Natalie M. Costa

Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina

On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster negative affect predicted disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms. Also, Katrina-related posttraumatic stress disorder symptoms were predicted by the number of hurricane exposure events and sex (being female). Predisaster generalized anxiety disorder symptoms predicted postdisaster generalized anxiety disorder symptoms, and predisaster trait anxiety predicted postdisaster depressive symptoms. Findings are discussed in terms of their relevance for developing interventions to mitigate the impact of disasters in youths.

One-Session Treatment of Specific Phobias in Youth: A Randomized Clinical Trial in the United States and Sweden.

One hundred and ninety-six youth, ages 7-16, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for various specific phobias were randomized to a one-session exposure treatment, education support treatment, or a wait list control group. After the waiting period, the wait list participants were offered treatment and, if interested, rerandomized to 1 of the 2 active treatments. The phobias were assessed with semistructured diagnostic interviews, clinician severity ratings, and behavioral avoidance tests, whereas fears, general anxiety, depression, and behavior problems were assessed with self- and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Results showed that both treatment conditions were superior to the wait list control condition and that 1-session exposure treatment was superior to education support treatment on clinician ratings of phobic severity, percentage of participants who were diagnosis free, child ratings of anxiety during the behavioral avoidance test, and treatment satisfaction as reported by the youth and their parents. There were no differences on self-report measures. Treatment effects were maintained at follow-up. Implications of these findings are discussed.

Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents

Background: Existing research indicates sleep problems to be prevalent in youth with internalizing disorders. However, childhood sleep problems are common in the general population and few data are available examining unique relationships between sleep, specific types of anxiety and depressive symptoms among non‐clinical samples of children and adolescents. Methods: The presence of sleep problems was examined among a community sample of children and adolescents (N=175) in association with anxiety and depressive symptoms, age, and gender. Based on emerging findings from the adult literature we also examined associations between cognitive biases and sleep problems. Results: Overall findings revealed significant associations between sleep problems and both anxiety and depressive symptoms, though results varied by age. Depressive symptoms showed a greater association with sleep problems among adolescents, while anxiety symptoms were generally associated with sleep problems in all youth. Cognitive factors (cognitive errors and control beliefs) linked with anxiety and depression also were associated with sleep problems among adolescents, though these correlations were no longer significant after controlling for internalizing symptoms. Conclusions: Results are discussed in terms of their implications for research and treatment of sleep and internalizing disorders in youth. Depression and Anxiety, 2009. Published 2008 Wiley‐Liss, Inc.

Physiological Response and Childhood Anxiety: Association With Symptoms of Anxiety Disorders and Cognitive Bias

This study examined the physiological response (skin conductance and heart rate [HR]) of youth exposed to a mildly phobic stimulus (video of a large dog) and its relation to child- and parent-reported anxiety symptoms and cognitive bias in a community-recruited sample of youth (n = 49). The results of this study indicated that HR and skin-conductance response were associated with youth report but not parent report of their childs symptoms of anxiety disorders and that HR response was more strongly associated with anxiety symptoms than skin-conductance response. Physiological response was uniquely associated with youth-reported symptoms of anxiety rather than youth-reported depression. Finally, HR response interacted with cognitive bias in predicting childhood anxiety disorder symptoms in a manner consistent with theories of the etiology of anxiety disorders.

Cognitive Errors, Anxiety Sensitivity, and Anxiety Control Beliefs: Their Unique and Specific Associations with Childhood Anxiety Symptoms.

This study examined the interrelations among negative cognitive errors, anxiety sensitivity, and anxiety control beliefs and explored their unique and specific associations with anxiety symptoms in a community sample of youth. Existing research has suggested that these constructs are related to childhood anxiety disorder symptoms; however, additional research is needed to test the interrelations among negative cognitive errors, anxiety sensitivity, and anxiety control beliefs and to determine if they show unique and specific associations with anxiety symptoms. The results of this study indicated that negative cognitive errors, anxiety sensitivity, and anxiety control beliefs were associated with each other and that they demonstrated unique concurrent associations with childhood anxiety disorder symptoms. Moreover, certain cognitive biases showed specificity in their association with anxiety symptoms versus depressive symptoms.

Paul Tillich's theory of existential anxiety: A preliminary conceptual and empirical examination

This paper conceptually explores Paul Tillichs theory of existential anxiety and examines existing research relevant to each of Tillichs domains of existential apprehension. This paper also reports data from two initial empirical studies of Tillichs model of existential anxiety and its relation to symptoms of anxiety and depression. A self-report measure of existential anxiety, the Existential Anxiety Questionnaire (EAQ) based on Tillichs conceptualization, was developed and data were collected from two socioeconomic and ethnically diverse samples of adults (Study 1, N=225; Study 2, N=331). Results indicated that the EAQ has good test-retest and internal consistency reliability and a factor structure consistent with theory. The EAQ also demonstrated good convergent and incremental validity estimates. The data suggest that existential anxiety concerns are common and that they are associated with symptoms of anxiety and depression as well as psychological distress related to identity problems. Results are discussed with regard to their support for the viability of employing Tillichs theory in empirical research on existential anxiety and the importance of further exploring the relation between existential anxiety concerns and other facets of emotional experience such as clinical anxiety and depression.

Loss and the Experience of Emotional Distress in Childhood

The objective of this study was to investigate loss and the experience of emotional distress through a series of three studies. In Study 1, results indicated that when controlling for the total number of traumas experienced, children with loss traumas did not differ significantly from children with other types of traumas in terms of the level of PTSD symptoms reported and diurnal cortisol levels. In Study 2, results indicated that youth with loss traumas had significantly higher parent-reported internalizing and externalizing symptoms than control participants. In Study 3, we replicated and extended findings from Study 1 using an independent sample of non-clinic-referred youth. Findings are discussed in terms of how loss events may constitute a traumatic stressor in youth.