvement in symptoms (18.5%). Exploratory analyses examined predictors of medication use. Findings suggest that antidepressant use is common among anxious youth, as is discontinuation of antidepressant use. Clinical implications and future directions are discussed.}, Doi = {10.1007/s10578-020-00983-w}, Key = {fds349362} } @article{fds302623, Author = {Gordon-Hollingsworth, AT and Becker, EM and Ginsburg, GS and Keeton, C and Compton, SN and Birmaher, BB and Sakolsky, DJ and Piacentini, J and Albano, AM and Kendall, PC and Suveg, CM and March, JS}, Title = {Anxiety Disorders in Caucasian and African American Children: A Comparison of Clinical Characteristics, Treatment Process Variables, and Treatment Outcomes.}, Journal = {Child Psychiatry Hum Dev}, Volume = {46}, Number = {5}, Pages = {643-655}, Year = {2015}, Month = {October}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-014-0507-x}, Abstract = {This study examined racial differences in anxious youth using data from the Child/Adolescent Anxiety Multimodal Study (CAMS) [1]. Specifically, the study aims addressed whether African American (n = 44) versus Caucasian (n = 359) children varied on (1) baseline clinical characteristics, (2) treatment process variables, and (3) treatment outcomes. Participants were ages 7-17 and met DSM-IV-TR criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Baseline data, as well as outcome data at 12 and 24 weeks, were obtained by independent evaluators. Weekly treatment process variables were collected by therapists. Results indicated no racial differences on baseline clinical characteristics. However, African American participants attended fewer psychotherapy and pharmacotherapy sessions, and were rated by therapists as less involved and compliant, in addition to showing lower mastery of CBT. Once these and other demographic factors were accounted for, race was not a significant predictor of response, remission, or relapse. Implications of these findings suggest African American and Caucasian youth are more similar than different with respect to the manifestations of anxiety and differences in outcomes are likely due to treatment barriers to session attendance and therapist engagement.}, Doi = {10.1007/s10578-014-0507-x}, Key = {fds302623} } @article{fds302613, Author = {White, SW and Lerner, MD and McLeod, BD and Wood, JJ and Ginsburg, GS and Kerns, C and Ollendick, T and Kendall, PC and Piacentini, J and Walkup, J and Compton, S}, Title = {Anxiety in youth with and without autism spectrum disorder: examination of factorial equivalence.}, Journal = {Behav Ther}, Volume = {46}, Number = {1}, Pages = {40-53}, Year = {2015}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/j.beth.2014.05.005}, Abstract = {Although anxiety is frequently reported among children and adolescents with autism spectrum disorder (ASD), it has not been established that the manifest symptoms of anxiety in the context of ASD are the same as those seen in youth without ASD. This study sought to examine the metric and latent factor equivalence of anxiety as measured by the Multidimensional Anxiety Scale for Children, parent-report (MASC-P) and child-report (MASC-C), in youth with anxiety disorders and ASD with intact verbal ability (n=109, M(age)=11.67 years, 99 male) and a gender-matched comparison group of typically developing (TD) children and adolescents with anxiety disorders but without ASD (n=342, M(age)=11.25 years, 246 male). Multigroup factorial invariance (MFI) using structural equation modeling indicated equivalent latent factors in youth with and without ASD on the MASC-C (metric invariance). However, the item means and covariances along with the relations among the factor scores were different for the youth with ASD (i.e., lack of evidence for scalar or structural invariance). The MASC-P data did not fit the measure's established structure for either the ASD or TD group, and post-hoc exploratory factor analysis revealed a different factor structure in the ASD group. Findings suggest that the MASC-C may not measure identical constructs in anxious youth with and without ASD. Further research on the structure of the MASC in clinical samples is warranted.}, Doi = {10.1016/j.beth.2014.05.005}, Key = {fds302613} } @article{fds370238, Author = {Bai, S and Rolon-Arroyo, B and Walkup, JT and Kendall, PC and Ginsburg, GS and Keeton, CP and Albano, AM and Compton, SN and Sakolsky, D and Piacentini, J and Peris, TS}, Title = {Anxiety symptom trajectories from treatment to 5- to 12-year follow-up across childhood and adolescence.}, Journal = {J Child Psychol Psychiatry}, Volume = {64}, Number = {9}, Pages = {1336-1345}, Year = {2023}, Month = {September}, url = {http://dx.doi.org/10.1111/jcpp.13796}, Abstract = {OBJECTIVE: The current study examined trajectories of anxiety during (a) acute treatment and (b) extended follow-up to better characterize the long-term symptom trajectories of youth who received evidence-based intervention for anxiety disorders using a person-centered approach. METHOD: Participants were 319 youth (age 7-17 years at enrollment), who participated in a multicenter randomized controlled trial for the treatment of pediatric anxiety disorders, Child/Adolescent Anxiety Multimodal Study, and a 4-year naturalistic follow-up, Child/Adolescent Anxiety Multimodal Extended Long-term Study, an average of 6.5 years later. Using growth mixture modeling, the study identified distinct trajectories of anxiety across acute treatment (Weeks 0-12), posttreatment (Weeks 12-36), and the 4-year-long follow-up, and identified baseline predictors of these trajectories. RESULTS: Three nonlinear anxiety trajectories emerged: "short-term responders" who showed rapid treatment response but had higher levels of anxiety during the extended follow-up; "durable responders" who sustained treatment gains; and "delayed remitters" who did not show an initial response to treatment, but showed low levels of anxiety during the maintenance and extended follow-up periods. Worse anxiety severity and better family functioning at baseline predicted membership in the delayed remitters group. Caregiver strain differentiated short-term responders from durable responders. CONCLUSIONS: Findings suggest that initial response to treatment does not guarantee sustained treatment gains over time for some youth. Future follow-up studies that track treated youth across key developmental transitions and in the context of changing social environments are needed to inform best practices for the long-term management of anxiety.}, Doi = {10.1111/jcpp.13796}, Key = {fds370238} } @article{fds271456, Author = {Wei, C and Hoff, A and Villabø, MA and Peterman, J and Kendall, PC and Piacentini, J and McCracken, J and Walkup, JT and Albano, AM and Rynn, M and Sherrill, J and Sakolsky, D and Birmaher, B and Ginsburg, G and Keeton, C and Gosch, E and Compton, SN and March, J}, Title = {Assessing anxiety in youth with the multidimensional anxiety scale for children.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {43}, Number = {4}, Pages = {566-578}, Year = {2014}, ISSN = {1537-4416}, url = {http://dx.doi.org/10.1080/15374416.2013.814541}, Abstract = {The present study examined the psychometric properties, including discriminant validity and clinical utility, of the youth self-report and parent-report forms of the Multidimensional Anxiety Scale for Children (MASC) among youth with anxiety disorders. The sample included parents and youth (N = 488, 49.6% male) ages 7 to 17 who participated in the Child/Adolescent Anxiety Multimodal Study. Although the typical low agreement between parent and youth self-reports was found, the MASC evidenced good internal reliability across MASC subscales and informants. The main MASC subscales (i.e., Physical Symptoms, Harm Avoidance, Social Anxiety, and Separation/Panic) were examined. The Social Anxiety and Separation/Panic subscales were found to be significantly predictive of the presence and severity of social phobia and separation anxiety disorder, respectively. Using multiple informants improved the accuracy of prediction. The MASC subscales demonstrated good psychometric properties and clinical utilities in identifying youth with anxiety disorders.}, Doi = {10.1080/15374416.2013.814541}, Key = {fds271456} } @article{fds271492, Author = {Chrisman, A and Egger, H and Compton, SN and Curry, J and Goldston, DB}, Title = {Assessment of Childhood Depression.}, Journal = {Child Adolesc Ment Health}, Volume = {11}, Number = {2}, Pages = {111-116}, Publisher = {WILEY}, Year = {2006}, Month = {May}, ISSN = {1475-357X}, url = {http://dx.doi.org/10.1111/j.1475-3588.2006.00395.x}, Abstract = {Depression as a disorder in childhood began to be increasingly recognised in the 1970s. Epidemiologic community and clinic-based studies have characterised the prevalence, clinical course, and complications of this illness throughout childhood and adolescence into adulthood. This paper reviews two instruments for assessing depression in prepubertal children - the Dominic Interactive and The Preschool Age Psychiatric Assessment. Both instruments are useful in screening for psychiatric disorders and reliably identifying the presence of depressive symptoms in young children.}, Doi = {10.1111/j.1475-3588.2006.00395.x}, Key = {fds271492} } @article{fds373921, Author = {Fleischer, NJ and Gosch, E and Roberts, MB and Albano, AM and Ginsburg, G and Piacentini, J and Birmaher, B and Compton, SN and Walkup, J and Kendall, PC and Carper, MM}, Title = {Asthma and anxiety in children and adolescents: characteristics and treatment outcomes.}, Journal = {J Asthma}, Pages = {1-9}, Year = {2023}, Month = {November}, url = {http://dx.doi.org/10.1080/02770903.2023.2280906}, Abstract = {OBJECTIVE: This study (a) examined anxious youth with and without asthma on measures of negative self-talk, parental psychopathology, worry content, physical symptoms, panic symptoms, generalized symptoms, and separation anxiety symptoms, and (b) tested if outpatient CBT or medication were differentially effective in reducing anxiety for youth with asthma and anxiety. METHODS: This secondary analysis separated youth with an anxiety disorder into asthma and non-asthma groups. Youth were also compared on response to treatments (i.e. CBT, sertraline, combined, and placebo). RESULTS: A total of 488 participants participated in the original study, with an average age of 10 years (SD 2.87). Youth with comorbid asthma and anxiety demonstrated higher rates of negative self-talk. Youth with comorbid asthma and anxiety did not differ from the non-asthma group on measures of physical symptoms, anxiety disorder specific symptoms, parental psychopathology, or worry content. Youth with asthma and anxiety responded similarly to the non-asthma group to treatment across treatment conditions. CONCLUSIONS: Treatment was comparably effective for youth with comorbid asthma and anxiety and youth with anxiety. Future research could examine the effects of psychopharmaceuticals on asthma and anxiety comorbidity.}, Doi = {10.1080/02770903.2023.2280906}, Key = {fds373921} } @article{fds271474, Author = {Roy, AK and Vasa, RA and Bruck, M and Mogg, K and Bradley, BP and Sweeney, M and Bergman, RL and McClure-Tone, EB and Pine, DS and CAMS Team}, Title = {Attention bias toward threat in pediatric anxiety disorders.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {47}, Number = {10}, Pages = {1189-1196}, Year = {2008}, Month = {October}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e3181825ace}, Abstract = {OBJECTIVE: To examine attention bias toward threat faces in a large sample of anxiety-disordered youths using a well-established visual probe task. METHOD: Study participants included 101 children and adolescents (ages 7-18 years) with generalized anxiety disorder, social phobia, and/or separation anxiety disorder enrolled in a multisite anxiety treatment study. Nonanxious youths (n = 51; ages 9-18 years) were recruited separately. Participants were administered a computerized visual probe task that presents pairs of faces portraying threat (angry), positive (happy), and neutral expressions. They pressed a response key to indicate the spatial location of a probe that replaced one of the faces on each trial. Attention bias scores were calculated from response times to probes for each emotional face type. RESULTS: Compared to healthy youths, anxious participants demonstrated a greater attention bias toward threat faces. This threat bias in anxious patients did not significantly vary across the anxiety disorders. There was no group difference in attention bias toward happy faces. CONCLUSIONS: These results suggest that pediatric anxiety disorders are associated with an attention bias toward threat. Future research may examine the manner in which cognitive bias in anxious youths changes with treatment.}, Doi = {10.1097/CHI.0b013e3181825ace}, Key = {fds271474} } @article{fds371650, Author = {Nagendran, A and Compton, S and Follette, WC and Golenchenko, A and Compton, A and Grizou, J}, Title = {Avatar led interventions in the Metaverse reveal that interpersonal effectiveness can be measured, predicted, and improved.}, Journal = {Sci Rep}, Volume = {12}, Number = {1}, Pages = {21892}, Year = {2022}, Month = {December}, url = {http://dx.doi.org/10.1038/s41598-022-26326-4}, Abstract = {Experiential learning has been known to be an engaging and effective modality for personal and professional development. The Metaverse provides ample opportunities for the creation of environments in which such experiential learning can occur. In this work, we introduce a novel interpersonal effectiveness improvement framework (ELAINE) that combines Artificial Intelligence and Virtual Reality to create a highly immersive and efficient learning experience using avatars. We present findings from a study that uses this framework to measure and improve the interpersonal effectiveness of individuals interacting with an avatar. Results reveal that individuals with deficits in their interpersonal effectiveness show a significant improvement (p < 0.02) after multiple interactions with an avatar. The results also reveal that individuals interact naturally with avatars within this framework, and exhibit similar behavioral traits as they would in the real world. We use this as a basis to analyze the underlying audio and video data streams of individuals during these interactions. We extract relevant features from these data and present a machine-learning based approach to predict interpersonal effectiveness during human-avatar conversation. We conclude by discussing the implications of these findings to build beneficial applications for the real world.}, Doi = {10.1038/s41598-022-26326-4}, Key = {fds371650} } @article{fds376564, Author = {Walkup, JT and Compton, SN and Kendall, PC}, Title = {Behavioral Therapy, Sertraline, or Both in Childhood Anxiety Reply}, Journal = {NEW ENGLAND JOURNAL OF MEDICINE}, Volume = {360}, Number = {23}, Pages = {2477-2477}, Publisher = {MASSACHUSETTS MEDICAL SOC}, Year = {2009}, Month = {June}, Key = {fds376564} } @article{fds371745, Author = {Krishnappa Babu and PR and Aikat, V and Di Martino and JM and Chang, Z and Perochon, S and Espinosa, S and Aiello, R and L H Carpenter and K and Compton, S and Davis, N and Eichner, B and Flowers, J and Franz, L and Dawson, G and Sapiro, G}, Title = {Blink rate and facial orientation reveal distinctive patterns of attentional engagement in autistic toddlers: a digital phenotyping approach.}, Journal = {Sci Rep}, Volume = {13}, Number = {1}, Pages = {7158}, Year = {2023}, Month = {May}, url = {http://dx.doi.org/10.1038/s41598-023-34293-7}, Abstract = {Differences in social attention are well-documented in autistic individuals, representing one of the earliest signs of autism. Spontaneous blink rate has been used to index attentional engagement, with lower blink rates reflecting increased engagement. We evaluated novel methods using computer vision analysis (CVA) for automatically quantifying patterns of attentional engagement in young autistic children, based on facial orientation and blink rate, which were captured via mobile devices. Participants were 474 children (17-36 months old), 43 of whom were diagnosed with autism. Movies containing social or nonsocial content were presented via an iPad app, and simultaneously, the device's camera recorded the children's behavior while they watched the movies. CVA was used to extract the duration of time the child oriented towards the screen and their blink rate as indices of attentional engagement. Overall, autistic children spent less time facing the screen and had a higher mean blink rate compared to neurotypical children. Neurotypical children faced the screen more often and blinked at a lower rate during the social movies compared to the nonsocial movies. In contrast, autistic children faced the screen less often during social movies than during nonsocial movies and showed no differential blink rate to social versus nonsocial movies.}, Doi = {10.1038/s41598-023-34293-7}, Key = {fds371745} } @article{fds271498, Author = {Phillips, SD and Kramer, TL and Compton, SN and Burns, BJ and Robbins, JM}, Title = {Case-mix adjustment of adolescent mental health treatment outcomes.}, Journal = {J Behav Health Serv Res}, Volume = {30}, Number = {1}, Pages = {125-136}, Year = {2003}, ISSN = {1094-3412}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12633009}, Abstract = {Case-mix adjustment methods are needed to account for differences between providers when the youth they treat have characteristics that adversely affect treatment success. This study explores variables for adjusting mental health treatment outcomes for adolescents and the differential effects of case-mix adjustment on providers' performance. Linear regression modeling was used to identify case-mix variables for five outcomes. Predictive equations for each outcome were developed for models based on intake clinical data alone, clinical data plus administrative data, and clinical data plus data describing youth history and family environment. Variance explained by intake clinical data alone did not increase appreciably with the addition of administrative data or data describing youth history and family environment. Adjusting outcomes changed the relative performance of certain individual providers substantially, but had a more moderate impact on the overall interpretation of providers' performance.}, Doi = {10.1007/BF02287818}, Key = {fds271498} } @article{fds271467, Author = {Curry, J and Compton, SN and March, JS}, Title = {CBT VERSUS SUPPORTIVE THERAPY FOR DEPRESSION}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {44}, Number = {9}, Pages = {842-843}, Publisher = {Elsevier BV}, Year = {2005}, Month = {September}, url = {http://dx.doi.org/10.1016/s0890-8567(09)62188-2}, Doi = {10.1016/s0890-8567(09)62188-2}, Key = {fds271467} } @article{fds326330, Author = {Lee, P and Zehgeer, A and Ginsburg, GS and McCracken, J and Keeton, C and Kendall, PC and Birmaher, B and Sakolsky, D and Walkup, J and Peris, T and Albano, AM and Compton, S}, Title = {Child and Adolescent Adherence With Cognitive Behavioral Therapy for Anxiety: Predictors and Associations With Outcomes.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {48}, Number = {sup1}, Pages = {S215-S226}, Year = {2019}, url = {http://dx.doi.org/10.1080/15374416.2017.1310046}, Abstract = {Cognitive behavioral therapy (CBT) for anxiety disorders is effective, but nonadherence with treatment may reduce the benefits of CBT. This study examined (a) four baseline domains (i.e., demographic, youth clinical characteristics, therapy related, family/parent factors) as predictors of youth adherence with treatment and (b) the associations between youth adherence and treatment outcomes. Data were from 279 youth (7-17 years of age, 51.6% female; 79.6% White, 9% African American), with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, who participated in CBT in the Child/Adolescent Anxiety Multimodal Study. Adherence was defined in three ways (session attendance, therapist-rated compliance, and homework completion). Multiple regressions revealed several significant predictors of youth adherence with CBT, but predictors varied according to the definition of adherence. The most robust predictors of greater adherence were living with both parents and fewer youth comorbid externalizing disorders. With respect to outcomes, therapist ratings of higher youth compliance with CBT predicted several indices of favorable outcome: lower anxiety severity, higher global functioning, and treatment responder status after 12 weeks of CBT. Number of sessions attended and homework completion did not predict treatment outcomes. Findings provide information about risks for youth nonadherence, which can inform treatment and highlight the importance of youth compliance with participating in therapy activities, rather than just attending sessions or completing homework assignments.}, Doi = {10.1080/15374416.2017.1310046}, Key = {fds326330} } @article{fds271477, Author = {Compton, SN and Walkup, JT and Albano, AM and Piacentini, JC and Birmaher, B and Sherrill, JT and Ginsburg, GS and Rynn, MA and McCracken, JT and Waslick, BD and Iyengar, S and Kendall, PC and March, JS}, Title = {Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {4}, Pages = {1}, Year = {2010}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20051130}, Abstract = {OBJECTIVE: To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS), a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT), sertraline (SRT), and their combination (COMB) against pill placebo (PBO) for the treatment of separation anxiety disorder (SAD), generalized anxiety disorder (GAD) and social phobia (SoP) in children and adolescents. METHODS: Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. RESULTS: CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488) children and adolescents (ages 7-17 years) with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. CONCLUSIONS: CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT) and pharmacologic (SSRI) treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results of CAMS will hold important implications for informing practice-relevant decisions regarding the initial treatment of youth with anxiety disorders. TRIAL REGISTRATION: ClinicalTrials.gov NCT00052078.}, Doi = {10.1186/1753-2000-4-1}, Key = {fds271477} } @article{fds302619, Author = {Rynn, MA and Walkup, JT and Compton, SN and Sakolsky, DJ and Sherrill, JT and Shen, S and Kendall, PC and McCracken, J and Albano, AM and Piacentini, J and Riddle, MA and Keeton, C and Waslick, B and Chrisman, A and Iyengar, S and March, JS and Birmaher, B}, Title = {Child/Adolescent anxiety multimodal study: evaluating safety.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {54}, Number = {3}, Pages = {180-190}, Year = {2015}, Month = {March}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2014.12.015}, Abstract = {OBJECTIVE: To evaluate the frequency of adverse events (AEs) across 4 treatment conditions in the Child/Adolescent Anxiety Multimodal Study (CAMS), and to compare the frequency of AEs between children and adolescents. METHOD: Participants ages 7 to 17 years (mean = 10.7 years) meeting the DSM-IV criteria for 1 or more of the following disorders: separation anxiety disorder, generalized anxiety disorder, or social phobia were randomized (2:2:2:1) to cognitive-behavioral therapy (CBT, n = 139), sertraline (SRT, n = 133), a combination of both (COMB, n = 140), or pill placebo (PBO, n = 76). Data on AEs were collected via a standardized inquiry method plus a self-report Physical Symptom Checklist (PSC). RESULTS: There were no differences between the double-blinded conditions (SRT versus PBO) for total physical and psychiatric AEs or any individual physical or psychiatric AEs. The rates of total physical AEs were greater in the SRT-alone treatment condition when compared to CBT (p < .01) and COMB (p < .01). Moreover, those who received SRT alone reported higher rates of several physical AEs when compared to COMB and CBT. The rate of total psychiatric AEs was higher in children (≤12 years) across all arms (31.7% versus 23.1%, p < .05). Total PSC scores decreased over time, with no significant differences between treatment groups. CONCLUSION: The results support the tolerability/safety of selective serotonin reuptake inhibitor (SSRI) treatment for anxiety disorders even after adjusting for the number of reporting opportunities, leading to no differences in overall rates of AEs. Few differences occurred on specific items. Additional monitoring of psychiatric AEs is recommended in children (≤12 years). Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov; NCT00052078.}, Doi = {10.1016/j.jaac.2014.12.015}, Key = {fds302619} } @article{fds328085, Author = {Selles, RR and Franklin, M and Sapyta, J and Compton, SN and Tommet, D and Jones, RN and Garcia, A and Freeman, J}, Title = {Children's and Parents' Ability to Tolerate Child Distress: Impact on Cognitive Behavioral Therapy for Pediatric Obsessive Compulsive Disorder.}, Journal = {Child Psychiatry Hum Dev}, Volume = {49}, Number = {2}, Pages = {308-316}, Year = {2018}, Month = {April}, url = {http://dx.doi.org/10.1007/s10578-017-0748-6}, Abstract = {The present study explored the concept of tolerance for child distress in 46 children (ages 5-8), along with their mothers and fathers, who received family-based CBT for OCD. The study sought to describe baseline tolerance, changes in tolerance with treatment, and the predictive impact of tolerance on symptom improvement. Tolerance was rated by clinicians on a single item and the CY-BOCS was used to measure OCD severity. Descriptive results suggested that all participants had some difficulty tolerating the child's distress at baseline while paired t tests indicated large improvements were made over treatment (d = 1.2-2.0). Fathers' initial tolerance was significantly related to symptom improvement in a multivariate regression as were fathers' and children's changes in distress tolerance over the course of treatment. Overall, results provide support for examining tolerance of child distress including its predictive impact and potential as a supplemental intervention target.}, Doi = {10.1007/s10578-017-0748-6}, Key = {fds328085} } @article{fds327201, Author = {Alexander, JR and Houghton, DC and Twohig, MP and Franklin, ME and Saunders, SM and Neal-Barnett, AM and Compton, SN and Woods, DW}, Title = {Clarifying the Relationship between Trichotillomania and Anxiety.}, Journal = {J Obsessive Compuls Relat Disord}, Volume = {13}, Pages = {30-34}, Year = {2017}, Month = {April}, url = {http://dx.doi.org/10.1016/j.jocrd.2017.02.004}, Abstract = {Although research has consistently linked unidimensional anxiety with Trichotillomania (TTM) severity, the relationships between TTM severity and anxiety dimensions (i.e., cognitive and somatic anxiety) are unknown. This knowledge gap limits current TTM conceptualization and treatment. The current study examined these relationships with data collected from ninety-one adults who participated in a randomized clinical trial for TTM treatment. To examine whether the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) could be used to measure multidimensional anxiety in TTM samples, we conducted a factor analysis. Results showed four emergent factors, including a cognitive factor and three somatic factors (neurophysiological, autonomic, and panic). Based on prior research, it was hypothesized that TTM severity would be related to the cognitive anxiety dimension and that psychological inflexibility would mediate the association. Hypotheses were not made regarding the relationship between TTM severity and somatic anxiety. Regression analyses indicated that only cognitive dimensions of anxiety predicted TTM severity and that psychological inflexibility mediated this relationship. Implications for the conceptualization and treatment of TTM are discussed.}, Doi = {10.1016/j.jocrd.2017.02.004}, Key = {fds327201} } @article{fds363902, Author = {Casline, EP and Ogle, RR and Peris, TS and Kendall, PC and Piacentini, J and Compton, SN and Keeton, C and Ginsburg, GS}, Title = {Client-rated facilitators and barriers to long-term youth anxiety disorder recovery.}, Journal = {J Clin Psychol}, Volume = {78}, Number = {11}, Pages = {2164-2179}, Year = {2022}, Month = {November}, url = {http://dx.doi.org/10.1002/jclp.23400}, Abstract = {OBJECTIVE: This study examined client ratings of 26 facilitators and barriers to anxiety improvement approximately 6 years after randomization to treatment for anxiety. METHOD: 319 youth (average 17.12 years old; 82.1% Caucasian; 58.6% female) participated in the longitudinal follow-up study to child and adolescent anxiety multimodal study (CAMS), a randomized controlled trial of medication, cognitive-behavioral therapy (CBT), combination, and placebo. RESULTS: Correcting for multiple comparisons, CBT components (i.e., problem solving, changing unhelpful thoughts, relaxation skills) were rated significantly more helpful among youth without, versus with, an anxiety disorder at follow-up. Barriers that differentiated youth with and without an anxiety disorder included being bullied and difficulty applying therapy content to new situations. Comparisons between youth with different anxiety disorder trajectories (e.g., stable remission, relapsed, or chronically ill) also revealed several differences. CONCLUSION: Findings suggest that client-rated facilitators and barriers covary with anxiety disorder recovery and may serve as useful tools when evaluating long-term treatment efficacy.}, Doi = {10.1002/jclp.23400}, Key = {fds363902} } @article{fds271479, Author = {Kendall, PC and Compton, SN and Walkup, JT and Birmaher, B and Albano, AM and Sherrill, J and Ginsburg, G and Rynn, M and McCracken, J and Gosch, E and Keeton, C and Bergman, L and Sakolsky, D and Suveg, C and Iyengar, S and March, J and Piacentini, J}, Title = {Clinical characteristics of anxiety disordered youth.}, Journal = {J Anxiety Disord}, Volume = {24}, Number = {3}, Pages = {360-365}, Year = {2010}, Month = {April}, ISSN = {0887-6185}, url = {http://dx.doi.org/10.1016/j.janxdis.2010.01.009}, Abstract = {Reports the characteristics of a large, representative sample of treatment-seeking anxious youth (N=488). Participants, aged 7-17 years (mean 10.7 years), had a principal DSM-IV diagnosis of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), or social phobia (SP). Although youth with a co-primary diagnosis for which a different disorder-specific treatment would be indicated (e.g., major depressive disorder, substance abuse) were not included, there were few other exclusion criteria. Participants and their parent/guardian underwent an extensive baseline assessment using a broad array of measures capturing diagnostic status, anxiety symptoms and severity, and areas of functional impairment. Means and standard deviations of the measures of psychopathology and data on diagnostic status are provided. The sample had moderate to severe anxiety disorder and was highly comorbid, with 55.3% of participants meeting criteria for at least one non-targeted DSM-IV disorder. Anxiety disorders in youth often do not present as a single/focused disorder: such disorders in youth overlap in symptoms and are highly comorbid among themselves.}, Doi = {10.1016/j.janxdis.2010.01.009}, Key = {fds271479} } @article{fds271485, Author = {Franklin, ME and Sapyta, J and Freeman, JB and Khanna, M and Compton, S and Almirall, D and Moore, P and Choate-Summers, M and Garcia, A and Edson, AL and Foa, EB and March, JS}, Title = {Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial.}, Journal = {JAMA}, Volume = {306}, Number = {11}, Pages = {1224-1232}, Year = {2011}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21934055}, Abstract = {CONTEXT: The extant literature on the treatment of pediatric obsessive-compulsive disorder (OCD) indicates that partial response to serotonin reuptake inhibitors (SRIs) is the norm and that augmentation with short-term OCD-specific cognitive behavior therapy (CBT) may provide additional benefit. OBJECTIVE: To examine the effects of augmenting SRIs with CBT or a brief form of CBT, instructions in CBT delivered in the context of medication management. DESIGN, SETTING, AND PARTICIPANTS: A 12-week randomized controlled trial conducted at 3 academic medical centers between 2004 and 2009, involving 124 pediatric outpatients between the ages of 7 and 17 years with OCD as a primary diagnosis and a Children's Yale-Brown Obsessive Compulsive Scale score of 16 or higher despite an adequate SRI trial. INTERVENTIONS: Participants were randomly assigned to 1 of 3 treatment strategies that included 7 sessions over 12 weeks: 42 in the medication management only, 42 in the medication management plus instructions in CBT, and 42 in the medication management plus CBT; the last included 14 concurrent CBT sessions. MAIN OUTCOME MEASURES: Whether patients responded positively to treatment by improving their baseline obsessive-compulsive scale score by 30% or more and demonstrating a change in their continuous scores over 12 weeks. RESULTS: The medication management plus CBT strategy was superior to the other 2 strategies on all outcome measures. In the primary intention-to-treat analysis, 68.6% (95% CI, 53.9%-83.3%) in the plus CBT group were considered responders, which was significantly better than the 34.0% (95% CI, 18.0%-50.0%) in the plus instructions in CBT group, and 30.0% (95% CI, 14.9%-45.1%) in the medication management only group. The results were similar in pairwise comparisons with the plus CBT strategy being superior to the other 2 strategies (P < .01 for both). The plus instructions in CBT strategy was not statistically superior to medication management only (P = .72). The number needed-to-treat analysis with the plus CBT vs medication management only in order to see 1 additional patient at week 12, on average, was estimated as 3; for the plus CBT vs the plus instructions in CBT strategy, the number needed to treat was also estimated as 3; for the plus instructions in CBT vs medication management only the number needed to treat was estimated as 25. CONCLUSIONS: Among patients aged 7 to 17 years with OCD and partial response to SRI use, the addition of CBT to medication management compared with medication management alone resulted in a significantly greater response rate, whereas augmentation of medication management with the addition of instructions in CBT did not. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00074815.}, Doi = {10.1001/jama.2011.1344}, Key = {fds271485} } @article{fds271473, Author = {Walkup, JT and Albano, AM and Piacentini, J and Birmaher, B and Compton, SN and Sherrill, JT and Ginsburg, GS and Rynn, MA and McCracken, J and Waslick, B and Iyengar, S and March, JS and Kendall, PC}, Title = {Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.}, Journal = {N Engl J Med}, Volume = {359}, Number = {26}, Pages = {2753-2766}, Year = {2008}, Month = {December}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18974308}, Abstract = {BACKGROUND: Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. METHODS: In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. RESULTS: The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline. CONCLUSIONS: Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.)}, Doi = {10.1056/NEJMoa0804633}, Key = {fds271473} } @article{fds271466, Author = {Compton, SN and March, JS and Brent, D and Albano, AM and Weersing, R and Curry, J}, Title = {Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {43}, Number = {8}, Pages = {930-959}, Year = {2004}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15266189}, Abstract = {OBJECTIVE: To review the literature on the cognitive-behavioral treatment of children and adolescents with anxiety and depressive disorders within the conceptual framework of evidence-based medicine. METHOD: The psychiatric and psychological literature was systematically searched for controlled trials applying cognitive-behavioral treatment to pediatric anxiety and depressive disorders. RESULTS: For both anxiety and depression, substantial evidence supports the efficacy of problem-specific cognitive-behavioral interventions. Comparisons with wait-list, inactive control, and active control conditions suggest medium to large effects for symptom reduction in primary outcome domains. CONCLUSIONS: From an evidence-based perspective, cognitive-behavioral therapy is currently the treatment of choice for anxiety and depressive disorders in children and adolescents. Future research in this area will need to focus on comparing cognitive-behavioral psychotherapy with other treatments, component analyses, and the application of exportable protocol-driven treatments to divergent settings and patient populations.}, Doi = {10.1097/01.chi.0000127589.57468.bf}, Key = {fds271466} } @article{fds337699, Author = {Villabø, MA and Narayanan, M and Compton, SN and Kendall, PC and Neumer, S-P}, Title = {Cognitive-behavioral therapy for youth anxiety: An effectiveness evaluation in community practice.}, Journal = {J Consult Clin Psychol}, Volume = {86}, Number = {9}, Pages = {751-764}, Year = {2018}, Month = {September}, url = {http://dx.doi.org/10.1037/ccp0000326}, Abstract = {OBJECTIVE: To compare the effectiveness of individual cognitive-behavioral therapy (ICBT) and group CBT (GCBT) for referred children with anxiety disorders within community mental health clinics. METHOD: Children (N = 165; ages 7-13 years) referred to 5 clinics in Norway because of primary separation anxiety disorder (SAD), social anxiety disorder (SOC), or generalized anxiety disorder (GAD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria participated in a randomized clinical trial. Participants were randomized to ICBT, GCBT, or wait list (WL). WL participants were randomized to 1 of the 2 active treatment conditions following the wait period. Primary outcome was loss of principal anxiety disorder over 12 weeks and 2-year follow-up. RESULTS: Both ICBT and GCBT were superior to WL on all outcomes. In the intent-to-treat analysis, 52% in ICBT, 65% in GCBT, and 14% in WL were treatment responders. Planned pairwise comparisons found no significant differences between ICBT and GCBT. GCBT was superior to ICBT for children diagnosed with SOC. Improvement continued during 2-year follow-up with no significant between-groups differences. CONCLUSIONS: Among anxiety disordered children, both individual and group CBT can be effectively delivered in community clinics. Response rates were similar to those reported in efficacy trials. Although GCBT was more effective than ICBT for children with SOC following treatment, both treatments were comparable at 2-year follow-up. Dropout rates were lower in GCBT than in ICBT, suggesting that GCBT may be better tolerated. Response rates continued to improve over the follow-up period, with low rates of relapse. (PsycINFO Database Record}, Doi = {10.1037/ccp0000326}, Key = {fds337699} } @article{fds323537, Author = {Houghton, DC and Maas, J and Twohig, MP and Saunders, SM and Compton, SN and Neal-Barnett, AM and Franklin, ME and Woods, DW}, Title = {Comorbidity and quality of life in adults with hair pulling disorder.}, Journal = {Psychiatry Res}, Volume = {239}, Pages = {12-19}, Year = {2016}, Month = {May}, url = {http://dx.doi.org/10.1016/j.psychres.2016.02.063}, Abstract = {Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed.}, Doi = {10.1016/j.psychres.2016.02.063}, Key = {fds323537} } @article{fds356951, Author = {Harstad, S and Bjaastad, JF and Hjemdal, O and Compton, S and Waaktaar, T and Aalberg, M}, Title = {Competence and Adherence Scale for Cognitive Behavioural Therapy (CAS-CBT) for anxiety disorders in youth: Reliability and factor structure}, Journal = {Behavioural and Cognitive Psychotherapy}, Year = {2021}, Month = {January}, url = {http://dx.doi.org/10.1017/S1352465821000217}, Abstract = {Background: There has been increased research interest into the concept of treatment integrity within psychotherapy research. The Competence and Adherence Scale for Cognitive Behavioural Therapy (CAS-CBT) was developed to measure therapists' competence and adherence in cognitive behavioural therapy (CBT), when delivered to children and youth with anxiety disorders. Aims: The aim of this study was to evaluate the psychometric properties of the CAS-CBT in a naturalistic treatment setting. Method: Ratings of 212 randomly selected sessions from a clinical effectiveness trial for children with anxiety disorders (n = 165, mean age = 10.46 years, SD = 1.49) were analysed to assess the psychometric properties of CAS-CBT. Therapy format included both individual sessions and group sessions. Results: Internal consistency for the CAS-CBT was excellent (Cronbach's alpha =.88). Factor analysis suggested a two-factor solution for the total sample, where the first factor was related to CBT structure and session goals, and the second factor was associated with process and relational skills. The individual CBT treatment condition (ICBT) and group CBT treatment condition (GCBT) showed the same factor solution. Conclusion: The CAS-CBT is a feasible and reliable measure for assessing competence and adherence to CBT in the treatment of anxious children. Future research is needed to further assess the generalizability of this scale, its psychometric properties in different treatment populations and with other treatment approaches, and ideally with larger sample sizes.}, Doi = {10.1017/S1352465821000217}, Key = {fds356951} } @article{fds365567, Author = {Krishnappa Babu and PR and Di Martino and JM and Chang, Z and Perochon, S and Aiello, R and Carpenter, KLH and Compton, S and Davis, N and Franz, L and Espinosa, S and Flowers, J and Dawson, G and Sapiro, G}, Title = {Complexity analysis of head movements in autistic toddlers.}, Journal = {J Child Psychol Psychiatry}, Volume = {64}, Number = {1}, Pages = {156-166}, Year = {2023}, Month = {January}, url = {http://dx.doi.org/10.1111/jcpp.13681}, Abstract = {BACKGROUND: Early differences in sensorimotor functioning have been documented in young autistic children and infants who are later diagnosed with autism. Previous research has demonstrated that autistic toddlers exhibit more frequent head movement when viewing dynamic audiovisual stimuli, compared to neurotypical toddlers. To further explore this behavioral characteristic, in this study, computer vision (CV) analysis was used to measure several aspects of head movement dynamics of autistic and neurotypical toddlers while they watched a set of brief movies with social and nonsocial content presented on a tablet. METHODS: Data were collected from 457 toddlers, 17-36 months old, during their well-child visit to four pediatric primary care clinics. Forty-one toddlers were subsequently diagnosed with autism. An application (app) displayed several brief movies on a tablet, and the toddlers watched these movies while sitting on their caregiver's lap. The front-facing camera in the tablet recorded the toddlers' behavioral responses. CV was used to measure the participants' head movement rate, movement acceleration, and complexity using multiscale entropy. RESULTS: Autistic toddlers exhibited significantly higher rate, acceleration, and complexity in their head movements while watching the movies compared to neurotypical toddlers, regardless of the type of movie content (social vs. nonsocial). The combined features of head movement acceleration and complexity reliably distinguished the autistic and neurotypical toddlers. CONCLUSIONS: Autistic toddlers exhibit differences in their head movement dynamics when viewing audiovisual stimuli. Higher complexity of their head movements suggests that their movements were less predictable and less stable compared to neurotypical toddlers. CV offers a scalable means of detecting subtle differences in head movement dynamics, which may be helpful in identifying early behaviors associated with autism and providing insight into the nature of sensorimotor differences associated with autism.}, Doi = {10.1111/jcpp.13681}, Key = {fds365567} } @article{fds357891, Author = {Chang, Z and Di Martino and JM and Aiello, R and Baker, J and Carpenter, K and Compton, S and Davis, N and Eichner, B and Espinosa, S and Flowers, J and Franz, L and Harris, A and Howard, J and Perochon, S and Perrin, EM and Krishnappa Babu and PR and Spanos, M and Sullivan, C and Walter, BK and Kollins, SH and Dawson, G and Sapiro, G}, Title = {Computational Methods to Measure Patterns of Gaze in Toddlers With Autism Spectrum Disorder.}, Journal = {JAMA Pediatr}, Volume = {175}, Number = {8}, Pages = {827-836}, Year = {2021}, Month = {August}, url = {http://dx.doi.org/10.1001/jamapediatrics.2021.0530}, Abstract = {IMPORTANCE: Atypical eye gaze is an early-emerging symptom of autism spectrum disorder (ASD) and holds promise for autism screening. Current eye-tracking methods are expensive and require special equipment and calibration. There is a need for scalable, feasible methods for measuring eye gaze. OBJECTIVE: Using computational methods based on computer vision analysis, we evaluated whether an app deployed on an iPhone or iPad that displayed strategically designed brief movies could elicit and quantify differences in eye-gaze patterns of toddlers with ASD vs typical development. DESIGN, SETTING, AND PARTICIPANTS: A prospective study in pediatric primary care clinics was conducted from December 2018 to March 2020, comparing toddlers with and without ASD. Caregivers of 1564 toddlers were invited to participate during a well-child visit. A total of 993 toddlers (63%) completed study measures. Enrollment criteria were aged 16 to 38 months, healthy, English- or Spanish-speaking caregiver, and toddler able to sit and view the app. Participants were screened with the Modified Checklist for Autism in Toddlers-Revised With Follow-up during routine care. Children were referred by their pediatrician for diagnostic evaluation based on results of the checklist or if the caregiver or pediatrician was concerned. Forty toddlers subsequently were diagnosed with ASD. EXPOSURES: A mobile app displayed on a smartphone or tablet. MAIN OUTCOMES AND MEASURES: Computer vision analysis quantified eye-gaze patterns elicited by the app, which were compared between toddlers with ASD vs typical development. RESULTS: Mean age of the sample was 21.1 months (range, 17.1-36.9 months), and 50.6% were boys, 59.8% White individuals, 16.5% Black individuals, 23.7% other race, and 16.9% Hispanic/Latino individuals. Distinctive eye-gaze patterns were detected in toddlers with ASD, characterized by reduced gaze to social stimuli and to salient social moments during the movies, and previously unknown deficits in coordination of gaze with speech sounds. The area under the receiver operating characteristic curve discriminating ASD vs non-ASD using multiple gaze features was 0.90 (95% CI, 0.82-0.97). CONCLUSIONS AND RELEVANCE: The app reliably measured both known and new gaze biomarkers that distinguished toddlers with ASD vs typical development. These novel results may have potential for developing scalable autism screening tools, exportable to natural settings, and enabling data sets amenable to machine learning.}, Doi = {10.1001/jamapediatrics.2021.0530}, Key = {fds357891} } @article{fds370624, Author = {Isaev, DY and Sabatos-DeVito, M and Di Martino and JM and Carpenter, K and Aiello, R and Compton, S and Davis, N and Franz, L and Sullivan, C and Dawson, G and Sapiro, G}, Title = {Computer Vision Analysis of Caregiver-Child Interactions in Children with Neurodevelopmental Disorders: A Preliminary Report.}, Journal = {J Autism Dev Disord}, Year = {2023}, Month = {April}, url = {http://dx.doi.org/10.1007/s10803-023-05973-0}, Abstract = {We report preliminary results of computer vision analysis of caregiver-child interactions during free play with children diagnosed with autism (N = 29, 41-91 months), attention-deficit/hyperactivity disorder (ADHD, N = 22, 48-100 months), or combined autism + ADHD (N = 20, 56-98 months), and neurotypical children (NT, N = 7, 55-95 months). We conducted micro-analytic analysis of 'reaching to a toy,' as a proxy for initiating or responding to a toy play bout. Dyadic analysis revealed two clusters of interaction patterns, which differed in frequency of 'reaching to a toy' and caregivers' contingent responding to the child's reach for a toy by also reaching for a toy. Children in dyads with higher caregiver responsiveness had less developed language, communication, and socialization skills. Clusters were not associated with diagnostic groups. These results hold promise for automated methods of characterizing caregiver responsiveness in dyadic interactions for assessment and outcome monitoring in clinical trials.}, Doi = {10.1007/s10803-023-05973-0}, Key = {fds370624} } @article{fds302622, Author = {Skarphedinsson, G and Weidle, B and Thomsen, PH and Dahl, K and Torp, NC and Nissen, JB and Melin, KH and Hybel, K and Valderhaug, R and Wentzel-Larsen, T and Compton, SN and Ivarsson, T}, Title = {Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: a randomized controlled trial.}, Journal = {Eur Child Adolesc Psychiatry}, Volume = {24}, Number = {5}, Pages = {591-602}, Publisher = {SPRINGER}, Year = {2015}, Month = {May}, ISSN = {1018-8827}, url = {http://dx.doi.org/10.1007/s00787-014-0613-0}, Abstract = {Expert guidelines recommend cognitive-behavior therapy (CBT) as a first-line treatment in pediatric obsessive-compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors when CBT is not effective. However, the recommendations for CBT non-responders are not supported by empirical data. Our objective was to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Randomized controlled trial conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7-17 years, with DSM-IV primary OCD were randomized to SRT or continued CBT for 16 weeks. These participants had been classified as non-responders to CBT following 14 weekly sessions. Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS <16). The study was a part of the Nordic Long-Term OCD Treatment Study (NordLOTS). Intent-to-treat sample included 50 participants, mean age 14.0 (SD = 2.7) and 48 (n = 24) males. Twenty-one of 28 participants (75%) completed continued CBT and 15 of 22 participants (69.2%) completed SRT. Planned pairwise comparison of the CY-BOCS total score did not reveal a significant difference between the treatments (p = .351), the response rate was 50.0% in the CBT group and 45.4% in the SRT group. The multivariate χ (2) test suggested that there were no statistically significant differences between groups (p = .727). Within-group effect sizes were large and significant across both treatments. These large within-group effect sizes suggest that continued treatment for CBT non-responders is beneficial. However, there was no significant between-group differences in SRT or continued CBT at post-treatment.}, Doi = {10.1007/s00787-014-0613-0}, Key = {fds302622} } @article{fds339514, Author = {Gonzalez, A and Rozenman, M and Langley, AK and Kendall, PC and Ginsburg, GS and Compton, S and Walkup, JT and Birmaher, B and Albano, AM and Piacentini, J}, Title = {Correction to: Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale (Child & Youth Care Forum, (2017), 46, 3, (395-412), 10.1007/s10566-016-9381-y)}, Journal = {Child and Youth Care Forum}, Volume = {47}, Number = {5}, Pages = {769-770}, Publisher = {Springer Nature America, Inc}, Year = {2018}, Month = {October}, url = {http://dx.doi.org/10.1007/s10566-018-9466-x}, Abstract = {The original version of this article unfortunately contains the following errors. This has been corrected with this erratum.}, Doi = {10.1007/s10566-018-9466-x}, Key = {fds339514} } @article{fds271496, Author = {Compton, SN and Cuffel, BJ and Burns, BJ and Goldman, W}, Title = {Datapoints: Effects of changing from five to ten preauthorized outpatient sessions.}, Journal = {Psychiatr Serv}, Volume = {51}, Number = {10}, Pages = {1223}, Year = {2000}, Month = {October}, url = {http://dx.doi.org/10.1176/appi.ps.51.10.1223}, Doi = {10.1176/appi.ps.51.10.1223}, Key = {fds271496} } @article{fds271488, Author = {Caporino, NE and Brodman, DM and Kendall, PC and Albano, AM and Sherrill, J and Piacentini, J and Sakolsky, D and Birmaher, B and Compton, SN and Ginsburg, G and Rynn, M and McCracken, J and Gosch, E and Keeton, C and March, J and Walkup, JT}, Title = {Defining treatment response and remission in child anxiety: signal detection analysis using the pediatric anxiety rating scale.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {52}, Number = {1}, Pages = {57-67}, Year = {2013}, Month = {January}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2012.10.006}, Abstract = {OBJECTIVE: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. METHOD: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multi-site, randomized controlled trial that examined the relative efficacy of cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline [SRT]), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The clinician-rated PARS was administered pre- and posttreatment (delivered over 12 weeks). Quality receiver operating characteristic methods assessed the performance of various PARS percent reductions and absolute cut-off scores in predicting treatment response and remission, as determined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule for DSM-IV. Corresponding change in impairment was evaluated using the Child Anxiety Impact Scale. RESULTS: Reductions of 35% and 50% on the six-item PARS optimally predicted treatment response and remission, respectively. Post-treatment PARS raw scores of 8 to 10 optimally predicted remission. Anxiety improved as a function of PARS-defined treatment response and remission. CONCLUSIONS: Results serve as guidelines for operationalizing treatment response and remission in future research and in making cross-study comparisons. These guidelines can facilitate translation of research findings into clinical practice.}, Doi = {10.1016/j.jaac.2012.10.006}, Key = {fds271488} } @article{fds336058, Author = {Palitz, SA and Caporino, NE and McGuire, JF and Piacentini, J and Albano, AM and Birmaher, B and Walkup, JT and Compton, SN and Ginsburg, GS and Kendall, PC}, Title = {Defining Treatment Response and Remission in Youth Anxiety: A Signal Detection Analysis With the Multidimensional Anxiety Scale for Children.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {57}, Number = {6}, Pages = {418-427}, Year = {2018}, Month = {June}, url = {http://dx.doi.org/10.1016/j.jaac.2018.03.013}, Abstract = {OBJECTIVE: To determine the percent reduction cutoffs on the Multidimensional Anxiety Scale for Children (MASC) that optimally predict treatment response and remission in youth with anxiety disorders. METHOD: Youths and their parents completed the MASC-C/P before and after treatment, and the Anxiety Disorders Interview Schedule for DSM-IV-Child and Parent Versions (ADIS-IV-C/P) and the Clinical Global Impression-Improvement Scale (CGI-I) were administered by independent evaluators. Treatment response and remission were defined by post-treatment ratings on the CGI-I and the ADIS-IV-C/P, respectively. Quality receiver operating characteristic methods determined the optimal cutoff on the MASC-P for predicting overall remission (loss of all study entry diagnoses) and optimal percent reductions on the MASC-P for predicting treatment response and remission of separation anxiety, social anxiety, and generalized anxiety. RESULTS: A post-treatment raw score of 42 optimally predicted remission. A reduction of 35% on the total MASC-P predicted treatment response. A reduction of 30% on the Separation Anxiety/Panic subscale of the MASC-P predicted separation anxiety remission. A reduction of 35% on the Social Anxiety subscale of the MASC-P predicted social anxiety remission. The MASC did not evidence a cutoff for remission of generalized anxiety disorder. CONCLUSION: MASC cutoffs can facilitate comparison across studies and guide practice, aiding clinicians in assessing progress and informing treatment plans.}, Doi = {10.1016/j.jaac.2018.03.013}, Key = {fds336058} } @article{fds302616, Author = {Houghton, DC and Capriotti, MR and De Nadai and AS and Compton, SN and Twohig, MP and Neal-Barnett, AM and Saunders, SM and Franklin, ME and Woods, DW}, Title = {Defining treatment response in trichotillomania: a signal detection analysis.}, Journal = {J Anxiety Disord}, Volume = {36}, Pages = {44-51}, Year = {2015}, Month = {December}, ISSN = {0887-6185}, url = {http://dx.doi.org/10.1016/j.janxdis.2015.09.008}, Abstract = {The Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and the NIMH Trichotillomania Severity Scale (NIMH-TSS) are two widely used measures of trichotillomania severity. Despite their popular use, currently no empirically-supported guidelines exist to determine the degrees of change on these scales that best indicate treatment response. Determination of such criteria could aid in clinical decision-making by defining clinically significant treatment response/recovery and producing accurate power analyses for use in clinical trials research. Adults with trichotillomania (N=69) participated in a randomized controlled trial of psychotherapy and were assessed before and after treatment. Response status was measured via the Clinical Global Impressions-Improvement Scale, and remission status was measured via the Clinical Global Impressions-Severity Scale. For treatment response, a 45% reduction or 7-point raw score change on the MGH-HPS was the best indicator of clinically significant treatment response, and on the NIMH-TSS, a 30-40% reduction or 6-point raw score difference was most effective cutoff. For disorder remission, a 55-60% reduction or 7-point raw score change on the MGH-HPS was the best predictor, and on the NIMH-TSS, a 65% reduction or 6-point raw score change was the best indicator of disorder remission. Implications of these findings are discussed.}, Doi = {10.1016/j.janxdis.2015.09.008}, Key = {fds302616} } @article{fds271459, Author = {Vitiello, B and Brent, DA and Greenhill, LL and Emslie, G and Wells, K and Walkup, JT and Stanley, B and Bukstein, O and Kennard, BD and Compton, S and Coffey, B and Cwik, MF and Posner, K and Wagner, A and March, JS and Riddle, M and Goldstein, T and Curry, J and Capasso, L and Mayes, T and Shen, S and Gugga, SS and Turner, JB and Barnett, S and Zelazny, J}, Title = {Depressive symptoms and clinical status during the Treatment of Adolescent Suicide Attempters (TASA) Study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {10}, Pages = {997-1004}, Year = {2009}, Month = {October}, url = {http://dx.doi.org/10.1097/CHI.0b013e3181b5db66}, Abstract = {OBJECTIVE: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. METHOD: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. RESULTS: Most patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤ 28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r = 0.43, p < .0001) and declined in parallel. CONCLUSIONS: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.}, Doi = {10.1097/CHI.0b013e3181b5db66}, Key = {fds271459} } @article{fds271490, Author = {Almirall, D and Compton, SN and Gunlicks-Stoessel, M and Duan, N and Murphy, SA}, Title = {Designing a pilot sequential multiple assignment randomized trial for developing an adaptive treatment strategy.}, Journal = {Stat Med}, Volume = {31}, Number = {17}, Pages = {1887-1902}, Year = {2012}, Month = {July}, ISSN = {0277-6715}, url = {http://dx.doi.org/10.1002/sim.4512}, Abstract = {There is growing interest in how best to adapt and readapt treatments to individuals to maximize clinical benefit. In response, adaptive treatment strategies (ATS), which operationalize adaptive, sequential clinical decision making, have been developed. From a patient's perspective an ATS is a sequence of treatments, each individualized to the patient's evolving health status. From a clinician's perspective, an ATS is a sequence of decision rules that input the patient's current health status and output the next recommended treatment. Sequential multiple assignment randomized trials (SMART) have been developed to address the sequencing questions that arise in the development of ATSs, but SMARTs are relatively new in clinical research. This article provides an introduction to ATSs and SMART designs. This article also discusses the design of SMART pilot studies to address feasibility concerns, and to prepare investigators for a full-scale SMART. We consider an example SMART for the development of an ATS in the treatment of pediatric generalized anxiety disorders. Using the example SMART, we identify and discuss design issues unique to SMARTs that are best addressed in an external pilot study prior to the full-scale SMART. We also address the question of how many participants are needed in a SMART pilot study. A properly executed pilot study can be used to effectively address concerns about acceptability and feasibility in preparation for (that is, prior to) executing a full-scale SMART.}, Doi = {10.1002/sim.4512}, Key = {fds271490} } @article{fds336060, Author = {Pistorello, J and Jobes, DA and Compton, SN and Locey, NS and Walloch, JC and Gallop, R and Au, JS and Noose, SK and Young, M and Johnson, J and Dickens, Y and Chatham, P and Jeffcoat, T and Dalto, G and Goswami, S}, Title = {Developing Adaptive Treatment Strategies to Address Suicidal Risk in College Students: A Pilot Sequential, Multiple Assignment, Randomized Trial (SMART).}, Journal = {Arch Suicide Res}, Volume = {22}, Number = {4}, Pages = {644-664}, Year = {2017}, url = {http://dx.doi.org/10.1080/13811118.2017.1392915}, Abstract = {This pilot study investigated the potential to utilize adaptive treatment strategies for treating moderate to severe suicidal risk among college students. This article will describe the unique study design and report on feasibility and acceptability findings. A 2-stage Sequential Multiple Assignment Randomized Trial (SMART) was conducted: In Stage 1, 62 suicidal college students were randomized to either a suicide-focused or a treatment-as-usual condition (4-8 weeks). Those deemed insufficient responders were re-randomized to one of two Stage 2 interventions-both suicide-focused but one comprehensive and multimodal and the other flexible and theoretically agnostic (4-16 additional weeks). Recruitment rates were high, treatment dropout levels were lower than expected for the setting, study dropouts were rare, and counselors were able to deliver suicide-focused approaches with fidelity. Treatment satisfaction was high among clients and moderately high among counselors. Findings from this pilot show that a SMART is highly feasible and acceptable to suicidal college students, counselors, and campuses.}, Doi = {10.1080/13811118.2017.1392915}, Key = {fds336060} } @article{fds369783, Author = {Almirall, D and Compton, S and Murphy, SA}, Title = {Development of adaptive treatment strategies in mood disorders: Rethinking maintenance therapy trials}, Journal = {INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY}, Volume = {13}, Pages = {29-29}, Publisher = {CAMBRIDGE UNIV PRESS}, Year = {2010}, Month = {January}, Key = {fds369783} } @article{fds327204, Author = {Hoff, AL and Kendall, PC and Langley, A and Ginsburg, G and Keeton, C and Compton, S and Sherrill, J and Walkup, J and Birmaher, B and Albano, AM and Suveg, C and Piacentini, J}, Title = {Developmental Differences in Functioning in Youth With Social Phobia.