Anxiety disorders are among the most common forms of psychopathology reported by children and adolescents. Anxiety disorders in children have debilitating consequences, both for the child and his/her family. In addition, research indicates that, in many cases, these disorders follow a chronic and persistent course. The efficacy of child-focused cognitive-behavioural interventions in the treatment of childhood anxiety disorders has been well demonstrated by recent, well-controlled research. This treatment outcome literature is briefly reviewed. Most recently, however, interventions used in the treatment of childhood anxiety disorders have taken the form of combined interventions aimed both at the anxious child and his or her family. This paper reviews two related bodies of research in presenting a case for the involvement of families in the treatment of childhood anxiety. First, the etiological evidence implicating the families of anxious children in the development and/or maintenance of childhood anxiety is presented. Second, the treatment outcome studies that have empirically evaluated this type of combined intervention are reviewed.

Treatment of conduct problems in the home setting has received much attention in the literature, and there are well established, empirically derived treatment programs that have been demonstrated to be effective. However, treatment for conduct problems in the classroom has not received a comparable amount of attention, and the intervention programs are diverse, occasionally lacking empirical support, and often not consistent with strategies used in the home setting. As past research has demonstrated that conduct problems in multiple settings is related to poorer prognosis, it is logical to suggest that interventions should focus on as many of the settings as possible in which a child displays the behaviour problems. This paper reviews the literature on the effects of conduct problems in the classroom, on teacher managerial skills, and on interventions across the home and school settings. It is concluded that classroom management of conduct problems could be improved by providing a hierarchical system of intervention strategies.

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

Evidence suggests that cognitive behaviour therapy is the treatment of choice for both irritable bowel syndrome (IBS) and panic disorder (PD). The present study examines the treatment issues relating to a woman diagnosed with both IBS and PD (with agoraphobia), where therapy for PD was disrupted by IBS symptoms. Group therapy was then initiated for IBS, and this was associated with a large decrease in general anxiety and depression, and an increase in confidence concerning management of the pain caused by the IBS. This finding is discussed with respect to its possible implications for the treatment of people suffering both IBS and PD.

The aim of the study was to compare the psychophysiological pattern associated with obsessive–compulsive disorder (OCD) in clinical patients (n = 13) and checking behaviours in a nonclinical population (n = 13) to evaluate the validity of the anxiety reduction hypothesis. A second objective was to examine the psychophysiological pattern associated with prevention of ritualistic behaviour in the OCD group and of checking behaviour in the control group. A guided imagery methodology was utilised in order to examine the progression of the behaviours over time. Various psychophysiological measures were incorporated to account for the response to personalised imagery presented in four distinct stages. The stages included setting the scene, approach, incident, and consequence. Both the psychophysiological and the subjective response to the ritual/checking and response-prevention/no-checking scripts were higher than to the neutral script for both groups. A trend towards significantly higher heart rate response to the response-prevention/no-checking than to the ritual/checking script was also observed. Higher levels of depersonalisation and anxiety in the OCD group were observed following prevention of the ritual. The patterns of response indicated obsessive–compulsive behaviour may act to prevent the level of anxiety experienced by an individual from escalating, rather than to reduce it from an already elevated level.