Category: Treatment - Other
Anxiety and depression are among the most common disorders affecting children (Costello et al., 2003). Although CBT is an effective form of treatment for anxiety disorders, as many as 40% of children with anxiety disorders do not have significant symptom reduction following treatment (James et al., 2013). Thus, it is important to identify risk and maintaining factors to target in treatment. Cognitive control has been linked with both worry and rumination (Beckwe et al., 2013), and may be a shared underlying risk or maintaining factor. Cognitive control training has been shown to decrease anxiety and depression symptoms in adults (Calkins et al., 2015), but these findings have yet to be extended to children. Therefore, the primary aim of the current study is to examine the feasibility and acceptability of administering an adapted computerized cognitive control training for symptoms of anxiety and depression in children. Three case examples are presented.
Three children from the rural Midwest participated in a nine-week cognitive control training intervention. The first child (C1) was an 11-year-old non-Hispanic white male. The second child (C2) was a 12-year-old non-Hispanic white male. The third child (C3) was an 11-year-old non-Hispanic white female. C3 dropped out at week 7 due to family and environmental factors. All children completed the Beck Anxiety Inventory for Youth, the Beck Depression Inventory for Youth, the Penn State Worry Questionnaire- Child version and the Child Response Styles Questionnaire- Rumination subscale at week 1, 5, and 9. The cognitive control training intervention consisted of a modified version of the Paced Auditory Serial Addition Task (PASAT; Gronwall, 1977) and the Attention Training Technique (ATT; Wells, 1990). The PASAT is a computerized working memory task that involves continuously adding serially presented digits. The ATT consists of actively listening and focusing attention in the context of simultaneous sounds presented at different loudness and spatial locations. Children completed the tasks weekly in the lab.
Scores reported here are pre-, mid- and post-treatment. For anxiety, C1’s scores dropped from 58 to 55 to 55; C2’s scores dropped from 56 to 42 to 42; C3’s scores dropped from 49 to 40. For depression, C1’s scores decreased from 61 to 59 to 59; C2’s scores decreased form 53 to 41 to 39; C3’s scores decreased from 59 to 51. Worry scores for C1 dropped from 21 to 16 and then increased to 17; C2’s scores dropped from 28 to 26 to 20; C3’s scores decreased from 17 to 10. For rumination, C1’s scores decreased from 18 to 13 to 13; C2’s scores decreased from 18 to 9 to 6; C3’s scores decreased from 16 to 14.
This case series provides support for the feasibility and effectiveness of cognitive control training for symptoms of anxiety and depression in children. All of the children were able to complete the tasks with few breaks. Furthermore, both parents rated their overall satisfaction with the study as very satisfied at the end of treatment. In terms of symptoms, overall results generally suggested a reduction in symptoms of anxiety, depression, worry and rumination. Limitations, implications, and future directions of the results will be discussed.
Moselle Campbell– Graduate Student, Southern Illinois University, Carbondale, Illinois
Mandi Logsdon– Graduate Student, Southern Illinois University, Carterville, Illinois
Sarah Kertz– Assistant Professor, Southern Illinois University-Carbondale, Carbondale, Illinois