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {46}, Number = {5}, Pages = {686-694}, Year = {2017}, url = {http://dx.doi.org/10.1080/15374416.2015.1079779}, Abstract = {Social phobia (SoP) in youth may manifest differently across development as parent involvement in their social lives changes and social and academic expectations increase. This cross-sectional study investigated whether self-reported and parent-reported functioning in youth with SoP changes with age in social, academic, and home/family domains. Baseline anxiety impairment data from 488 treatment-seeking anxiety-disordered youth (ages 7-17, N = 400 with a SoP diagnosis) and their parents were gathered using the Child Anxiety Impact Scale and were analyzed using generalized estimating equations. According to youth with SoP and their parents, overall difficulties, social difficulties, and academic difficulties increased with age, even when controlling for SoP severity. These effects significantly differed for youth with anxiety disorders other than SoP. Adolescents may avoid social situations as parental involvement in their social lives decreases, and their withdrawn behavior may result in increasing difficulty in the social domain. Their avoidance of class participation and oral presentations may increasingly impact their academic performance as school becomes more demanding. Implications are discussed for the early detection and intervention of SoP to prevent increased impairment over the course of development.}, Doi = {10.1080/15374416.2015.1079779}, Key = {fds327204} } @article{fds347050, Author = {Jensen, S and Højgaard, DRMA and Hybel, KA and Mortensen, EL and Skarphedinsson, G and Melin, K and Ivarsson, T and Nissen, JB and Weidle, B and Valderhaug, R and Torp, NC and Dahl, K and Compton, S and Thomsen, PH}, Title = {Distinct trajectories of long-term symptom severity in pediatric obsessive-compulsive disorder during and after stepped-care treatment.}, Journal = {J Child Psychol Psychiatry}, Volume = {61}, Number = {9}, Pages = {969-978}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1111/jcpp.13155}, Abstract = {BACKGROUND: First-line treatments for pediatric obsessive-compulsive disorder (OCD) include exposure-based cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs). No studies have thus far identified distinct classes and associated predictors of long-term symptom severity during and after treatment. Yet, these could form the basis for more personalized treatment in pediatric OCD. METHOD: The study included 269 OCD patients aged 7-17 years from the Nordic Long-term OCD Treatment Study (NordLOTS). All participants received stepped-care treatment starting with 14 weekly sessions of manualized CBT. Nonresponders were randomized to either prolonged CBT or SSRIs. Symptom severity was assessed using the Children's Yale-Brown Obsessive-Compulsive Scale at seven time points from pre- to post-treatment and over a three-year follow-up. Latent class growth analysis (LCGA) was performed to identify latent classes of symptom severity trajectories. Univariate and multivariate analyses were used to detect differences between classes and identify predictors of trajectory class membership including several clinical and demographic variables. TRIAL REGISTRY: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119. RESULTS: Three LCGA classes were identified: (a) acute, sustained responders (54.6%); (b) slow, continued responders (23.4%); and (c) limited long-term responders (21.9%). Class membership was predicted by distinct baseline characteristics pertaining to age, symptom severity, contamination/cleaning and anxiety symptoms. CONCLUSIONS: The LCGA suggests three distinct trajectory classes of long-term symptom severity during and after treatment in pediatric OCD with different clinical profiles at pretreatment. The results point to required clinical attention for adolescent patients with contamination/cleaning and anxiety symptoms who do not show convincing responses to first-line treatment even though they may have reached the established cutoff for treatment response.}, Doi = {10.1111/jcpp.13155}, Key = {fds347050} } @article{fds369896, Author = {Rabner, JC and Olino, TM and Albano, AM and Ginsburg, GS and Compton, SN and Piacentini, J and Sakolsky, D and Birmaher, B and Gosch, E and Kendall, PC}, Title = {Do youth anxiety measures assess the same construct consistently throughout treatment? Results are...complicated.}, Journal = {Child Psychiatry Hum Dev}, Year = {2023}, Month = {March}, url = {http://dx.doi.org/10.1007/s10578-023-01515-y}, Abstract = {Interventionists interpret changes in symptoms as reflecting response to treatment. However, changes in symptom functioning and the measurement of the underlying constructs may be reflected in reported change. Longitudinal measurement invariance (LMI) is a statistical approach that assesses the degree to which measures consistently capture the same construct over time. We examined LMI in measures of anxiety severity/symptoms [i.e., Pediatric Anxiety Rating Scale (PARS), Multidimensional Anxiety Scale for Children (MASC), Screen for Child Anxiety and Related Disorders (SCARED)] in anxious youth at baseline and posttreatment. Initial fit was inadequate for 27 of 38 baseline and posttreatment models, but model modifications resulted in acceptable fit. Tests of LMI supported scalar invariance for the PARS and many, but not all, MASC and SCARED subscales. Findings suggest that the PARS, and many MASC and SCARED subscales can accurately be used to measure change over time, however, others may reflect changes in measurement properties.}, Doi = {10.1007/s10578-023-01515-y}, Key = {fds369896} } @article{fds323538, Author = {Houghton, DC and McFarland, CS and Franklin, ME and Twohig, MP and Compton, SN and Neal-Barnett, AM and Saunders, SM and Woods, DW}, Title = {DSM-5 Trichotillomania: Perception of Adults With Trichotillomania After Psychosocial Treatment.}, Journal = {Psychiatry}, Volume = {79}, Number = {2}, Pages = {164-169}, Year = {2016}, url = {http://dx.doi.org/10.1080/00332747.2016.1144438}, Abstract = {OBJECTIVE: Trichotillomania (TTM) is associated with significant embarrassment and is viewed negatively by others. A potentially important outcome variable that is often overlooked in treatment for TTM is appearance and social perception. METHOD: The present study tested whether participants in a randomized controlled trial (RCT) of psychotherapy for TTM are viewed more positively by others. All participants in the trial were photographed at baseline and posttreatment. Three treatment responders and three treatment nonresponders were selected randomly for the present study. Several healthy controls were also photographed in a similar manner. Undergraduate college students (N = 245) assessed whether they would reject the person socially, whether the individual has a psychological or medical problem, and attractiveness. RESULTS: Individuals with TTM were viewed more negatively than healthy controls at baseline, but treatment responders showed positive improvements on all perceptions relative to nonresponders. While treatment responders were still perceived more poorly than controls on social rejection and perceptions of problems at posttreatment, responders where rated no differently than controls on attractiveness at posttreatment. CONCLUSIONS: The results suggest that persons with TTM who respond to treatment are rated by others as significantly improved in appearance, but they might be still stigmatized or socially rejected.}, Doi = {10.1080/00332747.2016.1144438}, Key = {fds323538} } @article{fds271472, Author = {Freeman, JB and Garcia, AM and Coyne, L and Ale, C and Przeworski, A and Himle, M and Compton, S and Leonard, HL}, Title = {Early childhood OCD: preliminary findings from a family-based cognitive-behavioral approach.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {47}, Number = {5}, Pages = {593-602}, Year = {2008}, Month = {May}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e31816765f9}, Abstract = {OBJECTIVE: To examine the relative efficacy of family-based cognitive-behavioral therapy (CBT) versus family-based relaxation treatment (RT) for young children ages 5 to 8 years with obsessive-compulsive disorder (OCD). METHOD: Forty-two young children with primary OCD were randomized to receive 12 sessions of family-based CBT or family-based RT. Assessments were conducted before and after treatment by independent raters blind to treatment assignment. Primary outcomes included scores on the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global Impressions-Improvement. RESULTS: For the intent-to-treat sample, CBT was associated with a moderate treatment effect (d = 0.53), although there was not a significant difference between the groups at conventional levels. For the completer sample, CBT had a large effect (d = 0.85), and there was a significant group difference favoring CBT. In the intent-to-treat sample, 50% of children in the CBT group achieved remission as compared to 20% in the RT group. In the completer sample, 69% of children in the CBT group achieved a clinical remission compared to 20% in the RT group. CONCLUSIONS: Results indicate that children with early-onset OCD benefit from a treatment approach tailored to their developmental needs and family context. CBT was effective in reducing OCD symptoms and in helping a large number of children achieve a clinical remission.}, Doi = {10.1097/CHI.0b013e31816765f9}, Key = {fds271472} } @article{fds373395, Author = {Perochon, S and Di Martino and JM and Carpenter, KLH and Compton, S and Davis, N and Eichner, B and Espinosa, S and Franz, L and Krishnappa Babu, PR and Sapiro, G and Dawson, G}, Title = {Early detection of autism using digital behavioral phenotyping.}, Journal = {Nat Med}, Volume = {29}, Number = {10}, Pages = {2489-2497}, Year = {2023}, Month = {October}, url = {http://dx.doi.org/10.1038/s41591-023-02574-3}, Abstract = {Early detection of autism, a neurodevelopmental condition associated with challenges in social communication, ensures timely access to intervention. Autism screening questionnaires have been shown to have lower accuracy when used in real-world settings, such as primary care, as compared to research studies, particularly for children of color and girls. Here we report findings from a multiclinic, prospective study assessing the accuracy of an autism screening digital application (app) administered during a pediatric well-child visit to 475 (17-36 months old) children (269 boys and 206 girls), of which 49 were diagnosed with autism and 98 were diagnosed with developmental delay without autism. The app displayed stimuli that elicited behavioral signs of autism, quantified using computer vision and machine learning. An algorithm combining multiple digital phenotypes showed high diagnostic accuracy with the area under the receiver operating characteristic curve = 0.90, sensitivity = 87.8%, specificity = 80.8%, negative predictive value = 97.8% and positive predictive value = 40.6%. The algorithm had similar sensitivity performance across subgroups as defined by sex, race and ethnicity. These results demonstrate the potential for digital phenotyping to provide an objective, scalable approach to autism screening in real-world settings. Moreover, combining results from digital phenotyping and caregiver questionnaires may increase autism screening accuracy and help reduce disparities in access to diagnosis and intervention.}, Doi = {10.1038/s41591-023-02574-3}, Key = {fds373395} } @article{fds363252, Author = {Babiano-Espinosa, L and Skarphedinsson, G and Weidle, B and Wolters, LH and Compton, S and Ivarsson, T and Skokauskas, N}, Title = {eCBT Versus Standard Individual CBT for Paediatric Obsessive-Compulsive Disorder.}, Journal = {Child Psychiatry Hum Dev}, Volume = {54}, Number = {6}, Pages = {1567-1576}, Year = {2023}, Month = {December}, url = {http://dx.doi.org/10.1007/s10578-022-01350-7}, Abstract = {Obsessive-compulsive disorder (OCD) is characterized by recurring obsessions and compulsions often with severe impairment affecting 1-3% of children and adolescents. Cognitive behavioural therapy (CBT) is the therapeutic golden standard for paediatric OCD. However, face-to-face CBT is limited by accessibility, availability, and quality of delivery. Enhanced CBT (eCBT) a combination of face-to-face sessions at the clinic and treatment at home via webcam and a supportive app system aims to address some of these barriers. In this pilot study, we compared eCBT outcomes of 25 paediatric patients with OCD benchmarked against traditional face-to-face CBT (n = 269) from the Nordic Long-term OCD Treatment Study, the largest paediatric OCD CBT study to date. Pairwise comparisons showed no difference between eCBT and NordLOTS treatment outcomes. Mean estimate difference was 2.5 in favour of eCBT (95% CI - 0.3 to 5.3). eCBT compared to NordLOTS showed no significant differences between response and remission rates, suggesting similar effectiveness.}, Doi = {10.1007/s10578-022-01350-7}, Key = {fds363252} } @article{fds271460, Author = {Barlow, A and Mullany, B and Neault, N and Compton, S and Carter, A and Hastings, R and Billy, T and Coho-Mescal, V and Lorenzo, S and Walkup, JT}, Title = {Effect of a paraprofessional home-visiting intervention on American Indian teen mothers’ and infants’ behavioral risks: a randomized controlled trial.}, Journal = {Am J Psychiatry}, Volume = {170}, Number = {1}, Pages = {83-93}, Publisher = {American Psychiatric Publishing}, Year = {2013}, Month = {January}, ISSN = {0002-953X}, url = {http://dx.doi.org/10.1176/appi.ajp.2012.12010121}, Abstract = {OBJECTIVE: The authors sought to examine the effectiveness of Family Spirit, a paraprofessional-delivered, home-visiting pregnancy and early childhood intervention,in improving American Indian teen mothers’ parenting outcomes and mothers’and children’s emotional and behavioral functioning 12 months postpartum. METHOD: Pregnant American Indian teens(N=322) from four southwestern tribal reservation communities were randomlyassigned in equal numbers to the Family Spirit intervention plus optimized standard care or to optimized standard care alone. Parent and child emotional and behavioral outcome data were collected at baseline and at 2, 6, and 12 months postpartum using self-reports, interviews,and observational measures. RESULTS: At 12 months postpartum, mothers in the intervention group had significantly greater parenting knowledge parenting self-efficacy, and home safety attitudes and fewer externalizing behaviors,and their children had fewer externalizing problems. In a subsample of mothers with any lifetime substance use at baseline (N=285; 88.5%), children in the intervention group had fewer externalizing and dysregulation problems than those in the standard care group, and fewer scored in the clinically “at risk” range ($10th percentile) for externalizing and internalizing problems. No between-group differences were observed for outcomes measured by the Home Observation for Measurement of the Environment scale. CONCLUSIONS: Outcomes 12 months postpartum suggest that the Family Spirit intervention improves parenting and infant outcomes that predict lower lifetime behavioral and drug use risk for participating teen mothers and children.}, Doi = {10.1176/appi.ajp.2012.12010121}, Key = {fds271460} } @article{fds327207, Author = {Costello, EJ and Compton, SN and Keeler, G and Angold, A}, Title = {Effect of poverty on emotional symptoms in children - Reply}, Journal = {JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION}, Volume = {291}, Number = {4}, Pages = {424-424}, Year = {2004}, Key = {fds327207} } @article{fds271501, Author = {Case, B}, Title = {Effect of poverty on emotional symptoms in children.}, Journal = {JAMA}, Volume = {291}, Number = {4}, Pages = {424}, Year = {2004}, Month = {January}, url = {http://dx.doi.org/10.1001/jama.291.4.424-a}, Doi = {10.1001/jama.291.4.424-a}, Key = {fds271501} } @article{fds369776, Author = {Kolitsopoulos, F and Ramaker, S and Compton, SN and Broderick, S and Orazem, J and Bao, W and Lokhnygina, Y and Marschall, K and Chappell, P}, Title = {Effects of Long-Term Sertraline Use on Pediatric Growth and Development: The Sertraline Pediatric Registry for The Evaluation of Safety (SPRITES).}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {33}, Number = {1}, Pages = {2-13}, Year = {2023}, Month = {February}, url = {http://dx.doi.org/10.1089/cap.2022.0048}, Abstract = {Objective: To describe the results of the Sertraline Pediatric Registry for The Evaluation of Safety (SPRITES) outcome measures of cognitive, emotional, and physical development following long-term treatment with sertraline (for up to 3 years) in children and adolescents aged 6-16 years. Methods: SPRITES was a long-term, multicenter, open-label, prospective observational study designed to compare physical and psychological development in pediatric patients exposed to sertraline (with or without psychotherapy) or psychotherapy alone in usual care settings. Data were summarized descriptively, and outcomes were evaluated using a marginal structural model. Results: Between April 2012 and September 2020, 941 patients across 44 U.S. sites participated in the study. At baseline, 695 participants were exposed to sertraline (physician prescribed) with or without psychotherapy, and 245 participants were exposed to psychotherapy alone. Of these, 432 participants (46.0%) completed the full 3-year study follow-up. No significant changes across time were found in standardized height, BRIEF (Behavior Rating Inventory of Executive Function), Trails B, and Tanner stage based on cumulative sertraline exposure or exposure since the last visit. Change in mean standardized weight across time was positively associated with both cumulative sertraline exposure (p = 0.02) and exposure since the last visit (p = 0.029). The mean changes from baseline across time in standardized weight were standard deviations of 0.02, 0.03, 0.16, and 0.17 at months 3, 6, 30, and 36, respectively. However, this finding was not observed in the mean change across time in standardized body mass index, which was not statistically significant. Conclusions: Results are consistent with normal development. Although a statistically significant finding for standardized weight was observed in comparative analyses, the magnitude of the change is small and observed at higher doses of sertraline only. No other significant differences were observed between the "sertraline" group and the "no pharmacological therapy" group on other primary outcome measures. ClinicalTrials.gov identifier: NCT01302080.}, Doi = {10.1089/cap.2022.0048}, Key = {fds369776} } @article{fds341760, Author = {Murias, M and Major, S and Compton, S and Buttinger, J and Sun, JM and Kurtzberg, J and Dawson, G}, Title = {Electrophysiological Biomarkers Predict Clinical Improvement in an Open-Label Trial Assessing Efficacy of Autologous Umbilical Cord Blood for Treatment of Autism.}, Journal = {Stem Cells Transl Med}, Volume = {7}, Number = {11}, Pages = {783-791}, Year = {2018}, Month = {November}, url = {http://dx.doi.org/10.1002/sctm.18-0090}, Abstract = {This study was a phase I, single-center, and open-label trial of a single intravenous infusion of autologous umbilical cord blood in young children with autism spectrum disorder (ASD). Twenty-five children between the ages of 2 and 6 with a confirmed diagnosis of ASD and a qualified banked autologous umbilical cord blood unit were enrolled. Safety results and clinical outcomes measured at 6 and 12 months post-infusion have been previously published. The purpose of the present analysis was to explore whether measures of electroencephalography (EEG) theta, alpha, and beta power showed evidence of change after treatment and whether baseline EEG characteristics were predictive of clinical improvement. The primary endpoint was the parent-reported Vineland adaptive behavior scales-II socialization subscale score, collected at baseline, 6- and 12-month visits. In addition, the expressive one word picture vocabulary test 4 and the clinical global impression-improvement scale were administered. Electrophysiological recordings were taken during viewing of dynamic social and nonsocial stimuli at 6 and 12 months post-treatment. Significant changes in EEG spectral characteristics were found by 12 months post-infusion, which were characterized by increased alpha and beta power and decreased EEG theta power. Furthermore, higher baseline posterior EEG beta power was associated with a greater degree of improvement in social communication symptoms, highlighting the potential for an EEG biomarker to predict variation in outcome. Taken together, the results suggest that EEG measures may be useful endpoints for future ASD clinical trials. Stem Cells Translational Medicine 2018;7:783-791.}, Doi = {10.1002/sctm.18-0090}, Key = {fds341760} } @article{fds302617, Author = {Houghton, DC and Balsis, S and Stein, DJ and Compton, SN and Twohig, MP and Saunders, SM and Franklin, ME and Neal-Barnett, AM and Woods, DW}, Title = {Examining DSM criteria for trichotillomania in a dimensional framework: implications for DSM-5 and diagnostic practice.}, Journal = {Compr Psychiatry}, Volume = {60}, Pages = {9-16}, Year = {2015}, Month = {July}, ISSN = {0010-440X}, url = {http://dx.doi.org/10.1016/j.comppsych.2015.04.011}, Abstract = {BACKGROUND: Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. OBJECTIVES: First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). METHOD: Statistics derived from item response theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. RESULTS: The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. CONCLUSIONS: Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts.}, Doi = {10.1016/j.comppsych.2015.04.011}, Key = {fds302617} } @article{fds369780, Author = {Bushnell, GA and Brookhart, MA and Gaynes, BN and Compton, SN and Dusetzina, SB and Sturmer, T}, Title = {Examining Parental Adherence as a Predictor of Child SSRI Adherence in Pediatric Anxiety}, Journal = {PHARMACOEPIDEMIOLOGY AND DRUG SAFETY}, Volume = {26}, Pages = {240-241}, Publisher = {WILEY}, Year = {2017}, Month = {August}, Key = {fds369780} } @article{fds336057, Author = {Bushnell, GA and Brookhart, MA and Gaynes, BN and Compton, SN and Dusetzina, SB and Stürmer, T}, Title = {Examining Parental Medication Adherence as a Predictor of Child Medication Adherence in Pediatric Anxiety Disorders.}, Journal = {Med Care}, Volume = {56}, Number = {6}, Pages = {510-519}, Year = {2018}, Month = {June}, url = {http://dx.doi.org/10.1097/MLR.0000000000000911}, Abstract = {BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the recommended first-line pharmacotherapy for pediatric anxiety disorders but adherence remains difficult to predict. OBJECTIVES: To estimate SSRI adherence in children with anxiety disorders and determine if prior parental medication adherence is predictive of child high SSRI adherence. METHODS: We identified children (3-17 y) initiating SSRI treatment after an anxiety disorder diagnosis in a commercial claims database (2005-2014). We evaluated parent SSRI, statin, and antihypertensive adherence [6-mo proportion days covered (PDC), high adherence=PDC≥0.80] in the year before child SSRI initiation. We estimated risk differences (RD) of child high SSRI adherence (6-mo PDC) stratified by parent adherence and multivariable risk ratios using modified Poisson regression. We estimated change in c-statistic and risk reclassification when adding parent-level covariates with child-level covariates to predict child adherence. RESULTS: In 70,979 children with an anxiety disorder (59%=female, 14=median age), the mean 6-month SSRI PDC was 0.72, with variation by anxiety disorder. Overall 64% of children had high adherence if their parent had high SSRI adherence versus 53% of children with parents with low SSRI adherence (RD, 12%; multivariable risk ratios, 1.17; 95% confidence interval, 1.14-1.20). Findings were similar for parent statin (RD=10%) and antihypertensive adherence (RD=8%) and when stratified by child age and parent sex. There was minor improvement in risk reclassification and the c-statistic after adding parent adherence and parent-level covariates. CONCLUSIONS: Parental medication adherence could help providers identify children at risk of nonadherence to inform the treatment decision, reduce unnecessary medication switches, and lead to broader effective interventions.}, Doi = {10.1097/MLR.0000000000000911}, Key = {fds336057} } @article{fds359489, Author = {Babu, PRK and Di Martino and JM and Chang, Z and Perochon, S and Carpenter, KLH and Compton, S and Espinosa, S and Dawson, G and Sapiro, G}, Title = {Exploring Complexity of Facial Dynamics in Autism Spectrum Disorder.}, Journal = {IEEE Trans Affect Comput}, Volume = {14}, Number = {2}, Pages = {919-930}, Year = {2023}, url = {http://dx.doi.org/10.1109/taffc.2021.3113876}, Abstract = {Atypical facial expression is one of the early symptoms of autism spectrum disorder (ASD) characterized by reduced regularity and lack of coordination of facial movements. Automatic quantification of these behaviors can offer novel biomarkers for screening, diagnosis, and treatment monitoring of ASD. In this work, 40 toddlers with ASD and 396 typically developing toddlers were shown developmentally-appropriate and engaging movies presented on a smart tablet during a well-child pediatric visit. The movies consisted of social and non-social dynamic scenes designed to evoke certain behavioral and affective responses. The front-facing camera of the tablet was used to capture the toddlers' face. Facial landmarks' dynamics were then automatically computed using computer vision algorithms. Subsequently, the complexity of the landmarks' dynamics was estimated for the eyebrows and mouth regions using multiscale entropy. Compared to typically developing toddlers, toddlers with ASD showed higher complexity (i.e., less predictability) in these landmarks' dynamics. This complexity in facial dynamics contained novel information not captured by traditional facial affect analyses. These results suggest that computer vision analysis of facial landmark movements is a promising approach for detecting and quantifying early behavioral symptoms associated with ASD.}, Doi = {10.1109/taffc.2021.3113876}, Key = {fds359489} } @article{fds271483, Author = {Conelea, CA and Woods, DW and Zinner, SH and Budman, C and Murphy, T and Scahill, LD and Compton, SN and Walkup, J}, Title = {Exploring the impact of chronic tic disorders on youth: results from the Tourette Syndrome Impact Survey.}, Journal = {Child Psychiatry Hum Dev}, Volume = {42}, Number = {2}, Pages = {219-242}, Year = {2011}, Month = {April}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-010-0211-4}, Abstract = {Prior research has demonstrated that chronic tic disorders (CTD) are associated with functional impairment across several domains. However, methodological limitations, such as data acquired by parental report, datasets aggregated across child and adult samples, and small treatment-seeking samples, curtail interpretation. The current study explored the functional impact of tics among youth in a large, "virtual" community sample. An Internet-based survey was completed by families with children who had CTD. The sample included 740 parents and 232 of their children (ages 10-17 years). The survey assessed impact across five functional domains: physical, social, familial, academic, and psychological. Health-related quality of life and perceptions of discrimination resulting from tics were also assessed. Results suggest that (1) youth with CTD experience mild to moderate functional impairment, (2) impairment is generally positively correlated with tic severity, (3) children with CTD plus one or more co-occurring psychiatric conditions tend to have greater functional impairment, and (4) a notable portion of youth with CTD experience discrimination due to tics. Implications and limitations of these findings are discussed.}, Doi = {10.1007/s10578-010-0211-4}, Key = {fds271483} } @article{fds327203, Author = {Strawn, JR and Compton, SN and Robertson, B and Albano, AM and Hamdani, M and Rynn, MA}, Title = {Extended Release Guanfacine in Pediatric Anxiety Disorders: A Pilot, Randomized, Placebo-Controlled Trial.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {27}, Number = {1}, Pages = {29-37}, Year = {2017}, Month = {February}, url = {http://dx.doi.org/10.1089/cap.2016.0132}, Abstract = {OBJECTIVE: This is a feasibility study evaluating the safety, tolerability, and potential anxiolytic efficacy of the α2 agonist guanfacine extended-release (GXR) in children and adolescents with generalized anxiety disorder (GAD), separation anxiety disorder (SAD), or social phobia/social anxiety disorder. METHODS: Youth aged 6-17 years with a primary diagnosis of GAD, SAD, and/or social anxiety disorder were treated with flexibly dosed GXR (1-6 mg daily, n = 62) or placebo (n = 21) for 12 weeks. The primary aim of this study was to determine the safety and tolerability of GXR in youth with anxiety disorders, which involved the analysis of treatment-emergent adverse events (TEAEs), the emergence of suicidal ideation and behaviors, vital signs, and electrocardiographic/laboratory parameters. Exploratory efficacy measures included dimensional anxiety scales (Pediatric Anxiety Rating Scale [PARS] and Screen for Child Anxiety Related Emotional Disorders [SCARED]), as well as the Clinical Global Impression-Improvement (CGI-I) scale. As this was an exploratory study, no inferential statistical analyses were performed. RESULTS: GXR was safe and well tolerated. Treatment-related mean ± standard deviation changes in heart rate (GXR: 1.8 ± 12 beats per minute [bpm] decrease; placebo: 0.5 ± 11 bpm decrease), systolic blood pressure (GXR: 2.3 ± 11 mm Hg decrease; placebo: 1.7 ± 11 mm Hg decrease), or diastolic blood pressure (GXR: 1.3 ± 9 mm Hg decrease; placebo: 0.9 ± 7 mm Hg increase) were similar between treatment groups. TEAEs, including headache, somnolence/fatigue, abdominal pain, and dizziness, were consistent with the known safety profile of GXR. No differences were observed between treatment groups for PARS and SCARED scores, although at endpoint, a higher proportion of subjects receiving GXR versus placebo demonstrated CGI-I scores ≤2 (54.2% vs. 31.6%), as rated by the clinician investigator. CONCLUSIONS: GXR was well tolerated in pediatric subjects with GAD, SAD, and/or social anxiety disorder. ClinicalTrials.gov Identifier: NCT01470469.}, Doi = {10.1089/cap.2016.0132}, Key = {fds327203} } @article{fds323534, Author = {Alexander, JR and Houghton, DC and Twohig, MP and Franklin, ME and Saunders, SM and Neal-Barnett, AM and Compton, SN and Woods, DW}, Title = {Factor analysis of the Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version.}, Journal = {J Obsessive Compuls Relat Disord}, Volume = {11}, Pages = {31-38}, Year = {2016}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jocrd.2016.08.001}, Abstract = {The Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A; Flessner et al., 2008) measures the degree to which hair pulling in Trichotillomania (TTM) can be described as "automatic" (i.e., done without awareness and unrelated to affective states) and/or "focused" (i.e., done with awareness and to regulate affective states). Despite preliminary evidence in support of the psychometric properties of the MIST-A, emerging research suggests the original factor structure may not optimally capture TTM phenomenology. Using data from a treatment-seeking TTM sample, the current study examined the factor structure of the MIST-A via exploratory factor analysis. The resulting two factor solution suggested the MIST-A consists of a 5-item "awareness of pulling" factor that measures the degree to which pulling is done with awareness and an 8-item "internal-regulated pulling" factor that measures the degree to which pulling is done to regulate internal stimuli (e.g., emotions, cognitions, and urges). Correlational analyses provided preliminary evidence for the validity of these derived factors. Findings from this study challenge the notions of "automatic" and "focused" pulling styles and suggest that researchers should continue to explore TTM subtypes.}, Doi = {10.1016/j.jocrd.2016.08.001}, Key = {fds323534} } @article{fds302614, Author = {Freeman, J and Sapyta, J and Garcia, A and Compton, S and Khanna, M and Flessner, C and FitzGerald, D and Mauro, C and Dingfelder, R and Benito, K and Harrison, J and Curry, J and Foa, E and March, J and Moore, P and Franklin, M}, Title = {Family-based treatment of early childhood obsessive-compulsive disorder: the Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr)--a randomized clinical trial.