Friends or Foes? Predictors of Treatment Outcome of Cognitive Behavioral Therapy for Childhood Anxiety Disorders Julliette Liber
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1 Friends or Foes? Predictors of Treatment Outcome of Cognitive Behavioral Therapy for Childhood Anxiety Disorders Friends or Foes? Predictors of Treatment Outcome of Cognitive Behavioral Therapy for Childhood Anxiety Disorders Julliette Liber
2 ISBN Cover by Lecarpentier grafisch ontwerp Printed by Optima Grafische Communicatie, Rotterdam, the Netherlands This study was funded by Netherlands Foundation for Mental Health, situated in Utrecht and by Curium/ Revolving Fund LUMC.
3 FRIENDS OR FOES? PREDICTORS OF TREATMENT OUTCOME OF COGNITIVE BEHAVIORAL THERAPY FOR CHILDHOOD ANXIETY DISORDERS Proefschrift ter verkrijging van de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof. mr. P.F. van der Heijden, volgens besluit van het College voor Promoties te verdedigen op woensdag 5 november 2008 klokke uur door Juliëtte Margo Liber geboren te Krimpen aan den IJssel in 1976
4 PROMOTIECOMMISSIE Promotores: Copromotor: Referent: Overige leden: Prof. dr. Ph. D. A. Treffers Prof. dr. F. C. Verhulst (Erasmus Universiteit) Dr. B. M. Van Widenfelt Prof. dr. P. M. Prins (Universiteit van Amsterdam) Prof. dr. M. Dekovic (Universiteit Utrecht) Dr. N. D. J. Van Lang Dr. I. M. Van Vliet
5 DE RIDDER VAN VOGELENZANG Er leefde een ridder in Vogelenzang, Al heel lang geleden, verschrikkelijk lang, Die draken versloeg voor een roos en een zoen, Zoals men dat nu nog maar zelden ziet doen. Die dappere ridder van Vogelenzang! Maar s avonds in het donker dan was hij zo bang! Dan lag hij te beven tot kwart over zeven, Want altijd in t donker hoorde hij leven! En iedere nacht, om zijn angst kwijt te raken, Probeerde hij vrolijke rijmpjes te maken, En telkens begon hij van voren af aan: Wat heb ik vandaag voor heldhaftigs gedaan? Vijf draken verslagen, Een jonkvrouw gered! Waarom lig ik dan zo Te rillen in bed? En prompt overdag, als de hemel ging klaren, Versloeg hij weer draken, of t kevertjes waren, Die dappere ridder van Vogelenzang. Maar s avonds in t donker dan werd hij weer bang. Dan ging hij weer rijmen van voren af aan: Wat heb ik vandaag voor plezierigs gedaan? Mijn paard opgetuigd En mijn helm ingevet, Mijn vrouw toegeknikt Toen ze thee heeft gezet. Waarom lig ik dan zo te trillen in bed? Om een uur des nachts werd het meestal te bar! Dan raakte de ridder totaal in de war! Dan jankte hij zachtjes, bij ieder geluid En lang maar te prevelen, stil voor zich uit: Een jonkvrouw verslagen, Vijf draken gered Maar zeg ik het goed? Nee, het lijkent wel pet! Mijn vrouw afgetuigd En mijn paard ingevet Een draak toegeknikt toen hij thee had gezet Ik weet het niet meer en ik hoor weer geluid k Ben bang in het donker! Wie haalt me d r uit? Moederrrrr! (Annie M. G. Schmidt, 1987/ 2007)
6 THE KNIGHT OF BIRDIES-SONG A long, long time ago, terribly long, There once lived a knight at Birdies-song Who conquered dragons for a rose and a kiss As one nowadays will rarely witness He was such a brave knight, our knight of Birdies-song But in hours of darkness he was terrified He would lay trembling in his bed till morning light (Annie M. G. Schmidt, 1987/ 2007)
7 CONTENTS Chapter 1 Introduction 9 Chapter 2 No differences between group versus individual treatment of childhood anxiety disorders in a randomized clinical trial 27 Chapter 3 Parenting and parental anxiety and depression as predictors of treatment outcome for childhood anxiety disorders: Has the role of fathers been underestimated? 43 Chapter 4 Social performance predicts treatment outcome in children with anxiety disorders 63 Chapter 5 Comorbidity and cognitive behavioral treatment outcome for childhood anxiety disorders 79 Chapter 6 Examining the relation between the therapeutic alliance, treatment adherence, and outcome of cognitive behavioral treatment for children with anxiety disorders 97 Chapter 7 General Discussion 115 References 131 Appendix 149 Summary 157 Summary in Dutch 163 Curriculum Vitae 169
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