Looking for mediators: cognition, perceived control and coping in the treatment of anxiety-disordered children

In this dissertation several putative mediators in the treatment of anxiety disorders in children were examined. Parallel to this, two additional instruments were developed to improve the measurement of mediators. The main conclusions are: 1) An increase in positive thoughts and coping strategies precedes a decrease in anxiety level during the treatment of childhood anxiety disorders; 2) Both positive thoughts and negative thoughts are related to anxiety disorders in children, which has implications for the use of the Power of Nonnegative Thinking hypothesis and Tripartite model in children; 3) A decrease in negative thoughts does not seem to precede a decrease of anxiety level during the treatment of anxiety disorders in children; 4) Changes in perceived control do not only precede, but also follow upon a change in symptom level during the treatment of childhood anxiety; 5) A change in an avoidant coping style does not precede a change in symptom level in the treatment of childhood anxiety, but instead follows upon a change in anxiety level; 6) The Perceived Control Implicit Association Procedure (IAP) can be used to indirectly assess perceived control in children, but it cannot be applied yet to measure intra-individual change; 7) The Anxiety Severity Interview for Children and Adolescents (ASICA) can be used to repeatedly assess anxiety severity during treatment and its use is valuable both for the clinician and the client; 8) The Children’s Automatic Thoughts Questionnaire-Negative/ Positive (CATS-N/P) is a valid and reliable instrument to measure both negative and positive thoughts in children; 9) Further research is needed to establish which treatment techniques bring about change in putative treatment mediators.