Table 1.
Treatment Studies of Psychotherapies for Preschool Depression and Anxiety
| Author | Diagnostic Category | RCT (Y/N) | Sample Size (N) | Form of Treatment | Outcome Measure | Results | Follow-up Data (Y/N) |
|---|---|---|---|---|---|---|---|
| Hirshfeld- Becker et al. (2010)38 | Anxiety disorders | Y | N = 64 | Parent-child CBT | Structured diagnostic interviews with parents (K- SADS–E supplemented by the avoidant disorder module from the Diagnostic Interview for Children and Adolescents, Parent Version); laboratory assessments of behavioral inhibition; parent ratings of coping | Active tx resulted in significantly greater decrease in anxiety disorders, increase in coping, and improvements on the CGI-I | Y—gains maintained at 1-year follow-up |
| Rapee et al. (2010)41 | High risk for anxiety disorders | Y | N = 146 | A 6-session, group- based parent intervention | The Anxiety Disorders Interview Schedule for Children and Parents IV–Parent Version; the Spence Children’s Anxiety Scale; and the Temperament Assessment Battery for Children–Revised | Active tx showed lower frequency and severity of anxiety disorders and symptoms | Y— Diagnostic interviews and questionnaire measures were repeated at 12, 24, and 36 months; |
| Cohen and Mannarino (1996)48 | PTSD related to sexual abuse | Y | N = 67 | CBT adapted for sexually abused preschool children (CBT-SAP) | CBCL, Child Sexual Behavior Inventory, Weekly Behavior Report, Preschool Symptom Self-Report | Active tx had highly significant symptomatic improvement on most outcome measures vs. control | Y— improvements sustained at 6- and 12- month follow-ups |
| Deblinger et al. (2001)49 | PTSD related to sexual abuse | Y | N = 54 | CBT groups | CBCL, SLC-90 and other PTSD specific measures | Mothers in active tx showed improved parenting and children demonstrated greater knowledge of body safety skills vs. control | Y—gains sustained at 3 month follow-up |
| Scheeringa et al. (2011)50 | PTSD | Y | N = 64 | Trauma-focused CBT (TF-CBT) | Structured parent-report psychiatric interview (PAPA) and the Adverse Events Checklist (AEC) | Active tx showed significant improvements in symptoms of PTSD | Y—gains sustained at 6 months |
| Pincus et al. (2008)54 | Separation anxiety disorder (SAD) | Y | N = 34 (to date) | Modified PCIT with Bravery-Directed Interaction (BDI) | Diagnostic interviews with the parent and child, parent self-report instruments, child self-report instruments, and behavioral observation of parent child interaction | Active tx showed improvements in SAD severity vs. control group | Y—gains were maintained at 3-, 6-, and 12- monthfollow- ups |
| Oerbeck et al. (2012)55 | Selective mutism (SM) | N | N = 7 | A home- and- kindergarten-based intervention | Teacher-reported School Speech Questionnaire (SSQ), CGI | Six children spoke in all kindergarten settings after a mean of 14 weeks treatment; Mean SSQ scores increased significantly from baseline and mean CGI decreased significantly from baseline | Y—results maintained at 1-year follow-up |
| Freeman et al. (2008)57 | OCD | Y | N = 42 | 12 sessions of family-based CBT | Scores on the Children’s Yale–Brown Obsessive Compulsive Scale and CGI-I | Tx group showed higher rates of remission and large effect sizes vs. controls | N |
| Ginsburg et al. (2011)58 | OCD | N | N = 7 | A 12-week family- based intervention | Weekly ratings of OC symptoms and family accommodation, measures assessing the severity and impact of OC symptoms and child and family functioning | Active tx resulted in reduction in OC symptoms (6 of 7 responders on CGI- I) and improvements in parental accommodation of child OC behaviors | Y—gains sustained at 1-month follow-up |
| Luby et al. (2012)70 | Preschool depression | Y | N = 54 | Modified PCIT with Emotion Development (ED) (PCIT-ED) | PAPA, BRIEF-P, EMODIFF | Active tx was significantly more effective on executive functioning and emotion recognition skills vs. control. | N |
Note: BRIEF = Behavior Rating Inventory of Executive Function-Preschool Version; CBCL = Child Behavior Checklist; CBT = cognitive behavioral therapy; CGI = Clinical Global Impression Scale; CGI-I = Clinical Global Impressions-Improvement; EMODIFF = Penn Emotion Differentiation Test; K-SADS–E = Schedule for Affective Disorder and Schizophrenia for School-Age Children; OCD = obsessive compulsive disorder; PAPA = Preschool Age Psychiatric Assessment; PCIT = Parent-child interaction therapy; PTSD = posttraumatic stress disorder; RCT = randomized controlled trial; tx = treatment.