Dysregulation in Youth with Anxiety Disorders: Relationship to Acute and 7- to 19- Year Follow-Up Outcomes of Cognitive-Behavioral Therapy

Child Psychiatry Hum Dev. 2016 Aug;47(4):539-47. doi: 10.1007/s10578-015-0587-2.

Abstract

This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7- to 19-year follow-up outcomes of cognitive-behavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non-Hispanic White) from two randomized clinical trials completed a follow-up assessment 7-19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow-up outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non-targeted psychopathology at follow-up. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self-regulation. However, youth with a pretreatment dysregulation profile likely need follow-up to monitor for the emergence of other disorders.

Keywords: Adolescents; Anxiety; Children; Dysregulation; Self-regulation; Treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Affect
  • Aggression / psychology
  • Anxiety / psychology
  • Anxiety / therapy*
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Child
  • Cognition
  • Cognitive Behavioral Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Treatment Outcome