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Trends in research on child anxiety and school refusal
Clinical Psychology Review, Vol. 20, No. 4, pp. 427–428, 2000 Copyright © 2000 Elsevier Science Ltd. Printed in the USA. All rights reserved 0272-7358/00/$–see front matter
PII S0272-7358(99)00036-7
TRENDS IN RESEARCH ON CHILD ANXIETY AND SCHOOL REFUSAL: AN INTRODUCTION Neville J. King Monash University
Bruce J. Tonge Monash Medical Centre
A BURGEONING LITERATURE has now emerged on the epidemiology, assessment, treatment, and prevention of childhood anxiety disorders. This special issue of Clinical Psychology Review draws together a collection of five reviews of the available research literature on a number of select topics. In the first article, Eleonora Gullone’s (2000) reviews over a century’s research on the normal fears of children and adolescents. This author shows how a range of research methodologies have been used to determine whether fear content, prevalence, and intensity are significantly influenced by age, gender, socioeconomic status, and culture. In many ways this article helps set the stage for the more clinically focused papers that follow. Many assessment procedures and diagnostic tools are now available to clinicians and researchers interested in childhood phobias and anxiety disorders. In their article, Carolyn Schniering, Jennifer Hudson, and Ronald Rapee (2000) outline some of the major assessment methods: structured diagnostic interviews, self-reports, behavioral measures, cognitive measures, and psychophysiological measures. These authors remind us of the need for developmental sensitivity, reliability, and validity in the assessment of child anxiety. Fortunately, significant advances have been made in the treatment of anxiety disorders in children in children and adolescents. In her article, Paula Barrett (2000) provides an overview of research undertaken on the efficacy of cognitive-behavioral interventions with anxiety-disordered children. Quite correctly, this author reminds us of the need for treatment research to be guided by developmental considerations. The author
Correspondence should be addressed to Neville King, Faculty of Education, Monash University, Clayton, Victoria 3168, Australia. E-mail: [email protected]
427
428
N. J. King and B. J. Tonge
also points out that cultural and ethnic diversity have not been sufficiently addressed in treatment studies, thus seriously comprising the generalizability of research findings. Anxiety-based school refusal is a challenging problem for mental health professionals and school authorities. In recent years, cognitive-behavior therapy has emerged as possible cost-efficient and effective intervention. An article from our own research group (King, Tonge, Heyne, & Ollendick, 2000) reviews the clinical and research support for the efficacy of cognitive-behavior therapy with school-refusing children. At first glance, the findings are encouraging for the efficacy and acceptability of cognitive-behavioral treatment strategies. On the other hand, more conservative conclusions are reached when stringent criteria are applied regarding evidentiary support for psychosocial interventions. In the final article, Caroline Donovan and Susan Spence (Donovan & Spence, 2000) examine research developments in the prevention of childhood anxiety disorders. The authors show how research on childhood anxiety has identified many risk factors, somewhat fewer protective factors, and a number of treatment strategies. These advances help inform the way in which mental health professionals and researchers approach the prevention of childhood anxiety disorders. Although research on the prevention of childhood anxiety disorders is still in its infancy, recent findings are encouraging for the efficacy of preventive strategies with at risk children. Mindful of efforts to bridge the scientist-practitioner gap (Sobell, 1996), we hope that is special issue helps foster a reciprocal dialogue or exchange between mental health professionals and researchers interested in childhood anxiety disorders. Ideally, such an exchange should lead to improvements in clinical practice and service delivery for anxious children and their parents. At the same time, a positive exchange should help in the refinement of the many exciting future research possibilities as outlined by our contributors. REFERENCES Barrett, P. M. (2000). Treatment of childhood anxiety: Developmental aspects. Clinical Psychology Review, 20, 479–494. Donovan, C., & Spence, S. (2000). Prevention of childhood anxiety disorders. Clinical Psychology Review, 20, 509–531. Gullone, E. (2000). The development of normal fear: A century of research. Clinical Psychology Review, 20, 429–451. King, N., Tonge, B. J., Heyne, D., & Ollendick, T. H. (2000). Research on the cognitive-behavioral treatment of school refusal: A review and recommendations. Clinical Psychology Review, 20, 495–507. Schniering, C. A., Hudson, J. L., & Rapee, R. M. (2000). Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clinical Psychology Review, 20, 453–478. Sobell, L. C. (1996). Bridging the gap between scientists and practitioners: The challenge before us. Behavior Therapy, 27, 297–320.
