Ingrid Leth

Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents☆

The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder as opposed to 26.4% who had other principal diagnoses and a secondary anxiety disorder. The national database not only provides a valuable prevalence estimate of anxiety disorders in every-day non-research psychiatric settings, but also highlights the importance of applying standardized screening instruments as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.

Seksuelle overgreb mod børn og unge

Leth, I., Stenvig, B. & Pedersen, A.: Sexual abuse of children and adolescents: Extent and characteristics. Nordisk Psykologi, 40, 383–393. Following earlier studies in Norway and Sweden, the present report concerns a postal questionnaire study of sexual abuse of children and adolescents (under age 18) in Denmark. From a national population register, 2000 demographically representative individuals in the age range 18 to 50 years were selected. A 66% response rate was obtained. Abuse was reported by 14% of the female respondents and 7% of the male respondents. The abusers were mainly men; among abused males, however, 26% reported abuse by a female. Most of the reported cases were serious (attempted or completed coitus), and occured both within and outside of the family. The episodes of abuse were unreported at the time of occurence by 60% of the males and 52% of the females. Sexual abuse appears to be spread through all socio-economic levels.

Exploring the Effect of Case Formulation Driven CBT for Children with Anxiety Disorders: A Feasibility Study

BACKGROUND Little is known about the effect of case-formulation based cognitive behaviour therapy (CBT) for anxious children. AIM The present study explores the feasibility of case-formulation driven CBT for anxious children. Parents were involved in treatment as either co-facilitators (involved only as the childs assistants, treatment being primarily directed at the child), or as co-clients (parents received therapy targeting theoretically established maintaining mechanisms; children received half of the sessions, parents the other half). METHOD Feasibility of the case-formulation driven CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta-analyses. Children aged 7-12 years and their parents participated (n = 54). Families were assessed at pre- and posttreatment and at 6-month follow-up. RESULTS All families completed treatment and the percentage of recovery in the case-formulation driven approach was comparable to results obtained in manualized treatments. CONCLUSION The findings from this stage I study supports the notion that a case-formulation driven approach to CBT may be a feasible option when selecting treatment for anxious children; however, further studies must be conducted before firm conclusions can be drawn.

Parental changes after involvement in their anxious child's cognitive behavior therapy.

OBJECTIVE Specific parental behaviors and cognitions are associated with child anxiety. Studies informing us of the directionality of the associations are lacking. We investigated the effect of parental involvement in childrens anxiety treatment on parental behaviors and cognitions. METHOD Children (N=54, 7-12 years) and parents were randomly allocated to different treatment groups (involved, not involved). Observed behavior, self-reported behavior and cognitions were assessed separately for mothers and fathers at pre-, posttreatment and follow-up. RESULTS There were no differences over time for self-reported parental efficacy and observed negativity, but self-reported autonomy granting increased for both groups over time. Differential effects were found between groups for observed paternal over-involvement (fathers involved in treatment showed a more rapid decrease) and self-reported maternal autonomy-granting (non-involved mothers showed a greater increase). CONCLUSION Our findings suggest that child anxiety significantly influences parental behaviors and cognitions. Child therapy may successfully change the family system.

The Children's Rights Convention in Denmark: A Status Report on Implementation

Research Findings: The United Nations Convention on the Rights of the Child was ratified by Denmark in 1991 but never incorporated into Danish legislation; instead the State party has chosen a stepwise implementation in legal and social praxis. However, this process mirrors a remarkable reluctance to approve the Convention as a legitimate part of Danish legislation, as it is argued that the Danish welfare state embodies a social and legislative framework that in general terms ensures childrens rights. But the role of the Convention in Denmark is weak and relatively invisible and does not ensure an adherence in local municipalities to either the national legislation or the demands of the Convention. Practice or Policy: A critical examination reveals that for vulnerable groups of children this lack of legitimacy of the Convention has serious consequences. Therefore, the Convention occupies a paradoxical status as ratified but not fully integrated into Danish legal and social praxis.