Hanna Kley

Predictors of outcome in a cognitive-behavioral group program for children and adolescents with social anxiety disorder.

The present study examined predictors of treatment outcome among children and adolescents with social anxiety disorder (SAD). Seventy-five participants (8-13 years) participated in a 12-session cognitive behavioral group treatment (CBT). Potential predictors were the pre-treatment severity of anxious symptoms assessed from both the childs and parents perspective as well as depressive symptoms (child report only) and general emotional distress in parent (parent self-report). Furthermore, the relationship between treatment outcome and childs self-reported pre-post changes in self-consciousness and maladaptive anxiety regulation was investigated. Pre-treatment level of social anxiety reported by the child was a significant predictor for outcome, i.e. children with higher levels of social anxiety at pretreatment reported a greater reduction in social anxiety at post-treatment. Reduction in self-consciousness and maladaptive anxiety regulation both predicted reduction in social anxiety, although not independently. The results suggest that tailoring intervention to include strategies for emotion regulation of anxiety may improve treatment outcome.

Safety behaviors, self-focused attention and negative thinking in children with social anxiety disorder, socially anxious and non-anxious children

BACKGROUND AND OBJECTIVES Cognitive behavioral models of social anxiety disorder (SAD) in adults suggest several mechanisms that maintain social anxiety. So far, little is known about the role of these processes in childhood social anxiety. METHODS In this study, 21 children with SAD, 21 children with high social anxiety and 21 non-anxious controls (age between 8 and 13 years) were asked about their use of safety behavior in anxiety producing situations. Furthermore, children were asked to indicate their levels of anxiety, self-focused attention and frequency of positive and negative cognitions while engaging in a performance task in front of two adults. RESULTS As expected, a significant group effect was found for all dependent variables, with children suffering from SAD reporting the most frequent use of safety behavior and highest levels of anxiety, self-focused attention and negative cognitions during the task, followed by socially anxious children and controls. Unexpectedly, only self-focused attention mediated the relationship between general social anxiety and state anxiety in response to the task. LIMITATIONS We assessed only the general use of safety behavior in social threatening situations and not with respect to the performance task. CONCLUSIONS The results provide important preliminary evidence for differences between clinical and non-clinical groups in childhood anxiety in maintaining variables as proposed from cognitive models in adults. In particular, self-focused attention seems to be relevant. Targeting the change of inappropriate attentional focus could be promising for treatment improvement in childhood social anxiety.

Manipulating self-focused attention in children with social anxiety disorder and in socially anxious and non-anxious children

Cognitive behavioral models of social anxiety disorder (SAD) in adults suggest that self-focused attention maintains social anxiety. However, this hypothesis has not yet been tested in children. This study therefore examined self-focused attention in relation to social anxiety in children. Self-focused attention was experimentally varied (internal vs. external) in 20 children with SAD, 20 children with high social anxiety and 20 non-anxious controls while engaging in a performance task in front of two adults. As expected, a significant group effect was found for all dependent variables, with children suffering from social anxiety disorder reporting the highest levels of anxiety, negative mood, and negative cognitions, and the lowest levels of self-rated performance and positive cognitions, followed by socially anxious children and controls. A significant effect of the focus condition was that children with heightened internal self-focus reported more anxiety, worse expected performance evaluation by others and more frequent negative cognitions. Unexpectedly, no interaction between social anxiety group and focus condition was found. Taken together, the results provide important preliminary evidence for the generally detrimental role of self-focused attention on child anxiety in social situations.

Prävention sozialer Angststörungen im Kindes- und Jugendalter: Notwendig oder überflüssig?

In dem vorliegenden Überblicksbeitrag wird zunächst anhand der Symptomatik und des Verlaufs sozialer Ängste und sozialer Phobien vom Kindes- und Jugendalter bis hin zum Erwachsenenalter deutlich gemacht, dass es notwendig ist, wirksame Präventionsprogramme zu entwickeln, um soziale Ängste von Kindern und Jugendlichen bereits frühzeitig zu reduzieren bzw. einer Chronifizierung und Verschlimmerung entgegenzuwirken. Darauf aufbauend wird der Stand der Forschung zur Prävention sozialer Ängste bzw. sozialer Phobien im Kindes- und Jugendalter vorgestellt und bewertet.

Dank an die Gutachter

Im jetzt ablaufenden Jahr wurde ein Grosteil der im Bundesgesundheitsblatt — Gesundheitsforschung — Gesundheitsschutz publizierten Original- und Ubersichtsbeitrage einem Peer-Review-Verfahren durch normalerweise je zwei Gutachter pro Beitrag unterzogen. Die Redaktion mochte an dieser Stelle allen im folgenden aufgefuhrten Gutachtern fur ihre Mitwirkung danken, durch die sie entscheidend zur Verbesserung und Aufrechterhaltung der Qualitat dieser Zeitschrift beitragen.

«Moderne Zeiten» – Stress, Burnout und Möglichkeiten der Prävention und Intervention

Accessible online at: www.karger.com/ver Fax +49 761 4 52 07 14 Information@Karger.de www.karger.com Herr Professor Dormann, die neuesten Gesundheitsreporte bescheinigen uns wieder, dass krankheitsbedingte Fehltage im Arbeitsleben sinken, psychische Erkrankungen jedoch ansteigen. Das Thema Burnout spielt hierbei sicherlich eine große Rolle. Eine holländische Studie besagt, dass 10–15% der Bevölkerung Burnout-Werte aufweisen, bei denen eine arbeitsplatzbezogene oder medizinische Intervention angesagt wäre. Wie zeigt sich Burnout am Arbeitsplatz und was sind die auslösenden Faktoren?