To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The Belfast Ramped Pyroxidation/Combustion (RPO/RC) facility was established at the 14CHRONO Centre (Queen’s University Belfast). The facility was created to provide targeted analysis of bulk material for refined chronological analysis and carbon source attribution for a range of sample types. Here we report initial RPO results, principally on background material, but also including secondary standards that are routinely analyzed at 14CHRONO. A description of our setup, methodology, and background (blank) correction method for the system are provided. The backgrounds (anthracite, spar calcite, Pargas marble) reported by the system are in excess of 35,000 14C years BP with a mean age of 39,345 14C years BP (1σ = 36,497–43,800 years BP, N=44) with F14C = 0.0075 ± 0.0032. Initial results for standards are also in good agreement with consensus values: TIRI-B pine radiocarbon age = 4482 ± 47 years BP (N=13, consensus = 4508 years BP); IAEA-C6 ANU Sucrose F14C= 1.5036 ± 0.0034 (N=10, consensus F14C = 1.503). These initial tests have allowed problematic issues to be identified and improvements made for future analyses.
The rupture of atherosclerotic plaques is the prerequisite for adverse cardiovascular events. Calcification morphology plays a critical role in plaque stability, therefore accurate calcification classification is essential for favourable patient management. Blood biomarkers may be a worthwhile approach to stratify patients based on calcification phenotype. Vitamin K-dependent Matrix γ-carboxyglutamate (Gla) protein (MGP) is a potent inhibitor of vascular calcification. Recent studies have demonstrated the potential utility of circulating non-functional MGP (dp-ucMGP) measurements to determine arterial stiffness and calcification levels. The objective of this study was to examine the relationship between circulating dp-ucMGP and calcification phenotype within symptomatic atherosclerotic lesions. Consenting patients undergoing standard endarterectomy procedures were recruited (n = 29). Fasting venous blood was collected preoperatively. Circulating plasma levels of dp-ucMGP were quantified using the inaKtif MGP (dp-ucMGP) iSYS kit. A bicinchoninic acid assay was used to standardise the total protein content present in each sample. High-resolution micro-CT imaging was conducted on the excised atherosclerotic specimens postoperatively. ImageJ post-processing was used to accurately quantify the calcification volume (≥ 130 Hounsfield Units) and determine the total number of calcified particles (3D objects counter plugin). Thirteen carotid (average age 71 years, 9 male) and fourteen peripheral lower limb (average age 65 years, 12 male) patients were examined. One patient had a carotid and a peripheral lower limb plaque (age 79, male). Peripheral lower limb specimens have larger volumes of calcification and higher numbers of calcified particles than carotid samples (472 ± 310 vs 85 ± 113mm3, p < 0.0005; 13919 ± 16034 vs 3476 ± 6208, p = 0.061.) While a higher dp-ucMGP value was noted in carotid than peripheral lower limb patients (214 ± 52 vs 169 ± 36pmol/L, p = 0.014) there was no correlation between circulating dp-ucMGP and calcification volume or number of calcified particles (rs = -0.329 and rs = 0.046). Previous research also found that peripheral lower limb lesions contain higher volumes of calcification than carotid lesions. There is currently no published data on calcified particle comparisons. Patients with symptomatic carotid disease are assumed to have a degree of peripheral arterial disease, this could explain the higher levels of circulating dp-ucMGP in carotid patients. The current study did not examine the dietary patterns of individuals with regards to Vitamin K intake or analyse other areas of the vasculature for additional calcification. This may interfere with dp-ucMGP measurements. This study serves as a preliminary investigation into the potential of dp-ucMGP as a blood based biomarker to distinguish between symptomatic atherosclerotic calcification phenotypes.
Background: Preschool-aged children exhibit a relatively high prevalence rate of anxiety disorders, and the course of these disorders is often chronic. However, surprisingly few studies have focused on the treatment of anxiety in this age group. In response to this limitation, the purpose of the current study was to examine the effectiveness of an open trial of the Fun FRIENDS (FF) program, a downward extension of the FRIENDS programs for preschool-aged children (5–7 years), in a community clinic setting. Method: The sample included 31 children diagnosed with an anxiety disorder. Treatment consisted of 10 weekly sessions administered in a group format. Parents also received two information sessions. Child anxiety, behavioural inhibition, and resiliency were assessed at preintervention, immediate postintervention, and at 12-month follow-up. Results: Significant decreases in child anxiety and shyness and improvements on measures of resiliency were observed following the completion of treatment. Conclusions: The results of this study provide support for the effectiveness of the Fun FRIENDS program as a treatment for anxiety in young children. Further, this study adds to the relatively small body of research focused on the use of CBT to treat anxiety disorders in this population.
