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Gepubliceerd in: Child Psychiatry & Human Development 3/2018

08-12-2017 | Original Article

The Link Between Anxiety Severity and Irritability Among Anxious Youth: Evaluating the Mediating Role of Sleep Problems

Auteurs: Bridget Poznanski, Danielle Cornacchio, Stefany Coxe, Donna B. Pincus, Dana L. McMakin, Jonathan S. Comer

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 3/2018

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Abstract

Although recent studies have linked pediatric anxiety to irritability, research has yet to examine the mechanisms through which youth anxiety may be associated with irritability. Importantly, sleep related problems (SRPs) have been associated with both child anxiety and irritability, but research has not considered whether the link between youth anxiety and irritability may be accounted for by SRPs. The present study investigated whether SRPs mediated the relationship between anxiety severity and irritability in a large sample of treatment-seeking anxious youth (N = 435; ages 7–19 years, M = 12.7; 55.1% female). Anxiety severity, SRPs and irritability showed significant pairwise associations, and the indirect effect of youth anxiety severity on irritability, via SRPs, was positive and significant. The present analysis is the first to examine youth anxiety, irritability, and SPRs in a single model in a sample of anxious youth, and provides preliminary evidence that SRPs partially mediate links between child anxiety and irritability.
Literatuur
1.
go back to reference Costello EJ, Egger HL, Copeland W, Erkanli A, Angold A (2011) The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. In: Silverman WK, Field AP (eds) Anxiety disorders in children and adolescents, 2nd edn. Cambridge University Press, Cambridge Costello EJ, Egger HL, Copeland W, Erkanli A, Angold A (2011) The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. In: Silverman WK, Field AP (eds) Anxiety disorders in children and adolescents, 2nd edn. Cambridge University Press, Cambridge
2.
go back to reference Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber M et al (2012) Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69:372–380CrossRefPubMed Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber M et al (2012) Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69:372–380CrossRefPubMed
3.
go back to reference Langley AK, Bergman RL, McCracken J, Piacentini JC (2004) Impairment in childhood anxiety disorders: preliminary examination of the Child Anxiety Impact Scale-Parent Version. J Child Adolesc Psychopharmacol 14:105–114CrossRefPubMed Langley AK, Bergman RL, McCracken J, Piacentini JC (2004) Impairment in childhood anxiety disorders: preliminary examination of the Child Anxiety Impact Scale-Parent Version. J Child Adolesc Psychopharmacol 14:105–114CrossRefPubMed
4.
go back to reference Comer JS, Blanco C, Grant B, Hasin D, Liu SM, Turner JB, Olfson M (2011) Health-related quality of life across the anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 72:43–50CrossRefPubMed Comer JS, Blanco C, Grant B, Hasin D, Liu SM, Turner JB, Olfson M (2011) Health-related quality of life across the anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 72:43–50CrossRefPubMed
5.
go back to reference Lopez B, Turner RJ, Saavedra LM (2005) Anxiety and risk for substance dependence among late adolescents/young adults. J Anxiety Disord 19(3):275–294CrossRefPubMed Lopez B, Turner RJ, Saavedra LM (2005) Anxiety and risk for substance dependence among late adolescents/young adults. J Anxiety Disord 19(3):275–294CrossRefPubMed
6.
go back to reference Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG et al (1999) Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 29:9–17CrossRefPubMed Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG et al (1999) Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 29:9–17CrossRefPubMed
7.
go back to reference Althoff RR, Verhulst FC, Rettew DC, Hudziak JJ, van der Ende J (2010) Adult outcomes of childhood dysregulation: a 14-year follow-up study. J Am Acad Child Adolesc Psychiatry 49:1105–1116PubMedPubMedCentral Althoff RR, Verhulst FC, Rettew DC, Hudziak JJ, van der Ende J (2010) Adult outcomes of childhood dysregulation: a 14-year follow-up study. J Am Acad Child Adolesc Psychiatry 49:1105–1116PubMedPubMedCentral
8.
go back to reference Cornacchio D, Crum KI, Coxe S, Pincus DB, Comer JS (2016) Irritability and severity of anxious symptomatology among youth with anxiety disorders. J Am Acad Child Adolesc Psychiatry 55(1):54–61CrossRefPubMed Cornacchio D, Crum KI, Coxe S, Pincus DB, Comer JS (2016) Irritability and severity of anxious symptomatology among youth with anxiety disorders. J Am Acad Child Adolesc Psychiatry 55(1):54–61CrossRefPubMed
10.
