Clinical Focus

  • Psychiatry

Academic Appointments

  • Professor - Med Center Line, Psychiatry and Behavioral Sciences

Administrative Appointments

  • Residency Training Director, Psychiatry (2010 - Present)
  • Chief of Adult Clinical Services, Psychiatry (2006 - Present)
  • Associate Chair of Education and Training, Psychiatry (2011 - Present)

Honors & Awards

  • Teacher of the Year, Department of Psychiatry, Stanford University School of Medicine (1994)
  • Faculty Scholars Award, William T. Grant (1995)
  • Selected as Educators for C.A.R.E. Program Faculty Member, Stanford University School of Medicine (2008)
  • Leadership in Education Award, Stanford University School of Medicine (2008)
  • Leadership in Education Award, Stanford University School of Medicine (2009)
  • Golden Apple Award for Professor of the Year, Stanford University/Palo Alto University Consortium (2010)

Professional Education

  • Internship:UCSF Medical Center (1985) CA
  • Fellowship:Stanford University Medical Center (1988) CA
  • Board Certification: Psychiatry, American Board of Psychiatry and Neurology (1993)
  • Residency:Stanford University Medical Center (1986) CA
  • Medical Education:UCSF Medical Center (1984) CA
  • MPH, Univ of California Berkeley, Epidemiology (1982)
  • BS, University of San Francisco (1977)

Research & Scholarship

Current Research and Scholarly Interests

Dr. Hayward’s research has focused on the emergence of internalizing disorders during adolescence. His interests are in epidemiology of adolescent psychopathology in school-based studies and the role of puberty in determining onset of internalizing disorders in young adolescent girls in particular. He studies risk factors for the onset of adolescent panic disorder and social anxiety disorder. Dr. Hayward also helped to develop the Stanford Center on Adolescence, a multidisciplinary research and training Center funded by the Carnegie Corporation of New York, where he is now Associate Director. The Center sponsors research at Stanford University and provides syntheses of the scientific knowledge-base so that both public and private policy makers can develop and disseminate strategies for aiding adolescents. Dr. Hayward is also active in medical education and in 2008 was selected as one of the "Educators-for-Care" physicians in the Medical School. Dr. Hayward has also been the recipient of the teacher of the year award by graduating residents.


2015-16 Courses


All Publications

  • Attentional Biases for Threat in At-Risk Daughters and Mothers With Lifetime Panic Disorder JOURNAL OF ABNORMAL PSYCHOLOGY Mogg, K., Wilson, K. A., Hayward, C., Cunning, D., Bradley, B. P. 2012; 121 (4): 852-862


    Children of parents with panic disorder (PD) have high risk for developing anxiety disorders. However, the mechanisms involved in transmission of risk are uncertain. Cognitive models of anxiety propose that information-processing biases underlie anxiety vulnerability; in particular, attentional biases for threat. Consequently, this study examined attentional biases in mothers with lifetime PD and their daughters (aged 9-14 years). Sixty mother-daughter dyads (n = 120) were recruited to the study; half the mothers had lifetime PD (i.e., either a current or past history of PD), and half had no psychiatric history. Attentional biases were assessed using a visual-probe task with pictorial and word stimuli related to physical-health threat. Stimulus duration was varied to examine the time-course of attentional biases (initial orienting and maintained attention). Results showed an attentional bias for threat in daughters of mothers with lifetime PD, compared with daughters of mothers with no PD history. Specifically, at-risk daughters had an attentional bias for physical-health threat cues (words and pictures) at the longer stimulus duration of 1250 ms (but not at 500 ms). In addition, attentional bias for threat in girls was associated with increased physical-health threat worries. Mothers with lifetime PD did not significantly differ from mothers with no PD history on the indices of attentional bias. The findings are discussed in terms of an attentional threat-monitoring strategy in at-risk girls and argue against the view that there is simple transmission of an anxiety-related attentional processing style across generations.

