RESEARCH - Anxiety

Child and Adolescent Anxiety Multimodal Study

Principal Investigator: John T. Walkup, M.D.

This 6-year, multi-site randomized controlled trial is sponsored by the NIMH. The purpose of this study is to further our knowledge of the treatment of childhood anxiety disorders, specifically separation anxiety disorder, social phobia, and generalized anxiety disorder. This research compares the relative efficacy of sertraline, cognitive-behavioral-therapy (CBT), combination of sertraline and CBT, and pill placebo in reducing symptoms of anxiety and associated impairment in youth ages 7-17.

A total of 488 participants will be enrolled in the study, and approximately 100 of these will be at Johns Hopkins. The study design consists of two phases: a 12-week treatment phase, and a 6-month maintenance phase. Participants are assessed by independent evaluator at the end of treatment and 3 months and 6 months following treatment. Successful treatment of childhood anxiety disorders holds the hope of decreasing acute distress, and also altering the life trajectory of affected individuals. This comparative treatment trial should aid in answering the important question “which treatment works best for whom?”

Baltimore City Anxiety Treatment Study in the Schools (BCATSS)

Principal Investigator: Golda Ginsburg, Ph.D.

This 3-year study, funded by the NIMH, examines the effectiveness of cognitive-behavioral-therapy (CBT), when conducted in schools by school-based counselors for treating childhood anxiety disorders. Eligible children must have one of the following disorders: separation anxiety, social phobia, generalized anxiety, or specific phobia. The study compares the relative effectiveness of school-based CBT to usual care among 30 children in Baltimore city elementary and middle schools.

Publications:

Ginsburg, G.S. & Drake, K.L (2002).  School-based CBT for Anxious African-American Adolescents: A controlled Pilot Study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 768-775.

Investigation of Neural Differences in Emotional Attention in
Children with and without Pediatric Anxiety Disorders

Principal Investigator: Roma A. Vasa, M.D.

This NIMH sponsored study uses functional magnetic resonance imaging (fMRI) to examine brain differences underlying emotional attention in children with and without anxiety disorders. Boys and girls, ages 8 to 12 years, with one or more of the following disorders are eligible to participate: separation anxiety disorder, generalized anxiety disorder and social phobia. This study has two parts, which collectively take approximately 6 hours. In the first part, children will undergo a psychiatric evaluation to determine study eligibility. In the second part, eligible children will undergo a mock fMRI scan to familiarize them to the scanning environment. This will be followed by the real fMRI scan. None of these tests are harmful or painful and all testing is done free of charge. There are no direct medical benefits from taking part in the study. Participants will receive $100.00 and a picture of their brain. Results of this study may be useful for understanding what causes anxiety in children and may help to develop more focused assessment and treatment methods.

Publications:

Vasa, R. A., Grados, M., Slomine, B., Herskovitz, E. H., Thompson, R. E., Salorio, C., Christensen. J., Wurtsa, C., Riddle, M. A., Gerring, J. P. (2004). Neuroimaging correlates of anxiety after pediatric traumatic brain injury. Biological Psychiatry, 55(3), 208-216.

Vasa, R. A., Roberson-Nay, R., Klein, R. G., Mannuzza, S., Moulton, J. L., Guardino, M., Merikangas, A., Carlino, A. R., Pine, D. S. (2007). Memory deficits in children with and at risk for anxiety disorders. Depression and Anxiety, 24(2), 85-94.

Pilot Study: D-Cycloserine Augmentation of CBT for Social Phobia

Principal Investigator: Golda S. Ginsburg, Ph.D.

Social phobia is one of the most common psychiatric disorders in youth and is associated with significant impairment in school performance, social functioning, and family relationships. Both pharmacotherapy and cognitive-behavior-therapy (CBT) are efficacious treatments. However, many children do not improve with these treatments. This study capitalizes on the recent successes in translational research by investigating the relative benefits of the addition of D-cycloserine (DCS) to a standardized program of CBT to improve response rates social phobia. The specific aims of the study are to compare the benefits of DCS-augmented CBT relative to placebo-augmented CBT in socially anxious youth. Ten subjects, ages 8-17, will be treated for 10 weeks in this pilot study.