Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Acad Child Adolesc Psychiatry. 2015 Jun;54(6):454-63. doi: 10.1016/j.jaac.2015.03.018. Epub 2015 Apr 1.

Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study.

Author information

1
Centre for Emotional Health, Macquarie University, Sydney, Australia.
2
King's College London, Institute of Psychiatry, Psychology and Neuroscience, Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry (SGDP) Centre, London.
3
University of Aarhus, Denmark.
4
Research Institute Child Development and Education, University of Amsterdam.
5
School of Psychology and Clinical Language Sciences, University of Reading, UK.
6
University Medical Center Groningen, University of Groningen, The Netherlands.
7
Institute of Clinical Medicine, University of Oslo, Norway and Anxiety Research Network, Haukeland University Hospital, Bergen, Norway.
8
Ruhr-Universität Bochum, Germany.
9
University Koblenz-Landau, Landau, Germany.
10
University of Basel, Switzerland.
11
Yale University, New Haven, CT.
12
MRC Cognition and Brain Sciences Unit, Cambridge, UK.
13
Anxiety Research Network, Haukeland University Hospital.
14
School of Psychology, University of Sussex, UK. Electronic address: k.lester@sussex.ac.uk.
15
King's College London, Institute of Psychiatry, Psychology and Neuroscience, Medical Research Council (MRC) Social, Genetic and Developmental Psychiatry (SGDP) Centre, London. Electronic address: thalia.eley@kcl.ac.uk.

Abstract

OBJECTIVE:

The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic, and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child's gender, type of anxiety disorder, initial severity and comorbidity, and parents' psychopathology would significantly predict outcome.

METHOD:

A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models. Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these time points.

RESULTS:

Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly predicted response (although not remission) at follow-up.

CONCLUSION:

SoAD, nonanxiety comorbidity, and parental psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes.

KEYWORDS:

anxiety disorders; cognitive-behavioral therapy; predictors; treatment

Comment in

PMID:
26004660
PMCID:
PMC4469376
DOI:
10.1016/j.jaac.2015.03.018
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center