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J Am Acad Child Adolesc Psychiatry. 2013 Jan;52(1):57-67. doi: 10.1016/j.jaac.2012.10.006. Epub 2012 Nov 30.

Defining treatment response and remission in child anxiety: signal detection analysis using the pediatric anxiety rating scale.

Author information

1
Temple University. Electronic address: nicole.caporino@temple.edu.

Abstract

OBJECTIVE:

To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders.

METHOD:

Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS), a multi-site, randomized controlled trial that examined the relative efficacy of cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline [SRT]), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The clinician-rated PARS was administered pre- and posttreatment (delivered over 12 weeks). Quality receiver operating characteristic methods assessed the performance of various PARS percent reductions and absolute cut-off scores in predicting treatment response and remission, as determined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule for DSM-IV. Corresponding change in impairment was evaluated using the Child Anxiety Impact Scale.

RESULTS:

Reductions of 35% and 50% on the six-item PARS optimally predicted treatment response and remission, respectively. Post-treatment PARS raw scores of 8 to 10 optimally predicted remission. Anxiety improved as a function of PARS-defined treatment response and remission.

CONCLUSIONS:

Results serve as guidelines for operationalizing treatment response and remission in future research and in making cross-study comparisons. These guidelines can facilitate translation of research findings into clinical practice.

PMID:
23265634
PMCID:
PMC3616384
DOI:
10.1016/j.jaac.2012.10.006
[Indexed for MEDLINE]
Free PMC Article

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