Treatment of Separation Anxiety Disorder in Childhood

描述（由申请人提供）：本申请是NIMH的一个指导性的以患者为导向的研究职业发展奖（K23）的请求，以促进申请人唐娜B的学术职业发展。Pincus博士申请人将与她的主要导师大卫巴洛博士和共同导师希拉·艾伯格博士、托马斯·奥伦迪克博士、安妮·玛丽·阿尔巴诺博士和西蒙·布德曼博士密切合作，发展进行临床研究的专业知识，为患有焦虑症的幼儿建立创新和有效的干预措施。在一个跨越五年的职业发展计划中，申请人已经划定了具体的短期和长期目标，为她以病人为导向的研究生涯做好准备。短期目标包括在几个“核心”领域获得额外的教学培训和指导，这些领域是为了深化她的现有技能并将她的技能扩展到新领域。申请人的长期目标是开发一个程序化的研究路线，重点是开发有效的，创新的治疗儿童焦虑症，并启动一个高效的研究生涯作为临床科学家。一项正式的研究计划被提出来调查最普遍的，但研究最不足的儿童焦虑症：分离焦虑症（SAD）。尽管越来越多的证据表明SAD在幼儿中普遍存在，并与后来的精神病理学有关，但很少有研究调查SAD干预措施的疗效的治疗研究;那些确实存在的研究通常不包括幼儿。最近的实验证据突出了将父母更集中地纳入儿童焦虑症治疗的潜在临床效用。拟议的研究计划的主要目标是应用现有的，经验支持的父母培训干预（亲子互动疗法; PCIT），以治疗4-8岁的儿童SAD。虽然最初被设计为对立儿童的治疗，PCIT整合了焦虑研究人员指出的每一种技能，作为减少儿童焦虑的必要训练成分，因此，预计将有效减少儿童的分离恐惧行为，并促进改善亲子互动。本项目的具体目标是：（1）评估PCIT减少幼儿分离焦虑行为的疗效（2）评估治疗后3个月、6个月和12个月的长期维持变化（3）研究潜在的改善机制。这项研究项目将是第一个对照临床试验，已进行了非常年幼的儿童与分离焦虑，因此，将开始，以填补一个显着的差距，我们的知识，这一风险人群。该项目将为申请人提供一个坚实的技能基础，为焦虑症儿童及其家庭持续开发创新的，经经验验证的干预措施。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from the NIMH to foster the academic career development of the applicant, Donna B. Pincus, Ph.D. The applicant will work closely with her primary mentor, Dr. David Barlow, and co-mentors, Dr. Sheila Eyberg, Dr. Thomas Ollendick, Dr. Anne Marie Albano, and Dr. Simon Budman, to develop expertise in conducting clinical research to establish innovative and efficacious interventions for young children with anxiety disorders. In a career development plan spanning five years, the applicant has delineated specific short-term and long-term goals to prepare her for a patient-oriented research career. Short term goals include obtaining additional didactic training and mentoring in several "core" areas that have been chosen to deepen her existing skills as well as expand her skills into new areas. The applicant's long term goals are to develop a programmatic line of research that is focused on developing efficacious, innovative treatments for childhood anxiety disorders, and to launch a highly productive research career as a clinical scientist. A formal research plan is proposed to investigate the most prevalent, yet most under-researched anxiety disorder in childhood: Separation Anxiety Disorder (SAD). Despite growing evidence that SAD is prevalent in young children and linked to later psychopathology, there have been few treatment studies investigating the efficacy of interventions for SAD; those that do exist typically have not included young children. Recent experimental evidence highlights the potential clinical utility of incorporating parents more centrally in the treatment of childhood anxiety disorders. The primary goal of the proposed research plan is to apply an existing, empirically supported parent training intervention (Parent-Child Interaction Therapy; PCIT) to the treatment of children ages 4-8 with SAD. Although originally designed as a treatment of oppositional children, PCIT incorporates each of the skills anxiety researchers have indicated as essential training components for reducing child anxiety, and thus, is expected to be effective in reducing children's separation fearful behaviors and in promoting improved parent-child interactions. The specific goals of this project are: (1) to evaluate the efficacy of PCIT for reducing separation anxious behaviors in young children (2) to assess long term maintenance of change at 3, 6, and 12 months following treatment (3) to investigate potential mechanisms of improvement. This research project will be the first controlled clinical trial that has been conducted with very young children with separation anxiety, and thus, will begin to fill in a significant gap in our knowledge of this at-risk population. This project will provide the applicant with a solid foundation of skills for the continued development of innovative, empirically validated interventions for children with anxiety disorders and their families.