Treatment of Separation Anxiety Disorder in Childhood

描述(由申请人提供)：本申请是为了向NIMH申请一项有指导的以患者为导向的研究职业发展奖(K23)，以促进申请人Donna B.Pincus博士的学术生涯发展。申请人将与她的主要导师David Barlow博士以及共同导师Sheila Eyberg博士、Thomas Ollendick博士、Anne Marie阿尔巴o博士和Simon Budman博士密切合作，以发展进行临床研究的专业知识，以建立针对患有焦虑症的幼儿的创新且有效的干预措施。在一份跨越五年的职业发展计划中，申请者描绘了具体的短期和长期目标，为她以患者为导向的研究职业生涯做好准备。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，这些领域已经被选中，以加深她现有的技能，并将她的技能扩展到新的领域。申请者的长期目标是开发一系列方案研究，专注于开发有效的、创新的儿童焦虑症治疗方法，并作为一名临床科学家开始一项富有成效的研究生涯。提出了一项正式的研究计划，以调查儿童时期最普遍、但研究最少的焦虑症：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，但很少有治疗研究调查SAD干预措施的有效性；那些确实存在的研究通常不包括幼儿。最近的实验证据强调了在儿童焦虑症的治疗中让父母更集中地参与治疗的潜在临床效用。拟议研究计划的主要目标是将现有的、有经验支持的父母培训干预(亲子互动疗法；PCIT)应用于治疗4-8岁患有SAD的儿童。尽管PCIT最初是为治疗对立儿童而设计的，但它包含了研究人员指出的每一项技能，作为减少儿童焦虑的基本训练组成部分，因此，预计将有效地减少儿童分离恐惧行为，并促进改善亲子互动。本项目的具体目标是：(1)评估PCIT对减少幼儿分离焦虑行为的有效性(2)评估治疗后3、6和12个月变化的长期维持情况(3)探讨改善的潜在机制。这项研究项目将是对患有分离焦虑的非常年幼的儿童进行的第一项对照临床试验，因此，将开始填补我们对这一高危人群的认识的一个重大空白。该项目将为申请者提供坚实的技能基础，为焦虑症儿童及其家庭继续开发创新的、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.