16 results on '"Kerstin Thirlwall"'
Search Results
2. Parents’ Perspectives on Guided Parent-Delivered Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Qualitative Study
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Doireann O’Brien, Cathy Creswell, Kerstin Thirlwall, Charlotte Allard, Alex Brown, and Peter J. Cooper
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medicine.medical_treatment ,Cognition ,behavioral disciplines and activities ,Education ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Clinical Psychology ,mental disorders ,Developmental and Educational Psychology ,medicine ,Childhood anxiety ,Effective treatment ,Anxiety ,medicine.symptom ,Psychology ,Clinical psychology ,Qualitative research - Abstract
Cognitive Behavioural Therapy (CBT) is an effective treatment for child anxiety disorders. Low intensity forms of CBT, such as guided parent-delivered CBT (GPD-CBT), have been developed in order to increase access; however, it is unclear why some children benefit from this treatment and others do not. This qualitative study aimed to increase understanding of parents’ experiences of GPD-CBT and what facilitates and creates barriers to good outcomes. The sample was derived from a sample of families who took part in long-term follow-up assessments (reported in Brown et al., 2017). Data were analysed using thematic analysis. Two themes, containing five sub-themes were developed from the data. Theme one described factors influencing the experience of GPD-CBT. Theme two described perceived outcomes in the child and wider changes within the family. The identification of facilitators and barriers to the success of GPD-CBT could inform and improve future treatment delivery.
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- 2021
3. When Teens Self-Harm : How Parents, Teachers and Professionals Can Provide Calm and Compassionate Support
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Monika Parkinson, Lucy Willetts, Kerstin Thirlwall, Monika Parkinson, Lucy Willetts, and Kerstin Thirlwall
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- Teenagers--Suicidial behavior, Adolescent psychology, Teenagers--Care
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Supporting teens who self-harm can be stressful, with panic and anxiety muddying the waters and making it difficult to know how to respond. How do you help? What if you make it worse?This book guides you through the potential reasons for self-harming behaviour, helping you to respond with compassion and support. Quotes from young people who self-harm give insight into the mindset behind the behaviour, while expert guidance gives you the tools to help. Advice on regulating your own emotions, combined with a better understanding of why teens self-harm, allows you to provide a safe, nurturing environment to support your young person and reduce their self-harming behaviour.Grounded in the authors'extensive clinical experience in young people's mental health, this book guides you out of panic mode to create a secure, validating environment for teens who self-harm.
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- 2024
4. The utility of the SCAS-C/P to detect specific anxiety disorders among clinically anxious children
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Ronald M. Rapee, Carla E. Marin, Mikael Thastum, Chantal Herren, Maaike H. Nauta, Susanna Roberts, Susan M. Bögels, Kristian Arendt, Peter J. Cooper, Cathy Creswell, Gro Janne Wergeland, Kathryn J. Lester, Kerstin Thirlwall, Einar Heiervang, Tessa Reardon, Robert Keers, Jonathan R. I. Coleman, Silvia Schneider, Judith Blatter-Meunier, Wendy K. Silverman, Jennifer L. Hudson, Thalia C. Eley, Heidi J. Lyneham, Sanne M. Hogendoorn, Clinical Psychology and Experimental Psychopathology, Academic Medical Center, Ontwikkelingspsychologie (Psychologie, FMG), Brain and Cognition, and Research Institute for Child Development and Education
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Male ,050103 clinical psychology ,SYMPTOMS ,Psychometrics ,diagnosis ,Mothers ,PsycINFO ,Sensitivity and Specificity ,anxiety disorders ,Surveys and Questionnaires ,father ,medicine ,Humans ,0501 psychology and cognitive sciences ,Child ,Psychiatric Status Rating Scales ,child ,Phobias ,mother ,05 social sciences ,Separation anxiety disorder ,Social anxiety ,DSM-IV ANXIETY ,Reproducibility of Results ,Articles ,CARE ,medicine.disease ,Anxiety Disorders ,DEPRESSION SCALE ,COMMUNITY ,Psychiatry and Mental health ,Clinical Psychology ,PSYCHOMETRIC PROPERTIES ,Generalized anxiety ,AGREEMENT ,RELIABILITY ,Anxiety ,Female ,medicine.symptom ,Psychology ,PARENT VERSIONS ,INTERVIEW SCHEDULE ,Anxiety scale ,Clinical psychology - Abstract
