Children with facial paralysis due to Moebius syndrome exhibit reduced autonomic modulation during emotion processing / E. DE STEFANI in Journal of Neurodevelopmental Disorders, 11-1 (December 2019)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 11-1 (December 2019) . - 12 p. Titre : Children with facial paralysis due to Moebius syndrome exhibit reduced autonomic modulation during emotion processing Type de document : Texte imprimé et/ou numérique Auteurs : E. DE STEFANI, Auteur ; M. ARDIZZI, Auteur ; Y. NICOLINI, Auteur ; M. BELLUARDO, Auteur ; A. BARBOT, Auteur ; C. BERTOLINI, Auteur ; G. GAROFALO, Auteur ; B. BIANCHI, Auteur ; G. COUDE, Auteur ; L. MURRAY, Auteur ; P. F. FERRARI, Auteur Article en page(s) : 12 p. Langues : Anglais (eng) Mots-clés : Autonomic nervous system  Emotion recognition  Facial expressions  Moebius children  Respiratory sinus arrhythmia  Thermal infrared imaging Index. décimale : PER Périodiques Résumé : BACKGROUND: Facial mimicry is crucial in the recognition of others' emotional state. Thus, the observation of others' facial expressions activates the same neural representation of that affective state in the observer, along with related autonomic and somatic responses. What happens, therefore, when someone cannot mimic others' facial expressions? METHODS: We investigated whether psychophysiological emotional responses to others' facial expressions were impaired in 13 children (9 years) with Moebius syndrome (MBS), an extremely rare neurological disorder (1/250,000 live births) characterized by congenital facial paralysis. We inspected autonomic responses and vagal regulation through facial cutaneous thermal variations and by the computation of respiratory sinus arrhythmia (RSA). These parameters provide measures of emotional arousal and show the autonomic adaptation to others' social cues. Physiological responses in children with MBS were recorded during dynamic facial expression observation and were compared to those of a control group (16 non-affected children, 9 years). RESULTS: There were significant group effects on thermal patterns and RSA, with lower values in children with MBS. We also observed a mild deficit in emotion recognition in these patients. CONCLUSION: Results support "embodied" theory, whereby the congenital inability to produce facial expressions induces alterations in the processing of facial expression of emotions. Such alterations may constitute a risk for emotion dysregulation. En ligne : https://dx.doi.org/10.1186/s11689-019-9272-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=409 [article] Children with facial paralysis due to Moebius syndrome exhibit reduced autonomic modulation during emotion processing [Texte imprimé et/ou numérique] / E. DE STEFANI, Auteur ; M. ARDIZZI, Auteur ; Y. NICOLINI, Auteur ; M. BELLUARDO, Auteur ; A. BARBOT, Auteur ; C. BERTOLINI, Auteur ; G. GAROFALO, Auteur ; B. BIANCHI, Auteur ; G. COUDE, Auteur ; L. MURRAY, Auteur ; P. F. FERRARI, Auteur . - 12 p. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 11-1 (December 2019) . - 12 p. Mots-clés : Autonomic nervous system  Emotion recognition  Facial expressions  Moebius children  Respiratory sinus arrhythmia  Thermal infrared imaging Index. décimale : PER Périodiques Résumé : BACKGROUND: Facial mimicry is crucial in the recognition of others' emotional state. Thus, the observation of others' facial expressions activates the same neural representation of that affective state in the observer, along with related autonomic and somatic responses. What happens, therefore, when someone cannot mimic others' facial expressions? METHODS: We investigated whether psychophysiological emotional responses to others' facial expressions were impaired in 13 children (9 years) with Moebius syndrome (MBS), an extremely rare neurological disorder (1/250,000 live births) characterized by congenital facial paralysis. We inspected autonomic responses and vagal regulation through facial cutaneous thermal variations and by the computation of respiratory sinus arrhythmia (RSA). These parameters provide measures of emotional arousal and show the autonomic adaptation to others' social cues. Physiological responses in children with MBS were recorded during dynamic facial expression observation and were compared to those of a control group (16 non-affected children, 9 years). RESULTS: There were significant group effects on thermal patterns and RSA, with lower values in children with MBS. We also observed a mild deficit in emotion recognition in these patients. CONCLUSION: Results support "embodied" theory, whereby the congenital inability to produce facial expressions induces alterations in the processing of facial expression of emotions. Such alterations may constitute a risk for emotion dysregulation. En ligne : https://dx.doi.org/10.1186/s11689-019-9272-2 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=409

Deflections from adolescent trajectories of antisocial behavior: contextual and neural moderators of antisocial behavior stability into emerging adulthood / L. W. HYDE in Journal of Child Psychology and Psychiatry, 59-10 (October 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-10 (October 2018) . - p.1073-1082 Titre : Deflections from adolescent trajectories of antisocial behavior: contextual and neural moderators of antisocial behavior stability into emerging adulthood Type de document : Texte imprimé et/ou numérique Auteurs : L. W. HYDE, Auteur ; R. WALLER, Auteur ; D. S. SHAW, Auteur ; L. MURRAY, Auteur ; E. E. FORBES, Auteur Article en page(s) : p.1073-1082 Langues : Anglais (eng) Mots-clés : Antisocial behavior amygdala conduct disorder desistance ventral striatum Index. décimale : PER Périodiques Résumé : BACKGROUND: Early adulthood is a critical period when young men involved in antisocial behavior (AB) may desist. Factors including marriage and employment have been shown to predict desistance, but little work has examined whether biological factors (e.g. neural reactivity) predict deflections from lifelong AB trajectories. METHODS: We examined the continuity of, or desistance from, AB in early adulthood using group-based trajectories of AB across adolescence in a sample of 242 men from low-income, urban families. We examined contextual factors (romantic relationship quality, employment, neighborhood danger) and neural factors (amygdala reactivity to fearful faces, ventral striatum reactivity to reward) as moderators of the continuity of AB from adolescence (age 10-17) into early adulthood (age 22-23), and whether these pathways differed by race. RESULTS: High relationship satisfaction and employment at age 20 predicted decreased AB at age 22-23, but only among men with adolescent-onset/moderate AB trajectories. Ventral striatum reactivity predicted continued AB, but only among African-American men with early-starting AB. Amygdala reactivity to fearful faces was related to later AB for those in the early-starting group, but in divergent directions depending on race: amygdala reactivity to fearful faces was positively related to AB in European-Americans and negatively related to AB among African-Americans. CONCLUSIONS: Contextual factors only predicted deflections of AB in those engaged in late-starting, moderate levels of AB, whereas neural factors predicted continued AB only in those with early-starting, severe AB, and in divergent ways based on participant race. Though there is limited power to infer causality from this observational design, research on desistance broadly can contribute to informing personalized interventions for those engaged in serious adolescence AB. En ligne : http://dx.doi.org/10.1111/jcpp.12931 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369 [article] Deflections from adolescent trajectories of antisocial behavior: contextual and neural moderators of antisocial behavior stability into emerging adulthood [Texte imprimé et/ou numérique] / L. W. HYDE, Auteur ; R. WALLER, Auteur ; D. S. SHAW, Auteur ; L. MURRAY, Auteur ; E. E. FORBES, Auteur . - p.1073-1082. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-10 (October 2018) . - p.1073-1082 Mots-clés : Antisocial behavior amygdala conduct disorder desistance ventral striatum Index. décimale : PER Périodiques Résumé : BACKGROUND: Early adulthood is a critical period when young men involved in antisocial behavior (AB) may desist. Factors including marriage and employment have been shown to predict desistance, but little work has examined whether biological factors (e.g. neural reactivity) predict deflections from lifelong AB trajectories. METHODS: We examined the continuity of, or desistance from, AB in early adulthood using group-based trajectories of AB across adolescence in a sample of 242 men from low-income, urban families. We examined contextual factors (romantic relationship quality, employment, neighborhood danger) and neural factors (amygdala reactivity to fearful faces, ventral striatum reactivity to reward) as moderators of the continuity of AB from adolescence (age 10-17) into early adulthood (age 22-23), and whether these pathways differed by race. RESULTS: High relationship satisfaction and employment at age 20 predicted decreased AB at age 22-23, but only among men with adolescent-onset/moderate AB trajectories. Ventral striatum reactivity predicted continued AB, but only among African-American men with early-starting AB. Amygdala reactivity to fearful faces was related to later AB for those in the early-starting group, but in divergent directions depending on race: amygdala reactivity to fearful faces was positively related to AB in European-Americans and negatively related to AB among African-Americans. CONCLUSIONS: Contextual factors only predicted deflections of AB in those engaged in late-starting, moderate levels of AB, whereas neural factors predicted continued AB only in those with early-starting, severe AB, and in divergent ways based on participant race. Though there is limited power to infer causality from this observational design, research on desistance broadly can contribute to informing personalized interventions for those engaged in serious adolescence AB. En ligne : http://dx.doi.org/10.1111/jcpp.12931 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369