}, Journal = {JAMA Psychiatry}, Volume = {71}, Number = {6}, Pages = {689-698}, Year = {2014}, Month = {June}, ISSN = {2168-622X}, url = {http://dx.doi.org/10.1001/jamapsychiatry.2014.170}, Abstract = {IMPORTANCE: Cognitive behavior therapy (CBT) has been established as efficacious for obsessive-compulsive disorder (OCD) among older children and adolescents, yet its effect on young children has not been evaluated sufficiently. OBJECTIVE: To examine the relative efficacy of family-based CBT (FB-CBT) involving exposure plus response prevention vs an FB relaxation treatment (FB-RT) control condition for children 5 to 8 years of age. DESIGN, SETTING, AND PARTICIPANTS: A 14-week randomized clinical trial (Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children [POTS Jr]) conducted at 3 academic medical centers between 2006 and 2011, involving 127 pediatric outpatients 5 to 8 years of age who received a primary diagnosis of OCD and a Children's Yale-Brown Obsessive Compulsive Scale total score of 16 or higher. INTERVENTIONS: Participants were randomly assigned to 14 weeks of (1) FB-CBT, including exposure plus response prevention, or (2) FB-RT. MAIN OUTCOMES AND MEASURES: Responder status defined as an independent evaluator-rated Clinical Global Impression-Improvement scale score of 1 (very much improved) or 2 (much improved) and change in independent evaluator-rated continuous Children's Yale-Brown Obsessive Compulsive Scale total score. RESULTS Family-based CBT was superior to FB-RT on both primary outcome measures. The percentages of children who were rated as 1 (very much improved) or 2 (much improved) on the Clinical Global Impression-Improvement scale at 14 weeks were 72% for FB-CBT and 41% for FB-RT. The effect size difference between FB-CBT and FB-RT on the Clinical Global Impression-Improvement scale was 0.31 (95% CI, 0.17-0.45). The number needed to treat (NNT) with FB-CBT vs FB-RT was estimated as 3.2 (95% CI, 2.2-5.8). The effect size difference between FB-CBT and FB-RT on the Children's Yale-Brown Obsessive Compulsive Scale at week 14 was 0.84 (95% CI, 0.62-1.06). CONCLUSIONS AND RELEVANCE: A comprehensive FB-CBT program was superior to a relaxation program with a similar format in reducing OCD symptoms and functional impairment in young children (5-8 years of age) with OCD. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00533806.}, Doi = {10.1001/jamapsychiatry.2014.170}, Key = {fds302614} } @article{fds302631, Author = {Drysdale, AT and Hartley, CA and Pattwell, SS and Ruberry, EJ and Somerville, LH and Compton, SN and Lee, FS and Casey, BJ and Walkup, JT}, Title = {Fear and anxiety from principle to practice: implications for when to treat youth with anxiety disorders.}, Journal = {Biol Psychiatry}, Volume = {75}, Number = {11}, Pages = {e19-e20}, Year = {2014}, Month = {June}, ISSN = {0006-3223}, url = {http://dx.doi.org/10.1016/j.biopsych.2013.08.015}, Doi = {10.1016/j.biopsych.2013.08.015}, Key = {fds302631} } @article{fds271465, Author = {Pine, DS and Walkup, JT and Labellarte, MJ and Riddle, MA and Greenhill, L and Klein, R and Davies, M and Sweeney, M and Abikoff, H and Hack, S and al, E}, Title = {Fluvoxamine for the treatment of anxiety disorders in children and adolescents. The Research Unit on Pediatric Psychopharmacology Anxiety Study Group.}, Journal = {N Engl J Med}, Volume = {344}, Number = {17}, Pages = {1279-1285}, Year = {2001}, Month = {April}, ISSN = {0028-4793}, url = {http://dx.doi.org/10.1056/NEJM200104263441703}, Abstract = {BACKGROUND: Drugs that selectively inhibit serotonin reuptake are effective treatments for adults with mood and anxiety disorders, but limited data are available on the safety and efficacy of serotonin-reuptake inhibitors in children with anxiety disorders. METHODS: We studied 128 children who were 6 to 17 years of age; who met the criteria for social phobia, separation anxiety disorder, or generalized anxiety disorder; and who had received psychological treatment for three weeks without improvement. The children were randomly assigned to receive fluvoxamine (at a maximum of 300 mg per day) or placebo for eight weeks and were evaluated with rating scales designed to assess the degree of anxiety and impairment. RESULTS: Children in the fluvoxamine group had a mean (+/-SD) decrease of 9.7+/-6.9 points in symptoms of anxiety on the Pediatric Anxiety Rating Scale (range of possible scores, 0 to 25, with higher scores indicating greater anxiety), as compared with a decrease of 3.1+/-4.8 points among children in the placebo group (P<0.001). On the Clinical Global Impressions-Improvement scale, 48 of 63 children in the fluvoxamine group (76 percent) responded to the treatment, as indicated by a score of less than 4, as compared with 19 of 65 children in the placebo group (29 percent, P<0.001). Five children in the fluvoxamine group (8 percent) discontinued treatment because of adverse events, as compared with one child in the placebo group (2 percent). CONCLUSIONS: Fluvoxamine is an effective treatment for children and adolescents with social phobia, separation anxiety disorder, or generalized anxiety disorder.}, Doi = {10.1056/NEJM200104263441703}, Key = {fds271465} } @article{fds271481, Author = {Franklin, ME and Best, SH and Wilson, MA and Loew, B and Compton, SN}, Title = {Habit Reversal Training and Acceptance and Commitment Therapy for Tourette Syndrome: A Pilot Project}, Journal = {Journal of Developmental and Physical Disabilities}, Volume = {23}, Number = {1}, Pages = {49-60}, Publisher = {Springer Nature}, Year = {2011}, Month = {February}, ISSN = {1056-263X}, url = {http://dx.doi.org/10.1007/s10882-010-9221-1}, Abstract = {Chronic tic disorders (CTDs), including Tourette Syndrome, affect approximately 1 in 100 individuals, and pediatric onset is the norm. Pharmacotherapy has traditionally been the first line of treatment for CTD. However, given that partial response to pharmacotherapy is typical and that the side effect profile for efficacious medications warrants consideration before initiating treatment, there is a clear need to develop and disseminate psychosocial treatments to enhance outcomes among individuals with CTDs. The current report describes findings from a pilot project designed to: (a) train two sites in behavior therapy involving Habit Reversal Training (HRT) for CTDs; (b) pilot test the HRT protocol in adolescents and young adults with CTDs; (c) develop and refine a combined Habit Reversal Training plus Acceptance and Commitment Therapy (HRT+ACT) protocol for CTDs; and (d) pilot test the combined protocol in adolescents and young adults with CTDs. Results indicated that, on average, both the HRT alone and the HRT+ACT groups experienced substantial, clinically relevant, durable, and comparable reductions in tic symptoms through the 1 month follow-up, as well as improvements in participant and parent-rated global functioning over this same period. © 2011 Springer Science+Business Media, LLC.}, Doi = {10.1007/s10882-010-9221-1}, Key = {fds271481} } @article{fds364013, Author = {Webb, SJ and Emerman, I and Sugar, C and Senturk, D and Naples, AJ and Faja, S and Benton, J and Borland, H and Carlos, C and Levin, AR and McAllister, T and Santhosh, M and Bernier, RA and Chawarska, K and Dawson, G and Dziura, J and Jeste, S and Kleinhans, N and Murias, M and Sabatos-DeVito, M and Shic, F and McPartland, JC and Autism Biomarkers Consortium for Clinical Trials}, Title = {Identifying Age Based Maturation in the ERP Response to Faces in Children With Autism: Implications for Developing Biomarkers for Use in Clinical Trials.}, Journal = {Front Psychiatry}, Volume = {13}, Pages = {841236}, Year = {2022}, url = {http://dx.doi.org/10.3389/fpsyt.2022.841236}, Abstract = {Recent proposals have suggested the potential for neural biomarkers to improve clinical trial processes in neurodevelopmental conditions; however, few efforts have identified whether chronological age-based adjustments will be necessary (as used in standardized behavioral assessments). Event-related potentials (ERPs) demonstrate early differences in the processing of faces vs. objects in the visual processing system by 4 years of age and age-based improvement (decreases in latency) through adolescence. Additionally, face processing has been proposed to be related to social skills as well as autistic social-communication traits. While previous reports suggest delayed latency in individuals with autism spectrum disorder (ASD), extensive individual and age based heterogeneity exists. In this report, we utilize a sample of 252 children with ASD and 118 children with typical development (TD), to assess the N170 and P100 ERP component latencies (N170L and P100L, respectively), to upright faces, the face specificity effect (difference between face and object processing), and the inversion effect (difference between face upright and inverted processing) in relation to age. First, linear mixed models (LMMs) were fitted with fixed effect of age at testing and random effect of participant, using all available data points to characterize general age-based development in the TD and ASD groups. Second, LMM models using only the TD group were used to calculate age-based residuals in both groups. The purpose of residualization was to assess how much variation in ASD participants could be accounted for by chronological age-related changes. Our data demonstrate that the N170L and P100L responses to upright faces appeared to follow a roughly linear relationship with age. In the ASD group, the distribution of the age-adjusted residual values suggest that ASD participants were more likely to demonstrate slower latencies than would be expected for a TD child of the same age, similar to what has been identified using unadjusted values. Lastly, using age-adjusted values for stratification, we found that children who demonstrated slowed age-adjusted N170L had lower verbal and non-verbal IQ and worse face memory. These data suggest that age must be considered in assessing the N170L and P100L response to upright faces as well, and these adjusted values may be used to stratify children within the autism spectrum.}, Doi = {10.3389/fpsyt.2022.841236}, Key = {fds364013} } @article{fds355575, Author = {Crane, ME and Norris, LA and Frank, HE and Klugman, J and Ginsburg, GS and Keeton, C and Albano, AM and Piacentini, J and Peris, TS and Compton, SN and Sakolsky, D and Birmaher, B and Kendall, PC}, Title = {Impact of treatment improvement on long-term anxiety: Results from CAMS and CAMELS.}, Journal = {J Consult Clin Psychol}, Volume = {89}, Number = {2}, Pages = {126-133}, Year = {2021}, Month = {February}, url = {http://dx.doi.org/10.1037/ccp0000523}, Abstract = {OBJECTIVE: This article examined associations between change in youth and family characteristics during youth anxiety treatment and long-term anxiety severity and overall functioning. METHOD: Participants (N = 488; age 7-17 years; 45% male; 82% white) were randomized to 12 weeks of cognitive behavioral therapy (Coping Cat), medication (sertraline), their combination, or pill placebo in the Child/Adolescent Anxiety Multimodal Study (CAMS). A subset participated in the naturalistic follow-up Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS; n = 319; 3.70-11.83 years post-treatment). The current secondary analyses examined how change in anxiety severity (Child Global Impression-Severity), overall functioning (Children's Global Assessment Scale), caregiver psychopathology (Brief Symptom Inventory), caregiver strain (Family Burden Assessment Scale), and family dysfunction (Brief Family Assessment Measure) during CAMS was associated with anxiety severity and overall functioning years later (M = 7.72 years). CAMS procedures were registered on clinialtrials.gov. RESULTS: Improvements in factors related to functioning (i.e., overall functioning, family dysfunction, caregiver strain) were associated with improvements in anxiety severity in CAMELS (|βys| ≥ .04, ps ≤ .04). Improvements in factors related to psychopathology (i.e., anxiety severity, caregiver psychopathology) were associated with improvements in overall functioning in CAMELS (|βys| ≥ .23, ps ≤ .04). It was changes in each of the variables examined (rather than baseline values) that predicted anxiety severity and overall functioning. CONCLUSIONS: Both youth and family factors play a significant role in long-term treatment outcomes. Therapists would be wise to monitor how these factors change throughout treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).}, Doi = {10.1037/ccp0000523}, Key = {fds355575} } @article{fds349945, Author = {Chiappini, EA and Gosch, E and Compton, SN and Olino, TM and Birmaher, B and Sakolsky, D and Peris, TS and Piacentini, J and Albano, AM and Keeton, CP and Walkup, JT and Ginsburg, G and Kendall, PC}, Title = {In-Session Involvement in Anxious Youth Receiving CBT with/without Medication}, Journal = {Journal of Psychopathology and Behavioral Assessment}, Volume = {42}, Number = {4}, Pages = {615-626}, Year = {2020}, Month = {December}, url = {http://dx.doi.org/10.1007/s10862-020-09810-x}, Abstract = {Although in-session factors of CBT for youth anxiety (e.g., youth involvement; therapist behaviors) have demonstrated significant associations with treatment outcomes, no study has examined the role of concurrent selective-serotonin reuptake inhibitors (SSRI) on in-session behavior affecting youth outcomes. The combination of SSRI and CBT have demonstrated robust outcomes over either treatment alone. Research has also neglected to examine in-session behavior based on treatment phase (i.e., psychoeducation, exposure) and the association between in-session factors and treatment outcome. Youth (N = 190) were participants in the Children/Adolescent Anxiety Multimodal Study (Walkup et al. New England Journal of Medicine, 359, 2753-2766, 2008) who completed CBT; of these, n = 94 received concurrent sertraline. Tapes of psychoeducation/skill-building (first half) and exposure sessions (second half) were rated by reliable coders for positive youth involvement (e.g., participation, understanding), negative youth involvement (e.g., safety-behaviors, negative affect), and therapist behaviors. Youth and therapist in-session behaviors were examined as predictors of the trajectory of anxiety outcomes using multilevel modeling. Medication (sertraline) was examined as a moderator. Results indicated that positive and negative youth involvement in CBT was significantly associated with outcomes. Positive youth involvement during psychoeducation and exposure sessions predicted better outcomes, and negative youth involvement during psychoeducation sessions predicted less favorable outcomes. Sertraline did not moderate these findings. Therapist behaviors were not significantly associated with outcomes, likely due to limited variability and low frequency of observed behaviors. Youth in-sessions behaviors are associated with treatment outcomes in anxiety treatment. However, medication does not appear to have a differential impact on youth in-session behaviors.}, Doi = {10.1007/s10862-020-09810-x}, Key = {fds349945} } @article{fds339604, Author = {Bushnell, GA and Gaynes, BN and Compton, SN and Dusetzina, SB and Brookhart, MA and Stürmer, T}, Title = {Incidence of mental health hospitalizations, treated self-harm, and emergency room visits following new anxiety disorder diagnoses in privately insured U.S. children.}, Journal = {Depress Anxiety}, Volume = {36}, Number = {2}, Pages = {179-189}, Year = {2019}, Month = {February}, url = {http://dx.doi.org/10.1002/da.22849}, Abstract = {BACKGROUND: Anxiety disorders are one of the most common mental illnesses in children and associated with high healthcare utilization. We aimed to estimate 2-year cumulative incidence of mental health-related hospitalizations, treated self-harm, and emergency room (ER) visits in children newly diagnosed with anxiety disorders and, for context, in children without anxiety disorders. METHODS: We identified commercially insured treatment naïve children (3-17 years) with a new office-based anxiety disorder diagnosis (ICD-9-CM) from 2005-2014 in the MarketScan claims database. We followed children for up to 2 years after diagnosis for the first of each event: mental health-related hospitalization, inpatient, treated self-harm, and ER visits (any, anxiety-related, injury-related). Children without anxiety diagnoses were included as comparators, matched on age, sex, date, and region. We estimated cumulative incidence of each event using Kaplan-Meier analysis. RESULTS: From 2005-2014, we identified 198,450 children with a new anxiety diagnosis. One-year after anxiety diagnosis, 2.0% of children had a mental health-related hospitalization, 0.08% inpatient, treated self-harm, 1.4% anxiety-related ER visit, and 20% any ER visit; incidence was highest in older children with baseline comorbid depression. One-year cumulative incidence of each event was lower in the comparison cohort without anxiety (e.g., mental health-related hospitalizations = 0.5%, treated self-harm = 0.01%, and ER visits = 13%). CONCLUSIONS: Given the prevalence of anxiety disorders, 2-year incidence estimates translate to a significant number of children experiencing each event. Our findings offer caregivers, providers, and patients information to better understand the burden of anxiety disorders and can help anticipate healthcare utilization and inform efforts to prevent these serious events.}, Doi = {10.1002/da.22849}, Key = {fds339604} } @article{fds344883, Author = {Bushnell, GA and Gaynes, BN and Compton, SN and Dusetzina, SB and Olfson, M and Stürmer, T}, Title = {Incident Substance Use Disorder Following Anxiety Disorder in Privately Insured Youth.}, Journal = {J Adolesc Health}, Volume = {65}, Number = {4}, Pages = {536-542}, Year = {2019}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jadohealth.2019.05.007}, Abstract = {PURPOSE: Anxiety disorders in childhood might be associated with an increased risk of substance use disorders. Incident substance use-related diagnoses were quantified in the 2 years after youth were newly diagnosed with an anxiety disorder and in a similar cohort of youth without diagnosed anxiety. METHODS: Privately insured youth (10-17 years) were identified in a commercial claims database who were newly diagnosed with an anxiety disorder (2005-2014), treatment naïve, and without baseline substance-related disorder diagnoses. The comparison cohort included age, sex, region, and date matched youth with equivalent baseline exclusions. We used Kaplan-Meier estimator to calculate 2-year cumulative incidence of substance use disorder diagnosis following a new office-based anxiety disorder diagnosis (or match date for comparison cohort). RESULTS: In 131,271 youth with a new anxiety disorder diagnosis (male = 41%, median age = 14 years), 1.5% (95% confidence interval = 1.5-1.6) had an incident substance use disorder diagnosis 1 year after their anxiety diagnosis, 2.9% (95% confidence interval = 2.8-3.0) by 2 years. Over the same period, .5% and 1.1% of the comparison cohort had incident substance use disorder diagnoses (n = 1,321,701). In the anxiety cohort, 2-year incidence was higher in youth aged 14-17 years (4.6%) versus 10-13 years (.7%). Incidence of substance use diagnosis varied by anxiety disorder (e.g., 2-year incidence: 4.3% for post-traumatic stress disorder, 3.0% for generalized anxiety disorder). CONCLUSION: Approximately 3% of youth newly diagnosed with anxiety received an incident substance use disorder diagnosis within 2 years, almost threefold the incidence in youth without an anxiety diagnosis, emphasizing the need for increased awareness and prevention of substance-related disorders in pediatric anxiety.}, Doi = {10.1016/j.jadohealth.2019.05.007}, Key = {fds344883} } @article{fds327205, Author = {Bushnell, GA and Dusetzina, SB and Gaynes, BN and Compton, SN and White, AD and Stuermer, T}, Title = {Initial Prescription Medication for Children with Anxiety: Concordance with Evidence}, Journal = {PHARMACOEPIDEMIOLOGY AND DRUG SAFETY}, Volume = {24}, Pages = {283-284}, Publisher = {WILEY-BLACKWELL}, Year = {2015}, Month = {September}, Key = {fds327205} } @article{fds359116, Author = {Hollmann, K and Allgaier, K and Hohnecker, CS and Lautenbacher, H and Bizu, V and Nickola, M and Wewetzer, G and Wewetzer, C and Ivarsson, T and Skokauskas, N and Wolters, LH and Skarphedinsson, G and Weidle, B and de Haan, E and Torp, NC and Compton, SN and Calvo, R and Lera-Miguel, S and Haigis, A and Renner, TJ and Conzelmann, A}, Title = {Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study.}, Journal = {J Neural Transm (Vienna)}, Volume = {128}, Number = {9}, Pages = {1445-1459}, Year = {2021}, Month = {September}, url = {http://dx.doi.org/10.1007/s00702-021-02409-w}, Abstract = {Cognitive behavioral therapy (CBT) is the first choice of treatment of obsessive-compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote areas. The aim of this study was to investigate feasibility and acceptability of this telemedical approach. A total of nine children received 14 sessions of CBT. The first session took place face-to-face, the remaining 13 sessions via videoconference. OCD symptoms were recorded with a smartphone app and therapy materials were made accessible in a data cloud. We assessed diagnostic data before and after treatment and obtained measures to feasibility, treatment satisfaction and acceptability. Outcomes showed high acceptance and satisfaction on the part of patients with online treatment (89%) and that face-to-face therapy was not preferred over an internet-based approach (67%). The majority of patients and their parents classified the quality of treatment as high. They emphasized the usefulness of exposures with response prevention (E/RP) in triggering situations at home. The app itself was rated as easy to operate and useful. In addition to feasibility, a significant decrease in obsessive-compulsive symptoms was also achieved. Internet-based CBT for pediatric OCD is feasible and well received by the patients and their parents. Furthermore, obsessive-compulsive symptomatology decreased in all patients. The results of this study are encouraging and suggest the significance of further research regarding this technology-supported approach, with a specific focus on efficacy.Trial registration number: Clinical trials AZ53-5400.1-004/44.}, Doi = {10.1007/s00702-021-02409-w}, Key = {fds359116} } @article{fds362406, Author = {Conzelmann, A and Hollmann, K and Haigis, A and Lautenbacher, H and Bizu, V and App, R and Nickola, M and Wewetzer, G and Wewetzer, C and Ivarsson, T and Skokauskas, N and Wolters, LH and Skarphedinsson, G and Weidle, B and de Haan, E and Torp, NC and Compton, SN and Calvo, R and Lera-Miguel, S and Alt, A and Hohnecker, CS and Allgaier, K and Renner, TJ}, Title = {Internet-based psychotherapy in children with obsessive-compulsive disorder (OCD): protocol of a randomized controlled trial.}, Journal = {Trials}, Volume = {23}, Number = {1}, Pages = {164}, Year = {2022}, Month = {February}, url = {http://dx.doi.org/10.1186/s13063-022-06062-w}, Abstract = {BACKGROUND: Obsessive-compulsive disorder (OCD) in children can lead to a huge burden on the concerned patients and their family members. While successful state-of-the art cognitive behavioral interventions exist, there is still a lack of available experts for treatment at home, where most symptoms manifest. Internet-based cognitive behavioral therapy (iCBT) could overcome these restrictions; however, studies about iCBT in children with OCD are rare and mostly target computerized self-help resources and only email contact with the therapist. Therefore, we intended to build up and to evaluate an iCBT approach for children with OCD, replacing successful elements of traditional in-office face-to-face CBT, with face-to-face teleconferences, online materials, and apps. METHODS: With the help of a pilot feasibility study, we developed the iCBT consisting of 14 teleconference sessions with the child and parents. The sessions are supported by an app assessing daily and weekly symptoms and treatment course completed by children and parents. Additionally, we obtain heart rate and activity scores from the child via wristbands during several days and exposure sessions. Using a waiting list randomized control trial design, we aim to treat and analyze 20 children with OCD immediately after a diagnostic session whereas the control group of another set of 20 OCD patients will be treated after waiting period of 16 weeks. We will recruit 30 patients in each group to take account for potential dropouts. Outcomes for the treatment group are evaluated before randomization (baseline, t0), 16 weeks (end of treatment, t1), 32 weeks (follow-up 1, t2), and 48 weeks after randomization (follow-up 2, t3). For the waiting list group, outcomes are measured before the first randomization (baseline), at 16 weeks (waiting list period), 32 weeks (end of treatment), 48 weeks after the first randomization (follow-up I), and 64 weeks after the first randomization (follow-up II). DISCUSSION: Based on our experience of feasibility during the pilot study, we were able to develop the iCBT approach and the current study will investigate treatment effectiveness. Building up an iCBT approach, resembling traditional in-office face-to-face therapy, may ensure the achievement of well-known therapy effect factors, the acceptance in both patients and clinicians, and the wide distribution within the health system. TRIAL REGISTRATION: ClinicalTrials.gov NCT05037344 . Registered May 2019, last release August 13th, 2021.}, Doi = {10.1186/s13063-022-06062-w}, Key = {fds362406} } @article{fds271499, Author = {Compton, SN and Swanson, JW and Wagner, HR and Swartz, MS and Burns, BJ and Elbogen, EB}, Title = {Involuntary outpatient commitment and homelessness in persons with severe mental illness.}, Journal = {Ment Health Serv Res}, Volume = {5}, Number = {1}, Pages = {27-38}, Year = {2003}, Month = {March}, ISSN = {1522-3434}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12602644}, Abstract = {This study took preliminary steps to explore the relationship between involuntary outpatient commitment (OPC) and the risk of homelessness among individuals with severe mental disorders. Involuntarily hospitalized patients were randomly assigned to be released or maintained under OPC following hospital discharge. Multivariate analyses demonstrated that involuntary OPC was associated with a significant decrease in the risk of homelessness during the first 4 months following hospital discharge for participants with severe functional impairment at baseline. OPC did not appear to affect risk of homelessness among participants with mild-to-moderate functional impairment. Co-occurring substance abuse, treatment nonadherence, and outpatient services intensity were found to be strongly associated with episodes of homelessness. This study suggests that involuntary OPC may provide a short-term reduction in the risk of homelessness among a subgroup of treatment-reluctant individuals with severe mental disorders combined with severe functional impairment.}, Doi = {10.1023/a:1021755408267}, Key = {fds271499} } @article{fds376089, Author = {Barber, KE and Woods, DW and Ely, LJ and Saunders, SM and Compton, SN and Neal-Barnett, A and Franklin, ME and Capriotti, MR and Conelea, CA and Twohig, MP}, Title = {Long-term follow-up of acceptance-enhanced behavior therapy for trichotillomania.}, Journal = {Psychiatry Res}, Volume = {333}, Pages = {115767}, Year = {2024}, Month = {March}, url = {http://dx.doi.org/10.1016/j.psychres.2024.115767}, Abstract = {Acceptance-enhanced behavior therapy for trichotillomania (AEBT-TTM) is effective in reducing trichotillomania (TTM) symptoms, but the durability of treatment effects remains in question. This study analyzed 6-month follow-up data from a large randomized clinical trial comparing AEBT-TTM to an active psychoeducation and supportive therapy control (PST). Adults with TTM (N=85; 92% women) received 10 sessions of AEBT-TTM or PST across 12 weeks. Independent evaluators assessed participants at baseline, post-treatment, and 6 months follow-up. For both AEBT-TTM and PST, self-reported and evaluator-rated TTM symptom severity decreased from baseline to follow-up. TTM symptoms did not worsen from post-treatment to follow-up. At follow-up, AEBT-TTM and PST did not differ in rates of treatment response, TTM diagnosis, or symptom severity. High baseline TTM symptom severity was a stronger predictor of high follow-up severity for PST than for AEBT-TTM, suggesting AEBT-TTM may be a better option for more severe TTM. Results support the efficacy of AEBT-TTM and show that treatment gains were maintained over time. Although AEBT-TTM yielded lower symptoms at post-treatment, 6-month follow-up outcomes suggest AEBT-TTM and PST may lead to similar symptom levels in the longer term. Future research should examine mechanisms that contribute to long-term gain maintenance.}, Doi = {10.1016/j.psychres.2024.115767}, Key = {fds376089} } @article{fds355634, Author = {Peris, TS and Sugar, CA and Rozenman, MS and Walkup, JT and Albano, AM and Compton, S and Sakolsky, D and Ginsburg, G and Keeton, C and Kendall, PC and McCracken, JT and Piacentini, J}, Title = {Long-term Service Use Among Youths Previously Treated for Anxiety Disorder.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {60}, Number = {4}, Pages = {501-512}, Year = {2021}, Month = {April}, url = {http://dx.doi.org/10.1016/j.jaac.2020.07.911}, Abstract = {OBJECTIVE: (1) To describe rates of long-term service use among subjects previously enrolled in a landmark study of youth anxiety disorder treatment and followed into early adulthood; (2) to examine predictors of long-term service use; and (3) to examine the relationship between anxiety diagnosis and service use over time. METHOD: The Child/Adolescent Anxiety Multimodal Extended Long-term Study prospectively assessed youths treated through the Child/Adolescent Anxiety Multimodal Study at ages 7-17 years into early adulthood. A total of 319 youths (mean age 17.7, 55.2% female) previously randomized to cognitive-behavioral therapy, sertraline, combination, or placebo for the treatment of anxiety participated; 318 had service use data. Four annual clinic assessments were conducted along with telephone check-ins every 6 months. RESULTS: Overall, 65.1% of participants endorsed receiving some form of anxiety treatment over the course of the follow-up period, with more subjects reporting medication use than psychotherapy; 35.2% reported consistent use of services over the course of the study. Overall, service use declined over time in subjects with less severe anxiety but remained more steady in those with recurrent/chronic symptoms. Levels of life stress and depressive symptoms were associated with amount of service use over time whereas treatment-related variables (type of initial intervention, acute response, remission) were not. A subset of youths remained chronically anxious despite consistent service use. CONCLUSION: These findings point to the need to develop models of care that approach anxiety disorders as chronic health conditions in need of active long-term management.}, Doi = {10.1016/j.jaac.2020.07.911}, Key = {fds355634} } @article{fds346442, Author = {Bai, S and Ricketts, EJ and Thamrin, H and Piacentini, J and Albano, AM and Compton, SN and Ginsburg, GS and Sakolsky, D and Keeton, CP and Kendall, PC and Peris, TS}, Title = {Longitudinal Study of Sleep and Internalizing Problems in Youth Treated for Pediatric Anxiety Disorders.