Questionnaire measures offer a time and cost-effective alternative to full diagnostic assessments for identifying and differentiating between potential anxiety disorders and are commonly used in clinical practice. Little is known, however, about the capacity of questionnaire measures to detect specific anxiety disorders in clinically anxious preadolescent children. This study aimed to establish the ability of the Spence Children's Anxiety Scale (SCAS) subscales to identify children with specific anxiety disorders in a large clinic-referred sample (N = 1,438) of children aged 7 to 12 years. We examined the capacity of the Separation Anxiety, Social Phobia, Generalized Anxiety, and Physical Injury Fears (phobias) subscales to discriminate between children with and without the target disorder. We also identified optimal cutoff scores on subscales for accurate identification of children with the corresponding disorder, and examined the contribution of child, mother, and father reports. The Separation Anxiety subscale was able to accurately identify children with separation anxiety disorder, and this was replicated across all 3 reporters. Mother- and father-reported Social Phobia subscales also accurately identified children with social anxiety disorder, although child report was only able to accurately detect social anxiety disorder in girls. Using 2 or more reporters improved the sensitivity of the Separation Anxiety and Social Phobia subscales but reduced specificity. The Generalized Anxiety and Physical Injury Fears subscales failed to accurately identify children with the corresponding disorders. These findings have implications for the potential use of mother-, father-, and child-report SCAS subscales to detect specific disorders in preadolescent children in clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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- 2020
5. Free From Panic : A Teen’s Guide to Coping with Panic Attacks and Panic Symptoms
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Monika Parkinson, Kerstin Thirlwall, Lucy Willetts, Monika Parkinson, Kerstin Thirlwall, and Lucy Willetts
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- Panic disorders--Juvenile literature
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Panic symptoms and panic attacks can feel overwhelming and frightening. This book guides teens through the isolation and worry of living with panic symptoms or panic disorder. Through interactive exercises, this book shows that the key to unlocking freedom from panic is learning to understand our feelings, fears and bodies. Demonstrating that panic is a natural emotion that many people experience, it provides useful strategies drawn from a range of approaches including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT) to help teens to get on top of their fears and panic. Co-written by respected clinicians in the field, the strategies in this book are tried and tested in helping teens and young people in their journey through panic.
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- 2022
6. Guided parent-delivered cognitive behavioral therapy for childhood anxiety: Predictors of treatment response
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Cathy Creswell, Peter J. Cooper, and Kerstin Thirlwall
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Male ,Parents ,050103 clinical psychology ,Treatment response ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,Treatment outcome ,Anxiety ,Article ,Intervention (counseling) ,medicine ,Childhood anxiety ,Humans ,Stepped-care ,0501 psychology and cognitive sciences ,Child ,Prediction of response ,Cognitive Behavioral Therapy ,05 social sciences ,Child/adolescent ,medicine.disease ,Anxiety Disorders ,Treatment ,Cognitive behavioral therapy ,Clinical Psychology ,Psychiatry and Mental health ,Treatment Outcome ,Cognitive behavior therapy ,Cognitive therapy ,Female ,medicine.symptom ,Psychology ,Anxiety disorder ,050104 developmental & child psychology ,Clinical psychology - Abstract
Highlights • We examined predictors of response to low intensity treatment of childhood anxiety disorders. • Response was measured at two time points; post treatment and six month follow up. • Recovery was associated with child age, primary diagnosis of Generalized Anxiety Disorder (GAD) and treatment intensity. • The findings inform decision making about when to consider more intensive treatment., Background Guided Parent-delivered Cognitive Behaviour Therapy (GPD-CBT) is a brief, effective treatment for childhood anxiety disorders, however not all children respond favourably. Aims To examine predictors of response to GPD-CBT. Methods Parents of 125 children (7–12 years) with an anxiety disorder received GPD-CBT over 2.6 or 5.3 h. Recovery was measured post treatment and six months later. Results Younger children and those with primary Generalised Anxiety Disorder (GAD) improved more post treatment, but older children and those without primary GAD had better outcomes at six month follow up. Fewer children allocated to 2.6 h had recovered post treatment compared to those allocated to the 5.2 h intervention, but did not differ significantly six months later. Conclusions The identification of predictors of short and longer-term treatment outcomes can guide treatment decisions following this low-intensity approach.