First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial / M. TOMLINSON in Journal of Child Psychology and Psychiatry, 63-3 (March 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-3 (March 2022) . - p.261-272 Titre : First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : M. TOMLINSON, Auteur ; S. SKEEN, Auteur ; G. J. MELENDEZ-TORRES, Auteur ; X. HUNT, Auteur ; C. DESMOND, Auteur ; B. MORGAN, Auteur ; L. MURRAY, Auteur ; Peter J. COOPER, Auteur ; S. D. RATHOD, Auteur ; M. MARLOW, Auteur ; P. FEARON, Auteur Article en page(s) : p.261-272 Langues : Anglais (eng) Mots-clés : Infants  adolescence  cognitive development  home visiting intervention  low- and middle-income countries  parenting Index. décimale : PER Périodiques Résumé : BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13?years of age. We also estimated the current costs to replicate the intervention. METHOD: We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13?years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES?=?-0.17 [CI: -1.95, 0.05] and SRQ-20, ES?=?-0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION: In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13?years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important. En ligne : http://dx.doi.org/10.1111/jcpp.13482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457 [article] First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial [Texte imprimé et/ou numérique] / M. TOMLINSON, Auteur ; S. SKEEN, Auteur ; G. J. MELENDEZ-TORRES, Auteur ; X. HUNT, Auteur ; C. DESMOND, Auteur ; B. MORGAN, Auteur ; L. MURRAY, Auteur ; Peter J. COOPER, Auteur ; S. D. RATHOD, Auteur ; M. MARLOW, Auteur ; P. FEARON, Auteur . - p.261-272. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-3 (March 2022) . - p.261-272 Mots-clés : Infants  adolescence  cognitive development  home visiting intervention  low- and middle-income countries  parenting Index. décimale : PER Périodiques Résumé : BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13?years of age. We also estimated the current costs to replicate the intervention. METHOD: We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13?years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES?=?-0.17 [CI: -1.95, 0.05] and SRQ-20, ES?=?-0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION: In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13?years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important. En ligne : http://dx.doi.org/10.1111/jcpp.13482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457

A longitudinal investigation of the role of parental responses in predicting children's post-traumatic distress / R. M. HILLER in Journal of Child Psychology and Psychiatry, 59-7 (July 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.781-789 Titre : A longitudinal investigation of the role of parental responses in predicting children's post-traumatic distress Type de document : Texte imprimé et/ou numérique Auteurs : R. M. HILLER, Auteur ; R. MEISER-STEDMAN, Auteur ; S. LOBO, Auteur ; C. CRESWELL, Auteur ; P. FEARON, Auteur ; A. EHLERS, Auteur ; L. MURRAY, Auteur ; Sarah L. HALLIGAN, Auteur Article en page(s) : p.781-789 Langues : Anglais (eng) Mots-clés : Longitudinal  child  cognitive behavioural  parenting  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: While parental post-trauma support is considered theoretically important for child adjustment, empirical evidence concerning the specific aspects of parental responding that influence child post-traumatic distress, or the processes via which any such impacts occur, is extremely limited. We conducted a longitudinal examination of whether parental post-trauma appraisals, trauma-specific support style and general parenting style predicted child post-traumatic stress symptom severity (PTSS) following trauma; and whether such influences operated via the child's own appraisals and coping style. METHOD: We recruited 132 parent-child pairs following children's experience of acute trauma. We examined whether parental responses assessed at 1-month post-trauma, predicted child PTSS at 6-month follow-up. Parental trauma-specific appraisals and responses, and general parenting style, were assessed via both self-report and direct observations. Child-report questionnaires were used to assess PTSS