Specific Phobias

Helping Children and Teens With Anxiety Disorders and Depression

Understanding New Research and Treatment

When anxiety takes over, it interferes with your child’s ability to cope with fear, worry, and depression — and treatment is necessary.

Early intervention is critical. Waiting for your child to mature or grow out of these behaviors may not be the right approach. In some cases children may develop chronic anxiety and depression, which is often associated with substance abuse and other high-risk behaviors.

Anxiety Disorders (Pediatric) Research Study

This study examines whether an antibiotic, d-cycloserine (DCS), boosts the effectiveness of cognitive behavior therapy (CBT) for social anxiety. CBT has been shown to be effective for the treatment of social anxiety in children and adults, but even after treatment, approximately 40% may remain diagnosable. All participants will receive 12 weekly CBT sessions. In addition to receiving the CBT, participants will be randomly assigned (similar to a coin toss) to receive either DCS or a placebo (sugar pill). The pill will be taken 1-2 hours prior to each of the 12 CBT sessions.

Organization: 
NIMH
Principal Investigator: 
Jennifer A. Cameron, Ph.D.
Eligibility Criteria: 
  1. Subjects between 8 yrs of age (preadolescents) and under 55 yrs of age.
  2. Subjects medically healthy.
  3. Able to give informed consent.
  4. Not on psychotropic meds for a minimum of 6 weeks for fluoxetine; a minimum of 1 week for PRN benzodiazepines and beta blockers, and a minimum of 3 weeks for all other psychotropic meds.
  5. Subjects diagnosed with DSM IV symptoms of social phobia, generalized or specific type.
Exclusion Criteria: 
  1. Current major depressive disorder.
  2. Lifetime diagnosis of psychotic disorder, bipolar disorder, eating disorder, mental retardation, substance or alcohol dependence (other than nicotine); active suicidal ideation.
  3. Current or lifetime history of a neurological disorder (other than tic disorders, febrile seizures of infancy), seizure disorder.
  4. Any unstable medical condition.
  5. Use of any psychoactive substance in the past 30 days.
Contact: 
(800) 411-1222, prpl@mail.cc.nih.gov
Location: 
Bethesda, MD
State: 
Maryland

Anxiety Disorders (Pediatric) Research Study

This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.

Organization: 
NIMH
Principal Investigator: 
Daniel S. Pine, MD; 301-594-9960, Daniel.Pine@nih.hhs.gov
Eligibility Criteria: 

JUVENILE SUBJECTS

Age: 8 to 17

Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)

IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)

SUBJECTS WITH AN ANXIETY DISORDER

Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)

Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)

Clinical Impairment: CGAS less than 60

SUBJECTS WITH A MOOD DISORDER

Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))

Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)

Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)

ADULT SUBJECTS

Age: 20-40

Consent: Can give consent/assent.

IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.

Exclusion Criteria: 

ALL SUBJECTS:

Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.

Pregnancy

Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.

Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression

Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression

Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.

HEALTHY ADULT SUBJECTS

Any current psychiatric diagnosis. Assessment relies on SCID.

SUBJECTS WITH AN ANXIETY DISORDER

Current Major Depressive Disorder

Contact: 
Allison M. Detloff, 301-451-6817, detloffa@mail.nih.gov
Location: 
Bethesda
State: 
Maryland
Study End Date: 
Tue, 2013-12-31

Screening for Specific Phobias

If you suspect that you might suffer from a specific phobia, answer the questions below, print out the results and share them with your health care professional.

Are you troubled by the following?

Treatment

The vast majority of people with an anxiety disorder can be helped with professional care.

Success of treatment varies among people. Some may respond to treatment after a few months, while others may need more than a year. Treatment may be complicated if people have more than one anxiety disorder or suffer from depression or substance abuse. This is why treatment must be tailored to the individual.

Symptoms

Symptoms of having a specific phobia often include uncomfortable and terrifying feelings of anxiety:

News and Research

Phobias Make Feared Objects Appear Greater, More Persistent

The more afraid a person is of a spider, the bigger that individual perceives the spider to be, new research suggests. Understanding how a phobia affects the perception of feared objects can help clinicians create effective treatments for people who wish to overcome their phobias. (Journal of Anxiety Disorders, 2012; 26 (1): 20) Read more. 

Specific Phobias

New places, high bridges, old elevators may make all of us a bit uneasy or even frightened. We might try to avoid things that make us uncomfortable, but most people generally manage to control their fears and carry out daily activities without incident.

But people with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there's no threat or danger. The fear may not make any sense, but they feel powerless to stop it.

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ADAA is a national nonprofit organization dedicated to the prevention, treatment, and cure of anxiety, OCD, PTSD, depression, and related disorders and to improving the lives of all people who suffer from them.

 

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