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- 2017
- Full Text
- View/download PDF
7. Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders
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Susanna Roberts, Wendy K. Silverman, Catharine Creswell, Ronald M. Rapee, Polly Waite, Robert Keers, Kathryn J. Lester, Karen Krause, Patrick Smith, Silvia Schneider, Gro Janne Wergeland, Kerstin Thirlwall, Einar Heiervang, Kristian Arendt, Susan M. Bögels, Sanne M. Hogendoorn, Thalia C. Eley, Talia Morris, Chloe C. Y. Wong, Anna McKinnon, Gerome Breen, Chantal Herren, Maaike H. Nauta, Judith Blatter-Meunier, Peter J. Cooper, Sophie C. Schneider, Yasmine Rey, Mikael Thastum, Heidi J. Lyneham, Jennifer L. Hudson, Xiaohui Xu, Jonathan R. I. Coleman, Developmental Psychopathology (RICDE, FMG), Child Psychiatry, and Clinical Psychology and Experimental Psychopathology
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Male ,medicine.medical_specialty ,Adolescent ,Genotype ,medicine.medical_treatment ,CBT ,Anxiety ,Treatment response ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,medicine ,Genetics ,Humans ,Child ,Psychiatry ,Alleles ,Psychiatric Status Rating Scales ,Serotonin Plasma Membrane Transport Proteins ,Cognitive Behavioral Therapy ,business.industry ,Remission Induction ,Odds ratio ,medicine.disease ,Anxiety Disorders ,3. Good health ,030227 psychiatry ,Clinical trial ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Treatment Outcome ,Child, Preschool ,Papers ,Cohort ,Cognitive therapy ,Female ,Gene-Environment Interaction ,Therapygenetics ,medicine.symptom ,Attribution ,business ,030217 neurology & neurosurgery ,Anxiety disorder ,Clinical psychology - Abstract
BackgroundWe previously reported an association between 5HTTLPR genotype and outcome following cognitive–behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, with most reporting no association between genotype and CBT outcome.AimsTo replicate the association between 5HTTLPR and CBT outcome in child anxiety from the Genes for Treatment study (GxT Cohort 2, n = 829).MethodLogistic and linear mixed effects models were used to examine the relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both cohorts were performed.ResultsThere was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2. Mega-analyses identified a significant association between 5HTTLPR and remission from all anxiety disorders at follow-up (odds ratio 0.45, P = 0.014), but not primary anxiety disorder outcomes.ConclusionsThe association between 5HTTLPR genotype and CBT outcome did not replicate. Short-allele homozygotes showed more positive treatment outcomes, but with small, non-significant effects. Future studies would benefit from utilising whole genome approaches and large, homogenous samples.
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- 2016
8. Parent-Led CBT for Child Anxiety : Helping Parents Help Their Kids
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Cathy Creswell, Monika Parkinson, Kerstin Thirlwall, Lucy Willetts, Cathy Creswell, Monika Parkinson, Kerstin Thirlwall, and Lucy Willetts
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- Parent and child, Children, Cognitive therapy--Methods, Anxiety disorders--Treatment, Behavior disorders in children--Treatment, Patient education
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Parents can play a strong role in helping their children overcome anxiety disorders--given the right tools. This innovative, research-based book shows clinicians how to teach parents cognitive-behavioral therapy (CBT) techniques to use with their 5- to 12-year-old. Session-by-session guidelines are provided for giving parents the skills to promote children's flexible thinking and independent problem solving, help them face specific fears, and tackle accompanying difficulties, such as sleep problems and school refusal. User-friendly features include illustrative case studies, sample scripts, advice on combining face-to-face sessions with telephone support, and pointers for overcoming roadblocks. Several parent handouts can be downloaded and printed in a convenient 8 1/2'x 11'size.