Anxiety and depression tend to run in families. This paper reviews some of the family processes that are implicated in the development, maintenance, and treatment of these problems in children and adolescents. Empirical studies and our theoretical review show that social learning processes within the context of intimate relationships are important in the development of anxiety and depression. Family processes have been shown to be important in the treatment of anxiety disorders but parallel evidence is lacking with regard to depression in adolescents. Two models are shown to have demonstrated explanatory power and empirical support: social learning theory and attachment theory. Examples are given of how these models can be contrasted and integrated at both clinical and theoretical levels.
The literature indicates increasing evidence showing the benefits of classroom-based, universal preventive interventions for mental health and the link between social and emotional learning and academic performance. The FRIENDS program has been extensively tested and has showed promising results not only for preventing childhood anxiety, but also for improving students’ self-concept, social skills and coping skills. However, when it comes to communities in disadvantage, the results are mixed, with some studies reporting the need to include enhancements to the context in which the program is implemented to better support communities at risk. A combined intervention aiming to promote students’ social-emotional skills was piloted in a school located in a low socio-economic status area. Teachers received training to teach social and emotional skills for students and a resilience program for themselves. Students’ social-emotional outcomes were assessed at pre, post, 3 and 6 months following the intervention. Results showed that the intervention helped students to decrease their anxiety, and the intervention was well accepted by participants.
Anxiety disorders in older children and adolescents have long been acknowledged as impairing, persistent and predictive of future anxiety and mood-related disorders. Until recently, however, anxiety in preschoolers and younger children has been regarded as relatively uncommon and within normal developmental parameters. Increasing evidence is suggestive that symptoms of anxiety in preschoolers parallel those in older children (Hirshfeld-Becker, Micco, Mazirsky, Bruett, & Henin, 2011) with this under-investigated area attracting increasing interest from researchers and clinicians alike. The present review summarises the empirical literature on early intervention and prevention programs for anxiety in young children (aged 3–7 years) with a specific focus on the application of such programs in the school context and implications for guidance counsellors, an improved understanding of which is critical for informing effective intervention. The studies reviewed demonstrate promising outcomes for anxiety; however, there is still a significant amount of work to be done in terms of our understanding of developmentally appropriate, family-focused and child-led models of anxiety and early intervention and prevention protocols.
In the present study, parent–child interactions with anxious children were compared to parent–child interactions with the anxious children's nonsymptomatic siblings and parent–child interactions with nonclinic children. Participants included 33 anxious children, their parents and siblings, and 14 nonclinic children and their parents. Parent–child interactions were observed during two discussion tasks related to anxiety-provoking or challenging situations. Parent–child interactions were coded for the following variables: control, warmth, reward of coping behaviour and task involvement. Consistent with previous research, parents in the anxious group showed more control, less paternal warmth and less maternal reward of coping behaviour toward their anxious child compared to parents of nonclinic children. Parent–child interactions with the anxious child were similar to parent–child interactions with the nonsymptomatic sibling, with the exception of fathers who exhibited more control toward their anxious child. Parent–sibling interactions, however, also resembled the nonclinic parent–child interactions, with mothers of anxious children showing more control toward their nonsymptomatic child than mothers of nonclinic children. These findings suggest that the relationships of each parent and their anxious child may be influenced by how the parent and child interact with each other. Suggestions for future research are discussed.
This study aimed to (a) appraise the efficacy of a well validated Anglo-Australian anxiety-prevention and stress-resiliency program (FRIENDS) for use with culturally diverse migrant groups residing in Australia, (b) examine the social validity of FRIENDS, and (c) obtain information from both participants and facilitators regarding how the program can best be modified for specific use with non-English-speaking background (NESB) clients. To test the efficacy of the intervention, pre- and post-intervention evaluation of internalising symptoms and coping ability were compared with waiting-list control groups (matched according to ethnic group, gender, and school level). One hundred and six primary and ninety-eight high school students differentiated by cultural origin (former-Yugoslavian, Chinese, and mixed-ethnic) and school level (primary and high school), completed standardised measures of internalising symptoms and were allocated to either an intervention (n = 121) or a waiting-list (n = 83) condition. Both groups were readministered the assessment package for comparison following a 10-week treatment or waiting period. Consistent with a recent pilot study, pre/post-assessment indicated that participants in the intervention condition exhibited lower anxiety and a more positive future outlook than waiting-list participants. Participating students reported to be highly satisfied with the intervention. Despite the overall success of FRIENDS, the program may be enhanced by culturally sensitive supplements so that the program is more applicable for use with NESB participants. Suggestions for treatment program modifications of FRIENDS are discussed.
