Targeting neurobehavioral substrates of effortful control to reduce childhood anxiety The Camp Kidpower study protocol

Background Early childhood anxiety affects up to 20% of preschoolers, with long-term implications including depression, substance abuse, and suicide. Despite some success with exposure-based cognitive behavioral therapy (CBT), many children retain clinically significant symptoms, highlighting the need for innovative interventions. This study integrates the Research Domain Criteria (RDoC) and experimental medicine frameworks to target effortful control (EC)—the capacity to regulate attention and impulses—to reduce anxiety in young children through a novel intervention, Camp Kidpower . Methods This randomized clinical trial involves 90 preschoolers diagnosed with anxiety disorders, assigned to either an EC training camp or an active comparator condition (child-led play; CLP). The EC intervention incorporates play-based activities targeting selective attention, inhibitory control, and working memory, delivered over five weekly sessions with at-home practice. Anxiety and EC were assessed pre- and post-intervention using clinician ratings, parent/teacher reports, lab-based tasks, and neurophysiological measures (e.g., error-related negativity [ERN] and interchannel phase synchrony [ICPS]). Exploratory analyses include dose-response effects and moderators such as baseline EC, parental psychopathology, and child temperament. Discussion Camp Kidpower aims to enhance EC to mitigate anxiety in preschoolers, addressing the limitations of traditional CBT by offering an accessible, community-based intervention. This study will provide insight into the neurobehavioral mechanisms linking EC and anxiety, inform the design of targeted treatments, and evaluate potential moderators of intervention efficacy. If successful, the intervention could be disseminated broadly to clinics, schools, and community settings. Keywords : childhood anxiety, effortful control, ERN, interchannel phase synchrony, RCT Trial Registration: ClinicalTrials.gov ID NCT04960813; Registered Date 2025-02-04; Study Sponsor: Columbia University