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- 2017
9. Guided parent-delivered cognitive behaviour therapy for children with anxiety disorders: outcomes at 3- to 5-year follow-up
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Kerstin Thirlwall, Peter J. Cooper, Alexandra Brown, Chris Barker, Stephen Butler, Catherine Hobbs, and Cathy Creswell
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Male ,Parents ,050103 clinical psychology ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Psychological intervention ,law.invention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Intervention (counseling) ,Outcome Assessment, Health Care ,medicine ,Bibliotherapy ,Humans ,0501 psychology and cognitive sciences ,Child ,Psychiatry ,Cognitive Behavioral Therapy ,05 social sciences ,General Medicine ,medicine.disease ,Anxiety Disorders ,Mental health ,030227 psychiatry ,Clinical Psychology ,Anxiety ,Female ,medicine.symptom ,Psychology ,Anxiety disorder ,Follow-Up Studies ,Cohort study - Abstract
OBJECTIVES: Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment. DESIGN: A long-term follow-up (LTFU) cohort study. METHODS: Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months). RESULTS: At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range. CONCLUSIONS: Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment. PRACTITIONER POINTS: Treatment gains from brief guided parent-delivered cognitive behaviour therapy for children with anxiety are maintained for most children 3-5 years later. The majority of children who completed at least 50% of the intervention required no further mental health intervention in that time. Some children make continued improvement after completing the intervention. Data are based on a sample of families from southern England where the primary caregiving parent was free of mental health difficulties. Further research is needed to explore the mental health needs of those who do not benefit from this intervention.
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- 2017
10. Using symptom and interference questionnaires to identify recovery among children with anxiety disorders
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Rachel, Evans, Kerstin, Thirlwall, Peter, Cooper, and Cathy, Creswell
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Male ,Parents ,Psychiatric Status Rating Scales ,child ,Waiting Lists ,diagnosis ,questionnaire ,Reproducibility of Results ,Articles ,Anxiety Disorders ,Sensitivity and Specificity ,parent ,Treatment Outcome ,Surveys and Questionnaires ,Humans ,Female - Abstract
Questionnaires are widely used in routine clinical practice to assess treatment outcomes for children with anxiety disorders. This study was conducted to determine whether 2 widely used child and parent report questionnaires of child anxiety symptoms and interference (Spence Child Anxiety Scale [SCAS-C/P] and Child Anxiety Impact Scale [CAIS-C/P]) accurately identify recovery from common child anxiety disorder diagnoses as measured by a 'gold-standard' diagnostic interview. Three hundred thirty-seven children (7-12 years, 51% female) and their parents completed the ADIS-IV-C/P diagnostic interview and questionnaire measures (SCAS-C/P and CAIS-C/P) before (Time 1) and after (Time 2) treatment or wait-list. Time 2 parent reported interference (CAIS-P) was found to be a good predictor of absence of any diagnoses (area under the curve [AUC] = .81). In terms of specific diagnoses, Time 2 SCAS-C/P separation anxiety subscale (SCAS-C/P-SA) identified recovery from separation anxiety disorder well (SCAS-C-SA, AUC = .80; SCAS-P-SA, AUC = .82) as did the CAIS-P (AUC = .79). The CAIS-P also successfully identified recovery from social phobia (AUC = .78) and generalized anxiety disorder (AUC = .76). These AUC values were supported by moderate to good sensitivity (.70-.78) and specificity (.70-.73) at the best identified cut-off scores. None of the measures successfully identified recovery from specific phobia. The results suggest that questionnaire measures, particularly the CAIS-P, can be used to identify whether children have recovered from common anxiety disorders, with the exception of specific phobias. Cut-off scores have been identified that can guide the use of routine outcome measures in clinical practice. (PsycINFO Database Record
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- 2016
11. A genome-wide test of the differential susceptibility hypothesis reveals a genetic predictor of differential response to psychological treatments for child anxiety disorders
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Robert Keers, Thalia C. Eley, Silvia Schneider, Mikael Thastum, Richard Meiser-Stedman, Cathryn M. Lewis, Ronald M. Rapee, Kathryn J. Lester, Jonathan R. I. Coleman, Maaike H. Nauta, Gerome Breen, Robert Plomin, Jennifer L. Hudson, Susan M. Bögels, Cathy Creswell, Einar Heiervang, Susanna Roberts, Kerstin Thirlwall, and Clinical Psychology and Experimental Psychopathology
