2002 — 2006 |
Pincus, Donna B. |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Treatment of Separation Anxiety Disorder in Childhood
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.
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2006 — 2009 |
Pincus, Donna B. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Intensive Treatment of Adolescent Panic and Agoraphobia
[unreadable] DESCRIPTION (provided by applicant): Panic Disorder with or without agoraphobia (PDA) in adolescents is prevalent, chronic, and associated with substantial impairment, including avoidance of school, disruption of peer involvement and avoidance of autonomous activities. Perhaps for this reason, PDA is associated with more depression in adolescents compared to other anxiety disorders. Effective treatments for PDA exist in adults. In a study nearing completion at our center, we are demonstrating that a developmental adaptation of an empirically supported cognitive-behavioral treatment for PDA is effective compared to a wait-list control group. However, a rather high percentage of adolescents have refused to enter the trial due mostly to the length and timing of sessions (weekly sessions for three months of treatment). Families reported wanting more immediate relief from the significant impairment and disruption of everyday activities their adolescents were experiencing. Further, parents were not significantly involved in treatment despite their eagerness to be involved. Substantial evidence now exists that the inclusion of parents in the treatment of adolescent PDA might provide additional clinical benefit. Finally, a substantial integrated situational and interoceptive exposure component was not included in adolescents' treatment. The purpose of this application is to evaluate the efficacy and acceptability of a brief, developmentally tailored eight-day intensive treatment for PDA in adolescents referred to as adolescent panic control treatment with exposure (APE) relative to a waitlist control group and to explore the relative impact of involving parents directly in treatment. Ninety patients aged 12-17 will be randomly assigned to one of three conditions: intensive treatment including family members, intensive treatment without family members, or a waitlist control group. The specific goals of this project are: (1) to evaluate the efficacy of intensive APE for reducing symptoms of PDA in adolescents, (2) to assess long term durability of effects at 3, 6, and 12 months following treatment, (3) to assess the relative advantage of involving parents in treatment, (4) to assess the impact of treatment on impairment and quality of life of adolescents and their families, and (5) to analyze hypothesized mechanisms of change. [unreadable] [unreadable]
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