go back to reference Pickles A, Aglan A, Collishaw S, Messer J, Rutter M, Maughan B (2010) Predictors of suicidality across the life span: the Isle of Wight Study. Psychol Med 40:1453–1466CrossRefPubMed Pickles A, Aglan A, Collishaw S, Messer J, Rutter M, Maughan B (2010) Predictors of suicidality across the life span: the Isle of Wight Study. Psychol Med 40:1453–1466CrossRefPubMed
11.
go back to reference Stringaris A (2011) Irritability in children and adolescents: a challenge for DSM-5. Eur Child Adolesc Psychiatry 20:61–66CrossRefPubMed Stringaris A (2011) Irritability in children and adolescents: a challenge for DSM-5. Eur Child Adolesc Psychiatry 20:61–66CrossRefPubMed
12.
go back to reference Stringaris A, Cohen P, Pine DS, Leibenluft E (2009) Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry 166:1048–1054CrossRefPubMedPubMedCentral Stringaris A, Cohen P, Pine DS, Leibenluft E (2009) Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry 166:1048–1054CrossRefPubMedPubMedCentral
13.
go back to reference Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A (2016) The status of irritability in psychiatry: a conceptual and quantitative review. J Am Acad Child Adolesc Psychiatry 55:556–570CrossRefPubMedPubMedCentral Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A (2016) The status of irritability in psychiatry: a conceptual and quantitative review. J Am Acad Child Adolesc Psychiatry 55:556–570CrossRefPubMedPubMedCentral
14.
go back to reference Stoddard J, Stringaris A, Brotman MA, Montville D, Pine DS, Leibenluft E (2013) Irritability in child and adolescent anxiety disorders. Depress Anxiety 31:566–573CrossRefPubMedPubMedCentral Stoddard J, Stringaris A, Brotman MA, Montville D, Pine DS, Leibenluft E (2013) Irritability in child and adolescent anxiety disorders. Depress Anxiety 31:566–573CrossRefPubMedPubMedCentral
15.
go back to reference Alfano CA, Pina AA, Zerr AA, Villalta IK (2010) Pre-sleep arousal and sleep problems of anxiety-disorders youth. Child Psychiatry Hum Dev 41:156–167CrossRefPubMed Alfano CA, Pina AA, Zerr AA, Villalta IK (2010) Pre-sleep arousal and sleep problems of anxiety-disorders youth. Child Psychiatry Hum Dev 41:156–167CrossRefPubMed
17.
go back to reference Palmer CA, Alfano CA (2016) Sleep architecture relates to daytime affect and somatic complaints in clinically-anxious but not healthy children. J Clin Child Psychol 46:175–187CrossRef Palmer CA, Alfano CA (2016) Sleep architecture relates to daytime affect and somatic complaints in clinically-anxious but not healthy children. J Clin Child Psychol 46:175–187CrossRef
18.
go back to reference Rubens SL, Evans SC, Becker SP, Fite PJ, Tountas AM (2017) Self-reported time in bed and sleep quality in association with internalizing and externalizing symptoms in school-age youth. Child Psychiatry Hum Dev 48:455–467CrossRefPubMed Rubens SL, Evans SC, Becker SP, Fite PJ, Tountas AM (2017) Self-reported time in bed and sleep quality in association with internalizing and externalizing symptoms in school-age youth. Child Psychiatry Hum Dev 48:455–467CrossRefPubMed
19.
20.
go back to reference Baum KT, Desai A, Field J, Miller LE, Rausch J, Beebe DW (2014) Sleep restriction worsens mood and emotion regulation in adolescents. J Child Psychol Psychiatry 55:180–190CrossRefPubMed Baum KT, Desai A, Field J, Miller LE, Rausch J, Beebe DW (2014) Sleep restriction worsens mood and emotion regulation in adolescents. J Child Psychol Psychiatry 55:180–190CrossRefPubMed
21.
go back to reference Carvalho Bos S, Gomes A, Clemente V, Marques M, Pereira AT, Maia B et al (2009) Sleep and behavioral/emotional problems in children: a population-based study. Sleep Med 10:66–74CrossRefPubMed Carvalho Bos S, Gomes A, Clemente V, Marques M, Pereira AT, Maia B et al (2009) Sleep and behavioral/emotional problems in children: a population-based study. Sleep Med 10:66–74CrossRefPubMed
22.
