Trajectories of change in youth anxiety during cognitive—behavior therapy.
Year: 2014
Type: article
Abstract: OBJECTIVE: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive-behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks. METHOD: Four hundred eighty-eight youths ages 7-17 years (50% female; 74% ≤ 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale-Severity (CGI-S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls. RESULTS: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self-talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self-talk, avoidance behavior). CONCLUSIONS: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record
DOI: 10.1037/a0038402
Authors: Tara S. Peris, Scott N. Compton, Philip C. Kendall, Boris Birmaher, Joel Sherrill, John March, Elizabeth Gosch, Golda Ginsburg, Moira Rynn, James T. McCracken, Courtney P. Keeton, Dara Sakolsky, Cynthia Suveg, Sasha Aschenbrand, Daniel Almirall, Satish Iyengar, John T. Walkup, Anne Marie Albano, John Piacentini
Institutions: University of California, Los Angeles, Duke Medical Center, Temple University, University of Pittsburgh Medical Center, National Institute of Mental Health, National Institute of Mental Health, National Institute of Mental Health, Philadelphia College of Osteopathic Medicine, Johns Hopkins University, Johns Hopkins Medicine, Columbia University Irving Medical Center, New York State Psychiatric Institute, University of Georgia, University of Michigan, Institute for Social Research, Weill Cornell Medicine
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Awards: G1427384078, G1500068157, G2001567411, Child/Adolescent Anxiety Multimodal Treatment Study, G3562144180, G3858275863, G4614799307, G484797894, G5072896244, Child/Adolescent Anxiety Multimodal Treatment Study, G5955989614, Child/Adolescent Anxiety Multimodal Treatment Study (CAMS), G6790996323, Discovering Tailoring Variables in Childhood Mental Health Treatment Research, G8684357429, Statistics and Methodology in Clinical Trials, G8943702238
OpenAlex ID: W2050484358