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Ryoichi J. P. Noguchi, M.S., Michael M. Knepp, M.S., & Thomas H. Ollendick, Ph.D. INTRODUCTION METHOD  Studies of attention and memory have consistently.

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Presentation on theme: "Ryoichi J. P. Noguchi, M.S., Michael M. Knepp, M.S., & Thomas H. Ollendick, Ph.D. INTRODUCTION METHOD  Studies of attention and memory have consistently."— Presentation transcript:

1 Ryoichi J. P. Noguchi, M.S., Michael M. Knepp, M.S., & Thomas H. Ollendick, Ph.D. INTRODUCTION METHOD  Studies of attention and memory have consistently shown threat biases in anxiety groups across a range of contexts (Coles & Heimberg, 2002; Mathews, 1990). In these studies, researchers have hypothesized a link between frontal lobe dysfunction in relation to its regulation of the amygdale.  With respect to attentional focus, trait anxious individuals have demonstrated faster reaction times for negatively primed stimuli (Derryberry & Reed, 1998), suggesting the presence of a negative threat bias. This effect, however, has been limited to targets presented in the right visual field, implying left hemisphere dominance.  Given this left hemisphere dominance, we can expect a decrease in abilities on performance based tasks rather than verbal fluency tasks because the left hemisphere has been associated with verbal abilities, while the right hemisphere has been associated with performance.  We can further expect somatization and internalizing problems to increase as potential indicators of autonomic dysregulation in children and adolescents with generalized anxiety disorder like that found by Thayer, Friedman, and Borkovec (1996) with adults.  This study sought to investigate these associations in a clinical sample of youth. OTHER TITLE TEXT RESULTS Measures  Child Behavior Checklist (CBCL; Achenbach, 1991). The CBCL, a behavior checklist completed by parents who rate children’s behavioral or emotional problems and competencies, was used to identify internalizing and somatic symptoms.  Wechsler Intelligence Scale for Children, Third & Fourth Editions (WISC-III, WISC-IV; Wechsler, 1991, 2003). The WISC served as a broad measure of neuropsychological functioning, as intelligence has been found to be associated with neural efficiency (Neubauer & Fink, 2003) Procedure  Children were seen at the clinic for three sessions and administered a variety of assessments. Two clinicians worked with every family such that one clinician interviewed and administered measures to the parent(s), while another clinician conducted the child assessment. 42nd Annual Convention of the Association for Behavioral and Cognitive Therapies, Orlando, FL, November 13-16, 2008 Implications for Hemispheric Functioning in Youth with Generalized Anxiety Disorder Participants  Participants were children and their parents referred to a child research and assessment clinic for a psychoeducational assessment. The sample consisted of 71 children and adolescents between the ages of 7 and 16 years (M = 10.14, SD = 2.56) who received a Generalized Anxiety Disorder (GAD) diagnosis.  The comparison sample included 269 children and adolescents between the ages of 7 and 16 (M = 10.12, SD = 2.75) referred to the clinic who received a variety of diagnoses but not a GAD diagnosis.  Inclusionary criteria consisted of consensus diagnoses (Grills & Ollendick, 2003) that were based on a clinical team conference that included parent and child clinicians along with a licensed clinical psychologist.  Exclusionary criteria included a diagnosis of a pervasive developmental disorder, schizophrenia, or bipolar disorder.  Analyses reveal that on the WISC, children with GAD (M = 97.412, SD = 15.47) scored significantly lower on the Perceptual Reasoning Index than their non-GAD counterparts (M = 102.19, SD = 16.17), t(301) = 2.26, p <.03.  Specifically, on the Block Design subtest, GAD youth (M = 9.07, SD = 3.50) performed worse than non-GAD youth (M = 10.63, SD = 6.01), t(310) = 2.06, p <.05.  GAD and non-GAD youth did not otherwise differ in their performance on the WISC.  On the CBCL, mothers of GAD children reported more internalizing symptoms (T score M = 65.67, SD = 10.63) than mothers of non-GAD children (T score M = 60.04, SD = 11.37), t(301) = 3.68, p <.001  This increased reporting of internalizing problems was also seen through father reports such that fathers of GAD children (T score M = 63.94, SD = 12.20) reported higher levels of internalizing problems than fathers of non-GAD youth (T score M = 55.42, SD = 10.67), t(207) = 4.17, p <.001.  Similarly, mother reports of CBCL Somatic Symptoms were higher for GAD youth (T score M = 63.94, SD = 9.91) when compared with the controls (T score M = 59.90, SD = 9.05), t(302) = 3.21, p <.005. DISCUSSION  The current results reveal that the Block Design performance and perceptual reasoning were decreased in GAD youth, indicating possible right hemispheric dysregulation. In addition, parents of GAD youth reported higher levels of children’s internalizing and somatic problems than non-GAD youth, providing further evidence of autonomic dysregulation that has been found in adult samples (Thayer et al., 1996).  The results suggest a potential difference in right hemispheric dysregulation and autonomic dysregulation in GAD children when these children’s scores were compared to a clinical control sample. The results suggest that GAD youth may be more prone to problems with dysregulation than other clinical samples of children and may suggest potential problems with neural efficiency in GAD youth.  The present findings were limited such that the measures used (WISC, CBCL) are generally not indicators of hemispheric or autonomic functioning. Additionally, the comparison sample was also a clinical sample of children who received varying diagnoses. Future research may benefit from investigating potential mediating or moderating effects of hemispheric functioning. Identifying factors that contribute to decreases in hemispheric functioning can then allow us to devise intervention strategies tailored towards GAD youth. Possible interventions may include exercises to improve neural efficiency and activation.  Lastly, fathers of GAD children also reported higher Somatic Symptoms (T score M = 62.02, SD = 10.43) than fathers of non-GAD children (T score M = 56.76, SD = 7.80), t(208) = 3.82, p <.001. Difference in Scores of Perceptual Reasoning in GAD and Non-GAD Youths


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