    View details for DOI 10.1037/a0028052

    View details for Web of Science ID 000311527700006

    View details for PubMedID 22612199

  • Does Gender Moderate the Relationship Between Childhood Maltreatment and Adult Depression? CHILD MALTREATMENT Arnow, B. A., Blasey, C. M., Hunkeler, E. M., Lee, J., Hayward, C. 2011; 16 (3): 175-183


    Although considerable evidence demonstrates that adults who report childhood maltreatment are at increased risk of depression in adulthood, little is known about whether gender moderates risk. In a sample of 5,673 adult Health Maintenance Organization (HMO) patients, the authors employed the Patient Health Questionnaire-8 (PHQ-8) to assess major depressive disorder (MDD) and the Childhood Trauma Questionnaire (CTQ) to assess five different types of childhood maltreatment: emotional, physical, and sexual abuse, as well as emotional and physical neglect. Logistic regression models tested the main and interactive effects of gender and childhood maltreatment. Consistent with previous studies, men and women with histories of each type of childhood adversity were significantly more likely to meet criteria for MDD. However, the authors found no evidence that gender moderates the risk of depression. These findings suggest that men and women reporting history of childhood maltreatment are equally likely to suffer major depression in adulthood.

    View details for DOI 10.1177/1077559511412067

    View details for Web of Science ID 000294707400002

    View details for PubMedID 21727161

  • Life stress and first onset of psychiatric disorders in daughters of depressed mothers JOURNAL OF PSYCHIATRIC RESEARCH Gershon, A., Hayward, C., Schraedley-Desmond, P., Rudolph, K. D., Booster, G. D., Gotlib, I. H. 2011; 45 (7): 855-862


    This study used a comprehensive, interview-based measure of life stress to assess the role of different types of stress in predicting first onset of psychiatric disorders among daughters of depressed (n = 22) mothers and healthy (n = 22) mothers. Several types of stress were assessed: Chronic interpersonal stress, chronic non-interpersonal stress, episodic dependent (i.e., self-generated) interpersonal stress, episodic dependent non-interpersonal stress, episodic independent interpersonal stress, and episodic independent non-interpersonal stress. Daughters (ages 9-14) were recruited to have no clinically significant symptoms upon entry (T1). By a 30-month follow-up assessment (T2), 45% of the daughters of depressed mothers, but none of the daughters of healthy mothers, had developed a psychiatric disorder. Overall, daughters of depressed mothers were exposed to more severe chronic interpersonal and non-interpersonal stress than were daughters of healthy mothers. Further, daughters of depressed mothers who developed a psychiatric disorder by T2 were exposed to more severe chronic non-interpersonal stress and episodic dependent stress than were daughters of depressed mothers who remained healthy. We discuss the implications of these findings in the context of a stress-generation model for the intergenerational transmission of psychiatric risk among children of depressed mothers.

    View details for DOI 10.1016/j.jpsychires.2011.03.016

    View details for Web of Science ID 000292667900001

    View details for PubMedID 21524424

  • Catastrophizing, depression and pain-related disability GENERAL HOSPITAL PSYCHIATRY Arnow, B. A., Blasey, C. M., Constantino, M. J., Robinson, R., Hunkeler, E., Lee, J., Fireman, B., Khaylis, A., Feiner, L., Hayward, C. 2011; 33 (2): 150-156


    The objective of the study was to examine catastrophizing, depression and their interactive effects in predicting disability in patients with chronic pain.A battery of questionnaires was mailed to primary care patients in a large integrated health care delivery system. The Patient Health Questionnaire was used to assess major depression, the Coping Strategies Questionnaire assessed catastrophizing and the Graded Chronic Pain Scale was used to assess pain intensity and two measures of disability, including self-report of pain interference and days missed from usual activities. Patient medical records were used to assess severe medical illness. Of the 5808 respondents, 2618 met criteria for chronic pain. Multiple regression analyses, covarying for age, gender, severe medical illness and pain intensity, estimated the main and interactive effects of catastrophic thinking and depression on two measures of pain-related disability.Both catastrophic thinking and depression were statistically significant predictors of both measures of pain-related disability, with larger effect sizes observed for catastrophic thinking.Routine assessment of both catastrophic thinking and depression is important in the treatment of chronic pain patients, and modification of these factors may reduce disability and increase the ability of chronic pain patients to participate in daily life activity.

    View details for DOI 10.1016/j.genhosppsych.2010.12.008

    View details for Web of Science ID 000289183700009

    View details for PubMedID 21596208

  • Life stress and first onset of psychiatric disorders in daughters of depressed mothers Journal of Psychiatric Research Gershon A., Hayward C, Schraedley-Desmond P, Rudolph KD, Booster GD, Gotlieb IH. 2011; 45: 855-862
  • Catastrophizing Depression and Pain-Related Disability. General Hospital Psychiatry Arnow BA, Blasey C, Constantino MJ, Robinson R, Hunkeler E, Lee J, Fireman B, Khaylis A, Feiner L, Hayward C. 2011; 33 (2): 150-156
  • Failure to improve cigarette smoking abstinence with transdermal selegiline plus cognitive behavior therapy ADDICTION Killen, J. D., Fortmann, S. P., Murphy, G. M., Hayward, C., Fong, D., Lowenthal, K., Bryson, S. W., Killen, D. T., Schatzberg, A. F. 2010; 105 (9): 1660-1668


    To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence.Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks.Community smoking cessation clinic.243 adult smokers (> or =18 years of age; > or =10 cigarettes/day).Expired-air carbon monoxide confirmed 7-day point prevalence abstinence.STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response (P = 0.01). The survival rate through week 52 for those with high 'drive' scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low 'drive scores' on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo.Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low 'behavioral activation'.

    View details for DOI 10.1111/j.1360-0443.2010.03020.x

    View details for Web of Science ID 000280668200027

    View details for PubMedID 20707784

  • Failure to Improve Cigarette Smoking Abstinence With Transdermal Selegiline + Cognitive Behavioral Therapy. Addiction Killen JD, Fortmann SP, Murphy G, Hayward C, Fong D, Killen D, Schatzberg AF. 2010; 105: 1660-1668
  • The Interactive Effects of Puberty and Peer Victimization on Weight Concerns and Depression Symptoms Among Early Adolescent Girls JOURNAL OF EARLY ADOLESCENCE Compian, L. J., Gowen, L. K., Hayward, C. 2009; 29 (3): 357-375
  • Relationships Among Depression, Chronic Pain, Chronic Disabling Pain, and Medical Costs PSYCHIATRIC SERVICES Arnow, B. A., Blasey, C. M., Lee, J., Fireman, B., Hunkeler, E. M., Dea, R., Robinson, R., Hayward, C. 2009; 60 (3): 344-350


    Although evidence suggests that patients with depression use more medical services than those without depression, few studies have examined whether specific subgroups of patients with depression have higher utilization than others. The study compared costs for general medical care with and without psychiatric care for patients with major depression and disabling chronic pain (reference group) with costs for five other groups: those with depression and nondisabling chronic pain, those with major depressive disorder alone, those with no depression who had disabling chronic pain, those with depression who had chronic pain that was not disabling, and those who had neither pain nor depression. Costs for the group with major depressive disorder alone were compared to costs for the three groups without depression.A questionnaire assessing major depressive disorder, chronic pain, and pain-related disability was mailed to a random sample of Kaiser Permanente patients who visited a primary care clinic. A total of 5,808 patients responded (54% participation rate). Costs for a two-year period were obtained from Kaiser Permanente's Cost Management Information System. Analyses were adjusted for presence of any of four major chronic medical illnesses.Total costs for patients in the reference group were significantly higher than costs for the other five subgroups. Regression analyses indicated that continuous measures of severity of pain and severity of depression were associated with increased costs, but no statistically significant interaction of depression and pain on total cost was observed.Patients with major depressive disorder and comorbid disabling chronic pain had higher medical service costs than other groups of patients with and without depression. However, findings suggest that the increases in cost from having both pain and depression are additive and not multiplicative.

