Treatment of Child Anxiety in Pediatric Medical Settings

描述（由申请人提供）：这份重新提交的R34申请是为了响应NIMH关于精神健康干预研究探索性/开发性资助的项目公告（PAR-03-078）。总体目标是在初级保健机构中进一步确定和治疗儿童焦虑症。焦虑症非常普遍，并与严重的长期残疾有关。这些障碍发病早，持续时间长，往往对以后的调整有重大影响。大多数焦虑症没有被确诊和治疗。未能进行干预是一个重大的公共卫生问题。增加早期识别、适当转诊和获得有效治疗可能会减少疾病的负面影响。本报告提出了一种认知行为干预的发展，用于儿童医疗环境中无法解释的躯体投诉和焦虑症的儿童。大量的研究表明，躯体疾病和未确诊的焦虑症之间有着密切的关系，在普通儿科人群中，焦虑症的患病率也很高。然而，目前还没有研究针对儿科医疗环境中焦虑症的识别和治疗制定策略。这个应用程序旨在解决这个被忽视的临床问题。我们建议开发一种专门用于治疗焦虑症和相关躯体疾病的干预措施，并采用非传统的服务形式实施干预，在儿科医疗办公室的主持下提供治疗。

DESCRIPTION (provided by applicant): This R34 resubmitted application is in response to the NIMH program announcement on Exploratory/Development Grants for Mental Health Intervention Research (PAR-03-078). The overall goal is to further the identification and treatment of childhood anxiety disorders in primary care settings. Anxiety disorders are highly prevalent and associated with significant long-term disability. These disorders have early onsets, persist over time, and often have significant consequences for later adjustment. The majority of anxiety disorders are not identified and treated. The failure to intervene represents a major public health concern. Increased early recognition, appropriate referral, and access to effective treatments would likely reduce the disorders' negative impact. This submission proposes the development of a cognitive behavioral intervention for children with unexplained somatic complaints and anxiety disorders in pediatric medical settings. Vast research demonstrates a strong relationship between somatic complaints and undiagnosed anxiety disorders, as well as a high prevalence of anxiety disorders in general pediatric populations. No research, however, has been conducted to develop strategies for the identification and treatment of anxiety disorders in pediatric medical settings. This application is designed to address this neglected clinical issue. We propose to develop an intervention specifically designed to treat anxiety disorders and associated somatic complaints, and to implement the intervention using a nontraditional form of service delivery, offering treatment within the auspices of pediatric medical offices.