and potential mediators. RESULTS: Initial parent negative appraisals and encouragement of avoidant coping were associated with higher child-reported PTSS at 6-month follow-up. Predictive effects were maintained even when controlling for initial child symptom levels. Observational assessments broadly supported conclusions from self-report. There was evidence that parental influences may operate, in part, by influencing the child's own appraisals and coping responses. In contrast, there was no evidence for an influence of more "adaptive" support or general parenting style on child PTSS. CONCLUSIONS: Findings provide important insight into how elements of social support may influence child post-trauma outcomes. En ligne : http://dx.doi.org/10.1111/jcpp.12846 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368 [article] A longitudinal investigation of the role of parental responses in predicting children's post-traumatic distress [Texte imprimé et/ou numérique] / R. M. HILLER, Auteur ; R. MEISER-STEDMAN, Auteur ; S. LOBO, Auteur ; C. CRESWELL, Auteur ; P. FEARON, Auteur ; A. EHLERS, Auteur ; L. MURRAY, Auteur ; Sarah L. HALLIGAN, Auteur . - p.781-789. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.781-789 Mots-clés : Longitudinal  child  cognitive behavioural  parenting  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: While parental post-trauma support is considered theoretically important for child adjustment, empirical evidence concerning the specific aspects of parental responding that influence child post-traumatic distress, or the processes via which any such impacts occur, is extremely limited. We conducted a longitudinal examination of whether parental post-trauma appraisals, trauma-specific support style and general parenting style predicted child post-traumatic stress symptom severity (PTSS) following trauma; and whether such influences operated via the child's own appraisals and coping style. METHOD: We recruited 132 parent-child pairs following children's experience of acute trauma. We examined whether parental responses assessed at 1-month post-trauma, predicted child PTSS at 6-month follow-up. Parental trauma-specific appraisals and responses, and general parenting style, were assessed via both self-report and direct observations. Child-report questionnaires were used to assess PTSS and potential mediators. RESULTS: Initial parent negative appraisals and encouragement of avoidant coping were associated with higher child-reported PTSS at 6-month follow-up. Predictive effects were maintained even when controlling for initial child symptom levels. Observational assessments broadly supported conclusions from self-report. There was evidence that parental influences may operate, in part, by influencing the child's own appraisals and coping responses. In contrast, there was no evidence for an influence of more "adaptive" support or general parenting style on child PTSS. CONCLUSIONS: Findings provide important insight into how elements of social support may influence child post-trauma outcomes. En ligne : http://dx.doi.org/10.1111/jcpp.12846 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368

A randomised controlled trial of treatments of childhood anxiety disorder in the context of maternal anxiety disorder: clinical and cost-effectiveness outcomes / C. CRESWELL in Journal of Child Psychology and Psychiatry, 61-1 (January 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-1 (January 2020) . - p.62-76 Titre : A randomised controlled trial of treatments of childhood anxiety disorder in the context of maternal anxiety disorder: clinical and cost-effectiveness outcomes Type de document : Texte imprimé et/ou numérique Auteurs : C. CRESWELL, Auteur ; M. VIOLATO, Auteur ; S. CRUDDACE, Auteur ; S. GERRY, Auteur ; L. MURRAY, Auteur ; R. SHAFRAN, Auteur ; A. STEIN, Auteur ; L. WILLETTS, Auteur ; E. MCINTOSH, Auteur ; Peter J. COOPER, Auteur Article en page(s) : p.62-76 Langues : Anglais (eng) Mots-clés : Child  anxiety  cognitive behaviour therapy  mother  parent-child interaction Index. décimale : PER Périodiques Résumé : BACKGROUND: This study evaluated whether clinical and economic outcomes from CBT for child anxiety disorders in the context of maternal anxiety disorders are improved by adding treatment focused on (a) maternal anxiety disorders or (b) mother-child interactions. METHODS: Two hundred and eleven children (7-12 years, 85% White British, 52% female) with a primary anxiety disorder, whose mothers also had a current anxiety disorder, were randomised to receive (a) child-focused CBT with nonspecific control interventions (CCBT+Con), (b) CCBT with CBT for the maternal anxiety disorder (CCBT+MCBT), or (c) CCBT with an intervention targeting the mother-child interaction (CCBT+MCI). A cost-utility analysis from a societal perspective was conducted using mother/child