go back to reference Magee CA, Gordon R, Caputi P (2014) Distinct developmental trends in sleep duration during early childhood. Pediatrics 133:e1561–e1567CrossRefPubMed Magee CA, Gordon R, Caputi P (2014) Distinct developmental trends in sleep duration during early childhood. Pediatrics 133:e1561–e1567CrossRefPubMed
23.
go back to reference Minde K, Faucon A, Falkner S (1994) Sleep problems in toddlers: effects of treatment on their daytime behavior. J Am Acad Child Adolesc Psychiatry 33(8):1114–1121CrossRefPubMed Minde K, Faucon A, Falkner S (1994) Sleep problems in toddlers: effects of treatment on their daytime behavior. J Am Acad Child Adolesc Psychiatry 33(8):1114–1121CrossRefPubMed
24.
go back to reference Mindell JA, Meltzer LJ, Carskadon MA, Chervn RD (2009) Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Med 10(7):771–779CrossRefPubMed Mindell JA, Meltzer LJ, Carskadon MA, Chervn RD (2009) Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Med 10(7):771–779CrossRefPubMed
25.
go back to reference Mindell JA, Owens JA, Carskadon MA (1999) Developmental features of sleep. Child Adolesc Psychiatr Clin N Am 8:695–725PubMed Mindell JA, Owens JA, Carskadon MA (1999) Developmental features of sleep. Child Adolesc Psychiatr Clin N Am 8:695–725PubMed
26.
go back to reference Chase RM, Pincus DB (2011) Sleep-related problems in children and adolescents with anxiety disorders. Behav Sleep Med 9(4):224–236CrossRefPubMed Chase RM, Pincus DB (2011) Sleep-related problems in children and adolescents with anxiety disorders. Behav Sleep Med 9(4):224–236CrossRefPubMed
27.
go back to reference Hansen BH, Skirbekk B, Oerbeck B, Wentzel-Larsen T, Kristensen H (2013) Persistence of sleep problems in children with anxiety and attention deficit hyperactivity disorders. Child Psychiatry Hum Dev 44:290–304CrossRefPubMed Hansen BH, Skirbekk B, Oerbeck B, Wentzel-Larsen T, Kristensen H (2013) Persistence of sleep problems in children with anxiety and attention deficit hyperactivity disorders. Child Psychiatry Hum Dev 44:290–304CrossRefPubMed
28.
29.
go back to reference Boylan K, Rowe R, Duku E, Waldman I, Stepp S, Hipwell A et al (2017) Longitudinal profiles of girls’ irritable, defiant and antagonistic oppositional symptoms: evidence for group based differences in symptom severity. J Abnorm Child Psychol 45:1133–1145CrossRefPubMed Boylan K, Rowe R, Duku E, Waldman I, Stepp S, Hipwell A et al (2017) Longitudinal profiles of girls’ irritable, defiant and antagonistic oppositional symptoms: evidence for group based differences in symptom severity. J Abnorm Child Psychol 45:1133–1145CrossRefPubMed
30.
go back to reference Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ (2014) Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 53:550–558CrossRefPubMedPubMedCentral Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ (2014) Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 53:550–558CrossRefPubMedPubMedCentral
31.
go back to reference Silverman WK, Albano AM (1997) Anxiety disorders interview schedule for DSM–IV, child and parent versions. Psychological Corporation, San Antonio Silverman WK, Albano AM (1997) Anxiety disorders interview schedule for DSM–IV, child and parent versions. Psychological Corporation, San Antonio
32.
go back to reference Silverman WK, Ollendick TH (2005) Evidence-based assessment of anxiety and its disorders in children and adolescents. J Clin Child Psychol 34:380–411CrossRef Silverman WK, Ollendick TH (2005) Evidence-based assessment of anxiety and its disorders in children and adolescents. J Clin Child Psychol 34:380–411CrossRef
33.
go back to reference Comer JS, Kendall PC (2004) A symptom-level examination of parent-child agreement in the diagnosis of anxious youths. J Am Acad Child Adolesc Psychiatry 43:878–886CrossRefPubMed Comer JS, Kendall PC (2004) A symptom-level examination of parent-child agreement in the diagnosis of anxious youths. J Am Acad Child Adolesc Psychiatry 43:878–886CrossRefPubMed
35.
go back to reference Alfano CA, Ginsburg GS, Newman Kingery J (2007) Sleep-related problems among children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 46(2):224–232CrossRefPubMed Alfano CA, Ginsburg GS, Newman Kingery J (2007) Sleep-related problems among children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 46(2):224–232CrossRefPubMed
36.