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Male ,Multifactorial Inheritance ,INFORMATION ,medicine.medical_treatment ,Monozygotic twin ,Genome-wide association study ,Differential susceptibility hypothesis ,LIFE STRESS ,5-HTTLPR ,Developmental psychology ,0302 clinical medicine ,Child ,Applied Psychology ,EXTERNALIZING BEHAVIOR ,RISK ,Parenting ,05 social sciences ,General Medicine ,ASSOCIATION ,DEPRESSION ,Psychiatry and Mental health ,Clinical Psychology ,Mental Health ,Anxiety ,Female ,medicine.symptom ,Psychology ,050104 developmental & child psychology ,Clinical psychology ,ENVIRONMENTAL-INFLUENCES ,03 medical and health sciences ,medicine ,Humans ,Genetic Predisposition to Disease ,0501 psychology and cognitive sciences ,Innovations ,Differential response ,METAANALYSIS ,Cognitive Behavioral Therapy ,Mental health ,Twin study ,POLYMORPHISM ,Logistic Models ,Linear Models ,Cognitive therapy ,030217 neurology & neurosurgery ,Genome-Wide Association Study ,Anxiety disorders - Abstract
Background: The differential susceptibly hypothesis suggests that certain genetic variants moderate the effects of both negative and positive environments on mental health and may therefore be important predictors of response to psychological treatments. Nevertheless, the identification of such variants has so far been limited to preselected candidate genes. In this study we extended the differential susceptibility hypothesis from a candidate gene to a genome-wide approach to test whether a polygenic score of environmental sensitivity predicted response to cognitive behavioural therapy (CBT) in children with anxiety disorders. Methods: We identified variants associated with environmental sensitivity using a novel method in which within-pair variability in emotional problems in 1,026 monozygotic twin pairs was examined as a function of the pairs' genotype. We created a polygenic score of environmental sensitivity based on the whole-genome findings and tested the score as a moderator of parenting on emotional problems in 1,406 children and response to individual, group and brief parent-led CBT in 973 children with anxiety disorders. Results: The polygenic score significantly moderated the effects of parenting on emotional problems and the effects of treatment. Individuals with a high score responded significantly better to individual CBT than group CBT or brief parent-led CBT (remission rates: 70.9, 55.5 and 41.6%, respectively). Conclusions: Pending successful replication, our results should be considered exploratory. Nevertheless, if replicated, they suggest that individuals with the greatest environmental sensitivity may be more likely to develop emotional problems in adverse environments but also benefit more from the most intensive types of treatment.
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- 2016
12. HPA axis related genes and response to psychological therapies:Genetics and epigenetics
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Wendy K. Silverman, Polly Waite, Susanna Roberts, Heidi J. Lyneham, Krister W. Fjermestad, Kathryn J. Lester, Kerstin Thirlwall, Odd E. Havik, Cathy Creswell, Thalia C. Eley, Peter J. Cooper, Talia Morris, Ronald M. Rapee, Yasmin Rey, Mikael Thastum, Jonathan R. I. Coleman, Judith Blatter-Meunier, Gerome Breen, Sophie C. Schneider, Karen Krause, Chantal Herren, Maaike H. Nauta, Chloe C. Y. Wong, Jennifer L. Hudson, Kristian Arendt, Sanne M. Hogendoorn, Robert Keers, Silvia Schneider, and Child Psychiatry
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Oncology ,Epigenomics ,Male ,Pituitary-Adrenal System ,THERAPY ,Epigenesis, Genetic ,THERAPIES ,Genotype ,glucocorticoid receptor ,ANXIETY ,genetics ,Child ,genes ,DNA methylation ,treatment ,Methylation ,TREATMENT ,anxiety ,Anxiety Disorders ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,FKBP5 ,therapygenetics ,Child, Preschool ,Cognitive behavior therapy ,Female ,Psychology ,Anxiety disorder ,biological markers ,Clinical psychology ,Research Article ,medicine.medical_specialty ,Hypothalamo-Hypophyseal System ,cognitive behavior therapy ,Adolescent ,child/adolescent ,PSYCHOLOGICAL THERAPIES ,Polymorphism, Single Nucleotide ,Tacrolimus Binding Proteins ,Receptors, Glucocorticoid ,Internal medicine ,medicine ,Humans ,Epigenetics ,Allele ,Alleles ,Cognitive Behavioral Therapy ,HPA axis ,medicine.disease ,Psychological - Abstract
