Mediators and moderators of cognitive behavioral therapy for childhood anxiety disorders: information processing, emotion regulation and stressreactivity.

Although cognitive behavioral therapy for childhood anxiety disorders has shown to be effective, little is known about the mechanisms that moderate or mediate the treatment effect. More knowledge about mediators and moderators can contribute to more specific and effective therapies. The objective of this study is to determine if cognitive restructuring and emotion regulation strategies are mechanisms of cognitive therapy for childhood anxiety disorders. Furthermore, the moderating effects of effortful control, executive functions and stress reactivity are studied.

1a. Changes in outcome measures of anxiety can be partly explained by changes in self-reported thougths;
1b. Changes in outcome measures of anxiety can be partly explained by changes in selective attention and by changes in fear relevant cognitive schema's;
2a. Changes in outcome measures of anxiety can be partly explained by changes in self-reported emotion regulation strategies;
2b. Changes in outcome measures of anxiety can be partly explained by changes in processes of attention regulation and by changes in underlying schema's of 'perceived control';
3. Effortful control will moderate the treatment effect;
4. Executive functions will moderate the relation between mediators and the treatment effect. The treatment effect will be larger when executive functions are more developed;
5. Stress-reactivity will moderate the treatment effect;
6. Stress-reactivity is a vulnerability factor for developing an anxiety disorder and is an effect of an anxiety disorder;
7. Part of the variance in treatment effect can be explained by family characteristics (parents psychopathology and parenting style) and characteristics of the therapist.

Group 1: 12 sessions of Cognitive Behavioral Therapy according to the Coping Cat manual. 4 measure points: before therapy, after 8 sessions, after therapy and after 12 week follow-up period;

Group 2: 8 week Waiting List group. Children will receive the same therapy as group 1 after the waiting period. There are 5 measure points: before waiting list, before therapy, after 8 sessions of therapy, after therapy and after 12 week follow-up period.