go back to reference Alfano CA, Zakem AH, Costa NM, Taylor LK, Weems CF (2009) Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents. Depress Anxiety 26:503–512PubMed Alfano CA, Zakem AH, Costa NM, Taylor LK, Weems CF (2009) Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents. Depress Anxiety 26:503–512PubMed
37.
go back to reference Storch EA, Murphy TK, Lack CW, Geffken GR, Jacob ML, Goodman WK (2008) Sleep-related problems in pediatric obsessive-compulsive disorder. J Anxiety Disord 22(5):877–885CrossRefPubMed Storch EA, Murphy TK, Lack CW, Geffken GR, Jacob ML, Goodman WK (2008) Sleep-related problems in pediatric obsessive-compulsive disorder. J Anxiety Disord 22(5):877–885CrossRefPubMed
38.
go back to reference Achenbach TM, Rescorla LA (2001) Manual for ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth, and Families, Burlington Achenbach TM, Rescorla LA (2001) Manual for ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth, and Families, Burlington
39.
go back to reference Chorpita BF, Yim L, Moffit C, Umemoto LA, Francis SE (2000) Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 38:835–855CrossRefPubMed Chorpita BF, Yim L, Moffit C, Umemoto LA, Francis SE (2000) Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 38:835–855CrossRefPubMed
40.
go back to reference Wiggins JL, Mitchell C, Stringaris A, Leibenluft E (2014) Developmental trajectories of irritability and bidirectional associations with maternal depression. J Am Acad Child Adolesc Psychiatry 53:1191–1205CrossRefPubMedPubMedCentral Wiggins JL, Mitchell C, Stringaris A, Leibenluft E (2014) Developmental trajectories of irritability and bidirectional associations with maternal depression. J Am Acad Child Adolesc Psychiatry 53:1191–1205CrossRefPubMedPubMedCentral
41.
go back to reference Stringaris A, Zavos H, Leibenluft E, Maughan B, Eley TC (2012) Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry 169(1):47–54CrossRefPubMed Stringaris A, Zavos H, Leibenluft E, Maughan B, Eley TC (2012) Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry 169(1):47–54CrossRefPubMed
42.
go back to reference Roberson-Nay R, Leibenluft E, Brotman MA et al (2015) Longitudinal stability of genetic and environmental influences on irritability: from childhood to young adulthood. Am J Psychiatry 172:657–664CrossRefPubMed Roberson-Nay R, Leibenluft E, Brotman MA et al (2015) Longitudinal stability of genetic and environmental influences on irritability: from childhood to young adulthood. Am J Psychiatry 172:657–664CrossRefPubMed
43.
go back to reference Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Press, New York Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Press, New York
44.
go back to reference Taylor AB, MacKinnon DP, Tein JY (2008) Tests of the three-path mediated effect. Organ Res Methods 11:241–269CrossRef Taylor AB, MacKinnon DP, Tein JY (2008) Tests of the three-path mediated effect. Organ Res Methods 11:241–269CrossRef
45.
go back to reference Dahl RE (1996) The impact of inadequate sleep on children’s daytime cognitive function. Semin Pediatr Neurol 3:44–50CrossRefPubMed Dahl RE (1996) The impact of inadequate sleep on children’s daytime cognitive function. Semin Pediatr Neurol 3:44–50CrossRefPubMed
46.
go back to reference McMakin DL, Dahl RE, Buysse DJ, Cousins JC, Forbes EE, Silk JS et al (2016) The impact of experimental sleep restriction on affective functioning in social and nonsocial contexts among adolescents. J Child Psychol Psychiatry 57(9):1027–1037CrossRefPubMed McMakin DL, Dahl RE, Buysse DJ, Cousins JC, Forbes EE, Silk JS et al (2016) The impact of experimental sleep restriction on affective functioning in social and nonsocial contexts among adolescents. J Child Psychol Psychiatry 57(9):1027–1037CrossRefPubMed
47.
go back to reference Brown TA, Barlow DH (2009) A proposal for a dimensional classification system based on shared features of the DSM-IV anxiety and mood disorders: implications for assessment and treatment. Psychol Assess 21(3):256CrossRefPubMedPubMedCentral Brown TA, Barlow DH (2009) A proposal for a dimensional classification system based on shared features of the DSM-IV anxiety and mood disorders: implications for assessment and treatment. Psychol Assess 21(3):256CrossRefPubMedPubMedCentral
48.
go back to reference Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K et al (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 167(7):748–751CrossRefPubMed Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K et al (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 167(7):748–751CrossRefPubMed
49.
