title: Incidence, clinical correlates and treatment effect of rage in anxious children.
abstract: Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment.
authors.affiliation: Department of Pediatrics, University of South Florida, USA. Electronic address: cjohnco@health.usf.edu.
authors.forename: Carly
authors.initials: C
authors.lastname: Johnco
authors.affiliation: School of Social Work, University of South Florida, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Salloum
authors.affiliation: Department of Psychology, University of South Florida, USA.
authors.forename: Alessandro S
authors.initials: AS
authors.lastname: De Nadai
authors.affiliation: Department of Pediatrics, University of South Florida, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: McBride
authors.affiliation: Department of Psychology, Temple University, USA.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Crawford
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; Rogers Behavioral Health - Tampa Bay, USA; All Children's Hospital-Johns Hopkins Medicine, USA; Department of Health Policy and Management, University of South Florida, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D001010:Anxiety, Separation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D002648:Child; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007398:Interpersonal Relations; D008297:Male; D010287:Parent-Child Relations; D010379:Peer Group; D011599:Psychopathology; D011889:Rage; D011795:Surveys and Questionnaires
keywords: Anger attacks; Anxiety; Pediatric; Rage