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Description
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017
Description
Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors that may affect program outcomes. The current study investigates the relations between different aspects of implementation and their effect on outcomes of a school-based preventive intervention targeting anxiety symptoms. Specifically, the study examines: (1) the measurement of quality of delivery, (2) specific relations among implementation components, (3) relations between these facets and anxiety program outcomes. Implementation data were collected from nine school-based mental health staff and observer ratings. Program outcomes (pretest and immediate posttest) were measured from 59 participants and their parents (mostly mothers) in the intervention condition. Implementation components included adherence, quality of delivery, time spent, participant responsiveness, and perceived usefulness of program materials. Program outcomes included child-reported emotional expressivity, physiological hyperarousal, negative cognitions, social skills, self-efficacy, and child and parent reported levels of child anxiety. Study findings indicated that quality of delivery was best captured as two facets: skillful presentation and positive engagement. Adherence and quality of delivery were associated with greater participant responsiveness, although time spent was not. Significant relations were found between some implementation components and some program outcomes. Further efforts can be used to optimize the translation of evidence-based programs into real-world settings.
ContributorsChiapa, Amanda (Author) / Pina, Armando (Thesis advisor) / Dishion, Thomas (Committee member) / Wolchik, Sharlene (Committee member) / Grimm, Kevin (Committee member) / Berkel, Cady (Committee member) / Arizona State University (Publisher)
Created2017
Description
The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use.
ContributorsHaller, Moira (Author) / Chassin, Laurie (Thesis advisor) / Davis, Mary (Committee member) / Pina, Armando (Committee member) / Tein, Jenn-Yun (Committee member) / Arizona State University (Publisher)
Created2014
Description
Pediatric anxiety disorders are highly prevalent and while pharmacological intervention seems to be an effective treatment, the validity of reported adverse side effects remains unclear. <br/><br/>Objective: To analyze the nature of evidence regarding adverse side effects in the pharmacological treatment of pediatric anxiety disorders. <br/><br/>Approach: A search using Google Scholar, PubMed, and PsychInfo was conducted for meta-analyses of pharmacological treatment of pediatric anxiety disorders as well as randomized controlled trials. The focus was on adverse events.<br/><br/>Results and Conclusion: Reportings of a limited number of adverse events were found among resources available to clinician and patient informed sources to inform pharmacological treatment of pediatric anxiety disorders. Only a small fraction of adverse side effects were found in the research literature. This finding raises concerns about making informed decisions to treat pediatric anxiety disorders with pharmacotherapy.
ContributorsMartin, Mark (Co-author) / Reyes, Trevin (Co-author) / Whooley, Max (Co-author) / Pina, Armando (Thesis director) / Benoit, Renee (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
The purpose of this thesis study was to evaluate the nature of social anxiety in clinic-referred African American children versus their Caucasian counterparts. In particular, social anxiety symptom endorsement along the Social Phobia and Anxiety Inventory Scale for Children (SPAI-C; Beidel, Turner, & Morris, 1995) was examined in a sample of 107 African American and 364 Caucasian children (ages 7- to 17-years old) referred for anxiety. To evaluate symptom endorsement, simple descriptive analyses were conducted whereas measurement invariance tests were examined using confirmatory factor analyses. For the most commonly endorsed items, African American and Caucasian children shared seven of the top 10 most commonly identified social anxiety symptoms. Similar social fears across ethnicity focused on "assertiveness in situations perceived to be difficult" and ""speaking to large groups of peers they do not know." Findings also showed that African American children were more likely to report symptoms of "shaking when in social situations" than Caucasian children, and Caucasian children were more likely to report symptoms of "embarrassment when in front of adults" compared to African American children, but this was also on the basis of two items. When it came to the five factors of the SPAI-C, results showed measurement invariance across African American and Caucasian children. Overall, there were more similarities than differences between African American and Caucasian children in social anxiety symptoms based on the SPAI-C. Findings from this thesis study shed light on how to best accurately identify social anxiety among African American children compared to Caucasians, a contribution that can potentially impact assessment, treatment planning, and program response evaluation.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Gonzales, Nancy (Committee member) / Millsap, Roger (Committee member) / Arizona State University (Publisher)
Created2013