go back to reference Maxwell SE, Cole DA (2007) Bias in cross-sectional analyses of longitudinal mediation. Psychol Methods 12(1):23CrossRefPubMed Maxwell SE, Cole DA (2007) Bias in cross-sectional analyses of longitudinal mediation. Psychol Methods 12(1):23CrossRefPubMed
50.
go back to reference Savage J, Verhulst B, Copeland W, Althoff RR, Lichetnstin P, Roberson-Nay RA (2015) A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms. J Am Acad Child Adolesc Psychiatry 54:377–384CrossRefPubMedPubMedCentral Savage J, Verhulst B, Copeland W, Althoff RR, Lichetnstin P, Roberson-Nay RA (2015) A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms. J Am Acad Child Adolesc Psychiatry 54:377–384CrossRefPubMedPubMedCentral
51.
go back to reference Nadeau JM, Arnold EB, Keene AB, Collier AC, Lewin AB, Murphy TK, Storch EA (2015) Frequency and clinical correlates of sleep-related problems among anxious youth with autism spectrum disorders. Child Psychiatry Hum Dev 46:558–566CrossRefPubMed Nadeau JM, Arnold EB, Keene AB, Collier AC, Lewin AB, Murphy TK, Storch EA (2015) Frequency and clinical correlates of sleep-related problems among anxious youth with autism spectrum disorders. Child Psychiatry Hum Dev 46:558–566CrossRefPubMed
52.
go back to reference Caporino NE, Read KL, Shiffrin N, Settipani C, Kendall PC, Compton SN et al (2017) Sleep-related problems and the effects of anxiety treatment in children and adolescents. J Clin Child Psychol 46:675–685CrossRef Caporino NE, Read KL, Shiffrin N, Settipani C, Kendall PC, Compton SN et al (2017) Sleep-related problems and the effects of anxiety treatment in children and adolescents. J Clin Child Psychol 46:675–685CrossRef
53.
go back to reference Isper JC, Stein DJ, Hawkridge S, Hoppe L (2009) Pharmacotherapy for anxiety disorders in children and adolescents. Cochrane Database System Rev 3:CD005170 Isper JC, Stein DJ, Hawkridge S, Hoppe L (2009) Pharmacotherapy for anxiety disorders in children and adolescents. Cochrane Database System Rev 3:CD005170
54.
go back to reference Peterman JS, Carper MM, Elkins RM, Comer JS, Pincus DB, Kendall PC (2016) The effects of cognitive behavioral therapy for youth anxiety on sleep problems. J Anxiety Disord 37:78–88CrossRefPubMed Peterman JS, Carper MM, Elkins RM, Comer JS, Pincus DB, Kendall PC (2016) The effects of cognitive behavioral therapy for youth anxiety on sleep problems. J Anxiety Disord 37:78–88CrossRefPubMed
55.
go back to reference Rynn MA, Walkup JT, Compton SN, Sakolsky DJ, Sherrill JT, Shen S et al (2015) Child/adolescent anxiety multimodal study: evaluating safety. J Am Acad Child Adolesc Psychiatry 54:180–190CrossRefPubMed Rynn MA, Walkup JT, Compton SN, Sakolsky DJ, Sherrill JT, Shen S et al (2015) Child/adolescent anxiety multimodal study: evaluating safety. J Am Acad Child Adolesc Psychiatry 54:180–190CrossRefPubMed
56.
go back to reference Strawn JR, Welge JA, Wehry AM, Keeshin BR, Rynn MA (2015) Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety 32:149–157CrossRefPubMed Strawn JR, Welge JA, Wehry AM, Keeshin BR, Rynn MA (2015) Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety 32:149–157CrossRefPubMed
57.
go back to reference Walkup JT, Albano AM, Piacentini J, Boris B, Compton SN, Sherrill J et al (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359:2753–2766CrossRefPubMedPubMedCentral Walkup JT, Albano AM, Piacentini J, Boris B, Compton SN, Sherrill J et al (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359:2753–2766CrossRefPubMedPubMedCentral
Metagegevens
Titel
The Link Between Anxiety Severity and Irritability Among Anxious Youth: Evaluating the Mediating Role of Sleep Problems
Auteurs
Bridget Poznanski
Danielle Cornacchio
Stefany Coxe
Donna B. Pincus
Dana L. McMakin
Jonathan S. Comer
Publicatiedatum
08-12-2017
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 3/2018
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-017-0769-1

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