Effectiveness of Video-Feedback with Cognitive Preparation in Improving Social Performance and Anxiety through Super Skills for Life Programme Implemented in a School Setting

Mireia Orgilés, Silvia Melero, Iván Fernández-Martínez, José Pedro Espada, Alexandra Morales, Mireia Orgilés, Silvia Melero, Iván Fernández-Martínez, José Pedro Espada, Alexandra Morales

Abstract

Effectiveness of video-feedback with cognitive preparation to treat anxiety problems (especially social anxiety) has been scarcely explored on children. Super Skills for Life (SSL) is a CBT-based intervention to reduce anxiety and comorbid problems that, apart from social skills training and behavioural activation, integrates video-feedback with cognitive preparation. This study aimed to evaluate SSL effects, implemented in a school setting, on social performance and to test self-concept and social skills as potential mediators of pre- and post-test changes in social anxiety and generalized anxiety. Sample comprised 57 children aged 8-11 years with emotional symptoms. Children were video recorded in the first and last session to assess social performance. Anxiety and self-concept measures were completed by children pre-test and post-test. Participants reduced anxiety behaviours and improved social and communication skills after treatment. In general, girls showed better social performance than boys, but SSL impact was greater in males. Social self-concept was the only mediator of change in pre- to post-treatment social anxiety. This study provides evidence of SSL to improve children's social performance and reduce anxiety through video-feedback with cognitive preparation. Improving social concept seems essential to reduce social anxiety. An SSL programme is an ideal prevention protocol for anxious children.

Keywords: Super Skills for Life; anxiety symptoms; children; school; social performance; video-feedback.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Progress of children participating in the trial.

