Anxiety Disorders

Child and Adolescent Anxiety Multimodal Study (CAMS)

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

Current Status: Recruiting Complete

This was a 6-year, multi-site, randomized controlled trial sponsored by the NIMH. The purpose of this study was to examine the relative efficacy of various treatments aimed at reducing symptoms of anxiety disorders (separation anxiety disorder, social phobia, and generalized anxiety disorder) in children and adolescents aged 7-17 years. A total of 488 youth with anxiety disorders were randomized to receive 12 weeks of sertraline (an SSRI), cognitive-behavioral-therapy (CBT), combination of sertraline and CBT, or pill placebo. Following treatment, youth completed a 6-month maintenance phase and were assessed by an independent evaluator at the end of treatment and 3 months and 6 months following treatment. Results indicated that treatment was effective in reducing anxiety symptoms in nearly 81% of children treated with combination therapy, 60% of those treated with CBT, and 55% of those treated with sertraline. All treatments were significantly more effective than placebo and combination therapy was superior to both CBT and sertraline alone. This comparative treatment trial confirms that SSRI, CBT, and especially their combination, are effective treatments that may offer hope to youth suffering from anxiety disorders and may alter the life trajectory of affected individuals.

Publications:

Walkup, J., Albano, A., Piacentini, J., Birmaher, B., Compton, S., Sherrill, J., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359, 2753-2766.

Kendall, P., Compton, S., Walkup, J., Birmaher, B., Albano, A., Sherrill, J., et al. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders.

Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS)

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

Current Status: In progress

This study, funded by the NIMH, is a multi-site long-term follow-up of the sample of children and adolescents with anxiety disorders who participated in the original CAMS study (N=488). The goal of this study is to examine the long-term psychiatric, physical, and functional outcomes of youth with anxiety disorders who were treated between 2002 – 2007 with CBT, sertraline, a combination of CBT and sertraline, or a placebo. Specifically, each child will be evaluated every six months (once by phone and once in person) on measures of psychopathology, psychosocial and physical functioning, and service utilization. Results from this study will inform the field about: 1) the preventive effects of successful treatment on the development of later psychopathology, 2) treatment durability, 3) potential long-term adverse treatment effects, and 4) predictors of relapse.

Family-Based Prevention for Childhood Anxiety

Principal Investigator: Golda S. Ginsburg, Ph.D

Current Status: Recruiting

VOLUNTEERS being recruited for this study. Click here if you are interested.

This 5-year study, funded by NIMH, evaluates the effectiveness of a brief, family-based program for preventing anxiety disorders in the offspring of anxious parents. Eligible participants include parents who have been diagnosed with an anxiety disorder and their 7- to12-year-old children. A total of 100 families will be randomly assigned to receive an 8-week family-based prevention program immediately or after 1 year. All participants are closely monitored.

Publications:

Ginsburg, G. S. (in press). The Child Anxiety Prevention Study (CAPS): Intervention model and primary outcomes. Journal of Consulting and Clinical Psychology.

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.  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.

VOLUNTEERS being recruited for this study - Click here if you are interested.

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.

Emotional Attention and Memory in Pediatric Anxiety Disorders

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

This study aims to extend our knowledge of the attentional and memory processes that underlie anxiety.  Primarily, we will explore the possibility that anxiety is associated with an attentional bias toward threat, as well as a memory bias for negative emotional information. Subjects complete a behavioral task which examines attentional allocation when subjects are presented simultaneously with emotional and non-emotional information; the second part tests whether there are memory biases for the emotional stimuli. 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. (IRB protocol #NA_00014313)

VOLUNTEERS being recruited for this study - Click here if you are interested.

Learn more about treatment of children and adolescents with Anxiety Disorders at Johns Hopkins