Kate Fitzgerald, M.D., advances her research on a psychosocial program to reduce anxiety in preschool-aged children
Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes. The fear of new experiences is common for young children, but for the 20% who suffer from clinically significant anxiety, this fear can spiral into long-lasting negative effects. Current anxiety treatments do not work for all, with 30-50% of those who do receive treatment still having anxiety post treatment. When left unchecked, this clinically significant anxiety can persist into adulthood and can lead to depression, substance abuse, unemployment and even suicide.
Dr. Kate Fitzgerald, Associate Professor of Psychiatry at the University of Michigan, won the 2016 One Mind/Aim Sullivan Family Foundation Rising Star Award for her proposal to test the neurobiological and behavioral effects of an original psychosocial treatment aimed to strengthen effortful control (EC), a cognitive skill that she hypothesizes, if increased, could help remedy clinical anxiety in young children. Children who suffer from anxiety disorders typically display lower levels of effortful control than their non-anxious counterparts, making them less likely to directly confront fearful situations. They also exhibit a smaller error-related negativity (ERN) – a measure of brain response to errors believed to underlie effortful control. In children, a lower ERN may combine with a larger fear-potentiated startle (FPS) to increase anxiety.
Dr. Fitzgerald is testing her hypothesis via a series of interactive ‘Kidpower’ camp programs for preschoolers. Each camp includes 4-6 children and their parents, who attend 4-5 camp sessions over a number of consecutive weeks. The camps consist of several short game-like exercises that teach effortful control skills, including selective attention, response inhibition, and set shifting. Previous research by Dr. Fitzgerald and her UM collaborators, Drs. Kate Rosenblum and Maria Muzik, assessed the relationship between the ERN, FPS and a spectrum of anxiety severity in children as a foundational step.
In 2017, Dr. Fitzgerald enrolled 8 children with clinically significant anxiety into the Kidpower program. Each child’s anxiety was measured before and after the camps using the Preschool Anxiety Scale (PAS). The children’s mean PAS decreased from 32.33 at the study entry to 26.5 at study end. In addition, the effortful control behaviors for each participating child increased from pre- to post intervention as measured on the Dimensional Change Card Sort and Flanker tasks, as did their ERN. Although the sample size of this study was small, the findings are encouraging and consistent with her study aims; that the EC training provided within the camps helps increase ERN and decrease FPS, that the EC training increases effortful control behaviors, and that it may help to decrease anxiety. Seeing the positive results, Dr. Fitzgerald and her team are continuing to improve the protocol and intervention format of the camps in prep of the two to three more camps they intend to lead in 2018.
At a time when the current treatments for anxiety continue to fall short and the number of children who are taking prescription drugs is skyrocketing, it is exciting to see the progress Dr. Fitzgerald is making in this novel, non-drug treatment option for anxiety. We are honored to support Dr. Fitzgerald via the One Mind Rising Star Award program and are grateful to the donors of AIM for Mental Health who have enabled us to do so. Data from these initial studies will enable Dr. Fitzgerald to submit a competitive application to the National Institute of Mental Health with hopes of further expanding the scale and impact of this research.
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Watch Dr. Fitzgerald’s engaging talk at the 2016 Music Festival for Brain Health: