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Gepubliceerd in: Research on Child and Adolescent Psychopathology 12/2019

09-05-2019

Effects of Group-Based CBT on Post-Event Processing in Children with Social Anxiety Disorder Following an Experimental Social Stressor

Auteurs: Julia Asbrand, Julian Schmitz, Martina Krämer, Kai Nitschke, Nina Heinrichs, Brunna Tuschen-Caffier

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 12/2019

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Abstract

Theoretical models and previous research suggest that post-event processing (PEP) after social situations maintains social anxiety disorder (SAD). To date, little is known about PEP in childhood, a critical period for disorder development, or about possible positive effects of cognitive behavioral therapy (CBT) on PEP in children. Children with SAD (n = 71; aged 9–13 years) and healthy controls (n = 55) participated in a social stress task (Trier Social Stress Test for Children, TSST-C), which was repeated in children with SAD after either 12 sessions of CBT or a waiting period. PEP was assessed daily with regard to both valence and frequency, as well as in more detail regarding specific negative and positive ruminative thoughts 1 week after each TSST-C. Daily PEP after the TSST-C was more frequent and more negative in children with SAD compared to healthy controls, in particular during the first 2 days after the TSST-C. After CBT treatment, children with SAD reported more positive PEP but not less negative PEP compared to children in the waitlist control group. The current study suggests that negative PEP in children with SAD is most pronounced in the first days following social stress. Group-based CBT seems to be effective in building up positive cognitions after social stress in children, but developing specific interventions targeting negative PEP immediately after a social stressor may be necessary to further increase treatment efficacy.
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Voetnoten
1
Some previous studies have labeled PEP as “post-event rumination.” Rumination and PEP are closely related, but PEP describes a specific form of rumination after social events. The two terms are often used interchangeably and are assessed through the same measures (e.g., Abbott and Rapee 2004).
 
2
This study was part of a larger project aimed at measuring treatment success by including several outcome variables (state anxiety, negative cognitions, physiological arousal, perception of and worry about physiological symptoms, perception of academic performance, negative PEP, and parental cognitions). In consideration of length restrictions, the primary outcome variables are not all reported in one article. Additional articles will follow this primary outcome article. All articles include cross-references to other outcome measures.
 
3
For the present research question, the following measures were selected (from a larger pool of measures in the project).
 
4
For the respective analyses the percentages of data points identified as outliers and thus excluded from analysis were frequency after first TSST-C, 3.8%; valence after first TSST-C, 0.7%; frequency after second TSST-C, 3.6%; valence after second TSST-C, > 0.1%. Missing data and outliers were not substituted but instead a statistical approach was chosen that was able to handle missing data (mixed models).
 
5
The depression score correlated significantly with the negative TQ-C scale, r(109) = 0.492, p < 0.001, but not with the positive TQ-C scale, r(109) = −0.056, p = 0.565. When depression was partialled out of both TQ-C scales, the reanalysis of the reported model still yielded a significant main effect of group, F(1,111) = 12.09, p < 0.001, as well as an interaction between group and scale, F(1,110) = 6.02, p = 0.016, whereas the main effect of scale vanished, F(1,110) < 0.01, p = 0.979. The post hoc t test on the scores corrected for depression between groups showed a significant group effect for the negative TQ-C scale, t(98) = 3.61, p < 0.001, but not for the positive TQ-C scale, t(100) = 1.55, p = 0.123.
 
6
Rate of valid data: Several children rated frequency at 0 and did not report valence because they argued an absent thought can be neither pleasant nor unpleasant. These cases were not counted as missing data.
 
7
The rate of valid data was not related to symptom severity, p > 0.05.
 
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Metagegevens
Titel
Effects of Group-Based CBT on Post-Event Processing in Children with Social Anxiety Disorder Following an Experimental Social Stressor
Auteurs
Julia Asbrand
Julian Schmitz
Martina Krämer
Kai Nitschke
Nina Heinrichs
Brunna Tuschen-Caffier
Publicatiedatum
09-05-2019
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 12/2019
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-019-00558-x

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