Breaking new ground in treatment of pediatric patients
Children as young as four can suffer from full-blown anxiety disorders, such as obsessive compulsive disorder (OCD). Young children with OCD benefit markedly from family-based treatment. And a family history of OCD can predict how children will respond to common treatment approaches, assisting clinicians in selecting the appropriate therapy.
These and other important recent findings stem from the research of leading early childhood anxiety experts Abbe Mars Garcia, PhD and Jennifer B. Freeman, PhD, conducted through their Pediatric Anxiety Research Clinic at the Bradley Hasbro Children's Research Center.
The clinic, affiliated with The Warren Alpert Medical School of Brown University, provides assessment and treatment for children with OCD and other anxiety disorders. Among their ongoing studies, funded by the National Institute for Mental Health, are a collaborative effort (with Duke University Medical Center and the University of Pennsylvania School of Medicine) to test two treatment models for children ages five to eight with OCD. Patients are evaluated and then randomly assigned to either family-based cognitive behavioral treatment or family-based relaxation therapy.
Another study explores parenting and temperament effects on childhood anxiety disorders, with the goal of developing effective treatment. Through micro-analytic coding of parental behavior and physiological monitoring of children's reactive heart rate and respiration, the study assesses how anxious children and mothers interact and discuss problems.
A study now in the data analysis phase tracked children and adolescents ages 7 to 17 with OCD, evaluating their response to three different combinations of treatment
involving medication and varying intensities of cognitive behavioral treatment. The final outcome paper has been submitted to the Journal of the American Medical Association.
And finally, Garcia and Freeman are partnering with other institutions in a multi-site genetics study aimed at identifying susceptibility genes for OCD.
"OCD looks like it is a genetic illness, and kids might be the most genetically loaded segment of the population," says Garcia. "We don't know a lot about it, so we are collaborating on a study that investigates the genetic link." Meanwhile, she stresses, "We do know that little kids benefit from family-based cognitive behavioral treatment. Through a series of scaffolding steps, we can teach parents the skills to cope with their children's anxiety, as well as their own anxiety. And we can help children effectively manage the disorder."