Brian A. Buzzella

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.

Using Relationship Education Programs with Same-Sex Couples: A Preliminary Evaluation of Program Utility and Needed Modifications

Same-sex couples represent a group likely to benefit from relationship education, given the many unique challenges they face. However, it is unclear whether existing programs, predominantly designed for married heterosexual couples, are appropriate for use with same-sex couples. In this article we highlight the need for quality relationship education programs for same-sex couples and review the literature to identify unique needs of same-sex couples that may not be met by existing programs. We then describe a small survey of couple therapists and researchers conducted to provide preliminary information about whether same-sex couples are perceived to benefit from existing relationship education programs and whether modifications to program content are needed. Twenty respondents indicated that a core set of relationship education components were useful when working with same-sex couples, although the presentation of these components generally required modifications to remove heterosexist bias and to improve applicability to same-sex couples. In addition, several novel program foci were suggested (e.g., stigma management). Implications for the design and delivery of relationship education to same-sex couples are discussed.

The Impact of an 8-Day Intensive Treatment for Adolescent Panic Disorder and Agoraphobia on Comorbid Diagnoses☆

Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.

Comorbidity and Family Factors Associated with Selective Mutism

Recent findings suggest that Selective Mutism (SM) is best conceptualized as a childhood anxiety disorder and that oppositional behavior may or may not be a significant part of the clinical picture. Twenty-nine mothers of children with SM and 28 mothers of children who did not meet diagnostic criteria for any Axis I disorder (a community comparison group) completed parental self-report questionnaires and clinician-rated interviews assessing anxiety and oppositional behavior, parental psychopathology, and family factors with hypothesized relationships with childhood anxiety. Findings suggested that children with SM experienced more anxiety than those in the community comparison group, with significantly higher levels of social anxiety, rumination, and physical symptoms reported. Mothers of children with SM reported greater monitoring of their childrens activities, but they did not significantly differ from community comparison group mothers on reports of other parenting behaviors. Such findings may have important implications for guiding family involvement in psychosocial interventions.