research
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Intervention Research Head: Prof. Dr. Silvia Schneider |
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| Study participation |
Principal Investigator and Team
Prof. Dr. Silvia Schneider
Prof. Dr. Jürgen Margraf
Dr. Dirk Adolph
Michael Lippert, M.Sc.
Dr. Verena Pflug
Dipl. Stat. Xiao Chi Zhang
Collaborator
Technische Universität
Dresden, Prof. Hans-Ulrich Wittchen
Albert-Ludwigs-Universität Freiburg, Prof. Brunna
Tuschen-Caffier
Universität Koblenz-Landau, Prof. Tina In-Albon
Philipps-Universität Marburg, Prof. Hanna Christiansen
Universitätsklinikum Würzburg, Prof. Marcel Romanos
Funding
Bundesministerium für Bildung
und Forschung (Förderkennzeichen 01EE14202C)
Duration
Since April 2015
Description
The goal of the present trial is to improve our
understanding of a disorder-specific use of parental participation in
psychological treatment of childhood anxiety disorders. In sharp contrast to
adult anxiety disorders, childhood anxiety disorders are under-researched in
spite of their high prevalence, strong continuity into adulthood and powerful
prediction of adult disorders. However, effective treatments share exposure
interventions and thus extinction learning as a core ingredient. Basic research
indicates that suboptimal conditions for extinction learning and context
conditioning with the parents as powerful context variable could explain poorer
extinction learning and higher return of fear in children. Thus, we will
administer high doses of extinction trials with vs. without parental
participation to examine the disorder-specific efficacy of parental
participation. We expect that for separation anxiety disorder, but not for
specific phobia and social anxiety disorder, parent inclusion decreases return
of fear and yields more lasting treatment effects via optimizing extinction
learning. To test the hypothesis, we conduct a multicenter randomized clinical
trial with 400 children aged 8 to 16 years with a primary diagnosis of
separation anxiety, specific phobia or generalized anxiety disorder. The
treatment consists of 16 sessions á 60 min. (5 sessions over 4 weeks for
psychoeducation + rationale, 5 double sessions of IPI over 3 weeks, 1 session
for relapse prevention). While half of the children will attend treatment with
their parents the other half will attend without parents, but will receive the
same treatment ingredients. Before and after treatment children will be studied
in the psychophysiological lab to investigate extinction learning, contextual
fear and extinction deficits. Blood samples will be collected to study DNA
methylation in the pathogenesis, as predictors of therapy response and as
potential correlates of extinction elements in psychotherapy of anxiety
disorders.
The present
study has the goal to generate evidence-based recommendations for clinical
guidelines. The proposed study will disseminate effective treatments and build
new centers for the treatment of childhood anxiety disorders and thus improve
psychotherapy services in Germany for the most common mental disorders in
childhood. It is expected that early successful treatment