Study of Neuro-Cognitive Correlates of Pediatric Anxiety Disorders

• INCLUSION CRITERIA:

ALL JUVENILE SUBJECTS

• Age: 8-17 (subjects who consent as 17-year-olds but turn 18 during the course of thestudy will be eligible to complete all procedures completed by other subjects whoconsent as 17-year-olds but do not turn 18).

• Consent: can give consent/assent (Parents will provide consent; minors will provideassent)

• IQ: all subjects will have IQ>70 (Assessment relies on either a WASI or assessmentby trained clinical staff during the subject s screening visit. Completion ofrequired activities during the screening visit requires an IQ above 70.)

• Language: all subjects will speak English (Tasks in this protocol have not beenvalidated in languages other than English)

ALL ADULT SUBJECTS

• Age: 18-65

• Consent: can give consent

• IQ: all subjects will have IQ>70 (Assessment relies on either a WASI or assessmentby trained clinical staff during the subject s screening visit. Completion ofrequired activities during the screening visit requires an IQ above 70.)

• Language: all subjects will speak English (Tasks in this protocol have not beenvalidated in languages other than English)

ALL SUBJECTS WITH AN ANXIETY DISORDER

• Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, GeneralizedAnxiety Disorder, or Panic Disorder (Based on K-SADS (juveniles) or SCID (adults))

• Symptom Severity: Clinically significant, ongoing anxiety symptoms (This will bedocumented by clinician review with patients and their families during at least twovisits with families.)

• Clinical Impairment: Clinically significant, ongoing distress or impairment fromanxiety (This will be documented by clinician review with patients and theirfamilies during at least two visits with families.)

ALL PREVIOUSLY ENROLLED ADOLESCENT PATIENTS, CHILD AND ADULT HEALTHY VOLUNTEERS, AND ALL HEALTHY VOLUNTEERS TURNED PATIENTS

• Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, GeneralizedAnxiety Disorder, or Panic Disorder; No current diagnosis (Based on K-SADS (juveniles) or SCID (adults))

• Clinical Impairment (as applicable): Clinically significant, ongoing symptoms (Thiswill be documented by clinician review with patients and their families during atleast two visits with families.)

• Symptom Severity (as applicable): Clinically significant, ongoing symptoms (Thiswill be documented by clinician review with patients and their families during atleast two visits with families.)

EXCLUSION CRITERIA:

ALL SUBJECTS

• Any serious medical condition or condition that interferes with fMRI or M/EEGscanning, and for patients electing medication, any condition that increases risk ofSSRI treatment. (All patients will complete a medical history. Healthy volunteerparticipants will be medication- free and have no current serious medicalconditions, based on a review of their medical history. Subjects only will beexcluded from the MRI portions of the study based on this exclusion criterion.)

• Pregnancy (Subjects only will be excluded from the MRI portions of the study basedon this exclusion criterion.)

• Current use of any psychoactive substance; current suicidal ideation; currentdiagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severityto require pharmacotherapy. (These factors could complicate treatment with an SSRI.No subject on medication will be accepted into the trial. Subjects will not be takenoff of medications to enter the trial.)

• Current diagnoses Tourette's Disorder, major depressive disorder (MDD); obsessivecompulsive disorder (OCD), post-traumatic distress disorder, conduct disorder. (These factors may be affected by SSRI treatment, influencing ability to detecteffects on anxiety/symptoms of depression. Of note, subjects who present with adiagnosis of MDD or OCD will not be eligible for inclusion at the outset of thestudy. However, youth with anxiety disorders frequently develop OCD and MDD whenfollowed over time. Subjects will be allowed to remain in the study if they developthese diagnoses after enrollment.)

• Past or current history of mania, psychosis, or severe pervasive developmentaldisorder. (These factors may be affected by SSRI treatment, influencing ability todetect effects on anxiety/symptoms of depression. Of note, subjects who present witha diagnosis of MDD or OCD will not be eligible for inclusion at the outset of thestudy. However, youth with anxiety disorders frequently develop OCD and MDD whenfollowed over time. Subjects will be allowed to remain in the study if they developthese diagnoses after enrollment.)

• Recent use of an SSRI with failure to respond or tolerate SSRI treatment at anadequate dose and duration. (This is designed to exclude subjects who have failed atrial of an SSRI for their current problem with anxiety. For previously enrolledparticipants, including patients and healthy volunteers, current use of an SSRI doesnot exclude participation from follow-up research tasks.)

• History of any (excepting nicotine-related and cannabis-related) DSM5-definedmoderate to severe substance use disorder (or DSM-IV-defined substance dependence).

HEALTHY ADULT SUBJECTS

-Any current psychiatric diagnosis (Assessment relies on SCID)