The aim of the current pilot study was to examine the effectiveness of the FRIENDS program (a cognitive–behavioural intervention for children and adolescents with anxiety) within a community-based clinic in Brisbane, Australia. A total of 18 children participated in the study and completed the FRIENDS program at Pathways Health and Research Centre, an innovative research-based psychology clinic for children, adolescents and families. All participants either met criteria for an anxiety disorder (N = 11) or were experiencing subclinical symptoms of anxiety (N = 7) before commencing the intervention. Before and following treatment, participants were assessed using a diagnostic interview and completed a number of self-report questionnaires. Results indicated that 73% of the participants who met criteria for an anxiety disorder before the intervention were diagnosis-free following treatment. Positive treatment effects were also found for questionnaire data, indicating that there were significant reductions on self-report levels of anxiety and depression following treatment. The outcome of this research suggests that the FRIENDS program is an effective treatment for children with anxiety, and results from this community trial replicate findings from controlled treatment trials.
This study conducted the first evaluation of elements of social validity of the FRIENDS program, a cognitive-behavioural treatment package for childhood anxiety disorders. Parents, children, and adolescents were surveyed over time on their global satisfaction with the program, the acceptability of treatment components, and the completion of homework tasks. Results indicated a high level of satisfaction with the FRIENDS program and a high completion rate of homework tasks. Contrary to expectations, children rated the cognitive skills as more useful than adolescents did. Adolescents reported the behavioural strategy of graded exposure as more useful than other strategies. In addition, the relationship between treatment acceptability and clinical outcome was not significant. Limitations of the study and directions for further research are discussed.
This study evaluated the psychometric properties of the Diagnostic Interview Schedule for Children, Adolescents and Parents (DISCAP; Holland & Dadds, 1995), for DSM-IV anxiety disorders in children and adolescents. Two studies were conducted to examine the reliability and validity of the DISCAP. In the first study, the DISCAP and the Youth Self Report (YSR; Achenbach, 1991c) were administered to 120 nonclinical adolescents aged 12 through to 14 years. In the second study, the DISCAP and Child Behaviour Checklist (CBCL; Achenbach, 1991b) were administered to parents of 57 clinical children and adolescents aged 6 through to 16 years. Inter-rater reliability data was collected, and both concurrent and discriminant validity of the DISCAP were assessed against the YSR and CBCL. Inter-rater agreements for primary diagnoses were high, and rating scale data supported the concurrent and discriminant validity of the DISCAP diagnoses. Results suggest that the DISCAP can be used to facilitate reliable and valid diagnoses of childhood anxiety disorders.
Australia is a culturally diverse country with many migrant families in need of support and assistance from clinical psychologists. Yet, surveys indicate that migrants do not feel comfortable in accessing community mental health services, due to the lack of cultural sensitivity and understanding of our current practices. Despite this finding, there remains a paucity of research on migrant families, their different values and needs, and how they adjust to the Australian culture. The present article reviews research on migrant children, their characteristics, and the factors that help or hinder healthy adjustment to a new culture. This review focuses particularly on anxiety, which is not only the most common form of childhood psychopathology, but also frequently coincides with stressful life events such as migration. Our review concludes with recommendations for the development of assessment and intervention protocols, and areas of future research.
Young immigrants frequently experience anxiety as a consequence of the stress associated with migration. Despite being at high risk for the development of psychopathology, culturally sensitive assessment and intervention procedures for use with ethnic minority groups residing in Australia have yet to be developed and validated. The aims of the current study were to (a) investigate the level of anxiety in a sample of former-Yugoslavian teenage refugees; (b) appraise the efficacy of the FRIENDS program, a validated Anglo-Australian anxiety-prevention program, for use with this high-risk group; and (c) obtain information from both the program participants and facilitators regarding how the intervention could be modified to better meet the needs of this growing refugee population in Australia. Twenty female former-Yugoslavian youths completed standardised measures of internalising symptoms. Participants were allocated to either an intervention (n = 9) or a waiting list (n = 11) condition. In spite of the small sample size, post-assessment indicated that participants in the intervention condition reported significantly less internalising symptoms than participants in the waiting list condition. Social validity data indicated that, overall, participants were highly satisfied with the intervention. Suggestions for assessment and treatment program modifications are discussed.
This paper describes the development and preliminary findings of a program designed to prevent the development of anxiety and depressive symptoms in children aged 10 to 13 years. Using a universal prevention approach, a total of 594 children were randomly assigned on a class-by-class basis to either a 10-session family group CBT program (FRIENDS) routinely implemented as part of the school curriculum, or to a comparison group. Pre-post intervention changes were examined universally, and for children who scored above the clinical cut-off for anxiety at pretest. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms, regardless of their risk status, than the comparison group at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced improvements at posttest. Overall, these preliminary results appear to support the benefits of a school-based universal cognitive-behavioural intervention program. Implications of this study are discussed, and long-term follow-up measures are currently underway.
The present paper presents the results of a longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years. Participants were allocated to either a school-based cognitive-behavioural intervention or to a monitoring group, and completed standardised measures of anxiety, depression and coping style. Young people identified as “at risk” of an anxiety disorder were assessed for a clinical diagnosis with a structured diagnostic interview. Findings showed universal intervention as potentially successful in reducing symptoms of anxiety and increasing coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention was potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in addition to the implications and limitations of this study and directions for future research.
Previous research examining the clinical phenomenology of obsessive–compulsive disorder (OCD) has provided some evidence that OCD might be associated with different clinical correlates at different stages of development. In particular, there appears to be a bimodal distribution in terms of the age of onset of the disorder, a male predominance during childhood and adolescence compared to adulthood, stronger familial aggregation of OCD in early onset cases, and differences in the types of symptoms and the patterns of comorbidity across age groups. This study assessed the continuity in clinical presentation of OCD across three distinct age groups: children, adolescents and adults. It was hypothesised that the sample of children would be predominantly male, and would have a higher familial aggregation of OCD and/or anxiety/depression in first-degree relatives. It was further hypothesised that there would be significant age-related differences in terms of specific symptoms, patterns of comorbidity, OCD severity, functional impairment, and level of insight and distress. The results of this study support the developmental heterogeneity hypothesis, with significant differences occurring across age groups on a number of clinical features of OCD including age at onset, symptoms experienced, comorbidity, severity, insight and impairment. Implications of the findings and future directions for research in this area are discussed.
This study reported on the efficacy of Reciprocal Skills Training (RST), a family-based treatment modality for childhood externalising disorders. Children (N = 57) ranging from 7 to 12 years old who fulfilled diagnostic criteria for oppositional defiant disorder were randomly allocated to RST (in either a hospital or clinical setting) or a waiting-list control group. At posttreatment, no significant differences were observed across the two treatment settings. Results indicated that 95.5% of children in the hospital setting and 72.2% of children in the clinical setting no longer met criteria for oppositional defiant disorder, compared to 30% of children on the waiting list. Children in the treatment groups also obtained significantly lower scores on the Externalising scale of the Child Behaviour Checklist, compared to the waiting-list group. In addition, mothers' levels of stress and depression were significantly reduced at posttreatment, compared to mothers of children on the waiting list. These findings suggest that RST is an effective treatment modality for children displaying externalising behaviours, as well as for their mothers. The results are discussed in terms of limitations of the current study and future directions for research and clinical practice.
In 2001 we evaluated a universal prevention trial of anxiety during childhood, and also examined the effects of the program on levels of depression. Participants were 594 children aged 10—13 years from seven schools in Brisbane, Australia, who were randomly assigned to an intervention or control group on a school-by-school basis. The intervention was based on the group CBT program FRIENDS (Barrett, Lowry-Webster & Holmes, 1999a, 1999b, 1999c). Results were examined universally (for all children) and for children who scored above the clinical cut-off for anxiety at pre-test. At 12-month follow-up, intervention gains were maintained, as measured by self-reports and diagnostic interviews. Eighty-five per cent of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were diagnosis free in the intervention condition, compared to only 31.2% of children in the control group. Implications of these findings are examined, alongside limitations and directions for future research.
This study examines whether young migrants, differentiated by cultural background, (a) vary in their experience of cultural adjustment, emotional distress, levels of self-esteem, and coping ability, and (b) how they compare with Australian students on measures of self-esteem and coping ability. One hundred and seventy-three students differentiated by cultural origin (former-Yugoslavian, Chinese, Mixed-culture, and Australian) and school level (primary and high school) were recruited at random from public schools in South East Queensland. Students completed measures of cultural adjustment (Bicultural Involvement Questionnaire), anxiety and trauma (Revised Children's Manifest Anxiety Scale, Trauma Symptom Checklist), self-esteem (Coopersmith Self-Esteem Inventory, Rosenberg Self-Esteem Scale), and coping ability (Coping Scale for Children and Adolescents). The main findings from this study indicate that culturally diverse groups residing in Australia vary in their experience of cultural adaptation, level of self-esteem, and symptoms of emotional distress, illustrating culture-specific strengths and weaknesses among young non-English speaking (NESB) students. This study reveals information on how culturally diverse migrants acculturate, the type and severity of symptoms they experience, and their capacity to cope in stressful situations. The need for culture-specific early intervention and prevention programs is discussed.