PII S0272-7358(99)00036-7
TRENDS IN RESEARCH ON CHILD ANXIETY AND SCHOOL REFUSAL: AN INTRODUCTION Neville J. King Monash University
Bruce J. Tonge Monash Medical Centre
A BURGEONING LITERATURE has now emerged on the epidemiology, assessment, treatment, and prevention of childhood anxiety disorders. This special issue of Clinical Psychology Review draws together a collection of five reviews of the available research literature on a number of select topics. In the first article, Eleonora Gullone’s (2000) reviews over a century’s research on the normal fears of children and adolescents. This author shows how a range of research methodologies have been used to determine whether fear content, prevalence, and intensity are significantly influenced by age, gender, socioeconomic status, and culture. In many ways this article helps set the stage for the more clinically focused papers that follow. Many assessment procedures and diagnostic tools are now available to clinicians and researchers interested in childhood phobias and anxiety disorders. In their article, Carolyn Schniering, Jennifer Hudson, and Ronald Rapee (2000) outline some of the major assessment methods: structured diagnostic interviews, self-reports, behavioral measures, cognitive measures, and psychophysiological measures. These authors remind us of the need for developmental sensitivity, reliability, and validity in the assessment of child anxiety. Fortunately, significant advances have been made in the treatment of anxiety disorders in children in children and adolescents. In her article, Paula Barrett (2000) provides an overview of research undertaken on the efficacy of cognitive-behavioral interventions with anxiety-disordered children. Quite correctly, this author reminds us of the need for treatment research to be guided by developmental considerations. The author
Correspondence should be addressed to Neville King, Faculty of Education, Monash University, Clayton, Victoria 3168, Australia. E-mail: [email protected]
427
428
N. J. King and B. J. Tonge
also points out that cultural and ethnic diversity have not been sufficiently addressed in treatment studies, thus seriously comprising the generalizability of research findings. Anxiety-based school refusal is a challenging problem for mental health professionals and school authorities. In recent years, cognitive-behavior therapy has emerged as possible cost-efficient and effective intervention. An article from our own research group (King, Tonge, Heyne, & Ollendick, 2000) reviews the clinical and research support for the efficacy of cognitive-behavior therapy with school-refusing children. At first glance, the findings are encouraging for the efficacy and acceptability of cognitive-behavioral treatment strategies. On the other hand, more conservative conclusions are reached when stringent criteria are applied regarding evidentiary support for psychosocial interventions. In the final article, Caroline Donovan and Susan Spence (Donovan & Spence, 2000) examine research developments in the prevention of childhood anxiety disorders. The authors show how research on childhood anxiety has identified many risk factors, somewhat fewer protective factors, and a number of treatment strategies. These advances help inform the way in which mental health professionals and researchers approach the prevention of childhood anxiety disorders. Although research on the prevention of childhood anxiety disorders is still in its infancy, recent findings are encouraging for the efficacy of preventive strategies with at risk children. Mindful of efforts to bridge the scientist-practitioner gap (Sobell, 1996), we hope that is special issue helps foster a reciprocal dialogue or exchange between mental health professionals and researchers interested in childhood anxiety disorders. Ideally, such an exchange should lead to improvements in clinical practice and service delivery for anxious children and their parents. At the same time, a positive exchange should help in the refinement of the many exciting future research possibilities as outlined by our contributors. REFERENCES Barrett, P. M. (2000). Treatment of childhood anxiety: Developmental aspects. Clinical Psychology Review, 20, 479–494. Donovan, C., & Spence, S. (2000). Prevention of childhood anxiety disorders. Clinical Psychology Review, 20, 509–531. Gullone, E. (2000). The development of normal fear: A century of research. Clinical Psychology Review, 20, 429–451. King, N., Tonge, B. J., Heyne, D., & Ollendick, T. H. (2000). Research on the cognitive-behavioral treatment of school refusal: A review and recommendations. Clinical Psychology Review, 20, 495–507. Schniering, C. A., Hudson, J. L., & Rapee, R. M. (2000). Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clinical Psychology Review, 20, 453–478. Sobell, L. C. (1996). Bridging the gap between scientists and practitioners: The challenge before us. Behavior Therapy, 27, 297–320.