References

    1. Essau C.A., Gabbidon J. Epidemiology, comorbidity and mental health services utilization. In: Essau C.A., Ollendick T.H., editors. The Wiley-Blackwell Handbook of the Treatment of Childhood and Adolescent Anxiety. Wiley Blackwell; Chichester, UK: 2013. pp. 23–42.
    1. Orgilés M., Méndez X., Espada J.P., Carballo J.L., Piqueras J.A. Síntomas de trastornos de ansiedad en niños y adolescentes: Diferencias en función de la edad y el sexo en una muestra comunitaria. Revista de Psiquiatría y Salud Mental. 2012;5:115–120. doi: 10.1016/j.rpsm.2012.01.005.
    1. Voltas N., Hernández-Martínez C., Arija V., Canals J. The natural course of anxiety symptoms in early adolescence: Factors related to persistence. Anxiety Stress Coping. 2017;30:671–686. doi: 10.1080/10615806.2017.1347642.
    1. Broeren S., Muris P., Diamantopoulou S., Baker J. The course of childhood anxiety symptoms: Developmental trajectories and child-related factors in normal children. J. Abnorm. Child Psychol. 2013;41:81–95. doi: 10.1007/s10802-012-9669-9.
    1. Roza S.J., Hofstra M.B., van der Ende J., Verhulst F.C. Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: A 14-year follow-up during childhood, adolescence, and young adulthood. Am. J. Psychiatry. 2003;160:2116–2121. doi: 10.1176/appi.ajp.160.12.2116.
    1. Benjamin C.L., Harrison J.P., Settipani C.A., Brodman D.M., Kendall P.C. Anxiety and related outcomes in young adults 7 to 19 years after receiving treatment for child anxiety. J. Consult. Clin. Psychol. 2013;81:865–876. doi: 10.1037/a0033048.
    1. Essau C.A. Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety. 2005;22:130–137. doi: 10.1002/da.20115.
    1. Snell T., Knapp M., Healey A., Guglani S., Evans-Lacko S., Fernandez J., Meltzer H., Ford T. Economic impact of childhood psychiatric disorder on public sector services in Britain: Estimates from national survey data. J. Child Psychol. Psychiatry. 2013;54:977–985. doi: 10.1111/jcpp.12055.
    1. Huberty T.J. Test and performance anxiety. Princ. Leadersh. 2009;10:12–16.
    1. Albano A.M., Hayward C. Social anxiety disorder. In: Ollendick T.H., March J.S., editors. Phobic and Anxiety Disorders in Children and Adolescents: A clinician’s Guide to Effective Psychosocial and Pharmacological Interventions. Oxford University Press; New York, NY, USA: 2004. pp. 198–235.
    1. Ramos V., Piqueras J.A., García-López L. Efficacy and efficiency of the use of video-feedback in the cognitive-behavioral treatment of young people with social anxiety disorder. Clin. Salud. 2008;19:249–264.
    1. Cartwright-Hatton S., Hodges L., Porter J. Social anxiety in childhood: The relationship with self and observer rated social skills. J. Child Psychol. Psychiatry. 2003;44:737–742. doi: 10.1111/1469-7610.00159.
    1. Beidel D.C., Turner S.M., Morris T.L. Behavioral treatment of childhood social phobia. J. Consult. Clin. Psychol. 2000;68:1072–1080. doi: 10.1037/0022-006X.68.6.1072.
    1. Spence S.H., Donovan C., Brechman-Toussaint M. Social skills, social outcomes, and cognitive features of childhood social phobia. J. Abnorm. Psychol. 1999;108:211–221. doi: 10.1037/0021-843X.108.2.211.
    1. Beidel D.C., Ferrell C., Alfano C.A., Yeganeh R. The treatment of childhood social anxiety disorder. Psychiatr. Clin. N. Am. 2001;24:831–846. doi: 10.1016/S0193-953X(05)70266-5.
    1. Coplan R.J., Prakash K., O’Neil K., Armer M. Do You “Want” to Play? Distinguishing Between Conflicted Shyness and Social Disinterest in Early Childhood. Dev. Psychol. 2004;40:244–258. doi: 10.1037/0012-1649.40.2.244.
    1. La Greca A.M., Harrison H.M. Adolescent peer relations, friendships, and romantic relationships: Do they predict social anxiety and depression? J. Clin. Child Adolesc. Psychol. 2005;34:49–61. doi: 10.1207/s15374424jccp3401_5.
    1. Rodríguez J.O., Rosa-Alcázar A.I., Caballo V.E., García-López L.J., Orgilés M., López-Gollonet C. Treatment of social phobia in children and adolescents: A meta-analytic review. Behav. Psychol. 2003;11:599–622.
    1. Borowski S.K., Zeman J., Braunstein K. Social Anxiety and Socioemotional Functioning During Early Adolescence: The Mediating Role of Best Friend Emotion Socialization. J. Early Adolesc. 2018;38:238–260. doi: 10.1177/0272431616665212.
    1. Essau C.A., Olaya B., Sasagawa S., Pithia J., Bray D., Ollendick T.H. Integrating video-feedback and cognitive preparation, social skills training and behavioural activation in a cognitive behavioural therapy in the treatment of childhood anxiety. J. Affect. Disord. 2014;167:261–267. doi: 10.1016/j.jad.2014.05.056.
    1. Pilkonis P.A. The behavioral consequences of shyness 1. J. Personal. 1977;45:596–611. doi: 10.1111/j.1467-6494.1977.tb00174.x.
    1. Essau C.A., Conradt J., Sasagawa S., Ollendick T.H. Prevention of Anxiety Symptoms in Children: Results from a Universal School-Based Trial. Behav. Ther. 2012;43:450–464. doi: 10.1016/j.beth.2011.08.003.
