Predictors and moderators of treatment response in childhood anxiety disorders: Results from the CAMS trial

Document Type

Article

Publication Date

2014

Abstract

Objective: We sought to examine predictors and moderators of treatment outcomes among 488 youths ages 7-17 years (50% female; 74% ≤ 12 years) meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) criteria for diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavioral therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). Method: Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale-Improvement; CGI-I) outcome measures. Results: Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict Week 12 responder status (CGI-I). Participantsâ principal diagnosis moderated treatment outcomes but only on the PARS. No baseline variables were found to moderate treatment outcomes on Week 12 responder status (CGI-I). Discussion: Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Publication Title

Journal of consulting and clinical psychology

Volume

82

Issue

2

First Page

212

Last Page

224

Comments

This article was published in Journal of consulting and clinical psychology, Volume 82, Issue 2, Pages 212-224.

An authors' manuscript version is available from PubMed Central at the link.

The published version is available at http://dx.doi.org/10.1037/a0035458.

Copyright © 2014 APA.

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