Psykologisk Institut

Clinical predictors of response to cognitive-behavioral therapy in pediatric anxiety disorders: The Genes for Treatment (GxT) Study

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  • Jennifer L Hudson, Macquarie University Sydney, Australien
  • Robert Keers, King's College London, Storbritannien
  • Susanna Roberts, King's College London, Storbritannien
  • Jonathan R I Coleman, King's College London, Storbritannien
  • Gerome Breen, King's College London, Storbritannien
  • Kristian Arendt, Danmark
  • Susan Bögels, University of Amsterdam, Holland
  • Peter Cooper, University of Reading, Storbritannien
  • Cathy Creswell, University of Reading, Storbritannien
  • Catharina Hartman, University of Groningen, Holland
  • Einar R Heiervang, University of Oslo, Norge
  • Katrin Hötzel, Ruhr-Universität Bochum, Tyskland
  • Tina In-Albon, University of Koblenz-Landau, Tyskland
  • Kristen Lavallee, University of Koblenz-Landau, Tyskland
  • Heidi J Lyneham, Macquarie University, Sydney, Australien
  • Carla E Marin, Yale University, USA
  • Anna McKinnon, Macquarie University, Sydney, Australien
  • Richard Meiser-Stedman, Macquarie University, Sydney, Australien
  • Talia Morris, Macquarie University, Sydney, Australien
  • Maaike Nauta, University of Groningen, Holland
  • Ronald M Rapee, Macquarie University, Sydney, Australien
  • Silvia Schneider, Macquarie University, Sydney, Australien
  • Sophie C Schneider, Macquarie University, Sydney, Australien
  • Wendy K Silverman, Yale University, USA
  • Mikael Thastum
  • Kerstin Thirlwall, University of Reading, Storbritannien
  • Polly Waite, University of Reading, Storbritannien
  • Gro Janne Wergeland, Macquarie University, Sydney, Australien
  • Kathryn J Lester, University of Sussex, Storbritannien
  • Thalia C Eley, King's College London, Storbritannien

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.

TidsskriftAmerican Academy of Child and Adolescent Psychiatry. Journal
Sider (fra-til)454-63
Antal sider10
StatusUdgivet - jun. 2015

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