Assessment of childhood phobias

doi:10.1016/S0272-7358(97)00029-9

Clinical Psychology Review

Volume 17, Issue 7, November 1997, Pages 667-687

https://doi.org/10.1016/S0272-7358(97)00029-9 Get rights and content

Abstract

Childhood phobias can be successfully treated using a variety of behavioral strategies, provided there has been a psychometrically sound assessment. Measures are also important for the evaluation of treatment efficacy and the testing of hypotheses generated by new ideas and theories of children 's phobias. This paper outlines broad-based assessment procedures used in the evaluation of children's phobias, including the behavioral or problem-focused interview, the diagnostic interview, self-report inventories, caregiver completed instruments, behavioral observations, self-monitoring and physiological assessment. Reflecting recent theoretical and clinical advances in the study of childhood internalizing disorders, we also explore laboratory-based measures and family assessment measures. Particular attention is given to psychometric issues and developmental sensitivity in our discussion of these assessment procedures.

References (109)

D.C. Beidel
Assessing anxious emotion: A review of psychophysiological assessment in children
Clinical Psychology Review
(1989)
A.C. Friedman et al.
Treatment programs for severe night-time fears: A methodological note
Journal of Behavior Therapy and Experimental Psychiatry
(1989)
G.S. Ginsburg et al.
Family involvement in treating children with phobic and anxiety disorders: A look ahead
Clinical Psychology Review
(1995)
N.J. King et al.
Emotive imagery and children's nighttime fears: A multiple baseline evaluation
Journal of Behavior Therapy and Experimental Psychiatry
(1989)
P.J. Lang
Fear imagery: An information processing analysis
Behavior Therapy
(1977)
A.C. Logan et al.
Attention to external threat cues in anxiety states
Clinical Psychology Review
(1993)
T.H. Ollendick
Reliability and Validity of the Revised Fear Survey Schedule for Children (FSSC-R)
Behaviour Research and Therapy
(1983)
T.H. Ollendick
Cognitive-behavior therapy of panic disorder with agoraphobia in adolescents: A multiple baseline design analysis
Behavior Therapy
(1995)
T.H. Ollendick et al.
Cognitive behavior therapy with nighttime fearful children
Journal of Behavior Therapy and Experimental Psychiatry
(1991)
R.M. Rapee et al.
Reliability of the DSM-III-R childhood anxiety disorders using structured interview: Interrater and parent-child agreement
Journal of the American Academy of Child and Adolescent Psychiatry
(1994)

K. Ronan

Building a reasonable bridge in childhood anxiety assessment: A practitioner's resource guide

Cognitive and Behavioral Practice

(1996)

M.W. Scherer et al.

A Fear Survey Schedule for Children (FSS-FC): A factor analytic comparison with manifest anxiety (CMAS)

Behaviour Research and Therapy

(1968)

W.K. Silverman et al.

Age differences in the reliability of parents and child reports of child anxious symptomatology using a structured interview

Journal of the American Academy of Child and Adolescent Psychiatry

(1992)

W.K. Silverman et al.

Clinical issues in treating children with anxiety and phobic disorders

Cognitive and Behavioral Practice

(1995)

W.K. Silverman et al.

The anxiety disorders interview schedule for children

Journal of the American Academy of Child and Adolescent Psychiatry

(1988)

T.M. Achenbach

Integrative Guide for the 1991 CBCL 4–18, YSR, and TRF Profiles

(1991)

T.M. Achenbach et al.

American Psychiatric Association

A. Bandura et al.

Vicarious extinction of avoidance behavior

Journal of Personality and Social Psychology

(1967)

P.M. Barrett et al.

Cognitive and family processes in child anxiety

B.A. Barrios et al.

Fears and anxieties

D.C. Beidel

Psychophysiological assessment of anxious emotional states in children

Journal of Abnormal Psycholog

(1988)

K.L. Bierman et al.

Clinical child interviews: Approaches and developmental considerations

Journal of Child and Adolescent Psychotherapy

(1986)

A. Castaneda et al.

The children's form of the Manifest Anxiety Scale

Child Development

(1956)

B.F. Chorpita et al.

Child Anxiety Sensitivity Index: Considerations for children with anxiety disorders

Journal of Clinical Child Psychology

(1996)

M.R. Dadds et al.