    View details for Web of Science ID 000263723600010

    View details for PubMedID 19252047

  • A critical review of the empirical literature on the relation between anxiety and puberty CLINICAL PSYCHOLOGY REVIEW Reardon, L. E., Leen-Feldner, E. W., Hayward, C. 2009; 29 (1): 1-23


    The current paper critically reviews the empirical literature focused on the association between puberty and anxiety. A detailed review of more than 45 empirical articles is provided. There is some evidence that among girls, but not boys, a more advanced pubertal status (controlling for age) is associated with higher reported anxiety symptoms. Also among girls, earlier pubertal timing is linked to higher anxiety scores. It is unclear whether early puberty may lead to increased anxiety or if high anxiety influences pubertal timing. With respect to hormones, there were relatively few significant associations for girls, although this literature is very small. Among boys, several studies reported positive associations between both gonadal and adrenal hormones and anxiety. The direction of effect for these finding is also unstudied. The primary limitation of the hormone-anxiety literature pertains to the absence of pubertal measures in samples of youth in which hormones are measured. The paper concludes with a comprehensive examination of the methodological strengths and weaknesses of the literature and recommendations for future work.

    View details for DOI 10.1016/j.cpr.2008.09.005

    View details for Web of Science ID 000262821300001

    View details for PubMedID 19019513

  • The Interactive Effects of Puberty and Social Victimization on Weight Concerns and Depression Symptoms Among Early Adolescent Girls The Journal of early Adolescence Compian LJ, Gowen LK, Hayward C. 2009; 29 (3): 357-375
  • A Critical Review of the Empirical Literature on the Relationship between Anxiety and Puberty. Clinical Psychology Review Reardon LE, Leen-Feldner EW, Hayward C. 2009; 29: 1-23
  • Relationships Among Depression, Chronic Pain, Disability and Medical Costs Psychiatric Services Arnow BA, Blasey C, Lee J, Fireman B, Hunkeler EM, Dea R, Robinson R, Hayward C. 2009; 60 (3): 344-350
  • Gender, victimization, and psychiatric outcomes PSYCHOLOGICAL MEDICINE Gershon, A., Minor, K., Hayward, C. 2008; 38 (10): 1377-1391


    Although gender differences in rates of internalizing disorders, particularly depression, are well documented, the causes of these differences are not well understood. One influential hypothesis [Cutler & Nolen-Hoeksema, Sex Roles (1991), 24, 425-438] proposes that higher rates of depression in females compared to males may be partially attributable to gender differences in the effects of childhood sexual abuse. The present study has evaluated this possibility by reviewing evidence for gender moderating the effects of childhood victimization on psychiatric outcomes.Literature search using PsycINFO and Medline, applying the following inclusion criteria: publication from 1996 to 2006, community-based sampling, adequate male-to-female sample ratio, use of clearly defined psychiatric outcomes, and a statistical test of gender differences in the effects of childhood victimization on psychiatric outcomes.Thirty studies met inclusion criteria. Overall, the results were mixed. Nearly half of all studies find no gender differences. In studies that do observe gender differences, victimization tends to be associated with higher psychiatric risk in females in studies with adult samples, whereas in samples of youth, victimization tends to be associated with higher psychiatric risk in males. With respect to outcome, when gender differences were observed, outcomes were distributed across both internalizing and externalizing categories for both genders.The gender differences in prevalence rates of internalizing disorders, such as depression, do not appear to be attributable to differential effects of childhood victimization.