combined quality-adjusted life years (QALYs). [Trial registration: https://doi.org/10.1186/isrctn19762288]. RESULTS: MCBT was associated with immediate reductions in maternal anxiety compared to the nonspecific control; however, after children had also received CCBT, maternal outcomes in the CCBT+MCI and CCBT+Con arms improved and CCBT+MCBT was no longer superior. Neither CCBT+MCBT nor CCBT+MCI conferred a benefit over CCBT+Con in terms of child anxiety disorder diagnoses post-treatment [primary outcome] (adj RR: 1.22 (95% CI: 0.88, 1.67), p = .23; adj RR: 1.21 (95% CI: 0.88, 1.65), p = .24, respectively) or global improvement ratings (adj RR: 1.25 (95% CI: 0.99, 1.57), p = .06; adj RR: 1.18 (95% CI: 0.93, 1.50), p = .17) or six and 12 months later. No significant differences between the groups were found on the main economic outcome measures (child/mother combined QALY mean difference: CCBT+MCBT vs. CCBT+Con: -0.04 (95% CI: -0.12, 0.04), p = .29; CCBT+MCI vs. CCBT+Con: 0.02 (95% CI: -0.05, -0.09), p = .54). CCBT+MCI was associated with nonsignificantly higher costs than CCBT (mean difference: pound154 (95% CI: - pound1,239, pound1,547), p = .83) but, when taking into account sampling uncertainty, it may be cost-effective compared with CCBT alone. CONCLUSIONS: Good outcomes were achieved for children and their mothers across treatment arms. There was no evidence of significant clinical benefit from supplementing CCBT with either CBT for the maternal anxiety disorder or treatment focussed on mother-child interactions, but the addition of MCI (and not MCBT) may be cost-effective. En ligne : http://dx.doi.org/10.1111/jcpp.13089 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=413 [article] A randomised controlled trial of treatments of childhood anxiety disorder in the context of maternal anxiety disorder: clinical and cost-effectiveness outcomes [Texte imprimé et/ou numérique] / C. CRESWELL, Auteur ; M. VIOLATO, Auteur ; S. CRUDDACE, Auteur ; S. GERRY, Auteur ; L. MURRAY, Auteur ; R. SHAFRAN, Auteur ; A. STEIN, Auteur ; L. WILLETTS, Auteur ; E. MCINTOSH, Auteur ; Peter J. COOPER, Auteur . - p.62-76. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-1 (January 2020) . - p.62-76 Mots-clés : Child  anxiety  cognitive behaviour therapy  mother  parent-child interaction Index. décimale : PER Périodiques Résumé : BACKGROUND: This study evaluated whether clinical and economic outcomes from CBT for child anxiety disorders in the context of maternal anxiety disorders are improved by adding treatment focused on (a) maternal anxiety disorders or (b) mother-child interactions. METHODS: Two hundred and eleven children (7-12 years, 85% White British, 52% female) with a primary anxiety disorder, whose mothers also had a current anxiety disorder, were randomised to receive (a) child-focused CBT with nonspecific control interventions (CCBT+Con), (b) CCBT with CBT for the maternal anxiety disorder (CCBT+MCBT), or (c) CCBT with an intervention targeting the mother-child interaction (CCBT+MCI). A cost-utility analysis from a societal perspective was conducted using mother/child combined quality-adjusted life years (QALYs). [Trial registration: https://doi.org/10.1186/isrctn19762288]. RESULTS: MCBT was associated with immediate reductions in maternal anxiety compared to the nonspecific control; however, after children had also received CCBT, maternal outcomes in the CCBT+MCI and CCBT+Con arms improved and CCBT+MCBT was no longer superior. Neither CCBT+MCBT nor CCBT+MCI conferred a benefit over CCBT+Con in terms of child anxiety disorder diagnoses post-treatment [primary outcome] (adj RR: 1.22 (95% CI: 0.88, 1.67), p = .23; adj RR: 1.21 (95% CI: 0.88, 1.65), p = .24, respectively) or global improvement ratings (adj RR: 1.25 (95% CI: 0.99, 1.57), p = .06; adj RR: 1.18 (95% CI: 0.93, 1.50), p = .17) or six and 12 months later. No significant differences between the groups were found on the main economic outcome measures (child/mother combined QALY mean difference: CCBT+MCBT vs. CCBT+Con: -0.04 (95% CI: -0.12, 0.04), p = .29; CCBT+MCI vs. CCBT+Con: 0.02 (95% CI: -0.05, -0.09), p = .54). CCBT+MCI was associated with nonsignificantly higher costs than CCBT (mean difference: pound154 (95% CI: - pound1,239, pound1,547), p = .83) but, when taking into account sampling uncertainty, it may be cost-effective compared with CCBT alone. CONCLUSIONS: Good outcomes were achieved for children and their mothers across treatment arms. There was no evidence of significant clinical benefit from supplementing CCBT with either CBT for the maternal anxiety disorder or treatment focussed on mother-child interactions, but the addition of MCI (and not MCBT) may be cost-effective. En ligne : http://dx.doi.org/10.1111/jcpp.13089 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=413

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