Family processes in child anxiety

M. Dadds et al.

Behavioral observation

T.K. Daugherty et al.

Response perseveration and delayed responding in childhood behavior disorders

Journal of Child Psychology and Psychiatry

(1991)

T.K. Daugherty et al.

Behavior checklists and rating forms

P.A. DiNardo et al.

Reliability of DSM-III anxiety disorder categories using a new structured interview

Archives of General Psychiatry

(1983)

A.J. Finch et al.

Self-report instruments

C. Gerlsma et al.

Anxiety, depression, and perceptions of early parenting: A meta-analysis

Clinical Psychology Review

(1990)

J.A. Gray

The psychology of fear and stress

(1987)

A.M. Graziano et al.

Family self-control instruction for children's nighttime fear reduction

Journal of Consulting and Clinical Psychology

(1980)

A.M. Graziano et al.

Behavioral treatment of “nightfears” in children: Maintenance of improvement at 2 1/2- to 3-year follow-up

Journal of Consulting Clinical Psychology

(1982)

A.M. Graziano et al.

Self-control instructions for children's fear reduction

journal of Behavior Therapy and Experimental Psychiatry

(1979)

D.I. Hamilton et al.

Reliability of a behavioral avoidance test for the assessment of dog phobic children

Psychological Reports

(1991)

E. Hampe et al.

Phobic children one and two years posttreatment

Journal of Abnormal Psychology

(1973)

S.N. Haynes

Principles of behavioral assessment

(1978)

P.M. Heard et al.

Assessment and treatment of simple phobias in children: Effects on family and marital relationships

Behaviour Change

(1992)

B. Herjanic et al.

Are children reliable reporters?

Journal of Abnormal Child Psychology

(1975)

B. Herjauic et al.

Development of a structured psychiatric interview: Agreement between child and parent on individual symptoms

Journal of Abnormal Child Psychology

(1982)

T. Jacob et al.

Family assessment: Rationale, methods and future directions

(1988)

E.M. James et al.

Self-report instruments

J.H. Kashani et al.

Correlates of anxiety in psychiatrically hospitalized children and their parents

American Journal of Psychiatry

(1990)

A.E. Kazdin

The effectiveness of suggestion and pretesting on avoidance reduction in fearful subjects

Journal of Behavior Therapy and Experimental Psychiatry

(1973)

Cited by (30)

