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Additional Reference – Lecture 2, Risk & Resilience

Additional Reference – Lecture 2, Risk & Resilience. Schaffer, H.R. (2000). The early experience assumption: Past, present, and future, International Journal of Behavioral Development , 24, 1, pp5-14. Additional Reference, Lecture 2, Risk & Resilience.

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Additional Reference – Lecture 2, Risk & Resilience

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  1. Additional Reference – Lecture 2, Risk & Resilience • Schaffer, H.R. (2000). The early experience assumption: Past, present, and future, International Journal of Behavioral Development, 24, 1, pp5-14 Rosaleen McElvaney, Phd

  2. Additional Reference, Lecture 2, Risk & Resilience • Preview Ravens Siberer, U., Erhart, M., Gosch, A., Wille, N., The European KIDSCREEN Group (2008), Mental health of children and adolescents in 12 European countries: Results from the European KIDSCREEN study, Clinical Psychology and Psychotherapy, 15, 3, pp. 154-163 Rosaleen McElvaney, Phd

  3. Additional Reference – Lecture 3, Behavioural Model & ASD • Eikeseth, S., Smith, T., Jahr, E and Eldevik, S. (2002). Intensive behavioural treatments at school for 4-to-7 year-old children with autism. Behaviour Modification, 26, 49-68 Rosaleen McElvaney, Phd

  4. Models of Development and Mental Health Lecture 4: Cognitive Model: Anxiety

  5. Changing focus of children’s fears • (Koplewicz, 1996, in Dadds & Barrett, 2001, JCPP,Weems & Costa, 2005) Rosaleen McElvaney, Phd

  6. Anxiety Disorders • Separation anxiety disorder • Specific phobias • Selective mutism • Obsessive compulsive disorder • Generalised anxiety disorder • Panic attacks • Post Traumatic Stress Disorder/Acute Stress Disorder Rosaleen McElvaney, Phd

  7. Obsessive Compulsive Disorder & Generalized Anxiety Disorders 1% for adolescents 2-4% for GAD Adolescents> children Girls>boys for GAD No diff for OCD Prevalence of Anxiety Disorders • Anxiety Disorders • 7.3% of population? • Females>males • Continuity into adulthood • High co-morbidity • 44 adults per 1,000 (Office of National Statistics, 2000, cited in NICE Guidelines, 2004) • Separation Anxiety Disorder & Phobias • 4% and 2-3% • Children > Adolescents • Girls > Boys Rosaleen McElvaney, Phd

  8. Additional Reference, Lecture 4, Cognitive Model & Anxiety • Gosch, E.A., Flannery-Schroeder, E., Mauro, C.F., Compton, S.N. (2006). Principles of cognitive-behavioral therapy for anxiety disorders in children, Journal of Cognitive Psychotherapy, Vol. 20 Issue 3, pp.247-262, Rosaleen McElvaney, Phd

  9. Social Learning Theory Perspective • Bandura (1977) • Learning through direct observation as well as experience – modelling • Children may learn anxious responses through observing this behaviour being modelled by significant others – role models doubting their own ability or overestimate the likelihood of threat • Perceived self-efficacy to cope with and control anxiety-provoking stimuli Rosaleen McElvaney, Phd

  10. Information Processing Perspective • Cognitive bias at level of perception, encoding, interpretation and retrieval of information • Anxious children more attentive to potential dangers, more likely to interpret situations as dangerous and more likely to remember fear-relevant cues (Beck, Emery & Greenberg, cited in Gosch et al., 2006) Rosaleen McElvaney, Phd

  11. Triple vulnerability modelBarlow, 2000 • Genetic vulnerability • General psychological vulnerability concerning a sense of impending uncontrollable and unpredicatble threat • Specifc psychological vulnerability resulting from early learning experiences that lead a child to experience anxiety in certain situations • Barlow, D. (2000). Unravelling the mysteries of anxiety and its disorders from the persepctive of emotion theory, American Psychologist, 55, pp1245-1263. Rosaleen McElvaney, Phd

  12. Additional Reference, Lecture 4, Anxiety & Cognitive Model • Kendall, P.C., Hudson, J.L., Gosch, E., Flannery-Schroeder, E., Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomised clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, Vol 76, 2, pp. 282-297 Rosaleen McElvaney, Phd

  13. Kendall et al. study • Increasing parent involvement? • Reciprocal relationships between parents & children • Anxious children are more likely to have anxious parents whose behaviour may maintain anxiety and avoidance – parents may facilitate anxiety through reinforcement and modeling • Familial variables – high levels of parental anxiety predict pororere outcomes Rosaleen McElvaney, Phd

  14. Kendall et al. study contd. • Effectiveness of child-focussed cbt supported by randomized control trials for anxiety disorders when compared to randomised controls ( Branmish & Kendall, 2005; Comptom et al., 2004, cited in Kendall et al., 2008) • 56% of anxious youth no longer met criteria for diagnosis following cbt; 63% at 6-12 months follow up (Cartwright-Hatton et al., 2004, cited in Kendall et al., 2008) Rosaleen McElvaney, Phd

  15. Therapeutic InterventionGosch et al., 2006 • Assessment • Psychoeducation • Affective education • Self-instruction training • Cognitive restructuring • Problem-solving • Relaxation training • Modelling • Contingency management • Exposure Rosaleen McElvaney, Phd

  16. Cognitive Model - critique • Development of anxiety: Significant differences between those who suffer from anxiety and those who don’t, supports theory BUT Thinking causes disorder or is a result of disorder? • Manualised therapeutic interventions • Rigid procedures, need to take account of individuality • Extensive support for short term effects • Randomized controlled trials – ‘probably effective’ Rosaleen McElvaney, Phd

  17. Carr (2007) • 4 meta analyses of CBT for children with various difficulties (350 studies) • Average child fared better than 76% to 81% of children in control groups, 2 studies showed improvements maintained at 6 month follow up • ‘dose effect’ – 20-45 sessions acccounting for 50-75% of clients’ recovery Rosaleen McElvaney, Phd

  18. Caution in interpreting research • Just because there is a abundance of empirical research conducted on CBT does not mean there is more evidence for effectiveness of CBT • More amenable to traditional quantitative methodologies • More focussed on easily measurable symptom change • Does not take account of intrapersonal dynamics & relationships Rosaleen McElvaney, Phd

  19. Addditional References, Lecture 4, Anxiety & Cogntive Model • Butler, A., Chapman, J., Forman, E., & Beck, A. (2006). The empirical status of cognitive-behavioural therapy: A review of meta-analyses. Clinical Psychology Review. • Carr, A. (2007). The effectiveness of psychotherapy: A review of research. Dublin: Irish Council of Psychotherapy. Rosaleen McElvaney, Phd

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