    View details for DOI 10.1017/S0033291708003000

    View details for Web of Science ID 000259654300001

    View details for PubMedID 18387212

  • Extended Cognitive Behavior Therapy for Cigarette Smoking Cessation Addiction Killen JD, Fortmann SP, Schatzberg AF, Arredondo C, Murphy GM, Hayward C, Celio M, Cromp D, Fong D, Pandurangi M. 2008; 103: 1381-1390
  • Gender, victimization, and psychiatric outcomes Psychological Medicine Gershon A, Minor K, Hayward C. 2008: 1-15
  • Anxiety Sensitivity: The Missing Piece to the Agoraphobia-Without-Panic Puzzle. Behavior Modification Hayward C, Wilson KA. 2007; 31 (2): 162-173
  • Puberty and Gender Interact to Predict Social Anxiety in Early Adolescence. Journal of Adolescent Health Deardorff J, Hayward C, Wilson KA, Bryson S, Hammer LD, Agras S. 2007; 41 (1): 102-104
  • The Reliability of Self-reported Menarcheal Timing. Journal of Early Adolescence Smolak L, Krieg DB, Hayward C, Shisslak C, Taylor CB. 2007; 27: 386-398
  • Comorbid Depression, Chronic Pain and Disability in Primary Care. Psychometric Medicine Arnow BA, Hunkeler EM, Blasey C, Lee J, Constantino MJ, Fireman B, Kraemer HC, Dea R, Robinson R, Hayward C. 2006: 262-268
  • Lifetime Prevalence and Pseudocomorbidity in Psychiatric Research. Archives of General Psychiatry Wilson KA, Kraemer HC, Hayward C. 2006: 604-608
  • Unique Contributions of Anxiety Sensitivity to Avoidance: A Prospective Study in Adolescents Behaviour Research and Therapy Wilson KA, H. 2006; 44 (4): 601-609
  • A Prospective Evaluation of Agoraphobia andDepression Symptoms Following Panic Attacks in a Community Sample ofAdolescents. Journal of Anxiety Disorders Wilson KA, H. 2005; 19 (1): 87-103
  • Parent-Reported Risk Factors for Panic Attacks Journal of the American Academy of Child and Adolescent Psychiatry Hayward C, Wilson KA, Lagel K, Killen JD, Taylor CB. 2004; 43 (5): 613-620
  • Puberty and the Emergence of Gender Differences in Psychopathology Journal of Adolescent Health Hayward C, Sanborn K. 2002; 30S: 49-58
  • Cognitive-Behavioral Group Therapy for Social Phobia in Female Adolescents: Results of a Pilot Study Journal of the American Academy of Child and Adolescent Psychiatry Hayward C, Varady S, Albano AM, Thienemann M, Henderson L, Schatzberg AF. 2000; 39: 721-726
  • Predictors of Panic Attacks in Adolescence Journal of the American Academy of Child and Adolescent Psychiatry Hayward C, Killen JD, Kraemer HC, Taylor CB. 2000; 39: 207-214
  • Ethnic Differences in the Association Between Pubertal Status and Symptoms of Depression in Adolescent Girls Journal of Adolescent Health Hayward C, Gotlib IH, Schraedley PK, Litt IF. 1999; 25: 143-149
  • Linking self-reported childhood behavioral inhibition to adolescent social phobia JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Hayward, C., Killen, J. D., Kraemer, H. C., Taylor, C. B. 1998; 37 (12): 1308-1316


    Behavioral inhibition in children has been hypothesized to be a risk factor for the later development of social phobia. However, this hypothesis has yet to be demonstrated in a prospective study. The purpose of the study presented here is to test whether behavioral inhibition in childhood constitutes a risk factor for social phobia during adolescence.The sample consisted of 2,242 high school students assessed over a 4-year period. Assessments included self-report questionnaires, structured clinical interviews, and measurements of heart rate. Cox proportional hazards models were used to evaluate risk.Social avoidance, a component of behavioral inhibition, predicted onset of social phobia during high school. However, social avoidance was not related to depression in adolescence. Another component of behavioral inhibition, fearfulness, increased the risk for both social phobia and depression. Among subjects who were both socially avoidant and fearful, 22.3% developed social phobia--a risk more than four times greater than that for subjects with neither feature of behavioral inhibition.This prospective study demonstrates that behavioral inhibition in childhood increases the risk of social phobia in adolescence.