Behavioral Treatments for Anxiety in Minimally Verbal Children with ASD
2017, Anxiety in Children and Adolescents with Autism Spectrum Disorder: Evidence-Based Assessment and Treatment
Determining the presence of anxiety in minimally verbal children with ASD can be especially challenging given their limited ability to self-report coupled with the overlapping features of anxiety and ASD. In contrast to verbal individuals, for whom the verbal/cognitive and subjective response domains are customarily assessed, assessment in this population is often limited to the behavioral domain. We use the term anxious avoidance to refer to avoidant behavior associated with traditional indicators of anxiety (e.g., fearful affect); and simple avoidance to refer to avoidance of nonpreferred situations not associated with apparent anxiety. Behavioral assessment should include the use of parent report measures, naturalistic and structured observations, analysis of parent–child interactions that may reinforce anxiety and avoidant behavior, and evaluation of parental anxiety. Graduated exposure and related interventions demonstrated to be effective with typically developing children appear applicable to individuals with ASD—though minimally verbal children will likely be unable participate in cognitive-behavioral therapies.
Treatment of children's nighttime fears: The need for a modern randomised controlled trial
2007, Clinical Psychology Review
Children's nighttime fears are common and cause significant interference to the child's functioning as well as causing much distress for the child and family. Therefore, effective and cost-efficient interventions are urgently needed by mental health professionals and counsellors. The authors review 29 studies, which investigated the efficacy of psychosocial treatment for children's nighttime fears. Most studies employed multiple baseline across subject designs or between group designs and most employed cognitive-behavioral techniques (i.e., desensitisation, emotive imagery, cognitive self-instruction, and reinforcement procedures). Although multi-method, informant assessments were not always conducted, in most studies rapid reduction of nighttime fears was typically achieved after only a few sessions with maintenance of gains. On the basis of our review, we make recommendations about assessment and intervention issues for the effective treatment of children's nighttime fears. Finally, future research directions are discussed including the need for a modern randomised clinical trial to more fully investigate treatment efficacy and the role of non-specific treatment factors.
Analogue and virtual reality assessment
2006, Clinician's Handbook of Child Behavioral Assessment
Analogue assessment is defined as direct, systematic behavioral observations made of child behavior in a clinic or laboratory setting, especially where efforts are made to have the setting approximate, in some ways, more natural situations. Virtual reality technology is the most recent advance in the field of analogue assessment and it falls into the enactment/role-play category. It is defined as a three-dimensional interface that puts the interacting subject in a condition of active exchange with a world re-created via the computer. This chapter reviews the background information on analogue and virtual reality (VR) assessment, which are two relatively new developments in the childhood behavioral assessment field. It begins with a broad and theoretical approach by providing general background information on analogue and VR techniques and by describing how they address the aforementioned goals of behavioral assessment, including functional assessment, case conceptualization, and treatment planning for children. It also presents an illustrative example to demonstrate how these techniques can be used to accomplish these goals. It then reviews and critiques the empirical literature on the application of specific analogue and VR assessment techniques to diverse childhood problems. Finally, the chapter discusses the developmental considerations that have been largely ignored by the literature.
The etiology of specific fears and phobias in children: A critique of the non-associative account
2002, Behaviour Research and Therapy
Citation Excerpt :
In these cases, a diagnosis of specific phobia should be considered (see Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM-IV]; American Psychiatric Association [APA], 1994). While researchers have reached a considerable degree of consensus about the assessment and treatment of childhood specific phobias (King, Ollendick, & Murphy, 1997; Ollendick & King, 1998), their etiology remains a matter of some debate. Some researchers maintain that fears and phobias predominantly arise as a consequence of learning experiences.
The non-associative account of phobic etiology assumes that a number of specific fears (e.g., fear of heights, water, spiders, strangers, and separation) have an evolutionary background and may occur in the absence of learning experiences (e.g., conditioning). By this view, these specific fears pertain to stimuli that once posed a challenge to the survival of our prehistoric ancestors. Accordingly, they would emerge spontaneously during the course of normal development and only in a minority of individuals, these specific fears would persist into adulthood. While the non-associative approach has generated interesting findings, several critical points can be raised. First, it capitalizes on negative findings, i.e., the failure to document learning experiences (e.g., conditioning, modeling) in the history of phobic children. Second, it largely ignores factors that have been found to be crucial for the acquisition of early childhood fears (e.g., the developmental level of the child, stimulus characteristics such as novelty, aversiveness, and unpredictability, and early experience with uncontrollable events). As an alternative to the non-associative account, we briefly describe a multifactorial model of childhood fears and phobias.
Behavioural and cognitive-behavioural interventions for sleep disorders in infants and children: A review
1999, Sleep Medicine Reviews
This review covers the literature on behavioural and cognitive-behavioural treatments for sleep disturbance in infants, pre-school, and school-age children. Treatment areas are dyssomnias (disorders of initiating, maintaining, or excessive sleep) and parasomnias (behaviours which occur predominantly during sleep). Interventions aimed at preventing sleep disorder through targeting infant sleep patterns are also examined. Controlled experimental studies are the main focus of this review but case studies and clinical reports are also included. It is concluded that, for families willing to undertake behavioural and cognitive-behavioural interventions, some treatments appear effective for some infant and child sleep problems, in the short term at least. The adequacy of current research is discussed, and suggestions for future research are given.
Current approaches to etiology and pathophysiology of specific phobia
1998, Biological Psychiatry
Specific phobia is a common, heterogeneous disorder whose central feature is persistent, unreasonable fear of a circumscribed object or situation. This article reviews current etiological theories and empirical data that seem likely to be important in investigating the pathophysiology of this disorder. These include conditioning, modified conditioning, and nonassociative models of phobia development, physiological response to the phobic stimulus, neuroimaging, primate, and biological challenge studies. Pathophysiological hypotheses suggested by recent research on the neurcircuitry of conditioned fear are also discussed. Though specific phobias have been of less public health and clinical interest than other anxiety disorders, their circumscribed nature and possible relationship to conditioned fear may make them a productive subject for research into basic pathophysiology.

View all citing articles on Scopus

View full text