Background\ud \ud \ud Hypothalamic–pituitary–adrenal (HPA) axis functioning has been implicated in the development of stress-related psychiatric diagnoses and response to adverse life experiences. This study aimed to investigate the association between genetic and epigenetics in HPA axis and response to cognitive behavior therapy (CBT).\ud \ud \ud Methods\ud \ud \ud Children with anxiety disorders were recruited into the Genes for Treatment project (GxT, N = 1,152). Polymorphisms of FKBP5 and GR were analyzed for association with response to CBT. Percentage DNA methylation at the FKBP5 and GR promoter regions was measured before and after CBT in a subset (n = 98). Linear mixed effect models were used to investigate the relationship between genotype, DNA methylation, and change in primary anxiety disorder severity (treatment response).\ud \ud \ud Results\ud \ud \ud Treatment response was not associated with FKBP5 and GR polymorphisms, or pretreatment percentage DNA methylation. However, change in FKBP5 DNA methylation was nominally significantly associated with treatment response. Participants who demonstrated the greatest reduction in severity decreased in percentage DNA methylation during treatment, whereas those with little/no reduction in severity increased in percentage DNA methylation. This effect was driven by those with one or more FKBP5 risk alleles, with no association seen in those with no FKBP5 risk alleles. No significant association was found between GR methylation and response.\ud \ud \ud Conclusions\ud \ud \ud Allele-specific change in FKBP5 methylation was associated with treatment response. This is the largest study to date investigating the role of HPA axis related genes in response to a psychological therapy. Furthermore, this is the first study to demonstrate that DNA methylation changes may be associated with response to psychological therapies in a genotype-dependent manner.
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- 2015
13. The set up and evaluation of a consultation service for a permanence team
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Kerstin Thirlwall and Miriam Silver
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Clinical Psychology - Abstract
In a move to filter psychological thinking into placement plans and advance the management of specific cases, Northampton CAMHS has begun a consultation service with the local permanence team. Links made have improved the working relationship between these two agencies.
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- 2005
14. Serotonin tranporter methylation and response to cognitive\ud behaviour therapy in children with anxiety disorders
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Kerstin Thirlwall, Jennifer L. Hudson, Thalia C. Eley, Ronald M. Rapee, Cathy Creswell, Kathryn J. Lester, Gerome Breen, Susanna Roberts, Peter J. Cooper, Jonathan R. I. Coleman, and Chloe Wong Wong
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Male ,Oncology ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Epigenetics ,Child ,Serotonin transporter ,Biological Psychiatry ,Serotonin Plasma Membrane Transport Proteins ,Cognitive Behavioral Therapy ,biology ,business.industry ,DNA Methylation ,medicine.disease ,Anxiety Disorders ,030227 psychiatry ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Treatment Outcome ,Schizophrenia ,DNA methylation ,biology.protein ,Cognitive therapy ,Anxiety ,Female ,Original Article ,medicine.symptom ,Corrigendum ,business ,Anxiety disorder ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Anxiety disorders that are the most commonly occurring psychiatric disorders in childhood, are associated with a range of social and educational impairments and often continue into adulthood. Cognitive behaviour therapy (CBT) is an effective treatment option for the majority of cases, although up to 35–45% of children do not achieve remission. Recent research suggests that some genetic variants may be associated with a more beneficial response to psychological therapy. Epigenetic mechanisms such as DNA methylation work at the interface between genetic and environmental influences. Furthermore, epigenetic alterations at the serotonin transporter (SERT) promoter region have been associated with environmental influences such as stressful life experiences. In this study, we measured DNA methylation upstream of SERT in 116 children with an anxiety disorder, before and after receiving CBT. Change during treatment in percentage DNA methylation was significantly different in treatment responders vs nonresponders. This effect was driven by one CpG site in particular, at which responders increased in methylation, whereas nonresponders showed a decrease in DNA methylation. This is the first study to demonstrate differences in SERT methylation change in association with response to a purely psychological therapy. These findings confirm that biological changes occur alongside changes in symptomatology following a psychological therapy such as CBT.
