Cara A. Settipani
Temple University
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Featured researches published by Cara A. Settipani.
Journal of Consulting and Clinical Psychology | 2013
Courtney L. Benjamin; Julie P. Harrison; Cara A. Settipani; Douglas M. Brodman; Philip C. Kendall
OBJECTIVE This study evaluated follow-up outcomes associated with cognitive behavioral therapy (CBT) for childhood anxiety by comparing successfully and unsuccessfully treated participants 6.72 to 19.17 years after treatment. METHOD Participants were a sample of 66 youths (ages 7-14 years at time of treatment, ages 18-32 years at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56, range = 6.72-19.17) years prior. The present follow-up included self-report measures and a diagnostic interview to assess anxiety, depression, and substance misuse. RESULTS Compared with those who responded successfully to CBT for an anxiety disorder in childhood, those who were less responsive had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. Relative to a normative comparison group, those who were less responsive to CBT in childhood had higher rates of several anxiety disorders and substance misuse problems in adulthood. Participants remained at particularly increased risk, relative to the normative group, for generalized anxiety disorder and nicotine dependence regardless of initial treatment outcome. CONCLUSIONS The present study is the first to assess the long-term follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. Results support the presence of important long-term benefits of successful early CBT for anxiety.
Journal of Clinical Child and Adolescent Psychology | 2012
Philip C. Kendall; Cara A. Settipani; Colleen M. Cummings
Looking ahead, we review two themes concerning the treatment of youth anxiety: treatment personalization and its dissemination and implementation (DI). Anxious youth can be effectively treated, but not all youth respond, suggesting the need to further adapt, or personalize, interventions for nonresponders. Treatment personalization may benefit from increased knowledge of social phobia, modular and transdiagnostic treatments, and active mechanisms of change. Further, despite the availability of efficacious treatments, they remain underutilized in the community. DI needs to overcome concerns regarding treatment manuals, social and organizational factors, therapist training, and reaching underserved populations. Finally, computer-based programs can facilitate dissemination through both treating anxious youth and training therapists.
Journal of Clinical Child and Adolescent Psychology | 2013
Cara A. Settipani; Kelly A. O'Neil; Jennifer L. Podell; Rinad S. Beidas; Philip C. Kendall
The relationship between improvements in child anxiety and changes in parent factors (e.g., parental anxiety, parenting behaviors) is poorly understood. The present study investigated the directionality of change for child anxiety and parent factors among youth treated for anxiety disorders. Structural equation modeling examined these relationships pre- to posttreatment and at 1-year follow-up for 111 youth aged 7 to 14 (57% male, 84% Caucasian). Child anxiety was measured using the Anxiety Disorders Interview Schedule for Children and the Child Behavior Checklist. The State-Trait Anxiety Inventory, Childrens Report of Parental Behavior Inventory, and Family Assessment Device were used to measure maternal anxiety, psychological control, behavior control, and family affective involvement. Findings suggest that decreases in mother-reported child anxiety led to decreases in maternal anxiety. Decreases in maternal psychological control and family affective involvement preceded decreases in clinician-rated child anxiety. Youth who showed the most reductions in anxiety over the course of treatment were those who tended to have lower family affective involvement, behavior control, and maternal anxiety at pretreatment. Stability of the parent factors and child anxiety over time suggest that stability was greater for behavior control and maternal anxiety relative to affective involvement and psychological control. The findings are consistent with previous research indicating the importance of these parent factors as they relate to anxiety in youth. Furthermore, results indicate that changes in child anxiety may precede changes in parent factors and suggest that parental psychological control and affective involvement are important treatment targets for youth with anxiety disorders.
Journal of Anxiety Disorders | 2012
Cara A. Settipani; Connor M. Puleo; Bradley T. Conner; Philip C. Kendall
There is limited information about the nature of anxiety among youth with symptoms of autism spectrum disorder (ASD). The present study examined (a) differences in the clinical characteristics of anxious youth with and without symptoms of ASD and (b) the symptoms of anxiety that best distinguish between these groups. Results indicated that anxious youth with elevated ASD symptoms had significantly more diagnoses (e.g., specific phobias), and were more likely to meet diagnostic criteria for social phobia (and list social concerns among their top fears) than youth without elevated ASD symptoms. At the symptom level, severity of interpersonal worry based on parent report and severity of fear of medical (doctor/dentist) visits based on youth report best differentiated ASD status. The findings inform diagnostic evaluations, case conceptualization, and treatment planning for youth with anxiety disorders and ASD symptoms.
Journal of Consulting and Clinical Psychology | 2013
Colleen M. Cummings; Nicole E. Caporino; Cara A. Settipani; Kendra L. Read; Scott N. Compton; John S. March; Joel Sherrill; John Piacentini; James T. McCracken; John T. Walkup; Golda S. Ginsburg; Anne Marie Albano; Moira Rynn; Boris Birmaher; Dara Sakolsky; Elizabeth A. Gosch; Courtney P. Keeton; Philip C. Kendall
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 Childs 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.
Journal of Clinical Child and Adolescent Psychology | 2017
Nicole E. Caporino; Kendra L. Read; Nina Shiffrin; Cara A. Settipani; Philip C. Kendall; Scott N. Compton; Joel Sherrill; John Piacentini; John T. Walkup; Golda S. Ginsburg; Courtney P. Keeton; Boris Birmaher; Dara Sakolsky; Elizabeth A. Gosch; Anne Marie Albano
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.
Archive | 2011
Jeremy S. Cohen; Matthew P. Mychailyszyn; Cara A. Settipani; Sarah A. Crawley; Philip C. Kendall
An accurate diagnosis provides a foundation for case conceptualization and facilitates effective treatment practices. Accurate diagnoses are also critical to the organization of participants in empirical research. Although not without its own problems, the Diagnostic and Statistical Manual of Mental Disorders – Text Revision (DSMIV- TR), currently in its fourth iteration (American Psychiatric Association, 2000), is the most frequently used taxonomic system for organizing psychological disorders. Within this framework, disorders are presented as categories (discrete entities) characterized by specific criteria. However, one of the shortcomings associated with a categorical approach is the existence of considerable overlap in symptomatology among disorders. Moreover, comorbidity is common and, among youth with anxiety disorders, it is the norm (Kendall, Brady, & Verduin, 2001). For example, Curry, March, and Hervey (2004) found that 30–65% of children who met criteria for an anxiety disorder also met criteria for an additional disorder. Differential diagnosis among disorders (i.e., the anxiety disorders) poses challenges to both researchers and clinicians.
Child Psychiatry & Human Development | 2013
Cara A. Settipani; Philip C. Kendall
Child and Adolescent Psychiatric Clinics of North America | 2011
Courtney L. Benjamin; Connor M. Puleo; Cara A. Settipani; Douglas M. Brodman; Julie M. Edmunds; Colleen M. Cummings; Philip C. Kendall
Journal of Anxiety Disorders | 2016
Courtney Benjamin Wolk; Nicole E. Caporino; Susanna McQuarrie; Cara A. Settipani; Jennifer L. Podell; Sarah A. Crawley; Rinad S. Beidas; Philip C. Kendall