    1. James A.C., James G., Cowdrey F.A., Soler A., Choke A. Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd.; Hoboken, NJ, USA: 2015. Cognitive behavioural therapy for anxiety disorders in children and adolescents.
    1. Weisz J.R., Weiss B., Han S.S., Granger D.A., Morton T. Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychol. Bull. 1995;117:450–468. doi: 10.1037/0033-2909.117.3.450.
    1. Masia-Warner C., Nangle D.W., Hansen D.J. Bringing evidence-based child mental health services to the schools: General issues and specific populations. Educ. Treat. Children. 2006;29:165–172.
    1. Essau C.A., Sasagawa S., Jones G., Fernandes B., Ollendick T.H. Evaluating the real-world effectiveness of a cognitive behavior therapy-based transdiagnostic programme for emotional problems in children in a regular school setting. J. Affect. Disord. 2019;253:357–365. doi: 10.1016/j.jad.2019.04.036.
    1. Essau C., Ollendick T.H. The Super Skills for Life programme. University of Roehampton; London, UK: 2013.
    1. Clark D.M., Wells A. A cognitive model of social phobia. In: Heimberg R.G., Liebowitz M.R., Hope D.A., Schneier F.R., editors. Social Phobia: Diagnosis, Assessment, and Treatment. Guilford Press; New York, NY, USA: 1995. pp. 69–93.
    1. Harvey A.G., Clark D.M., Ehlers A., Rapee R.M. Social anxiety and self-impression: Cognitive preparation enhances the beneficial effects of video feedback following a stressful social task. Behav. Res. Ther. 2000;38:1183–1192. doi: 10.1016/S0005-7967(99)00148-5.
    1. Rapee R.M., Hayman K. The effects of video feedback on the self-evaluation of performance in socially anxious subjects. Behav. Res. Ther. 1996;34:315–322. doi: 10.1016/0005-7967(96)00003-4.
    1. Rodebaugh T.L. I might look OK, but I’m still doubtful, anxious, and avoidant: The mixed effects of enhanced video feedback on social anxiety symptoms. Behav. Res. Ther. 2004;42:1435–1451. doi: 10.1016/j.brat.2003.10.004.
    1. Parr C.J., Cartwright-Hatton S. Social anxiety in adolescents: The effect of video feedback on anxiety and the self-evaluation of performance. Clin. Psychol. Psychother. 2009;16:46–54. doi: 10.1002/cpp.599.
    1. Morgan J., Banerjee R. Social Anxiety and Self-Evaluation of Social Performance in a Nonclinical Sample of Children. J. Clin. Child Adolesc. Psychol. 2006;35:292–301. doi: 10.1207/s15374424jccp3502_13.
    1. Orgilés M., Fernández-Martínez I., Espada J.P., Morales A. Spanish version of Super Skills for Life: The short- and long-term effectiveness of a transdiagnostic prevention protocol for Spanish children. Anxiety Stress Coping. 2019;36:694–710. doi: 10.1080/10615806.2019.1645836.
    1. De la Torre-Luque A., Fiol-Veny A., Essau C.A., Balle M., Bornas X. Effects of a transdiagnostic cognitive behaviour therapy-based programme on the natural course of anxiety symptoms in adolescence. J. Affect. Disord. 2020;264:474–482. doi: 10.1016/j.jad.2019.11.078.
    1. Fernández-Martínez I., Morales A., Espada J.P., Essau C.A., Orgilés M. Effectiveness of the program Super Skills For Life in reducing symptoms of anxiety and depression in young Spanish children. Psicothema. 2019;31:298–304. doi: 10.7334/psicothema2018.336.
    1. Michels N., Vanaelst B., Stoppie E., Huybrechts I., Bammann K., De Henauw S., Sioen I. Parental and children’s report of emotional problems: Agreement, explanatory factors and event-emotion correlation. Child Adolesc. Ment. Health. 2013;18:180–186. doi: 10.1111/j.1475-3588.2012.00672.x.
    1. Goodman R. Psychometric Properties of the Strengths and Difficulties Questionnaire. J. Am. Acad. Child Adolesc. Psychiatry. 2001;40:1337–1345. doi: 10.1097/00004583-200111000-00015.
    1. García F., Musitu G., editors. In AF-5. Autoconcepto forma 5. Versión revisada y ampliada. TEA Ediciones; Madrid, Spain: 2014.
    1. Birmaher B., Brent D.A., Chiappetta L., Bridge J., Monga S., Baugher M. Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. J. Am. Acad. Child Adolesc. Psychiatry. 1999;38:1230–1236. doi: 10.1097/00004583-199910000-00011.
    1. Fydrich T., Chambless D.L., Perry K.J., Buergener F., Beazley M.B. Behavioral assessment of social performance: A rating system for social phobia. Behav. Res. Ther. 1998;36:995–1010. doi: 10.1016/S0005-7967(98)00069-2.
    1. Rosenthal R., Rosnow R.L. Contrast Analysis: Focused Comparisons in the Analysis of Variance. Cambridge University Press; Cambridge, UK: 1985.
    1. Fitzmaurice G.M., Laird N.M., Ware J.H. Applied Longitudinal Analysis. John Wiley & Sons; Boston, MA, USA: 2012.
    1. Liang K., Zeger S.L. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22. doi: 10.1093/biomet/73.1.13.
    1. Hayes A.F. Introduction to Mediation, Moderation, and Conditional Process. Analysis: A Regression-Based Approach. Guilford Press; New York, NY, USA: 2013.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren