Internationally recognized child psychologist Golda S. Ginsburg joins the faculty at the University of Connecticut this semester, bringing wide-ranging expertise in the study of anxiety in children to the Child Division of the Department of Psychiatry at UConn Health.
“I love working with children and having the potential to make a positive impact on their lives,” says Ginsburg, who comes to Connecticut from the Division of Child and Adolescent Psychiatry at The Johns Hopkins University School of Medicine, where she was a professor of psychiatry. “My clinical research agenda fits well with the work that my colleagues at UConn are currently doing.”
Ginsburg has been developing and evaluating interventions for anxious youth for more than 20 years. She has been the principal investigator or Co-PI on more than 10 clinical trials, including landmark trials funded by the National Institute of Mental Health (NIMH) for depression, anxiety, and Tourette’s syndrome. She is a lead investigator at the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care, and is completing a study focusing on interventions for pediatricians to help children with anxiety problems.
“What drew me into clinical research is the desire to know, in an empirical way, that the treatments I was providing to children and families were effective,” she says. “In the past, treatments were poorly understood and poorly evaluated. Today we are at a very different place than when I started in the field. We now have evidence-based assessments and interventions for many psychiatric disorders, including anxiety.”
Many people view anxiety disorders as a personal weakness rather than a true illness, Ginsburg says. “I think there’s much less stigma than there used to be, but it’s still there. We need to think of anxiety disorders and other psychiatric disorders the way we think about diabetes or heart disease, in that we should work on promoting prevention and treatment. We need to bring that model to mental health in general. This is especially true for kids at risk for struggles with anxiety.”
Anxiety is related to the fight-or-flight response that enables people to rapidly muster energy in order to cope with perceived threats, she explains. “In people with anxiety disorders, that system has gone haywire. I sometimes use the analogy of an alarm clock that rings when there’s danger. In some people, this alarm goes off when there is no danger, or when the danger is very small and they underestimate their coping ability.”
One of Ginsburg’s goals is to raise awareness of the prevalence of childhood anxiety and how to identify its early signs. She is noted for her development of a school-based treatment for anxiety that engages school social workers and psychologists, and she is the principal investigator of a large efficacy trial of school-based intervention for anxious youth funded by the U.S. Department of Education (DOE). A new project starting this month, also funded by the DOE, will help school nurses identify and intervene with anxious youth.
Ginsburg is a strong advocate of outreach to professionals such as school psychologists, nurses, pediatricians, and psychiatrists, to inform them about prevention and treatment strategies that have been shown to be effective for mental health disorders.
“I’ve been very interested in the work going on in Connecticut to boost efforts to identify kids who need help,” she says. “It’s what got me so excited about coming to UConn.”
Early intervention is key
For anxious children, early recognition of symptoms and taking proactive steps, are vital. In a 2009 report in the Journal of Consulting and Clinical Psychology, Ginsburg explains findings that a family-based intervention may help prevent the onset of anxiety disorders in the children of parents with anxiety disorders.
“I’ve worked with the offspring of anxious parents to help prevent the onset of anxiety, rather than wait for their children to develop the disorder,” she says. “The goal is to identify signs of these disorders early; but even if they are identified later, treatments do work. I’m optimistic with parents, and try to instill hope that their children are not doomed because they are struggling with anxiety.”
A leading authority on anxiety in youth, Ginsburg recently published results from a study that showed almost half of children successfully treated for anxiety relapsed 10 years later. “So we can’t treat anxiety for six months and then forget about it,” she explains. “We need to be vigilant toward recurrence. This requires a shift in thinking, with an emphasis on relapse prevention.”
Ginsburg earned a bachelor’s degree in psychology at California State University, Northridge, and her master’s and doctoral degrees in psychology at the University of Vermont. She completed her clinical psychology internship at the Hutchings Psychiatric Center and a postdoctoral fellowship in psychology at Florida International University.
Working toward prevention
The author of more than 100 peer-reviewed papers, Ginsburg has publications in premier journals such as JAMA Psychiatry, New England Journal of Medicine, Journal of the American Academy of Child and Adolescent Psychiatry, and Journal of Consulting and Clinical Psychology. She has given numerous invited presentations and regularly presents at national and international conferences.
A 2014 JAMA Psychiatry article authored by Ginsburg and her colleagues discusses how pediatric anxiety disorders are not only highly prevalent and impairing, but they are also considered gateway disorders in predicting adult psychiatric problems.
“A significant proportion of kids have chronic and debilitating anxiety,” she says. “We think factors related to the onset of anxiety disorders are multidimensional. There is an inherited genetic or biologic component, but we also know there is a large environmental component. Children’s life experiences help shape the symptoms they experience and their ability to cope.”
As a result of research by Ginsburg and other experts, today there is a more sophisticated array of evidence-based assessments and interventions for anxiety. In a 2011 study, she reported that youths treated with a combination of medication and cognitive behavior therapy had significantly higher rates of remission compared to all other treatment groups.
“As with many other areas within medicine, psychiatry is moving toward personalized treatment,” she says.
Also an educator and clinician, Ginsburg will provide teaching and training at UConn for medical students, residents, and fellows, and will collaborate with faculty at the Storrs campus on research and educational ventures.
Says Ginsburg, “I’m looking forward to the next chapter at UConn.”