}, Journal = {J Abnorm Child Psychol}, Volume = {48}, Number = {1}, Pages = {67-77}, Year = {2020}, Month = {January}, url = {http://dx.doi.org/10.1007/s10802-019-00582-x}, Abstract = {The current study examined prospective bidirectional links between dysregulated sleep, and anxiety and depression severity across 4 years, among youth with a history of anxiety disorder. Participants were 319 youth (age 11-26 years), who previously participated in a large multisite randomized controlled trial for the treatment of pediatric anxiety disorders, Child/Adolescent Anxiety Multimodal Study (CAMS), and subsequently enrolled in a naturalistic follow-up, Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), an average of 6.5 years later. They participated in four annual visits that included self-report items of dysregulated sleep and semi-structured multi-informant interviews of anxiety and depression. Dysregulated sleep was bidirectionally associated with clinician-rated anxiety and depression symptom severity across adolescence and young adulthood. However, these bidirectional relationships were attributable to youth mean levels of dysregulated sleep, and anxiety and depression severity over the 4 years. Elevations in dysregulated sleep at each visit, relative to mean levels, did not predict worse anxiety or depression severity 1 year later. Likewise visit-specific elevations in anxiety and depression severity, as opposed to average levels, did not predict higher levels of dysregulated sleep at the next visit. Having higher levels of dysregulated sleep or more severe internalizing problems across the four-year period, as opposed to reporting a relative increase in symptom severity at a particular visit, posed greater risk for poor mental health. Interventions should continue to assess and treat persistent sleep problems alongside anxiety and depression.}, Doi = {10.1007/s10802-019-00582-x}, Key = {fds346442} } @article{fds302625, Author = {Houghton, DC and Compton, SN and Twohig, MP and Saunders, SM and Franklin, ME and Neal-Barnett, AM and Ely, L and Capriotti, MR and Woods, DW}, Title = {Measuring the role of psychological inflexibility in Trichotillomania.}, Journal = {Psychiatry Res}, Volume = {220}, Number = {1-2}, Pages = {356-361}, Year = {2014}, Month = {December}, ISSN = {0165-1781}, url = {http://dx.doi.org/10.1016/j.psychres.2014.08.003}, Abstract = {Psychological Inflexibility (PI) is a construct that has gained recent attention as a critical theoretical component of Acceptance and Commitment Therapy (ACT). PI is typically measured by the Acceptance and Action Questionnaire-II (AAQ-II). However, the AAQ-II has shown questionable reliability in clinical populations with specific diagnoses, leading to the creation of content-specific versions of the AAQ-II that show stronger psychometric properties in their target populations. A growing body of the literature suggests that PI processes may contribute to hair pulling, and the current study sought to examine the psychometric properties and utility of a Trichotillomania-specific version of the AAQ-II, the AAQ-TTM. A referred sample of 90 individuals completed a battery of assessments as part of a randomized clinical trial of Acceptance-Enhanced Behavior Therapy for Trichotillomania. Results showed that the AAQ-TTM has two intercorrelated factors, adequate reliability, concurrent validity, and incremental validity over the AAQ-II. Furthermore, mediational analysis between emotional variables and hair pulling outcomes provides support for using the AAQ-TTM to measure the therapeutic process. Implications for the use of this measure will be discussed, including the need to further investigate the role of PI processes in Trichotillomania.}, Doi = {10.1016/j.psychres.2014.08.003}, Key = {fds302625} } @article{fds323539, Author = {Kendall, PC and Cummings, CM and Villabø, MA and Narayanan, MK and Treadwell, K and Birmaher, B and Compton, S and Piacentini, J and Sherrill, J and Walkup, J and Gosch, E and Keeton, C and Ginsburg, G and Suveg, C and Albano, AM}, Title = {Mediators of change in the Child/Adolescent Anxiety Multimodal Treatment Study.}, Journal = {J Consult Clin Psychol}, Volume = {84}, Number = {1}, Pages = {1-14}, Year = {2016}, Month = {January}, url = {http://dx.doi.org/10.1037/a0039773}, Abstract = {OBJECTIVE: Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). METHOD: Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. RESULTS: Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. CONCLUSIONS: The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.}, Doi = {10.1037/a0039773}, Key = {fds323539} } @article{fds327202, Author = {Hale, AE and Ginsburg, GS and Chan, G and Kendall, PC and McCracken, JT and Sakolsky, D and Birmaher, B and Compton, SN and Albano, AM and Walkup, JT}, Title = {Mediators of Treatment Outcomes for Anxious Children and Adolescents: The Role of Somatic Symptoms.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {47}, Number = {1}, Pages = {94-104}, Year = {2018}, url = {http://dx.doi.org/10.1080/15374416.2017.1280804}, Abstract = {Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors are effective treatments for pediatric anxiety disorders. However, the mechanisms of these treatments are unknown. Previous research indicated that somatic symptoms are reduced following treatment, but it is unclear if their reductions are merely a consequence of treatment gains. This study examined reductions in somatic symptoms as a potential mediator of the relationship between treatment and anxiety outcomes. Participants were 488 anxious youth ages 7-17 (M = 10.7), 50.4% male, 78.9% Caucasian, enrolled in Child/Adolescent Anxiety Multimodal Study, a large randomized control trial comparing 12-week treatments of CBT, sertraline, a combination of CBT and sertraline, and a pill placebo. Causal mediation models were tested in R using data from baseline, 8-, and 12-week evaluations. Somatic symptoms were assessed using the Panic/Somatic subscale from the Screen for Child Anxiety Related Emotional Disorders. Youth outcomes were assessed using the Pediatric Anxiety Rating Scale and Children's Global Assessment Scale. Reductions in somatic symptoms mediated improvement in anxiety symptoms and global functioning for those in the sertraline-only condition based on parent report. Conditions involving CBT and data based on child reported somatic symptoms did not show a mediation effect. Findings indicate that reductions in somatic symptoms may be a mediator of improvements for treatments including pharmacotherapy and not CBT. Although the overall efficacy of sertraline and CBT for anxiety may be similar, the treatments appear to function via different mechanisms.}, Doi = {10.1080/15374416.2017.1280804}, Key = {fds327202} } @article{fds366293, Author = {Makover, HB and Kendall, PC and Olino, T and Carper, MM and Albano, AM and Piacentini, J and Peris, T and Langley, AK and Gonzalez, A and Ginsburg, GS and Compton, S and Birmaher, B and Sakolsky, D and Keeton, C and Walkup, J}, Title = {Mediators of youth anxiety outcomes 3 to 12 years after treatment.}, Journal = {J Anxiety Disord}, Volume = {70}, Pages = {102188}, Year = {2020}, Month = {March}, url = {http://dx.doi.org/10.1016/j.janxdis.2020.102188}, Abstract = {OBJECTIVE: Test changes in perceived coping efficacy, negative self-statements, and interpretive biases to threat during treatment as potential mediators of the relationship between randomly assigned treatment conditions and long-term anxiety follow-ups. Age at randomization was also tested as a moderator of mediational relationships. METHOD: Participants included 319 youth (ages 7-17) from the Child/Adolescent Multimodal Study (CAMS) who participated in a naturalistic follow-up beginning an average of 6.5 years after the end of the CAMS intervention. The intervention conditions included cognitive behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), combined CBT and sertraline, and pill placebo. Putative mediators were measured four times during the intervention phase. Follow-up consisted of four annual assessments of current anxiety. RESULTS: Reductions on a measure of interpretive bias to threat over the course of the combined condition intervention, as compared to the placebo condition, mediated anxiety outcomes at the first follow-up visit. This mediated effect was not significant for the CBT-only or sertraline-only conditions when compared to the placebo condition. No other significant mediated effects were found for putative mediators. Age did not significantly moderate any mediated effects. CONCLUSION: Changes in youth-reported interpretive biases to threat over the course of combined youth anxiety interventions, as compared to a placebo intervention, may be associated with lower anxiety an average of 6.5 years following treatment.}, Doi = {10.1016/j.janxdis.2020.102188}, Key = {fds366293} } @article{fds345468, Author = {Keeton, CP and Caporino, NE and Kendall, PC and Iyengar, S and Lee, P and Peris, T and Sakolsky, D and Piacentini, J and Compton, SN and Albano, AM and Birmaher, B and Ginsburg, GS}, Title = {Mood and suicidality outcomes 3-11 years following pediatric anxiety disorder treatment.}, Journal = {Depress Anxiety}, Volume = {36}, Number = {10}, Pages = {930-940}, Year = {2019}, Month = {October}, url = {http://dx.doi.org/10.1002/da.22944}, Abstract = {BACKGROUND: Youth anxiety interventions have potential to reduce risk for depression and suicidality. METHODS: This naturalistic follow-up of the multi-site, comparative treatment trial, inking and behavior, and depressive symptoms 3-11 years (mean 6.25 years) following 12-week evidence-based youth anxiety treatment. Participants (N = 319; 10-26 years, mean 17 years) completed semiannual questionnaires and annual diagnostic interviews for 4 years. RESULTS: One-fifth (20.4%) of the sample met DSM-IV criteria for a mood disorder, 32.1% endorsed suicidal ideation, and 8.2% reported suicidal behavior. Latent class growth analysis yielded two linear trajectories of depressive symptoms, and 85% of the sample demonstrated a persistent low-symptom course over seven assessments. Child/Adolescent Anxiety Multimodal Study (CAMS) 12-week treatment outcome (positive response, remission) and treatment condition (cognitive behavior therapy [CBT], medication, CBT + medication, pill placebo) were not associated with subsequent mood disorder or suicidal thinking. CAMS remission predicted absence of suicidal behavior, and treatment response and remission predicted low depressive symptom trajectory. Greater baseline self-reported depressive symptoms predicted all long-term mood outcomes, and more negative life events predicted subsequent mood disorder, depressive symptom trajectory, and suicidal ideation. CONCLUSIONS: Effective early treatment of youth anxiety, including CBT, medication, or CBT + medication, reduces risk for subsequent chronic depressive symptoms and suicidal behavior. Attention to (sub)clinical depressive symptoms and management of negative life events may reduce odds of developing a mood disorder, chronic depressive symptoms, and suicidality. Findings contribute to evidence that early intervention for a primary disorder can serve as secondary prevention.}, Doi = {10.1002/da.22944}, Key = {fds345468} } @article{fds343763, Author = {Norris, LA and Rifkin, LS and Olino, TM and Piacentini, J and Albano, AM and Birmaher, B and Ginsburg, G and Walkup, J and Compton, SN and Gosch, E and Kendall, PC}, Title = {Multi-informant Expectancies and Treatment Outcomes for Anxiety in Youth.}, Journal = {Child Psychiatry Hum Dev}, Volume = {50}, Number = {6}, Pages = {1002-1010}, Year = {2019}, Month = {December}, url = {http://dx.doi.org/10.1007/s10578-019-00900-w}, Abstract = {Expectancies for a favorable treatment outcome have been associated with actual favorable outcomes but have been understudied in youth with anxiety. The current study applied structural equation modeling in a sample of anxious youth (N = 488; 7-17 years, M = 10.69, SD = 2.80) to examine whether a multi-informant latent expectancies factor, indicated by youth, parent, and therapist reports, predicted a latent posttreatment anxiety factor, controlling for a latent pretreatment anxiety factor. Both anxiety latent factors were indicated by youth, parent, and independent evaluator (IE) reports. Analyses also examined whether treatment condition (cognitive behavioral therapy, sertraline, combination, pill placebo) moderated the association between expectancies and outcome, and whether this association differed across development. Findings indicated that informant reports loaded similarly onto the latent factors. Results also demonstrated that treatment expectancies were positively associated with outcomes, and that this relationship held across treatment type and age group. Treatment implications and future research directions are discussed.}, Doi = {10.1007/s10578-019-00900-w}, Key = {fds343763} } @article{fds302630, Author = {Ginsburg, GS and Becker, EM and Keeton, CP and Sakolsky, D and Piacentini, J and Albano, AM and Compton, SN and Iyengar, S and Sullivan, K and Caporino, N and Peris, T and Birmaher, B and Rynn, M and March, J and Kendall, PC}, Title = {Naturalistic follow-up of youths treated for pediatric anxiety disorders.}, Journal = {JAMA Psychiatry}, Volume = {71}, Number = {3}, Pages = {310-318}, Year = {2014}, Month = {March}, ISSN = {2168-622X}, url = {http://dx.doi.org/10.1001/jamapsychiatry.2013.4186}, Abstract = {IMPORTANCE: Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems. Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents, particularly those treated with medication. OBJECTIVE: To determine whether acute clinical improvement and treatment type (i.e., cognitive behavioral therapy, medication, or their combination) predicted remission of anxiety and improvement in global functioning at a mean of 6 years after randomization and to examine predictors of outcomes at follow-up. DESIGN, SETTING, AND PARTICIPANTS: This naturalistic follow-up study, as part of the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), was conducted at 6 academic sites in the United States and included 288 youths (age range, 11-26 years; mean age, 17 years). Youths were randomized to 1 of 4 interventions (cognitive behavioral therapy, medication, combination, or pill placebo) in the Child/Adolescent Anxiety Multimodal Study (CAMS) and were evaluated a mean of 6 years after randomization. Participants in this study constituted 59.0% of the original CAMS sample. EXPOSURES: Participants were assessed by independent evaluators using a semistructured diagnostic interview to determine the presence of anxiety disorders, the severity of anxiety, and global functioning. Participants and their parents completed questionnaires about mental health symptoms, family functioning, life events, and mental health service use. MAIN OUTCOMES AND MEASURES: Remission, defined as the absence of all study entry anxiety disorders. RESULTS Almost half of the sample (46.5%) were in remission a mean of 6 years after randomization. Responders to acute treatment were significantly more likely to be in remission (odds ratio, 1.83; 95% CI, 1.08-3.09) and had less severe anxiety symptoms and higher functioning; the assigned treatment arm was unrelated to outcomes. Several predictors of remission and functioning were identified. CONCLUSIONS AND RELEVANCE: Youths rated as responders during the acute treatment phase of CAMS were more likely to be in remission a mean of 6 years after randomization, although the effect size was small. Relapse occurred in almost half (48%) of acute responders, suggesting the need for more intensive or continued treatment for a sizable proportion of youths with anxiety disorders. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00052078.}, Doi = {10.1001/jamapsychiatry.2013.4186}, Key = {fds302630} } @article{fds352830, Author = {Casline, EP and Ginsburg, GS and Piacentini, J and Compton, S and Kendall, P}, Title = {Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type.}, Journal = {Res Child Adolesc Psychopathol}, Volume = {49}, Number = {1}, Pages = {91-102}, Year = {2021}, Month = {January}, url = {http://dx.doi.org/10.1007/s10802-020-00711-x}, Abstract = {Long-term follow-up studies of anxiety treatment have found that greater exposure to negative life events (NLEs) predicts poorer anxiety outcomes, but none have examined whether specific types of NLEs are differentially associated with child outcomes. This study examined the frequency of NLEs and whether specific types of NLEs were associated with increased risk of having an anxiety disorder 6.5 years post randomization. Participants were 319 adolescents and adults, ages 11 to 26 (M = 17), enrolled in Child/Adolescent Anxiety Multimodal Extended Long-term Study. At their first follow-up visit, participants completed a diagnostic interview and a 40-item Life Events Scale that reflected whether specific events occurred since their last post treatment assessment. Life events were categorized into domains (i.e., family, academic, health, and social) via researcher consensus. Participants reported having experienced an average of four NLEs. Participants with an anxiety disorder at follow-up were significantly more likely to have failed a grade in school (OR = 5.9) and experienced a negative change in acceptance by peers (OR = 4.9; ps < 0.001). After controlling for gender, age, race, and SES, a greater number of NLEs in the academic domain increased the odds of having an anxiety disorder at follow-up (OR = 2.4, p < 0.001). No other domains were predictive of disorder status at follow-up. Findings highlight the value of examining specific NLEs in relation to the long-term child anxiety outcomes.}, Doi = {10.1007/s10802-020-00711-x}, Key = {fds352830} } @article{fds330044, Author = {Højgaard, DRMA and Hybel, KA and Ivarsson, T and Skarphedinsson, G and Becker Nissen and J and Weidle, B and Melin, K and Torp, NC and Valderhaug, R and Dahl, K and Mortensen, EL and Compton, S and Jensen, S and Lenhard, F and Thomsen, PH}, Title = {One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {56}, Number = {11}, Pages = {940-947.e1}, Year = {2017}, Month = {November}, url = {http://dx.doi.org/10.1016/j.jaac.2017.09.002}, Abstract = {OBJECTIVE: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up. METHOD: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes. RESULTS: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p = .001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT. CONCLUSION: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. Clinical trial registration information- Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.}, Doi = {10.1016/j.jaac.2017.09.002}, Key = {fds330044} } @article{fds302628, Author = {Gonzalez, A and Peris, TS and Vreeland, A and Kiff, CJ and Kendall, PC and Compton, SN and Albano, AM and Birmaher, B and Ginsburg, GS and Keeton, CP and March, J and McCracken, J and Rynn, M and Sherrill, J and Walkup, JT and Piacentini, J}, Title = {Parental anxiety as a predictor of medication and CBT response for anxious youth.}, Journal = {Child Psychiatry Hum Dev}, Volume = {46}, Number = {1}, Pages = {84-93}, Year = {2015}, Month = {February}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-014-0454-6}, Abstract = {The aim of this investigation was to evaluate how parental anxiety predicted change in pediatric anxiety symptoms across four different interventions: cognitive-behavioral therapy, medication (sertraline; SRT), their combination (COMB), and pill placebo. Participants were 488 youths (ages 7-17) with separation anxiety disorder, generalized anxiety disorder, and/or social phobia and their primary caregivers. Latent growth curve modeling assessed how pre-treatment parental trait anxiety symptoms predicted trajectories of youth anxiety symptom change across 12 weeks of treatment at four time points. Interactions between parental anxiety and treatment condition were tested. Parental anxiety was not associated with youth's pre-treatment anxiety symptom severity. Controlling for parental trait anxiety, youth depressive symptoms, and youth age, youths who received COMB benefitted most. Counter to expectations, parental anxiety influenced youth anxiety symptom trajectory only within the SRT condition, whereas parental anxiety was not significantly associated with youth anxiety trajectories in the other treatment conditions. Specifically, within the SRT condition, higher levels of parental anxiety predicted a faster and greater reduction in youth anxiety over the acute treatment period compared to youths in the SRT condition whose parents had lower anxiety levels. While all active treatments produced favorable outcomes, results provide insight regarding the treatment-specific influence of parental anxiety on the time course of symptom change.}, Doi = {10.1007/s10578-014-0454-6}, Key = {fds302628} } @article{fds342836, Author = {Norris, LA and Olino, TM and Gosch, EA and Compton, SN and Piacentini, J and Ginsburg, GS and Albano, AM and Walkup, JT and Birmaher, B and Kendall, PC}, Title = {Person-Centered Profiles Among Treatment-Seeking Children and Adolescents with Anxiety Disorders.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {49}, Number = {5}, Pages = {626-638}, Year = {2020}, url = {http://dx.doi.org/10.1080/15374416.2019.1602839}, Abstract = {Latent profile analysis (LPA) was used to derive homogeneous subgroups within the Child/Adolescent Anxiety Multimodal Study sample (N = 488; 7-17 years, M = 10.69, SD = 2.80) and examine whether class membership predicted or moderated treatment response. Subgroups were identified on baseline multi-informant measures of variables most consistently associated with outcome (youth anxiety/diagnosis, impairment, family psychopathology/functioning). Subgroup membership was examined as a predictor/moderator of outcome across the four treatment conditions (CBT, Sertraline, CBT+Sertraline, pill placebo) at posttreatment (12 weeks) and open-extension follow-up (24 weeks). Four subgroups emerged: mild symptoms/impairment, moderate symptoms/impairment, moderate symptoms/impairment with family dysfunction/parental psychopathology, and severe symptoms/impairment. There were significant between-class differences on socioeconomic status (SES; lower reported SES in the moderate with family dysfunction/parental psychopathology class compared to the mild and moderate class) and age (older age in the severe symptoms class compared to the other three classes). Youth in the mild symptoms/impairment class showed lower posttreatment anxiety across conditions but reported significantly lower symptom severity at baseline. Controlling for demographic differences, response to treatment type did not differ across classes. Analyses indicate that elevated family dysfunction/parental psychopathology clusters primarily within one subgroup of anxious youth rather than mapping onto symptom severity, highlighting the utility of LPA for clarifying within-person combinations of predictor/moderator variables. Implications for development of interventions targeting class-relevant variables are discussed.}, Doi = {10.1080/15374416.2019.1602839}, Key = {fds342836} } @article{fds271470, Author = {Compton, SN and Kratochvil, CJ and March, JS}, Title = {Pharmacotherapy for anxiety disorders in children and adolescents: An evidence-based medicine review}, Journal = {Psychiatric Annals}, Volume = {37}, Number = {7}, Pages = {504-517}, Year = {2007}, Month = {January}, ISSN = {0048-5713}, url = {http://dx.doi.org/10.3928/00485713-20070701-05}, Abstract = {These studies generally support the use of the SSRIs fluvoxamine, sertraline, and fluoxetine in the acute treatment of pediatric non-OCD anxiety disorders. Two large multicenter studies suggest a favorable outcome for paroxetine in the treatment of pediatric social anxiety disorder. Mixed results currently exist for the use of extended-release venlafaxine in the treatment of pediatric generalized anxiety disorder. In both of these latter studies, concerns with safety were present.}, Doi = {10.3928/00485713-20070701-05}, Key = {fds271470} } @article{fds271471, Author = {Compton, SN and Kratochvil, CJ and March, JS}, Title = {Pharmacotherapy for anxiety disorders in children and adolescents: an evidence-based medicine review.}, Journal = {Pediatr Ann}, Volume = {36}, Number = {9}, Pages = {586-598}, Year = {2007}, Month = {September}, ISSN = {0090-4481}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17910206}, Doi = {10.3928/0090-4481-20070901-10}, Key = {fds271471} } @article{fds323536, Author = {Houghton, DC and Franklin, MR and Twohig, MP and Franklin, ME and Compton, SN and Neal-Barnett, AM and Saunders, SM and Woods, DW}, Title = {Photographic Assessment of Change in Trichotillomania: Psychometric Properties and Variables Influencing Interpretation}, Journal = {Journal of Psychopathology and Behavioral Assessment}, Volume = {38}, Number = {3}, Pages = {505-513}, Publisher = {Springer Nature}, Year = {2016}, Month = {September}, url = {http://dx.doi.org/10.1007/s10862-016-9536-z}, Abstract = {Although photographic assessment has been found to be reliable in assessing hair loss in Trichotillomania, the validity of this method is unclear, particularly for gauging progress in treatment. The current study evaluated the psychometric properties of photographic assessment of change in Trichotillomania. Photographs showing hair loss of adults with Trichotillomania were taken before and after participating in a clinical trial for the condition. Undergraduate college students (N = 211) rated treatment response according to the photos, and additional archival data on hair pulling severity and psychosocial health were retrieved from the clinical trial. Photographic assessment of change was found to possess fair reliability (ICC = 0.53), acceptable criterion validity (r = 0.51), good concurrent validity (r = 0.30–0.36), and excellent incremental validity (ΔR2 = 8.67, p < 0.01). In addition, photographic measures were significantly correlated with change in quality of life (r = 0.42), and thus could be considered an index of the social validity of Trichotillomania treatment. Gender of the photo rater and pulling topography affected the criterion validity of photographic assessment (partial η2 = 0.05–0.11). Recommendations for improving photographic assessment and future directions for hair pulling research are discussed.}, Doi = {10.1007/s10862-016-9536-z}, Key = {fds323536} } @article{fds327200, Author = {Strawn, JR and Dobson, ET and Mills, JA and Cornwall, GJ and Sakolsky, D and Birmaher, B and Compton, SN and Piacentini, J and McCracken, JT and Ginsburg, GS and Kendall, PC and Walkup, JT and Albano, AM and Rynn, MA}, Title = {Placebo Response in Pediatric Anxiety Disorders: Results from the Child/Adolescent Anxiety Multimodal Study.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {27}, Number = {6}, Pages = {501-508}, Year = {2017}, Month = {August}, url = {http://dx.doi.org/10.1089/cap.2016.0198}, Abstract = {OBJECTIVES: The aim of this study is to identify predictors of pill placebo response and to characterize the temporal course of pill placebo response in anxious youth. METHODS: Data from placebo-treated patients (N = 76) in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multisite, randomized controlled trial that examined the efficacy of cognitive-behavioral therapy, sertraline, their combination, and placebo for the treatment of separation, generalized, and social anxiety disorders, were evaluated. Multiple linear regression models identified features associated with placebo response and models were confirmed with leave-one-out cross-validation. The likelihood of improvement in patients receiving pill placebo-over time-relative to improvement associated with active treatment was determined using probabilistic Bayesian analyses. RESULTS: Based on a categorical definition of response (Clinical Global Impressions-Improvement Scale score ≤2), nonresponders (n = 48), and pill placebo responders (n = 18) did not differ in age (p = 0.217), sex (p = 0.980), race (p = 0.743), or primary diagnosis (all ps > 0.659). In terms of change in anxiety symptoms, separation anxiety disorder and treatment expectation were associated with the degree of pill placebo response. Greater probability of placebo-related anxiety symptom improvement was observed early in the course of treatment (baseline to week 4, p < 0.0001). No significant change in the probability of placebo-related improvement was observed after week 4 (weeks 4-8, p = 0.07; weeks 8-12, p = 0.85), whereas the probability of improvement, in general, significantly increased week over week with active treatment. CONCLUSIONS: Pill placebo-related improvement occurs early in the course of treatment and both clinical factors and expectation predict this improvement. Additionally, probabilistic approaches may refine our understanding and prediction of pill placebo response.}, Doi = {10.1089/cap.2016.0198}, Key = {fds327200} } @article{fds302612, Author = {Read, KL and Settipani, CA and Peterman, J and Kendall, PC and Compton, S and Piacentini, J and McCracken, J and Bergman, L and Walkup, J and Sakolsky, D and Birmaher, B and Albano, AM and Rynn, M and Ginsburg, G and Keeton, C and Gosch, E and Suveg, C and Sherrill, J and March, J}, Title = {Predicting Anxiety Diagnoses and Severity with the CBCL-A: Improvement Relative to Other CBCL Scales?}, Journal = {J Psychopathol Behav Assess}, Volume = {37}, Number = {1}, Pages = {100-111}, Year = {2015}, Month = {March}, ISSN = {0882-2689}, url = {http://dx.doi.org/10.1007/s10862-014-9439-9}, Abstract = {The Child Behavior Checklist (CBCL) is a widely used parent-report of child and adolescent behavior. We examined the ability of the CBCL-A scale, a previously published subset of CBCL items, to predict the presence of generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and social phobia (SoP), as well as anxiety severity, among 488 youth randomized in the Child Anxiety Multimodal Study (CAMS). We predicted that the CBCL-A's unique inclusion of items related to somatic symptoms would better identify anxiety disorder and severity than other CBCL scales, given that somatic complaints are often key features of anxiety among youth. Results support the use of the anxiety-based CBCL subscales as first-line screeners for generally elevated symptoms of anxiety, rather than tools to identify specific anxiety disorders. Although somatic symptoms are often reported and included in diagnostic criteria for certain anxiety disorders (e.g., SAD, GAD), the unique combination of somatic and non-somatic symptoms for the CBCL-A subscale did not increase its ability to consistently predict the presence of specific anxiety disorders.}, Doi = {10.1007/s10862-014-9439-9}, Key = {fds302612} } @article{fds302627, Author = {Compton, SN and Peris, TS and Almirall, D and Birmaher, B and Sherrill, J and Kendall, PC and March, JS and Gosch, EA and Ginsburg, GS and Rynn, MA and Piacentini, JC and McCracken, JT and Keeton, CP and Suveg, CM and Aschenbrand, SG and Sakolsky, D and Iyengar, S and Walkup, JT and Albano, AM}, Title = {Predictors and moderators of treatment response in childhood anxiety disorders: results from the CAMS trial.}, Journal = {J Consult Clin Psychol}, Volume = {82}, Number = {2}, Pages = {212-224}, Year = {2014}, Month = {April}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0035458}, Abstract = {OBJECTIVE: We sought to examine predictors and moderators of treatment outcomes among 488 youths ages 7-17 years (50% female; 74% ≤ 12 years) meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) criteria for diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavioral therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). METHOD: Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale-Improvement; CGI-I) outcome measures. RESULTS: Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict Week 12 responder status (CGI-I). Participants' principal diagnosis moderated treatment outcomes but only on the PARS. No baseline variables were found to moderate treatment outcomes on Week 12 responder status (CGI-I). DISCUSSION: Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed.}, Doi = {10.1037/a0035458}, Key = {fds302627} } @article{fds302611, Author = {Torp, NC and Dahl, K and Skarphedinsson, G and Compton, S and Thomsen, PH and Weidle, B and Hybel, K and Valderhaug, R and Melin, K and Nissen, JB and Ivarsson, T}, Title = {Predictors associated with improved cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {54}, Number = {3}, Pages = {200-207.e1}, Year = {2015}, Month = {March}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2014.12.007}, Abstract = {OBJECTIVE: To identify predictors of treatment response in a large sample of pediatric participants with obsessive-compulsive disorder (OCD). The Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (NordLOTS) included 269 children and adolescents, 7 to 17 years of age, with a DSM-IV diagnosis of OCD. Outcomes were evaluated after 14 weekly sessions of exposure-based cognitive-behavioral therapy (CBT). METHOD: The association of 20 potential predictors, identified by literature review, along with their outcomes, was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) posttreatment. A CY-BOCS total score of ≤15 was the primary outcome measure. RESULTS: The univariate analyses showed that children and adolescents who were older had more severe OCD, greater functional impairment, higher rates of internalizing and externalizing symptoms, and higher levels of anxiety and depression symptoms before treatment had significantly poorer outcomes after 14 weeks of treatment. However, only age was a significant predictor in the multivariate model. CONCLUSION: In the multivariate analysis, only age predicted better treatment outcome. Using univariate analysis, a variety of predictors of poorer treatment outcome after CBT was identified. The high impact of comorbid symptoms on outcome in pediatric OCD suggests that treatment should address comorbidity issues. The lack of a family predictor may be related to high family involvement in this study. Future research strategies should focus on optimizing intervention in the presence of these characteristics to achieve greater benefits for patients with OCD. Clinical trial registration information-Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.}, Doi = {10.1016/j.jaac.2014.12.007}, Key = {fds302611} } @article{fds271468, Author = {Gosch, EA and Flannery-Schroeder, E and Mauro, CF and Compton, SN}, Title = {Principles of cognitive-behavioral therapy for anxiety disorders in children}, Journal = {Journal of Cognitive Psychotherapy}, Volume = {20}, Number = {3}, Pages = {247-262}, Publisher = {Springer Publishing Company}, Year = {2006}, Month = {January}, ISSN = {0889-8391}, url = {http://dx.doi.org/10.1891/jcop.20.3.247}, Abstract = {This article elucidates the theoretical underpinnings of cognitive-behavior therapy (CBT) as applied to the treatment of anxiety disorders in children, focusing on social phobia, generalized anxiety disorder, and separation anxiety disorder. It reviews behavioral and cognitive theories that have influenced this approach. We argue that it is necessary to understand the essential components of this approach in the context of these theories in order to provide effective, clinically sensitive, and child-focused treatment. Components discussed include assessment, psychoeducation, affective education, self-instruction training, cognitive restructuring, problem solving, relaxation training, modeling, contingency management, and exposure procedures. Hypothesized key processes, such as the need to be experiential in treatment, are presented for consideration. © 2006 Springer Publishing Company.}, Doi = {10.1891/jcop.20.3.247}, Key = {fds271468} } @article{fds371870, Author = {Barber, KE and Woods, DW and Bauer, CC and Twohig, MP and Saunders, SM and Compton, SN and Franklin, ME}, Title = {Psychometric Properties of Trichotillomania Severity Measures}, Journal = {Cognitive Therapy and Research}, Volume = {48}, Number = {1}, Pages = {18-29}, Year = {2024}, Month = {February}, url = {http://dx.doi.org/10.1007/s10608-023-10406-4}, Abstract = {Background: Trichotillomania (TTM) is a psychiatric disorder that leads to significant hair loss, distress, and impairment. Few validated measures exist to assess TTM, and psychometric research examining these tools is sparse. This study evaluated the psychometric properties of commonly used TTM severity measures and extended prior research by including hair loss severity ratings in our analyses. Methods: Participants included 91 adults (92.3% Female; M age = 35.0) with TTM who completed baseline assessments as part of a randomized clinical trial of psychotherapy for TTM. TTM measures included the Massachusetts General Hospital Hairpulling Scale (MGH-HS) and National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS). Independent evaluators rated photos of participants’ most severely affected pulling sites using a one-item hair loss severity scale. Results: Results showed mixed psychometric properties for TTM measures. The MGH-HS showed acceptable internal consistency (alpha = 0.83; omega = 0.89), while the NIMH-TSS had lower internal consistency (alpha = 0.52; omega = 0.73). Both the MGH-HS and NIMH-TSS demonstrated low test-retest reliability. Total scores on the MGH-HS and NIMH-TSS were not associated with hair loss severity. Conclusions: Given these findings, it is imperative to develop new, psychometrically-sound TTM measures. These results also emphasize the importance of a multi-method approach to TTM assessment. In addition to self-report and clinician-administered measures, hair loss severity ratings may offer valuable information as part of a comprehensive assessment of TTM.}, Doi = {10.1007/s10608-023-10406-4}, Key = {fds371870} } @article{fds342200, Author = {Bushnell, GA and Dusetzina, SB and Compton, SN and Gaynes, BN and Brookhart, MA and Stürmer, T}, Title = {Psychotherapy Claims Surrounding Pharmacotherapy Initiation in Children and Adolescents with Anxiety Disorders.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {29}, Number = {2}, Pages = {100-106}, Year = {2019}, Month = {March}, url = {http://dx.doi.org/10.1089/cap.2018.0108}, Abstract = {OBJECTIVES: Psychotherapy is an effective, recommended treatment for pediatric anxiety disorders. Nevertheless, individuals with mental health conditions often do not receive psychotherapy, with variation across provider types. This study sought to examine psychotherapy claims surrounding medication initiation in U.S. children with diagnosed anxiety disorders. METHODS: The study cohort included privately insured children (3-17 years) with a diagnosed anxiety disorder initiating a medication to treat anxiety from 2004 to 2014. We examined psychotherapy claims in the 3 months before and 3 months after medication initiation and described children with multiple (2+) psychotherapy claims per 3-month period. RESULTS: Of the 75,024 children initiating a medication for anxiety (median age = 14 years, 58% female), 35% had multiple psychotherapy claims before medication initiation, with variation by age, anxiety disorder, and psychiatric comorbidity and with little change across time. Psychotherapy claims after medication initiation varied by whether the child had prior psychotherapy: 80% in children with prior psychotherapy and 30% in children without prior psychotherapy claims (44% of children diagnosed by a psychiatrist, 21% of children diagnosed by a pediatrician). CONCLUSION: Many privately insured children do not have claims for psychotherapy before or after pharmacotherapy initiation for anxiety. Findings can inform future research and efforts to ultimately increase appropriate psychotherapy utilization in children with anxiety disorders.}, Doi = {10.1089/cap.2018.0108}, Key = {fds342200} } @article{fds372713, Author = {Barber, KE and Capel, LK and Merl, N and Twohig, MP and Saunders, SM and Compton, SN and Franklin, ME and Woods, DW}, Title = {Pulling Sites in Trichotillomania: Exploring Differences in Characteristics, Phenomenology, and Contextual Variables}, Journal = {Cognitive Therapy and Research}, Volume = {48}, Number = {1}, Pages = {164-176}, Year = {2024}, Month = {February}, url = {http://dx.doi.org/10.1007/s10608-023-10419-z}, Abstract = {Introduction: Trichotillomania is a heterogeneous disorder with a wide range of presentations. Past studies have described the phenomenology of trichotillomania, but individual differences based on the body site from which hair is pulled have not been thoroughly explored. Contextual variables relevant to pulling (e.g., settings, tool use) may vary as a function of pulling site. We constructed a detailed profile of individual and clinical characteristics based on pulling site and describe contextual factors associated with different pulling sites. Methods: Data were drawn from two randomized control trials of psychotherapy for trichotillomania. Participants included treatment-seeking adults with trichotillomania (N = 153; 89% women; Mage=33.41) who took part in either a face-to-face (n = 92) or an online (n = 61) trial. Study 1 explored differences in age, gender, trichotillomania symptom severity, and levels of automatic and focused pulling as a function of pulling site. Study 2 included a subset of Study 1 participants (n = 65) and examined pulling site differences for relevant contextual variables. Results: Study 1 revealed differences in age, gender, and level of automatic vs. focused pulling based on pulling site. Study 2 showed that pulling from different bodily sites was more likely to occur in specific settings and with certain tools. Discussion: These results reflect considerable variability in the phenomenology of trichotillomania across pulling sites and contribute to the overall understanding of trichotillomania. A clearer picture of contextual cues and clinical characteristics for different hair pulling sites has treatment implications. Clinical applications and future research directions are discussed.}, Doi = {10.1007/s10608-023-10419-z}, Key = {fds372713} } @article{fds355970, Author = {Jensen, S and Hybel, KA and Højgaard, DRMA and Nissen, JB and Weidle, B and Ivarsson, T and Skarphedinsson, G and Melin, K and Torp, NC and Carlsen, AH and Mortensen, EL and Lenhard, F and Compton, S and Thomsen, PH}, Title = {Quality of life in pediatric patients with obsessive-compulsive disorder during and 3 years after stepped-care treatment.}, Journal = {Eur Child Adolesc Psychiatry}, Volume = {31}, Number = {9}, Pages = {1377-1389}, Year = {2022}, Month = {September}, url = {http://dx.doi.org/10.1007/s00787-021-01775-w}, Abstract = {The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive-compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a 3-year follow-up period. Data from three symptom severity trajectory classes formed the basis of the QoL evaluation: acute (n = 127, N = 147), slow (n = 46, N = 63), and limited responders (n = 47, N = 59). Patients' QoL was assessed using parent and child ratings of the revised Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was analyzed by trajectory class using a random mixed effects model. The association between pre-treatment factors and long-term QoL was investigated across classes in a multivariate model. Three years after treatment, the acute responder class had reached QoL levels from a general population, whereas the limited responder class had not. The slow responder class reached norm levels for the child-rated QoL only. Higher levels of co-occurring externalizing symptoms before treatment were associated with lower parent-rated QoL during follow-up, while adolescence and higher levels of co-occurring internalizing symptoms were associated with lower child-rated QoL during follow-up. For some patients, residual OCD symptoms in the years after treatment, even at levels below assumed clinical significance, are associated with compromised QoL. Co-occurring symptoms could be part of the explanation. Assessing QoL after OCD treatment, beyond the clinician-rated symptom severity, could detect patients in need of further treatment and/or assessment. Trial registry: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.}, Doi = {10.1007/s00787-021-01775-w}, Key = {fds355970} } @article{fds371262, Author = {Coffman, M and Di Martino and JM and Aiello, R and Carpenter, KLH and Chang, Z and Compton, S and Eichner, B and Espinosa, S and Flowers, J and Franz, L and Perochon, S and Krishnappa Babu and PR and Sapiro, G and Dawson, G}, Title = {Relationship between quantitative digital behavioral features and clinical profiles in young autistic children.}, Journal = {Autism Res}, Volume = {16}, Number = {7}, Pages = {1360-1374}, Year = {2023}, Month = {July}, url = {http://dx.doi.org/10.1002/aur.2955}, Abstract = {Early behavioral markers for autism include differences in social attention and orienting in response to one's name when called, and differences in body movements and motor abilities. More efficient, scalable, objective, and reliable measures of these behaviors could improve early screening for autism. This study evaluated whether objective and quantitative measures of autism-related behaviors elicited from an app (SenseToKnow) administered on a smartphone or tablet and measured via computer vision analysis (CVA) are correlated with standardized caregiver-report and clinician administered measures of autism-related behaviors and cognitive, language, and motor abilities. This is an essential step in establishing the concurrent validity of a digital phenotyping approach. In a sample of 485 toddlers, 43 of whom were diagnosed with autism, we found that CVA-based gaze variables related to social attention were associated with the level of autism-related behaviors. Two language-related behaviors measured via the app, attention to people during a conversation and responding to one's name being called, were associated with children's language skills. Finally, performance during a bubble popping game was associated with fine motor skills. These findings provide initial support for the concurrent validity of the SenseToKnow app and its potential utility in identifying clinical profiles associated with autism. Future research is needed to determine whether the app can be used as an autism screening tool, can reliably stratify autism-related behaviors, and measure changes in autism-related behaviors over time.}, Doi = {10.1002/aur.2955}, Key = {fds371262} } @article{fds271500, Author = {Costello, EJ and Compton, SN and Keeler, G and Angold, A}, Title = {Relationships between poverty and psychopathology: a natural experiment.}, Journal = {JAMA}, Volume = {290}, Number = {15}, Pages = {2023-2029}, Year = {2003}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14559956}, Abstract = {CONTEXT: Social causation (adversity and stress) vs social selection (downward mobility from familial liability to mental illness) are competing theories about the origins of mental illness. OBJECTIVE: To test the role of social selection vs social causation of childhood psychopathology using a natural experiment. DESIGN: Quasi-experimental, longitudinal study. POPULATION AND SETTING: A representative population sample of 1420 rural children aged 9 to 13 years at intake were given annual psychiatric assessments for 8 years (1993-2000). One quarter of the sample were American Indian, and the remaining were predominantly white. Halfway through the study, a casino opening on the Indian reservation gave every American Indian an income supplement that increased annually. This increase moved 14% of study families out of poverty, while 53% remained poor, and 32% were never poor. Incomes of non-Indian families were unaffected. MAIN OUTCOME MEASURES: Levels of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, psychiatric symptoms in the never-poor, persistently poor, and ex-poor children were compared for the 4 years before and after the casino opened. RESULTS: Before the casino opened, the persistently poor and ex-poor children had more psychiatric symptoms (4.38 and 4.28, respectively) than the never-poor children (2.75), but after the opening levels among the ex-poor fell to those of the never-poor children, while levels among those who were persistently poor remained high (odds ratio, 1.50; 95% confidence interval, 1.08-2.09; and odds ratio, 0.91; 95% confidence interval, 0.77-1.07, respectively). The effect was specific to symptoms of conduct and oppositional defiant disorders. Anxiety and depression symptoms were unaffected. Similar results were found in non-Indian children whose families moved out of poverty during the same period. CONCLUSIONS: An income intervention that moved families out of poverty for reasons that cannot be ascribed to family characteristics had a major effect on some types of children's psychiatric disorders, but not on others. Results support a social causation explanation for conduct and oppositional disorder, but not for anxiety or depression.}, Doi = {10.1001/jama.290.15.2023}, Key = {fds271500} } @article{fds271486, Author = {Ginsburg, GS and Kendall, PC and Sakolsky, D and Compton, SN and Piacentini, J and Albano, AM and Walkup, JT and Sherrill, J and Coffey, KA and Rynn, MA and Keeton, CP and McCracken, JT and Bergman, L and Iyengar, S and Birmaher, B and March, J}, Title = {Remission after acute treatment in children and adolescents with anxiety disorders: findings from the CAMS.}, Journal = {J Consult Clin Psychol}, Volume = {79}, Number = {6}, Pages = {806-813}, Year = {2011}, Month = {December}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0025933}, Abstract = {OBJECTIVE: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7-17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. RESULTS: Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. CONCLUSIONS: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children.}, Doi = {10.1037/a0025933}, Key = {fds271486} } @article{fds337698, Author = {Swan, AJ and Kendall, PC and Olino, T and Ginsburg, G and Keeton, C and Compton, S and Piacentini, J and Peris, T and Sakolsky, D and Birmaher, B and Albano, AM}, Title = {Results from the Child/Adolescent Anxiety Multimodal Longitudinal Study (CAMELS): Functional outcomes.}, Journal = {J Consult Clin Psychol}, Volume = {86}, Number = {9}, Pages = {738-750}, Year = {2018}, Month = {September}, url = {http://dx.doi.org/10.1037/ccp0000334}, Abstract = {OBJECTIVE: To report functional outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), which examined the impact of youth anxiety treatment (cognitive-behavioral therapy [CBT], coping cat; Sertraline, SRT; COMB [CBT + SRT]; pill placebo) on (a) global and (b) domain-specific functioning assessed an average of 3.1 times, 3- to 12-years postrandomization (first assessment = mean 6.5 years postrandomization). METHOD: Three-hundred and 19 of 488 families from the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008) participated. Growth curve modeling examined the impact of treatment condition and acute treatment outcomes (i.e., response, remission) on global functioning, global and domain-specific impairment, and life satisfaction across follow-up visits. Logistic regressions explored the impact of treatment remission and condition on low frequency events (arrests/convictions) and education. RESULTS: Treatment responders and remitters demonstrated better global functioning, decreased overall impairment, and increased life satisfaction at follow-up. Treatment remission, but not response, predicted decreased domain-specific impairment (social relationships, self-care/independence, academic functioning), and maintenance of increased life satisfaction across follow-ups. Participants in the CBT condition, compared with pill placebo, demonstrated improved trajectories pertaining to life satisfaction, overall impairment, and impairment in academic functioning. Randomization to CBT or COMB treatment was associated with increasing employment rates. Trajectories for participants randomized to SRT was not significantly different from placebo. Treatment outcome and condition did not predict legal outcomes, school/work variables, or family life. CONCLUSION: Positive early intervention outcomes are associated with improved overall functioning, life satisfaction, and functioning within specific domains 6.5 years posttreatment. Treatment type differentially predicted trajectories of functioning. Findings support the positive impact of pediatric anxiety treatment into adolescence and early adulthood. (PsycINFO Database Record}, Doi = {10.1037/ccp0000334}, Key = {fds337698} } @article{fds336055, Author = {Ginsburg, GS and Becker-Haimes, EM and Keeton, C and Kendall, PC and Iyengar, S and Sakolsky, D and Albano, AM and Peris, T and Compton, SN and Piacentini, J}, Title = {Results From the Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS): Primary Anxiety Outcomes.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {57}, Number = {7}, Pages = {471-480}, Year = {2018}, Month = {July}, url = {http://dx.doi.org/10.1016/j.jaac.2018.03.017}, Abstract = {OBJECTIVE: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). Rates of stable anxiety remission (defined rigorously as the absence of all DSM-IV TR anxiety disorders across all follow-up years) and predictors of anxiety remission across a 4-year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive-behavioral therapy (CBT), their combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child and family variables, and interim negative life events. METHOD: Data were from 319 youths (age range 10.9-25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or generalized anxiety disorders and enrolled in the multi-site Child/Adolescent Anxiety Multimodal Study (CAMS). Participants were assessed annually by independent evaluators using the age-appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family functioning, life events, and mental health service use). RESULTS: Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely to be in the chronically ill group (odds ratio = 2.73; confidence interval = 1.14-6.54; p < .02); treatment type was not associated with remission status across the follow-up. Several variables (eg, male gender) predicted stable remission from anxiety disorders. CONCLUSION: Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can help tailor treatments to youth at greatest risk for chronic illness. CLINICAL TRIAL REGISTRATION INFORMATION: Child and Adolescent Anxiety Disorders (CAMS). http://clinicaltrials.gov/; NCT00052078.}, Doi = {10.1016/j.jaac.2018.03.017}, Key = {fds336055} } @article{fds271497, Author = {Farmer, EMZ and Compton, SN and Bums, BJ and Robertson, E}, Title = {Review of the evidence base for treatment of childhood psychopathology: externalizing disorders.}, Journal = {J Consult Clin Psychol}, Volume = {70}, Number = {6}, Pages = {1267-1302}, Year = {2002}, Month = {December}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12472301}, Abstract = {This article reviews controlled research on treatments for childhood externalizing behavior disorders. The review is organized around 2 subsets of such disorders: disruptive behavior disorders (i.e., conduct disorder, oppositional defiant disorder) and attention-deficit/hyperactivity disorder (ADHD). The review was based on a literature review of nonresidential treatments for youths ages 6-12. The pool of studies for this age group was limited, but results suggest positive outcomes for a variety of interventions (particularly parent training and community-based interventions for disruptive behavior disorders and medication for ADHD). The review also highlights the need for additional research examining effectiveness of treatments for this age range and strategies to enhance the implementation of effective practices.}, Doi = {10.1037//0022-006x.70.6.1267}, Key = {fds271497} } @article{fds271464, Author = {Compton, SN and Burns, BJ and Helen, LE and Robertson, E}, Title = {Review of the evidence base for treatment of childhood psychopathology: internalizing disorders.}, Journal = {J Consult Clin Psychol}, Volume = {70}, Number = {6}, Pages = {1240-1266}, Year = {2002}, Month = {December}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12472300}, Abstract = {This article reviews the empirical literature on psychosocial, psychopharmacological, and adjunctive treatments for children between the ages of 6 and 12 with internalizing disorders. The aim of this review was to identify interventions that have potential to prevent substance use disorders in adolescence by treating internalizing disorders in childhood. Results suggest that a variety of behavioral, cognitive-behavioral, and pharmacological interventions are effective in reducing symptoms of childhood depression, phobias, and anxiety disorders. None of the studies reviewed included substance abuse outcomes. Thus, little can be said about the relationship between early treatment and the prevention of later substance use. The importance of evaluating the generalizability of research-supported interventions to community settings is highlighted and recommendations for future research are offered.}, Doi = {10.1037//0022-006x.70.6.1240}, Key = {fds271464} } @article{fds271480, Author = {Walkup, JT and Compton, S}, Title = {Review: Pharmacotherapy increases response and reduces symptom severity in paediatric anxiety disorders}, Journal = {Evidence-Based Mental Health}, Volume = {13}, Number = {1}, Pages = {19}, Publisher = {BMJ}, Year = {2010}, Month = {February}, ISSN = {1362-0347}, url = {http://dx.doi.org/10.1136/ebmh.13.1.19}, Doi = {10.1136/ebmh.13.1.19}, Key = {fds271480} } @article{fds327208, Author = {Research Units on Pediatric Psychopharmacology (RUPP) Anxiety Study Group}, Title = {Searching for Moderators and Mediators of Pharmacological Treatment Effects in Children and Adolescents With Anxiety Disorders}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {42}, Number = {1}, Pages = {13-21}, Publisher = {Elsevier BV}, Year = {2003}, Month = {January}, url = {http://dx.doi.org/10.1097/00004583-200301000-00006}, Doi = {10.1097/00004583-200301000-00006}, Key = {fds327208} } @article{fds368898, Author = {Albano, AM and Comer, JS and Compton, SN and Piacentini, J and Kendall, PC and Birmaher, B and Walkup, JT and Ginsburg, GS and Rynn, MA and McCracken, J and Keeton, C and Sakolsky, DJ and Sherrill, JT}, Title = {Secondary Outcomes From the Child/Adolescent Anxiety Multimodal Study: Implications for Clinical Practice.}, Journal = {Evid Based Pract Child Adolesc Ment Health}, Volume = {3}, Number = {1}, Pages = {30-41}, Year = {2018}, url = {http://dx.doi.org/10.1080/23794925.2017.1399485}, Abstract = {BACKGROUND: Controlled evaluations comparing medication, cognitive-behavioral therapy (CBT), and their combination in the treatment of youth anxiety have predominantly focused on global ratings by independent evaluators. Such ratings are resource-intensive, may be of limited generalizability, and do not directly inform our understanding of treatment responses from the perspective of treated families. We examined outcomes from the perspective of treated youth and parents in the Child/Adolescent Anxiety Multimodal Study (CAMS). METHODS: Participants (N=488; ages 7-17 years) who had a primary diagnosis of separation, social, and/or generalized anxiety disorder were randomly assigned to a treatment condition in the CAMS trial. Linear mixed-effects and ANCOVA models examined parent- and youth-reported anxiety symptoms, impact of anxiety, broader internalizing and externalizing psychopathology, depressive symptoms, and family burden throughout the 12-week acute treatment phase and 6-month follow-up. RESULTS: At week 12, combination treatment showed superiority over placebo, sertraline, and CBT with regard to parent-reported youth anxiety symptoms, and sertraline and CBT as monotherapies showed superiority over placebo with regard to parent-reported youth anxiety. Combination therapy and sertraline also showed week 12 superiority over placebo with regard to parent-reported internalizing psychopathology, and superiority over placebo and CBT with regard to parent-reported impact of anxiety, family burden, and youth depressive symptoms. By week 36, parent reports of many youth outcomes were comparable across active conditions. Youth measures tracked parent measures on many outcomes. CONCLUSIONS: Findings were drawn on brief, readily available questionnaires that in conjunction with clinician measures can inform patient-centered care and collaborative decision-making.Trial Registry Name: Child and Adolescent Anxiety Disorders (CAMS)Registry identification number: NCT00052078Registry URL: https://www.clinicaltrials.gov/ct2/show/NCT00052078.}, Doi = {10.1080/23794925.2017.1399485}, Key = {fds368898} } @article{fds340611, Author = {Carpenter, KLH and Baranek, GT and Copeland, WE and Compton, S and Zucker, N and Dawson, G and Egger, HL}, Title = {Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children.}, Journal = {J Abnorm Child Psychol}, Volume = {47}, Number = {6}, Pages = {1075-1088}, Year = {2019}, Month = {June}, url = {http://dx.doi.org/10.1007/s10802-018-0502-y}, Abstract = {Anxiety disorders are prevalent and significantly impact young children and their families. One hypothesized risk factor for anxiety is heightened responses to sensory input. Few studies have explored this hypothesis prospectively. This study had two goals: (1) examine whether sensory over-responsivity is predictive of the development of anxiety in a large prospective sample of children, and (2) identify whether anxiety mediates the relationship between sensory over-responsivity and behavioral challenges. Children's sensory and anxiety symptoms were assessed in a community sample of 917 at 2-5 and again in 191 of these children at 6 years old. Parents also reported on a number of additional behavioral challenges previously found to be associated with both sensory over-responsivity and anxiety separately: irritability, food selectivity, sleep problems, and gastrointestinal problems. Forty three percent of preschool children with sensory over-responsivity also had a concurrent impairing anxiety disorder. Preschool sensory over-responsivity symptoms significantly and positively predicted anxiety symptoms at age six. This relationship was both specific and unidirectional. Finally, school-age anxiety symptoms mediated the relationship between preschool sensory over-responsivity symptoms and both irritability and sleep problems at school-age. These results suggest sensory over-responsivity is a risk factor for anxiety disorders. Furthermore, children who have symptoms of sensory over-responsivity as preschoolers have higher levels of anxiety symptoms at school-age, which in turn is associated with increased levels of school-age behavioral challenges.}, Doi = {10.1007/s10802-018-0502-y}, Key = {fds340611} } @article{fds271491, Author = {Compton, SN and Grant, PJ and Chrisman, AK and Gammon, PJ and Brown, VL and March, JS}, Title = {Sertraline in children and adolescents with social anxiety disorder: an open trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {40}, Number = {5}, Pages = {564-571}, Year = {2001}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11349701}, Abstract = {OBJECTIVE: The aim of this open-label study was to assess the therapeutic benefits, response pattern, and safety of sertraline in children with social anxiety disorder. METHOD: Fourteen outpatient subjects with a primary Axis I diagnosis of social anxiety disorder were treated in an 8-week open trial of sertraline. Diagnostic and primary outcome measures included the Anxiety Disorders Interview Schedule for Children, Clinical Global Impressions scale (CGI), Social Phobia and Anxiety Inventory for Children, and a standardized behavioral avoidance test. RESULTS: As measured by the CGI (Improvement subscale), 36% (5/14) of subjects were classified as treatment responders and 29% (4/14) as partial responders by the end of the 8-week trial. A significant clinical response appeared by week 6. Self-report and behavioral measures showed significant clinical improvement into normal range across all domains measured. The mean dose of sertraline was 123.21+/-37.29 mg per day. Sertraline was generally well tolerated. CONCLUSION: In open treatment, sertraline resulted in significant improvement in symptoms of childhood social anxiety disorder. Absolute response rates varied depending on rating scales used. Findings from this study are sufficiently strong to warrant a future multisite, randomized, double-blind, placebo-controlled trial of sertraline for treatment of childhood social anxiety disorder.}, Doi = {10.1097/00004583-200105000-00016}, Key = {fds271491} } @article{fds359117, Author = {Kolitsopoulos, F and Ramaker, S and Compton, S and Broderick, S and Orazem, J and Bao, W and Lokhnygina, Y and Chappell, P}, Title = {Sertraline Pediatric Registry for the Evaluation of Safety: Design and Clinical Characteristics of Pediatric Patients Prescribed Sertraline.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {31}, Number = {6}, Pages = {411-420}, Year = {2021}, Month = {August}, url = {http://dx.doi.org/10.1089/cap.2020.0170}, Abstract = {Objectives: To describe the study design and clinical characteristics of patients in the Sertraline Pediatric RegIstry for The Evaluation of Safety (SPRITES). Methods: SPRITES is an open-label postmarketing study of development and safety outcomes in patients aged 6 to 16 years treated with sertraline (with or without psychotherapy) compared with psychotherapy alone for up to 3 years in the United States. Baseline data included demographics and psychiatric history. Primary outcomes included measures of cognitive and emotional development (Trails B, Behavior Rating Inventory of Executive Function [BRIEF]), physical development (height and weight), and pubertal status (Tanner Stage). Data were also collected on present/lifetime risk of suicide-related events using the Columbia-Suicide Severity Rating Scale. Results: SPRITES enrolled 941 patients between the ages of 6 and 16 years. Patients' baseline mean age was 11.9 years (2.9), 57.2% were female, and 84.8% were white. Most patients (78.4%) had an anxiety disorder, and 15.6% were diagnosed with obsessive-compulsive disorder. The mean age at onset of first mental illness was 7.9 years. A higher percentage of sertraline-treated patients compared with patients who received no pharmacological treatment received prior psychotherapy (59.0% vs. 34.4%, p < 0.001), psychotropic medications for a psychiatric disorder (14.1% vs. 3.3%, p < 0.001), and other non-sertraline selective serotonin reuptake inhibitors (8.6% vs. 1.2%, p < 0.001). Most patients were moderately ill on the Clinical Global Impressions-Severity scale, and a higher (p < 0.001) percentage of sertraline-treated patients had a moderate-to-severe mental illness score compared with the no pharmacological treatment group (73.0% vs. 57.8%, respectively). Although patients at high and imminent risk of a suicidal event were excluded at study entry, the sertraline-treated patients reported higher levels of lifetime suicidal behavior compared with patients treated with no pharmacological treatment (5.8% vs. 2.5%, p = 0.039). Conclusions: Baseline data from this nonrandomized observational study suggest that patients prescribed sertraline are reflective of a more mentally ill study population compared with patients receiving psychotherapy. ClinicalTrials.gov identifier: NCT01302080.}, Doi = {10.1089/cap.2020.0170}, Key = {fds359117} } @article{fds323540, Author = {Caporino, NE and Read, KL and Shiffrin, N and Settipani, C and Kendall, PC and Compton, SN and Sherrill, J and Piacentini, J and Walkup, J and Ginsburg, G and Keeton, C and Birmaher, B and Sakolsky, D and Gosch, E and Albano, AM}, Title = {Sleep-Related Problems and the Effects of Anxiety Treatment in Children and Adolescents.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {46}, Number = {5}, Pages = {675-685}, Year = {2017}, url = {http://dx.doi.org/10.1080/15374416.2015.1063429}, Abstract = {This study examined (a) demographic and clinical characteristics associated with sleep-related problems (SRPs) among youth with anxiety disorders, and (b) the impact of anxiety treatment: cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline), their combination, and pill placebo on SRPs. Youth (N = 488, ages 7-17, 50% female, 79% White) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated. SRPs were reported by parents and youth. Findings differed by informant and by type of SRP, with evidence that SRPs are associated with age, anxiety severity, externalizing problems, functional impairment, and family burden at pretreatment. Anxiety treatment reduced SRPs; effect sizes were small to medium. Reductions in parent-reported separation-related sleep difficulties were significantly greater in active treatment than in the placebo condition, with the greatest reductions reported by parents of youth whose active treatment was multimodal or included sertraline. Youth whose anxiety treatment involved CBT reported significantly greater decreases in dysregulated sleep (e.g., sleeplessness). Both CBT for anxiety and sertraline appear to be somewhat effective in reducing SRPs, and multimodal treatment may be preferable depending on the symptom presentation. To inform practice, future research should examine a broad range of SRPs, incorporate objective measures of sleep, and evaluate the impact of behavioral strategies that directly target SRPs in youth with anxiety disorders.}, Doi = {10.1080/15374416.2015.1063429}, Key = {fds323540} } @article{fds271489, Author = {Almirall, D and Compton, SN and Rynn, MA and Walkup, JT and Murphy, SA}, Title = {SMARTer discontinuation trial designs for developing an adaptive treatment strategy.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {22}, Number = {5}, Pages = {364-374}, Year = {2012}, Month = {October}, ISSN = {1044-5463}, url = {http://dx.doi.org/10.1089/cap.2011.0073}, Abstract = {OBJECTIVE: Developing evidenced-based practices for the management of childhood psychiatric disorders requires research studies that address how to treat children during both the acute phase of the disorder and beyond. Given the selection of a medication for acute treatment, discontinuation trials are used to evaluate the effects of treatment duration (e.g., time on medication) and/or maintenance strategies following successful acute-phase treatment. Recently, sequential multiple assignment randomized trials (SMART) have been proposed for use in informing sequences of critical clinical decisions such as those mentioned. The objective of this article is to illustrate how a SMART study is related to the standard discontinuation trial design, while addressing additional clinically important questions with similar trial resources. METHOD: The recently completed Child/Adolescent Anxiety Multimodal Study (CAMS), a randomized trial that examined the relative efficacy of three acute-phase treatments for pediatric anxiety disorders, along with a next logical step, a standard discontinuation trial design, is used to clarify the ideas. This example is used to compare the discontinuation trial design relative to the SMART design. RESULTS: We find that the standard discontinuation trial can be modified slightly using a SMART design to yield high-quality data that can be used to address a wider variety of questions in addition to the impact of treatment duration. We discuss how this innovative trial design is ultimately more efficient and less costly than the standard discontinuation trial, and may result in more representative comparisons between treatments. CONCLUSIONS: Mental health researchers who are interested in addressing questions concerning the effects of continued treatment (for different durations) following successful acute-phase treatment should consider SMART designs in place of discontinuation trial designs in their research. SMART designs can be used to address these and other questions concerning individualized sequences of treatment, such as the choice of a rescue treatment in case of postacute phase relapse.}, Doi = {10.1089/cap.2011.0073}, Key = {fds271489} } @article{fds326112, Author = {Gonzalez, A and Rozenman, M and Langley, AK and Kendall, PC and Ginsburg, GS and Compton, S and Walkup, JT and Birmaher, B and Albano, AM and Piacentini, J}, Title = {Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale.}, Journal = {Child Youth Care Forum}, Volume = {46}, Number = {3}, Pages = {395-412}, Year = {2017}, Month = {June}, url = {http://dx.doi.org/10.1007/s10566-016-9381-y}, Abstract = {BACKGROUND: Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention. OBJECTIVE: This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth. METHODS: Participants (N=488, age 7 to 17) met diagnostic criteria for Social Phobia, Generalized Anxiety Disorder, and/or Separation Anxiety Disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial. RESULTS: Exploratory factor analysis yielded two factors (Accusation/Blame, Social Rejection). The SASSY full scale and Social Rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY Social Rejection factor accurately distinguished children and adolescents with Social Phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders. CONCLUSIONS: Findings suggest the potential utility of the SASSY Social Rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.}, Doi = {10.1007/s10566-016-9381-y}, Key = {fds326112} } @article{fds271463, Author = {Compton, SN and Nelson, AH and March, JS}, Title = {Social phobia and separation anxiety symptoms in community and clinical samples of children and adolescents.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {39}, Number = {8}, Pages = {1040-1046}, Year = {2000}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10939233}, Abstract = {OBJECTIVE: To examine the developmental progression and pattern of self-reported symptoms of social phobia (SP) and separation anxiety (SA) in community (n = 2,384) and clinical (n = 217) samples of children and adolescents, using a cross-sectional method. METHOD: Subjects were cross-classified by age, gender, and race. Using mean scores on the SP and SA subscales of the Multidimensional Anxiety Scale for Children, 4 categories of children were established: HighSP/HighSA, HighSP/LowSA, LowSP/HighSA, and LowSP/LowSA. Data were analyzed using a generalized logit model. RESULTS: Community sample: Preadolescents and females reported more symptoms of HighSP/HighSA and LowSP/HighSA than adolescents and males. White children reported more symptoms of HighSP/LowSA, while the opposite pattern was found among African-American children. Clinical sample: Similar to the community sample, preadolescents reported more symptoms of HighSP/HighSA. However, clinical males reported more symptoms of LowSP/HighSA than clinical females. CONCLUSIONS: In general, adolescents endorsed more symptoms of SP and fewer symptoms of SA than preadolescent children. Irrespective of age, white children endorsed more symptoms of SP and fewer symptoms of SA than African-American children. In the community sample, preadolescent boys endorsed more symptoms of SA and fewer symptoms of SP, suggesting a possible referral bias.}, Doi = {10.1097/00004583-200008000-00020}, Key = {fds271463} } @article{fds302626, Author = {Crawley, SA and Caporino, NE and Birmaher, B and Ginsburg, G and Piacentini, J and Albano, AM and Sherrill, J and Sakolsky, D and Compton, SN and Rynn, M and McCracken, J and Gosch, E and Keeton, C and March, J and Walkup, JT and Kendall, PC}, Title = {Somatic complaints in anxious youth.}, Journal = {Child Psychiatry Hum Dev}, Volume = {45}, Number = {4}, Pages = {398-407}, Year = {2014}, Month = {August}, ISSN = {0009-398X}, url = {http://dx.doi.org/10.1007/s10578-013-0410-x}, Abstract = {This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7-17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078).}, Doi = {10.1007/s10578-013-0410-x}, Key = {fds302626} } @article{fds327206, Author = {Compton, SN and Atkins, DC}, Title = {Statistics and research methodology at ABCT: AMASS and beyond}, Journal = {the Behavior Therapist}, Volume = {33}, Number = {7}, Pages = {140-141}, Year = {2010}, Abstract = {Twenty years ago, hierarchical regression and analysis of covariance were the established statistical methods commonly found in clinical psychology research studies. At present, these methods have largely given way to hierarchical linear models (HLM) and structural equation models (SEM), which are used in many—if not most—research studies. For more than two decades, ABCT has attempted to meet the ever-widening gap by offering a series of workshops during its annual conference that focus on topics related to statistics and research methodology. The primary motivation for applied researchers to stay on top of advances made in statistics and research methodology is that as our field matures, we are asking increasingly complex questions about human behavior that require more sophisticated research designs and statistical techniques. Here we present findings from this survey, address a frequent misunderstanding about AMASS sessions, and introduce the creation of a new Special Interest Group (SIG) devoted to Clinical Research Methods and Statistics. Results show that respondents expressed the most interest for workshops focused on HLM for continuous and nonnormal outcomes, power analyses, longitudinal mediation, missing data, and SEM approaches. (PsycINFO Database Record (c) 2016 APA, all rights reserved)}, Key = {fds327206} } @article{fds375366, Author = {Rabner, J and Olino, TM and Albano, AM and Keeton, CP and Sakolsky, D and Birmaher, B and Piacentini, J and Peris, TS and Compton, SN and Gosch, E and Ginsburg, GS and Pinney, EL and Kendall, PC}, Title = {Substance use outcomes from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS).}, Journal = {J Child Psychol Psychiatry}, Year = {2024}, Month = {January}, url = {http://dx.doi.org/10.1111/jcpp.13926}, Abstract = {BACKGROUND: Substance use problems and anxiety disorders are both highly prevalent and frequently cooccur in youth. The present study examined the benefits of successful anxiety treatment at 3-12 years after treatment completion on substance use outcomes (i.e. diagnoses and lifetime expected use). METHODS: The sample was from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), a naturalistic follow-up study to the Child/Adolescent Anxiety Multimodal Study (CAMS) which randomized youth to cognitive behavioral therapy (CBT; Coping cat), medication (sertraline), their combination, or pill placebo. The first CAMELS visit occurred an average of 6.5 years following CAMS randomization. Participants were 319 youth (65.4% of the CAMS sample), aged 7-17 years at CAMS baseline assessment with a mean age of 17.6 years (range: 11-26 years) at the time of the first CAMELS follow-up. Substance use outcomes included diagnoses as well as lifetime substance use (i.e. alcohol and tobacco use). RESULTS: Eleven of 319 (3.4%) CAMELS participants were diagnosed with a substance use disorder at the initial follow-up visit. When compared to the population lifetime rate of 11.4%, the rate of diagnoses in the posttreated sample was significantly lower. Additionally, rates of lifetime alcohol use were lower than population rates at the initial and final follow-up visits. Rates of lifetime tobacco use were similarly lower than lifetime population rates at the initial visit (driven by significantly lower rates in the CBT treatment condition), but higher by the final visit. Furthermore, treatment remission (but not treatment response) was associated with a lower rate of substance use diagnoses at the initial follow-up visit, although rates of lifetime alcohol and tobacco use did not differ by treatment outcome. CONCLUSIONS: Anxiety treatments confer a beneficial impact on problematic substance use (i.e. diagnoses) as well as on expected substance use (i.e. alcohol and tobacco use) for on average, a period of 6.5 years.}, Doi = {10.1111/jcpp.13926}, Key = {fds375366} } @article{fds346443, Author = {Cervin, M and Storch, EA and Piacentini, J and Birmaher, B and Compton, SN and Albano, AM and Gosch, E and Walkup, JT and Kendall, PC}, Title = {Symptom-specific effects of cognitive-behavioral therapy, sertraline, and their combination in a large randomized controlled trial of pediatric anxiety disorders.}, Journal = {J Child Psychol Psychiatry}, Volume = {61}, Number = {4}, Pages = {492-502}, Year = {2020}, Month = {April}, url = {http://dx.doi.org/10.1111/jcpp.13124}, Abstract = {BACKGROUND: Pediatric anxiety disorders are highly prevalent and associated with significant functional disabilities and lifelong morbidity. Cognitive-behavioral therapy (CBT), sertraline, and their combination are effective treatments, but little is known about how these treatments exert their effects. METHODS: Using network intervention analysis (NIA), we analyzed data from the largest randomized controlled treatment trial of pediatric anxiety disorders (Child/Adolescent Anxiety Multimodal Study, NCT00052078, clinicaltrials.gov/ct2/show/NCT00052078) and outlined the causal symptom domain-specific effects of CBT, sertraline, and their combination over the course of the 12-week treatment while taking into account both specificity and overlap between symptom domains. RESULTS: All active treatments produced positive effects with the most pronounced and consistent effects emerging in relation to psychological distress, family interference, and avoidance. Psychological distress was consistently the most and physical symptoms the least central symptom domain in the disorder network. CONCLUSIONS: All active treatments showed beneficial effects when compared to placebo, and NIA identified that these effects were exerted similarly across treatments and primarily through a reduction of psychological distress, family interference, and avoidance. CBT and sertraline may have differential mechanisms of action in relation to psychological distress. Given the lack of causal effects on interference outside family and physical symptoms, interventions tailored to target these domains may aid in the building of more effective treatments. Psychological distress and avoidance should remain key treatment focuses because of their central roles in the disorder network. The findings inform and promote developing more effective interventions.}, Doi = {10.1111/jcpp.13124}, Key = {fds346443} } @article{fds271475, Author = {Walkup, JT and Compton, SN and Kendall, PC}, Title = {The authors reply}, Journal = {New England Journal of Medicine}, Volume = {360}, Number = {23}, Pages = {2477}, Publisher = {MASSACHUSETTS MEDICAL SOC}, Year = {2009}, Month = {June}, ISSN = {0028-4793}, url = {http://dx.doi.org/10.1056/NEJMc090635}, Doi = {10.1056/NEJMc090635}, Key = {fds271475} } @article{fds271495, Author = {March, JS and Silva, SG and Compton, S and Shapiro, M and Califf, R and Krishnan, R}, Title = {The case for practical clinical trials in psychiatry.}, Journal = {Am J Psychiatry}, Volume = {162}, Number = {5}, Pages = {836-846}, Year = {2005}, Month = {May}, ISSN = {0002-953X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15863782}, Abstract = {OBJECTIVE: Clinical trials in psychiatry frequently fail to maximize clinical utility for practicing clinicians, or, stated differently, available evidence is not perceived by clinicians (and other decision makers) as sufficiently relevant to clinical practice, thereby diluting its impact. To attain maximum clinical relevance and acceptability, researchers must conduct clinical trials designed to meet the needs of clinicians and others who are making decisions about patients' care. The authors present the case for psychiatry's adoption of the practical clinical trials model, which is widely used in research in other areas of medicine. METHOD: The authors outline the characteristics and scope of practical clinical trials, give examples of practical clinical trials, and discuss the challenges of using the practical clinical trials model in psychiatry, including issues of funding. RESULTS: Practical clinical trials, which are intended to provide generalizable answers to important clinical questions without bias, are characterized by eight key features: a straightforward clinically relevant question, a representative sample of patients and practice settings, sufficient power to identify modest clinically relevant effects, randomization to protect against bias, clinical uncertainty regarding the outcome of treatment at the patient level, assessment and treatment protocols that enact best clinical practices, simple and clinically relevant outcomes, and limited subject and investigator burden. CONCLUSIONS: To implement the practical clinical trials model in psychiatry will require stable funding for network construction and maintenance plus methodological innovation in governance and trial selection, assessment, treatment, data management, site management, and data analytic procedures.}, Doi = {10.1176/appi.ajp.162.5.836}, Key = {fds271495} } @article{fds271494, Author = {March, JS and Silva, SG and Compton, S and Anthony, G and DeVeaugh-Geiss, J and Califf, R and Krishnan, R}, Title = {The Child and Adolescent Psychiatry Trials Network (CAPTN).}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {43}, Number = {5}, Pages = {515-518}, Year = {2004}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15100557}, Abstract = {OBJECTIVE: The current generation of clinical trials in pediatric psychiatry often fails to maximize clinical utility for practicing clinicians, thereby diluting its impact. METHOD: To attain maximum clinical relevance and acceptability, the Child and Adolescent Psychiatry Trials Network (CAPTN) will transport to pediatric psychiatry the practical clinical trials model widely used in other areas of medicine. RESULTS: CAPTN, a collaborative effort of the Duke Clinical Research Institute and the American Academy of Child and Adolescent Psychiatry, will conduct large, simple "practical" trials that provide generalizable answers to important clinical questions without bias. "Large" in this case means the random allocation of thousands of patients in hundreds of clinical centers to different treatments as they are delivered in community settings. "Simple" means that the number and type of data elements (and, hence, subject and investigator burden) is small and straightforward so as not to discourage provider or patient participation and to maximize the number of subjects per dollar spent. CONCLUSION: With 200 to 400 child and adolescent psychiatrists each participating in two or three practical clinical trials over 4 years, CAPTN promises to advance both the evidence base and research capacity in child and adolescent psychiatry.}, Doi = {10.1097/00004583-200405000-00004}, Key = {fds271494} } @article{fds271493, Author = {Shapiro, M and Silva, SG and Compton, S and Chrisman, A and DeVeaugh-Geiss, J and Breland-Noble, A and Kondo, D and Kirchner, J and March, JS}, Title = {The child and adolescent psychiatry trials network (CAPTN): infrastructure development and lessons learned.}, Journal = {Child Adolesc Psychiatry Ment Health}, Volume = {3}, Number = {1}, Pages = {12}, Year = {2009}, Month = {March}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19320979}, Abstract = {BACKGROUND: In 2003, the National Institute of Mental Health funded the Child and Adolescent Psychiatry Trials Network (CAPTN) under the Advanced Center for Services and Intervention Research (ACSIR) mechanism. At the time, CAPTN was believed to be both a highly innovative undertaking and a highly speculative one. One reviewer even suggested that CAPTN was "unlikely to succeed, but would be a valuable learning experience for the field." OBJECTIVE: To describe valuable lessons learned in building a clinical research network in pediatric psychiatry, including innovations intended to decrease barriers to research participation. METHODS: The CAPTN Team has completed construction of the CAPTN network infrastructure, conducted a large, multi-center psychometric study of a novel adverse event reporting tool, and initiated a large antidepressant safety registry and linked pharmacogenomic study focused on severe adverse events. Specific challenges overcome included establishing structures for network organization and governance; recruiting over 150 active CAPTN participants and 15 child psychiatry training programs; developing and implementing procedures for site contracts, regulatory compliance, indemnification and malpractice coverage, human subjects protection training and IRB approval; and constructing an innovative electronic casa report form (eCRF) running on a web-based electronic data capture system; and, finally, establishing procedures for audit trail oversight requirements put forward by, among others, the Food and Drug Administration (FDA). CONCLUSION: Given stable funding for network construction and maintenance, our experience demonstrates that judicious use of web-based technologies for profiling investigators, investigator training, and capturing clinical trials data, when coupled to innovative approaches to network governance, data management and site management, can reduce the costs and burden and improve the feasibility of incorporating clinical research into routine clinical practice. Having successfully achieved its initial aim of constructing a network infrastructure, CAPTN is now a capable platform for large safety registries, pharmacogenetic studies, and randomized practical clinical trials in pediatric psychiatry.}, Doi = {10.1186/1753-2000-3-12}, Key = {fds271493} } @article{fds352831, Author = {Jensen, S and Hybel, KA and Højgaard, DRMA and Nissen, JB and Skarphedinsson, G and Torp, NC and Ivarsson, T and Weidle, B and Mortensen, EL and Carlsen, AH and Melin, K and Compton, S and Thomsen, PH}, Title = {The Children's Yale-Brown Obsessive-Compulsive Scale's auxiliary items: Long-term outcome}, Journal = {Journal of Obsessive-Compulsive and Related Disorders}, Volume = {27}, Year = {2020}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jocrd.2020.100589}, Abstract = {Objective: Standard assessment of pediatric obsessive-compulsive disorder (OCD) patients includes ratings of insight, avoidance, indecisiveness, sense of responsibility, pervasive slowness, pathological doubting, and obsession-free intervals. The present study aims to identify pre-treatment associations of these clinical features to symptom severity and symptom dimensions as well as to describe and analyze the long-term levels and distribution in different treatment responder groups. Method: Severity ratings as well as clinical feature ratings were evaluated in 268 pediatric OCD patients using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at seven time points before, during, and up to three years after first-line cognitive-behavioral therapy. The CY-BOCS auxiliary items were evaluated on the basis of three symptom severity trajectory classes: acute, slow, and limited responders. Results: Insight, avoidance, pervasive slowness, and obsession-free intervals were positively associated with pre-treatment symptom severity. Symptom dimensions were associated with different auxiliary items. At three-year follow-up, the limited responder class had higher scores than the acute and slow responder classes on all items except for responsibility. Conclusion: The CY-BOCS auxiliary items are closely related to symptom dimensions and partly to symptom severity. The features appear to be dynamic concepts prone to change, yet, less so in patients showing limited long-term treatment response.}, Doi = {10.1016/j.jocrd.2020.100589}, Key = {fds352831} } @article{fds343375, Author = {Sanchez, AL and Comer, JS and Coxe, S and Albano, AM and Piacentini, J and Compton, SN and Ginsburg, GS and Rynn, MA and Walkup, JT and Sakolsky, DJ and Birmaher, B and Kendall, PC}, Title = {The Effects of Youth Anxiety Treatment on School Impairment: Differential Outcomes Across CBT, Sertraline, and their Combination.}, Journal = {Child Psychiatry Hum Dev}, Volume = {50}, Number = {6}, Pages = {940-949}, Year = {2019}, Month = {December}, url = {http://dx.doi.org/10.1007/s10578-019-00896-3}, Abstract = {Youth anxiety disorders are highly prevalent and are associated with considerable school impairment. Despite the identification of well-supported strategies for treating youth anxiety, research has yet to evaluate the differential effects of these treatments on anxiety-related school impairment. The present study leveraged data from the Child/Adolescent Anxiety Multimodal Study to examine differential treatment effects of CBT, sertraline, and their combination (COMB), relative to placebo (PBO), on anxiety-related school impairment among youth (N = 488). Latent growth modeling revealed that all three active treatments demonstrated superiority over PBO in reducing anxiety-related school impairment over time, with COMB showing the most robust effects. According to parent report, medication strategies may have stronger effects on anxiety-related school impairment among males than among females. Results were discrepant across parents and youth. Findings are discussed in terms of clinical implications for anxious youth and the need for continued research to examine treatment effects on anxiety-related school impairment.}, Doi = {10.1007/s10578-019-00896-3}, Key = {fds343375} } @article{fds345915, Author = {O'Rourke, SR and Branford, KR and Brooks, TL and Ives, LT and Nagendran, A and Compton, SN}, Title = {The Emotional and Behavioral Impact of Delivering Bad News to Virtual versus Real Standardized Patients: A Pilot Study.}, Journal = {Teach Learn Med}, Volume = {32}, Number = {2}, Pages = {139-149}, Year = {2020}, url = {http://dx.doi.org/10.1080/10401334.2019.1652180}, Abstract = {Phenomenon: Virtual standardized patients (vSPs) are becoming increasingly common in medical education, though one limitation of vSPs is the artificiality of computer-based simulators. Past research on the use of vSPs has not clearly established whether learners have different emotional responses to real SPs (rSPs) compared with vSPs; however, understanding learners' emotional responses to vSPs is important in providing realistic learning experiences and establishing the validity of this teaching and assessment tool. This study compared the emotional experiences of individuals who interacted with rSPs and vSPs. Approach: Sixty medical students at a medical school in the southeastern United States participated in the study. Participants were randomly assigned to deliver bad news to an rSP or vSP. The vSP for this study used a hybrid intelligence model that allowed a person to "inhabit" the vSP. Salivary cortisol and a self-report measure of mood-the Profile of Mood States, Second Edition (POMS 2)-were gathered before and after delivering the bad news. The SP and 2 independent evaluators rated the behavioral performance of each participant in real and virtual conditions. Participants also rated the performance of the SP. Findings: Participants in both conditions reported increased negative emotionality on the POMS 2 following the SP interaction. There were no significant between-group differences on the POMS 2 or salivary cortisol concentration following the SP interaction. Ratings by the SP and independent evaluators indicated that participants performed similarly on most interpersonal dimensions, except tone of voice. Participants perceived the vSP as less realistic than the rSP. Insights: These results suggest that medical students may have similar emotional and behavioral responses when delivering bad news to a vSP when compared to an rSP. These findings provide support for the continued use of vSPs in training learners to deliver bad news and other communication-based skills and to assess their performance on these tasks.}, Doi = {10.1080/10401334.2019.1652180}, Key = {fds345915} } @article{fds271482, Author = {Conelea, CA and Woods, DW and Zinner, SH and Budman, CL and Murphy, TK and Scahill, LD and Compton, SN and Walkup, JT}, Title = {The impact of Tourette Syndrome in adults: results from the Tourette Syndrome impact survey.}, Journal = {Community Ment Health J}, Volume = {49}, Number = {1}, Pages = {110-120}, Year = {2013}, Month = {February}, ISSN = {0010-3853}, url = {http://dx.doi.org/10.1007/s10597-011-9465-y}, Abstract = {Chronic tic disorders (CTD) are characterized by motor and/or vocal tics. Existing data on the impact of tics in adulthood is limited by small, treatment-seeking samples or by data aggregated across adults and children. The current study explored the functional impact of tics in adults using a nationwide sample of 672 participants with a self-reported CTD. The impact of tics on physical, social, occupational/academic, and psychological functioning was assessed. Results suggested mild to moderate functional impairment and positive correlations between impairment and tic severity. Notable portions of the sample reported social or public avoidance and experiences of discrimination resulting from tics. Compared to previously reported population norms, participants had more psychological difficulties, greater disability, and lower quality of life. The current study suggests that CTDs can adversely impact functioning in adults and highlights the need for clinical interventions and systemic efforts to address tic-related impairments.