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- 2014
15. The impact of maternal control on children's anxious cognitions, behaviours and affect: an experimental study
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Kerstin Thirlwall and Catharine Creswell
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Adult ,Male ,050103 clinical psychology ,media_common.quotation_subject ,Child Behavior ,Experimental and Cognitive Psychology ,Psychology, Child ,Affect (psychology) ,Developmental psychology ,Child Development ,Reference Values ,medicine ,Humans ,0501 psychology and cognitive sciences ,Single-Blind Method ,Risk factor ,Maternal Behavior ,Internal-External Control ,media_common ,Parenting ,05 social sciences ,Social environment ,Cognition ,Child development ,Anxiety Disorders ,Mother-Child Relations ,Psychiatry and Mental health ,Clinical Psychology ,El Niño ,Feeling ,Child, Preschool ,Personal Autonomy ,Anxiety ,Female ,medicine.symptom ,Psychology ,050104 developmental & child psychology - Abstract
Controlling parenting is associated with child anxiety however the direction of effects remains unclear. The present study implemented a Latin-square experimental design to assess the impact of parental control on children's anxious affect, cognitions and behaviour. A non-clinical sample of 24 mothers of children aged 4-5 years were trained to engage in (a) controlling and (b) autonomy-granting behaviours in interaction with their child during the preparation of a speech. When mothers engaged in controlling parenting behaviours, children made more negative predictions about their performance prior to delivering their speech and reported feeling less happy about the task, and this was moderated by child trait anxiety. In addition, children with higher trait anxiety displayed a significant increase in observed child anxiety in the controlling condition. The pattern of results was maintained when differences in mothers' levels of negativity and habitual levels of control were accounted for. These findings are consistent with theories that suggest that controlling parenting is a risk factor in the development of childhood anxiety.
- Published
- 2009
16. Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial.
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Thirlwall K, Cooper PJ, Karalus J, Voysey M, Willetts L, and Creswell C
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- Anxiety Disorders psychology, Child, Clinical Competence statistics & numerical data, Cognitive Behavioral Therapy education, Female, Follow-Up Studies, Humans, Intention to Treat Analysis, Male, Parents psychology, Psychiatric Status Rating Scales, United Kingdom, Waiting Lists, Anxiety Disorders therapy, Cognitive Behavioral Therapy methods, Outcome Assessment, Health Care statistics & numerical data, Parents education, Professional-Family Relations
- Abstract
Background: Promising evidence has emerged of clinical gains using guided self-help cognitive-behavioural therapy (CBT) for child anxiety and by involving parents in treatment; however, the efficacy of guided parent-delivered CBT has not been systematically evaluated in UK primary and secondary settings., Aims: To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders., Method: A total of 194 children presenting with a current anxiety disorder, whose primary carer did not meet criteria for a current anxiety disorder, were randomly allocated to full guided parent-delivered CBT (four face-to-face and four telephone sessions) or brief guided parent-delivered CBT (two face-to-face and two telephone sessions), or a wait-list control group (trial registration: ISRCTN92977593). Presence and severity of child primary anxiety disorder (Anxiety Disorders Interview Schedule for DSM-IV, child/parent versions), improvement in child presentation of anxiety (Clinical Global Impression - Improvement scale), and change in child anxiety symptoms (Spence Children's Anxiety Scale, child/parent version and Child Anxiety Impact scale, parent version) were assessed at post-treatment and for those in the two active treatment groups, 6 months post-treatment., Results: Full guided parent-delivered CBT produced superior diagnostic outcomes compared with wait-list at post-treatment, whereas brief guided parent-delivered CBT did not: at post-treatment, 25 (50%) of those in the full guided CBT group had recovered from their primary diagnosis, compared with 16 (25%) of those on the wait-list (relative risk (RR) 1.85, 95% CI 1.14-2.99); and in the brief guided CBT group, 18 participants (39%) had recovered from their primary diagnosis post-treatment (RR = 1.56, 95% CI 0.89-2.74). Level of therapist training and experience was unrelated to child outcome., Conclusions: Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.
- Published
- 2013
- Full Text
- View/download PDF
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