    View details for Web of Science ID 000077278300015

    View details for PubMedID 9847504

  • Psychiatric risk associated with early puberty in adolescent girls JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Hayward, C., Killen, J. D., Wilson, D. M., Hammer, L. D., Litt, I. F., Kraemer, H. C., Haydel, F., Varady, A., Taylor, C. B. 1997; 36 (2): 255-262


    This study prospectively evaluated the relationship between early puberty and the onset of internalizing symptoms and disorders in adolescent girls.The sample was drawn from 1,463 sixth-, seventh-, and eighth-grade girls who participated in a longitudinal school-based study of growth and development. Pubertal stage was determined by self-assessment of Tanner stage. Psychiatric assessments included self-report instruments and structured diagnostic interviews. Survival methods were utilized for data analysis.Girls with onset of internalizing symptoms were on average 5 months earlier in pubertal development than those who were asymptomatic (p < .001). In addition, girls with earlier maturation (earliest quartile) were more likely to develop internalizing symptoms than were nonearly matures (hazard ratio = 1.8, confidence interval = 1.2, 2.7). In a subsample of girls followed into high school, early-maturing girls were at marginally higher risk (p < .10) for developing internalizing disorders by the study's end. The highest risk for internalizing disorders was for those girls with both early puberty and prior internalizing symptoms (odds ratio = 3.3).Early puberty increases the risk of internalizing symptoms and perhaps internalizing disorders in adolescent girls.

    View details for Web of Science ID A1997WD92900017

    View details for PubMedID 9031579

  • Assessment and phenomenology of nonclinical panic attacks in adolescent girls JOURNAL OF ANXIETY DISORDERS Hayward, C., Killen, J. D., Kraemer, H. C., BLAIRGREINER, A., Strachowski, D., Cunning, D., Taylor, C. B. 1997; 11 (1): 17-32


    Recent reviews of studies concerning panic attacks in adolescents have emphasized research limitations, noting problems of validity, reliability, and lack of normative data. To address some of these limitations we evaluated two methods of panic ascertainment (questionnaire versus interview), reliability of interview-determined panic, and clinical correlates of panic symptoms in a large sample (N = 1013) of early adolescent girls. The 5.4% of the sample who, when interviewed, reported ever experiencing a panic attack scored significantly higher on measures of depression, anxiety sensitivity, and alcohol use, but were not more avoidant than others. Using the interview as the standard, the questionnaire had a specificity of 81% and a sensitivity of 72%. Adolescents do experience panic attacks-whether identified by questionnaire or interview-although for many the attacks may not be salient. Longitudinal studies are required to determine those qualities of nonclinical panic (severity, context, interpretation/attribution), which render some episodes as clinically meaningful.

    View details for Web of Science ID A1997WU76400002

    View details for PubMedID 9131879

  • Journal of Anxiety Disorders School Refusal in Girls with Nonclinical Panic Attacks. Journal of Anxiety Disorders Hayward C, Killen J, Wilson D, Hammer L, Blair-Greiner A, Strachowski D, Taylor CB 1995; 4 (9): 329-338


    Studies evaluating the risk of cardiovascular disease in the psychiatrically ill yield mixed results. Phobic anxiety in men is associated with an increased risk for cardiovascular disease, particularly sudden coronary death. This finding is in need of replication in women, and hypotheses regarding the potential mechanisms for this association warrant pilot testing. Other than this finding, there is only weak evidence supporting an association between psychiatric illness and risk for cardiovascular disease. This is surprising in light of the strong evidence that psychiatric illness in general is associated with elevated rates of cigarette smoking. In addition, there may also be higher rates of hypertension, hypercholesterolemia, and physical inactivity in some psychiatric disorders. Why the high rates of cigarette smoking and possibly other cardiovascular disease risk factors have not translated into consistently detectable elevated cardiovascular disease risk in individuals with psychiatric diagnoses is not apparent. Weaknesses in study designs and variations in assessment methods may partially explain the inconsistent results. Future studies of cardiovascular disease in the psychiatrically ill should be prospective, use nonclinical samples of men and women, have clear diagnostic criteria, determine order of onset of the two disorders if they coexist, and control for variability in known cardiovascular disease risk factors.

    View details for Web of Science ID A1995RU55500017

    View details for PubMedID 8521931

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