}, Doi = {10.1007/s10597-011-9465-y}, Key = {fds271482} } @article{fds345469, Author = {Wu, MS and Caporino, NE and Peris, TS and Pérez, J and Thamrin, H and Albano, AM and Kendall, PC and Walkup, JT and Birmaher, B and Compton, SN and Piacentini, J}, Title = {The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders.}, Journal = {J Abnorm Child Psychol}, Volume = {48}, Number = {1}, Pages = {79-89}, Year = {2020}, Month = {January}, url = {http://dx.doi.org/10.1007/s10802-019-00574-x}, Abstract = {This study examined the relationship between caregivers' and youths' treatment expectations and characteristics of exposure tasks (quantity, mastery, compliance) in cognitive-behavioral therapy (CBT) for childhood anxiety. Additionally, compliance with exposure tasks was tested as a mediator of the relationship between treatment expectations and symptom improvement. Data were from youth (N = 279; 7-17 years old) enrolled in the Child/Adolescent Anxiety Multimodal Study (CAMS) and randomized to cognitive-behavioral therapy (CBT) or the combination of CBT and sertraline for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. Caregivers and youth independently reported treatment expectations prior to randomization, anxiety was assessed pre- and post-treatment by independent evaluators blind to treatment condition, and exposure characteristics were recorded by the cognitive-behavioral therapists following each session. For both caregivers and youths, more positive expectations that anxiety would improve with treatment were associated with greater compliance with exposure tasks, and compliance mediated the relationship between treatment expectations and change in anxiety symptoms following treatment. Additionally, more positive parent treatment expectations were related to a greater number and percentage of sessions with exposure. More positive youth treatment expectations were associated with greater mastery during sessions focused on exposure. Findings underscore the importance of addressing parents' and youths' treatment expectations at the outset of therapy to facilitate engagement in exposure and maximize therapeutic gains.}, Doi = {10.1007/s10802-019-00574-x}, Key = {fds345469} } @article{fds336056, Author = {Kiff, CJ and Ernestus, S and Gonzalez, A and Kendall, PC and Albano, AM and Compton, SN and Birmaher, B and Ginsburg, GS and Rynn, M and Walkup, JT and McCracken, J and Piacentini, J}, Title = {The Interplay of Familial and Individual Risk in Predicting Clinical Improvements in Pediatric Anxiety Disorders.}, Journal = {J Clin Child Adolesc Psychol}, Volume = {47}, Number = {sup1}, Pages = {S542-S554}, Year = {2018}, url = {http://dx.doi.org/10.1080/15374416.2018.1460848}, Abstract = {Bioecological models of developmental psychopathology underscore the role of familial experiences of adversity and children's individual-level characteristics in heightening risk for pediatric anxiety through direct, combined, and interactive effects. To date, much of the existing research dedicated to pediatric anxiety disorders has largely been examined in bioecological models of diathesis-stress using community samples. This study extends our understanding of children's differential responsiveness to familial adversity by examining the diathesis-stress interaction of cumulative risk and children's individual-level vulnerabilities (negative affectivity and coping efficacy) within a clinic-referred treatment study for pediatric anxiety disorders. A cumulative risk index assessing exposure to familial adversity (e.g., socioeconomic status [SES], parent psychiatric illness) and self-reported measures of children's negative affectivity and coping efficacy were each measured at the intake of a randomized controlled clinical trial for the treatment of pediatric anxiety disorders (N = 488; 7-17 years of age). Trajectories of interviewer-rated anxiety symptoms were assessed across 12 weeks of treatment at baseline, 4 weeks, 8 weeks, and 12 weeks. Consistent with models of temperamental risk for mental health problems, negative affectivity predicted higher anxiety symptoms at intake. A significant diathesis-stress interaction between cumulative risk and coping efficacy emerged, as high risk and perceptions of lower coping efficacy attenuated declines in anxiety across 12 weeks. These patterns did not differ across treatment conditions. The results indicate that for youth experiencing high levels of stress, additional treatment efforts targeting familial stressors and coping efficacy may be important in maximizing treatment outcomes.}, Doi = {10.1080/15374416.2018.1460848}, Key = {fds336056} } @article{fds354286, Author = {Cervin, M and Norris, LA and Ginsburg, G and Gosch, EA and Compton, SN and Piacentini, J and Albano, AM and Sakolsky, D and Birmaher, B and Keeton, C and Storch, EA and Kendall, PC}, Title = {The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {60}, Number = {7}, Pages = {902-912.e5}, Year = {2021}, Month = {July}, url = {http://dx.doi.org/10.1016/j.jaac.2020.08.440}, Abstract = {OBJECTIVE: Pediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large, naturalistically followed-up cohort of anxiety-disordered youth. METHOD: Children and adolescents enrolled in a randomized controlled treatment trial of pediatric anxiety were followed-up on average 6 years posttreatment and then annually for 4 years. Structural equation modeling was used to estimate p at baseline. Both p and previously established predictors were modeled as predictors of long-term outcome. RESULTS: Higher levels of p at baseline were related to more mental health disorders, poorer functioning, and greater impairment across all measures at all follow-up time points. p Predicted outcome above and beyond previously identified predictors, including diagnostic comorbidity at baseline. Post hoc analyses showed that p predicted long-term anxiety outcome, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome. CONCLUSION: Children and adolescents with anxiety disorders who present with a liability toward broad mental health problems may be at a higher risk for poor long-term outcome across mental health and functional domains. Efforts to assess and to address this broad liability may enhance long-term outcome.}, Doi = {10.1016/j.jaac.2020.08.440}, Key = {fds354286} } @article{fds327209, Author = {THE RESEARCH UNITS ON PEDIATRIC PSYCHOPHARMACOLOGY (RUPP) ANXIETY STUDY GROUP}, Title = {The Pediatric Anxiety Rating Scale (PARS): development and psychometric properties.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {41}, Number = {9}, Pages = {1061-1069}, Publisher = {Elsevier BV}, Year = {2002}, Month = {September}, url = {http://dx.doi.org/10.1097/00004583-200209000-00006}, Abstract = {OBJECTIVE: To describe the development and psychometric properties of the Pediatric Anxiety Rating Scale (PARS), a clinician-rated instrument for assessing the severity of anxiety symptoms associated with common DSM-IV anxiety disorders (social phobia, separation anxiety disorder, and generalized anxiety disorder) in children. METHOD: As part of a multisite study of the efficacy of fluvoxamine, 128 children (aged 6-17) and their parents were interviewed weekly with the PARS. Data from multiple raters on a subsample of children (using live and videotaped interviews) were used to evaluate interrater reliability. Internal consistency, test-retest reliability, and validity (convergent, divergent) also were evaluated. RESULTS: The PARS showed high interrater reliability, adequate test-retest reliability, and fair internal consistency. Convergent and divergent validity were satisfactory. PARS scores were sensitive to treatment and paralleled change in other measures of anxiety symptoms and global improvement. CONCLUSIONS: The PARS is a useful clinician-rated instrument for assessing pediatric anxiety symptoms, severity, and impairment, particularly in treatment studies. Further study of the psychometric properties is warranted.}, Doi = {10.1097/00004583-200209000-00006}, Key = {fds327209} } @article{fds370239, Author = {Ong, CW and Woods, DW and Franklin, ME and Saunders, SM and Neal-Barnett, AM and Compton, SN and Twohig, MP}, Title = {The role of psychological flexibility in acceptance-enhanced behavior therapy for trichotillomania: Moderation and mediation findings.}, Journal = {Behav Res Ther}, Volume = {164}, Pages = {104302}, Year = {2023}, Month = {May}, url = {http://dx.doi.org/10.1016/j.brat.2023.104302}, Abstract = {Trichotillomania is characterized by recurrent pulling out of one's hair, leading to significant hair loss and accompanied by clinically significant distress and/or functional impairment. The current study used data from a randomized controlled trial comparing the effectiveness of acceptance-enhanced behavior therapy (AEBT) to psychoeducation plus supportive therapy (PST; active control) for trichotillomania in an adult sample. The objectives were to examine the moderating and mediating influence of trichotillomania-specific psychological flexibility in treatment for trichotillomania. Participants with lower baseline flexibility performed better in AEBT than PST in terms of greater symptom reduction and quality of life. Lower baseline flexibility also predicted higher likelihood of disorder recovery in AEBT relative to PST. In addition, relative to PST, symptom reduction in AEBT was mediated by psychological flexibility, controlling for anxiety and depression. These findings suggest that psychological flexibility is a relevant process of change in the treatment of trichotillomania. Clinical implications and directions for future research are discussed.}, Doi = {10.1016/j.brat.2023.104302}, Key = {fds370239} } @article{fds271484, Author = {Lewin, AB and Storch, EA and Conelea, CA and Woods, DW and Zinner, SH and Budman, CL and Scahill, LD and Compton, SN and Walkup, JT and Murphy, TK}, Title = {The roles of anxiety and depression in connecting tic severity and functional impairment.}, Journal = {J Anxiety Disord}, Volume = {25}, Number = {2}, Pages = {164-168}, Year = {2011}, Month = {March}, ISSN = {0887-6185}, url = {http://dx.doi.org/10.1016/j.janxdis.2010.08.016}, Abstract = {The current study examined relationships between tic severity and both functional impairment and perceived quality of life (QOL) in adults with a chronic tic disorder. The authors explored whether these relationships were moderated by anxiety and depressive symptoms. Five-hundred adults with Tourette's Disorder, Chronic Motor Tic Disorder, or Chronic Vocal Tic Disorder participated in a comprehensive self-report internet-based survey. Anxiety and depressive symptoms moderated the relationship between tic severity and functional impairment such that stronger relationships were documented in participants with elevated depressive or anxious symptoms. Limitations and implications for research and clinical practice are discussed.}, Doi = {10.1016/j.janxdis.2010.08.016}, Key = {fds271484} } @article{fds302632, Author = {Cummings, CM and Caporino, NE and Settipani, CA and Read, KL and Compton, SN and March, J and Sherrill, J and Piacentini, J and McCracken, J and Walkup, JT and Ginsburg, G and Albano, AM and Rynn, M and Birmaher, B and Sakolsky, D and Gosch, E and Keeton, C and Kendall, PC}, Title = {The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth.}, Journal = {J Consult Clin Psychol}, Volume = {81}, Number = {5}, Pages = {859-864}, Year = {2013}, Month = {October}, ISSN = {0022-006X}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000324780500012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {OBJECTIVE: We examined the therapeutic relationship with cognitive-behavioral therapists and with pharmacotherapists for youth from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008). The therapeutic relationship was examined in relation to treatment outcomes. METHOD: Participants were 488 youth (ages 7-17 years; 50% male) randomized to cognitive-behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), their combination, or placebo pill. Participants met criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). The therapeutic relationship was assessed by youth report at Weeks 6 and 12 of treatment using the Child's Perception of Therapeutic Relationship scale (Kendall et al., 1997). Outcome measures (Pediatric Anxiety Rating Scale; Research Units on Pediatric Psychopharmacology Anxiety Study Group, 2002; and Clinical Global Impressions Scales; Guy, 1976) were completed by independent evaluators blind to condition. RESULTS: For youth who received CBT only, a stronger therapeutic relationship predicted positive treatment outcome. In contrast, the therapeutic relationship did not predict outcome for youth receiving sertraline, combined treatment, or placebo. CONCLUSION: A therapeutic relationship may be important for anxious youth who receive CBT alone.}, Doi = {10.1037/a0033294}, Key = {fds302632} } @article{fds271478, Author = {Brent, DA and Greenhill, LL and Compton, S and Emslie, G and Wells, K and Walkup, JT and Vitiello, B and Bukstein, O and Stanley, B and Posner, K and Kennard, BD and Cwik, MF and Wagner, A and Coffey, B and March, JS and Riddle, M and Goldstein, T and Curry, J and Barnett, S and Capasso, L and Zelazny, J and Hughes, J and Shen, S and Gugga, SS and Turner, JB}, Title = {The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {10}, Pages = {987-996}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19730274}, Abstract = {OBJECTIVE: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. METHOD: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). RESULTS: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. CONCLUSIONS: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted.}, Doi = {10.1097/CHI.0b013e3181b5dbe4}, Key = {fds271478} } @article{fds271458, Author = {Podell, JL and Kendall, PC and Gosch, EA and Compton, SN and March, JS and Albano, A-M and Rynn, MA and Walkup, JT and Sherrill, JT and Ginsburg, GS and Keeton, CP and Birmaher, B and Piacentini, JC}, Title = {Therapist Factors and Outcomes in CBT for Anxiety in Youth.}, Journal = {Prof Psychol Res Pr}, Volume = {44}, Number = {2}, Pages = {89-98}, Year = {2013}, Month = {April}, ISSN = {0735-7028}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000318146500004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {This study examined the relationship between therapist factors and child outcomes in anxious youth who received cognitive-behavioral therapy (CBT) as part of the Child-Adolescent Anxiety Multimodal Study (CAMS). Of the 488 youth who participated in the CAMS project, 279 were randomly assigned to one of the CBT conditions (CBT only or CBT plus sertraline). Participants included youth (ages 7-17; M = 10.76) who met criteria for a principal anxiety disorder. Therapists included 38 cognitive-behavioral therapists. Therapist style, treatment integrity, and therapist experience were examined in relation to child outcome. Child outcome was measured via child, parent, and independent evaluator report. Therapists who were more collaborative and empathic, followed the treatment manual, and implemented it in a developmentally appropriate way had youth with better treatment outcomes. Therapist "coach" style was a significant predictor of child-reported outcome, with the collaborative "coach" style predicting fewer child-reported symptoms. Higher levels of therapist prior clinical experience and lower levels of prior anxiety-specific experience were significant predictors of better treatment outcome. Findings suggest that although all therapists used the same manual-guided treatment, therapist style, experience, and clinical skills were related to differences in child outcome. Clinical implications and recommendations for future research are discussed.}, Doi = {10.1037/a0031700}, Key = {fds271458} } @article{fds330474, Author = {Peris, TS and Caporino, NE and O'Rourke, S and Kendall, PC and Walkup, JT and Albano, AM and Bergman, RL and McCracken, JT and Birmaher, B and Ginsburg, GS and Sakolsky, D and Piacentini, J and Compton, SN}, Title = {Therapist-Reported Features of Exposure Tasks That Predict Differential Treatment Outcomes for Youth With Anxiety.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {56}, Number = {12}, Pages = {1043-1052}, Year = {2017}, Month = {December}, url = {http://dx.doi.org/10.1016/j.jaac.2017.10.001}, Abstract = {OBJECTIVE: Exposure tasks are recognized widely as a key component of cognitive-behavioral therapy (CBT) for child and adolescent anxiety. However, little research has examined specific exposure characteristics that predict outcomes for youth with anxiety and that may guide its application in therapy. METHOD: This study draws on a sample of 279 children and adolescents (48.4% male; 79.6% white) with a principal anxiety disorder who received 14 sessions of CBT, either alone or in combination with medication, through the Child/adolescent Anxiety Multimodal treatment Study (CAMS). The present study examines therapist-reported quantity, difficulty level, compliance, and mastery of exposure tasks as they related to CBT response (i.e., Clinical Global Impressions-Improvement ratings). Secondary treatment outcomes included reduction in anxiety symptom severity on the Pediatric Anxiety Rating Scale, global impairment measured via the Children's Global Assessment Scale, and parent-report of anxiety-specific functional impairment on the Child Anxiety Impairment Scale. RESULTS: Regression analyses indicated a dose-response relationship between therapist-reported quantity of exposure and independent evaluations of treatment outcome, with more time devoted to exposure linked to better outcomes. Similarly, greater time spent on more difficult (rather than mild or moderate) exposure tasks predicted better outcomes, as did therapist ratings of child compliance and mastery. CONCLUSION: The present findings highlight the importance of challenging children and adolescents with difficult exposure tasks and of collaborating to ensure compliance and mastery.}, Doi = {10.1016/j.jaac.2017.10.001}, Key = {fds330474} } @article{fds302610, Author = {Skarphedinsson, G and Compton, S and Thomsen, PH and Weidle, B and Dahl, K and Nissen, JB and Torp, NC and Hybel, K and Melin, KH and Valderhaug, R and Wentzel-Larsen, T and Ivarsson, T}, Title = {Tics Moderate Sertraline, but Not Cognitive-Behavior Therapy Response in Pediatric Obsessive-Compulsive Disorder Patients Who Do Not Respond to Cognitive-Behavior Therapy.}, Journal = {J Child Adolesc Psychopharmacol}, Volume = {25}, Number = {5}, Pages = {432-439}, Year = {2015}, Month = {June}, ISSN = {1044-5463}, url = {http://dx.doi.org/10.1089/cap.2014.0167}, Abstract = {OBJECTIVE: The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT. METHODS: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment. We investigated whether the presence or absence of comorbid tic disorder moderated treatment outcomes on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). RESULTS: Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with 7 receiving continued CBT and 5 receiving SRT, respectively. In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores than those who received continued CBT. CONCLUSIONS: Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.}, Doi = {10.1089/cap.2014.0167}, Key = {fds302610} } @article{fds302618, Author = {Peris, TS and Compton, SN and Kendall, PC and Birmaher, B and Sherrill, J and March, J and Gosch, E and Ginsburg, G and Rynn, M and McCracken, JT and Keeton, CP and Sakolsky, D and Suveg, C and Aschenbrand, S and Almirall, D and Iyengar, S and Walkup, JT and Albano, AM and Piacentini, J}, Title = {Trajectories of change in youth anxiety during cognitive-behavior therapy.}, Journal = {J Consult Clin Psychol}, Volume = {83}, Number = {2}, Pages = {239-252}, Year = {2015}, Month = {April}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0038402}, Abstract = {OBJECTIVE: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive-behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks. METHOD: Four hundred eighty-eight youths ages 7-17 years (50% female; 74% ≤ 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale-Severity (CGI-S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls. RESULTS: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self-talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self-talk, avoidance behavior). CONCLUSIONS: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record}, Doi = {10.1037/a0038402}, Key = {fds302618} } @article{fds323535, Author = {Houghton, DC and Mathew, AS and Twohig, MP and Saunders, SM and Franklin, ME and Compton, SN and Neal-Barnett, AM and Woods, DW}, Title = {Trauma and trichotillomania: A tenuous relationship}, Journal = {Journal of Obsessive-Compulsive and Related Disorders}, Volume = {11}, Pages = {91-95}, Publisher = {Elsevier BV}, Year = {2016}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jocrd.2016.09.003}, Abstract = {Some have argued that hair pulling in trichotillomania (TTM) is triggered by traumatic events, but reliable evidence linking trauma to TTM is limited. However, research has shown that hair pulling is associated with emotion regulation, suggesting a connection between negative affect and TTM. We investigated the associations between trauma, negative affect, and hair pulling in a cross-sectional sample of treatment seeking adults with TTM (N=85). In the current study, participants’ self-reported traumatic experiences were assessed during a structured clinical interview, and participants completed several measures of hair pulling severity, global TTM severity, depression, anxiety, experiential avoidance, and quality of life. Those who experienced trauma had more depressive symptoms, increased experiential avoidance, and greater global TTM severity. Although the presence of a trauma history was not related to the severity of hair pulling symptoms in the past week, depressive symptoms mediated the relationship between traumatic experiences and global TTM severity. These findings cast doubt on the notion that TTM is directly linked to trauma, but suggest that trauma leads to negative affect that individuals cope with through hair pulling. Implications for the conceptualization and treatment of TTM are discussed.}, Doi = {10.1016/j.jocrd.2016.09.003}, Key = {fds323535} } @article{fds336059, Author = {Bushnell, GA and Compton, SN and Dusetzina, SB and Gaynes, BN and Brookhart, MA and Walkup, JT and Rynn, MA and Stürmer, T}, Title = {Treating Pediatric Anxiety: Initial Use of SSRIs and Other Antianxiety Prescription Medications.}, Journal = {J Clin Psychiatry}, Volume = {79}, Number = {1}, Year = {2018}, url = {http://dx.doi.org/10.4088/JCP.16m11415}, Abstract = {OBJECTIVE: Multiple pharmacotherapies for treating anxiety disorders exist, including selective serotonin reuptake inhibitors (SSRIs), the recommended first-line pharmacotherapy for pediatric anxiety. We sought to describe initial antianxiety medication use in children and estimate how long antianxiety medications were continued. METHODS: In a large commercial claims database, we identified children (3-17 years) initiating prescription antianxiety medication from 2004 to 2014 with a recent anxiety diagnosis (ICD-9-CM = 293.84, 300.0x, 300.2x, 300.3x, 309.21, 309.81, 313.23). We estimated the proportion of children initiating each medication class across the study period and used multivariable regression to evaluate factors associated with initiation with an SSRI. We evaluated treatment length for each initial medication class. RESULTS: Of 84,500 children initiating antianxiety medication, 70% initiated with an SSRI (63% [95% CI, 62%-63%] SSRI alone, 7% [95% CI, 7%-7%] SSRI + another antianxiety medication). Non-SSRI medications initiated included benzodiazepines (8%), non-SSRI antidepressants (7%), hydroxyzine (4%), and atypical antipsychotics (3%). Anxiety disorder, age, provider type, and comorbid diagnoses were associated with initial medication class. The proportion of children refilling their initial medication ranged from 19% (95% CI, 18%-20%) of hydroxyzine initiators and 25% (95% CI, 24%-26%) of benzodiazepine initiators to 81% (95% CI, 80%-81%) of SSRI initiators. Over half (55%, 95% CI, 55%-56%) of SSRI initiators continued SSRI treatment for 6 months. CONCLUSIONS: SSRIs are the most commonly used first-line medication for pediatric anxiety disorders, with about half of SSRI initiators continuing treatment for 6 months. Still, a third began therapy on a non-SSRI medication, for which there is limited evidence of effectiveness for pediatric anxiety, and a notable proportion of children initiated with 2 antianxiety medication classes.}, Doi = {10.4088/JCP.16m11415}, Key = {fds336059} } @article{fds271476, Author = {Walkup, JT and Compton, S}, Title = {Use of Antidepressants in Children: Is It Time for a Comparative Effectiveness Trial? Deputy Editor's Comment}, Journal = {Journal of the American Academy of Child & Adolescent Psychiatry}, Volume = {49}, Number = {2}, Pages = {186-188}, Publisher = {Elsevier BV}, Year = {2010}, Month = {February}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2009.11.007}, Doi = {10.1016/j.jaac.2009.11.007}, Key = {fds271476} } @article{fds271469, Author = {Franklin, M and Cahill, SP and Compton, SN}, Title = {What is the question? A comment on "investigating treatment mediators when simple random assignment to a control group is not possible"}, Journal = {Clinical Psychology: Science and Practice}, Volume = {13}, Number = {4}, Pages = {337-341}, Publisher = {WILEY}, Year = {2006}, Month = {December}, ISSN = {0969-5893}, url = {http://dx.doi.org/10.1111/j.1468-2850.2006.00046.x}, Abstract = {Debate about psychotherapy research methods in the last decade has helped to highlight important issues related to the clinical utility of randomized controlled trials. Out of this debate, significant recent advances have been made in using randomized designs to examine treatment efficacy in settings more akin to those in the "real world" where most patients access mental health care. Doss and Atkins (2006) accurately note several potential limitations of treatment-treatment designs for testing mediation, especially when the same mediator may be operating in both active treatments, and they propose several ways that correlational methods can be useful in pursuing mediational hypotheses. These proposed methods are discussed and, using several specific psychotherapy research examples, the continuing relevance of randomized designs in answering specific questions about causality is underscored. © 2006 American Psychological Association.}, Doi = {10.1111/j.1468-2850.2006.00046.x}, Key = {fds271469} } %% Books @book{fds348810, Author = {Compton, SN and Kristensen, H and Villabø, MA}, Title = {Pediatric anxiety disorders}, Pages = {1-551}, Year = {2019}, Month = {January}, ISBN = {9780128130056}, url = {http://dx.doi.org/10.1016/C2016-0-04425-X}, Abstract = {Pediatric Anxiety Disorders provides a critical, updated and comprehensive overview of anxiety disorders in children and adolescents based on the current state of empirical research. The book provides specific clinical recommendations which integrate new knowledge from neuroscience and innovative delivery formats for interventions. This is the first reference to examine anxiety diagnoses in accordance with the latest edition of the DSM-5, including childhood onset disorders, such as Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Social Anxiety Disorder, Panic Disorder, Agoraphobia and Generalized Anxiety Disorder. The book assists clinicians in critically appraising the certainty of the evidence-base and the strength of clinical recommendations.}, Doi = {10.1016/C2016-0-04425-X}, Key = {fds348810} } %% Chapters in Books @misc{fds302615, Author = {Burns, BJ and Compton, SN and Egger, HL and Fanner, EMZ and Robertson, EB}, Title = {An Annotated Bibliography of Evidence for Diagnostic-Specific Psychosocial and Psychopharmacological Interventions}, Pages = {212-276}, Booktitle = {Community Treatment for Youth: Evidence-Based Interventions for Severe Emotional and Behavioral Disorders}, Publisher = {Oxford University Press}, Year = {2009}, Month = {January}, ISBN = {9780195134575}, url = {http://dx.doi.org/10.1093/acprof:oso/9780195134575.003.0011}, Abstract = {This chapter presents the evidence base for clinic and school-based interventions for four common childhood disorders or related symptom patterns: attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), disruptive behavior disorders, and anxiety disorders and related symptoms. It shows that within the existing base for each disorder, psychosocial interventions include an array of behavioral approaches. The psychopharmacology evidence base is strongest for ADHD, weaker for other disorders, and virtually nonexistent for anxiety disorders. Adjunctive studies examining a combination of psychosocial and psychopharmacological interventions were rare, with the largest and most sophisticated one for ADHD.}, Doi = {10.1093/acprof:oso/9780195134575.003.0011}, Key = {fds302615} } @misc{fds348811, Author = {Villabø, MA and Compton, SN}, Title = {Cognitive behavioral therapy}, Pages = {317-334}, Booktitle = {Pediatric Anxiety Disorders}, Year = {2019}, Month = {January}, ISBN = {9780128130056}, url = {http://dx.doi.org/10.1016/B978-0-12-813004-9.00015-3}, Abstract = {In this chapter, we provide an overview of the theoretical foundations of cognitive behavioral therapy (CBT) for pediatric anxiety disorders. Building on principles from classical and operant conditioning paired with cognitive and social learning theories, treatment principles for anxiety disorders have been developed. We describe core CBT principles and provide examples of how these can be applied in clinical practice with anxious youth. Although the empirical support for the effectiveness and efficacy of CBT for pediatric anxiety disorders is strong, there is still room for improvement. We discuss some recent developments and point to areas in need of more research.}, Doi = {10.1016/B978-0-12-813004-9.00015-3}, Key = {fds348811} } @misc{fds348809, Author = {Almeida, CES and Lopes, RD and Guimaraes, HP}, Title = {Introduction}, Pages = {3-11}, Booktitle = {Acid-base and Hydro-electrolytic Balance}, Publisher = {Editora Atheneu}, Year = {2005}, ISBN = {9780128130056}, url = {http://dx.doi.org/10.1016/B978-0-12-813004-9.00001-3}, Abstract = {This introductory chapter presents an overview of the book, Pediatric Anxiety Disorders. We describe the purpose of this volume and provide a description of the included chapters, which are presented under the following section headings: Foundations; Disorders; Interventions; Special Issues. The contributors of the chapters in each section of the volume represent the most prominent names in the field of pediatric anxiety disorders, research, and evidence-based clinical treatment.}, Doi = {10.1016/B978-0-12-813004-9.00001-3}, Key = {fds348809} } @misc{fds369777, Author = {Merwin, R and O'Rourke, S and Ives, L and Harstad, S and Brooks, T}, Title = {Third-wave cognitive behavioral therapies for the treatment of anxiety among children and adolescents}, Booktitle = {Pediatric Anxiety Disorders}, Publisher = {Academic Press}, Editor = {Compton, S and Villabo, M and Kristensen, H}, Year = {2019}, Month = {March}, ISBN = {9780128130056}, Abstract = {This is the first reference to examine anxiety diagnoses in accordance with the latest edition of the DSM-5, including childhood onset disorders, such as Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Social Anxiety ...}, Key = {fds369777} } | |
Duke University * Arts & Sciences * Faculty * Staff * Grad * Postdocs * Reload * Login |