Academic Impairment and Impact of Treatments Among Youth with Anxiety Disorders

Nail, Jennifer; Christofferson, Jennifer; Ginsburg, Golda S.; Drake, Kelly L.; Kendall, Philip C.; McCracken, James T.; Birmaher, Boris; Walkup, John T.; Compton, Scott N.; Keeton, Courtney; Sakolsky, Dara

doi:10.1007/s10566-014-9290-x

Cited by 68 publications

(53 citation statements)

References 32 publications

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“…Prior to treatment, anxiety severity was positively associated with more parent-reported academic impairment (Nail et al, 2014). In CAMS, academic functioning (i.e., ability to complete assignments and homework, concentrate on work, give oral reports, take tests, and get good grades) was measured using the Child Anxiety Impact Scale (CAIS).…”

Section: Treatmentmentioning

confidence: 99%

“…Given that a history of youth anxiety when concomitant with substance use may increase the likelihood of criminal behavior (e.g., Copeland et al, 2007), the effect of early intervention for anxiety on long-term legal outcomes warrants further research. To date, there is only one study (Ginsburg et al, 2014) evaluating long-term global functional outcomes for youth who received medication for anxiety in childhood, and no studies have examined domain-specific functional outcomes for youth initially treated for anxiety with medication. However, the impact of efficacious treatment in youth on functional outcomes as youth transition into adulthood remains largely unknown.…”

Section: Treatmentmentioning

confidence: 99%

“…CBT and SRT interventions are efficacious in the treatment of youth anxiety disorders and can reduce impairment in global and domain-specific (e.g., academic, family, and social) functioning immediately following treatment. In contrast to medication, six studies have assessed the long-term (>5-year posttreatment) durability of CBT (Barrett, Duffy, Dadds, & Rapee, 2001;Beidel et al, 2006;Benjamin et al, 2013;Garcia-Lopez et al, 2006;Kendall et al, 2004) or CBT and SRT for youth initially treated for anxiety (Ginsburg et al, 2014). To date, there is only one study (Ginsburg et al, 2014) evaluating long-term global functional outcomes for youth who received medication for anxiety in childhood, and no studies have examined domain-specific functional outcomes for youth initially treated for anxiety with medication.…”

Section: Treatmentmentioning

confidence: 99%

“…However, the impact of efficacious treatment in youth on functional outcomes as youth transition into adulthood remains largely unknown. Of these studies, three reported on functional outcomes (Benjamin et al, 2013;Ginsburg et al, 2014;Kendall et al, 2004), but findings differ by sample size and measurement tool. In contrast to medication, six studies have assessed the long-term (>5-year posttreatment) durability of CBT (Barrett, Duffy, Dadds, & Rapee, 2001;Beidel et al, 2006;Benjamin et al, 2013;Garcia-Lopez et al, 2006;Kendall et al, 2004) or CBT and SRT for youth initially treated for anxiety (Ginsburg et al, 2014).…”

Section: Treatmentmentioning

confidence: 99%

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Fear and missing out: Youth anxiety and functional outcomes.

Swan

Kendall

2016

Clinical Psychology: Science and Practice

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116

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Anxiety disorders are prevalent and associated with functional impairments. Outcome research has focused on symptom reduction, rather than positive factors such as life satisfaction and improved functioning. We review the impact of youth anxiety disorders and elevated anxiety symptoms on academic, occupational, family, social, and legal functioning. Emphasis is placed on the degree to which developmental trajectories differ for youth with and without anxiety disorders. In some areas, psychopathology generally, rather than anxiety specifically, is associated with functional impairment.Other studies support youth anxiety as a unique predictor of functional impairment. In particular, social anxiety is associated with impairments in social functioning throughout development. The short-and long-term impacts of anxiety treatment in youth are discussed.Last, research directions are suggested.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Fear and missing out: Youth anxiety and functional outcomes.

Swan

Kendall

2016

Clinical Psychology: Science and Practice

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116

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“…11,19 Despite many available treatments, the majority of children with anxiety disorders do not receive treatment. 24 The objectives of this systematic review are to evaluate the comparative effectiveness of psychotherapy and pharmacotherapy for childhood anxiety disorders and to evaluate the harms and safety concerns associated with these treatments.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Anxiety in Children

Wang¹,

Whiteside²,

Sim³

et al. 2017

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Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders

et al. 2017

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IMPORTANCE Childhood anxiety is common. Multiple treatment options are available, but existing guidelines provide inconsistent advice on which treatment to use.OBJECTIVES To evaluate the comparative effectiveness and adverse events of cognitive behavioral therapy (CBT) and pharmacotherapy for childhood anxiety disorders. DATA SOURCES We searched MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and SciVerse Scopus from database inception through February 1, 2017.STUDY SELECTION Randomized and nonrandomized comparative studies that enrolled children and adolescents with confirmed diagnoses of panic disorder, social anxiety disorder, specific phobias, generalized anxiety disorder, or separation anxiety and who received CBT, pharmacotherapy, or the combination.DATA EXTRACTION AND SYNTHESIS Independent reviewers selected studies and extracted data. Random-effects meta-analysis was used to pool data. MAIN OUTCOMES AND MEASURESPrimary anxiety symptoms (measured by child, parent, or clinician), remission, response, and adverse events.RESULTS A total of 7719 patients were included from 115 studies. Of these, 4290 (55.6%) were female, and the mean (range) age was 9.2 (5.4-16.1) years. Compared with pill placebo, selective serotonin reuptake inhibitors (SSRIs) significantly reduced primary anxiety symptoms and increased remission (relative risk, 2.04; 95% CI, 1.37-3.04) and response (relative risk, 1.96; 95% CI, 1.60-2.40). Serotonin-norepinephrine reuptake inhibitors (SNRIs) significantly reduced clinician-reported primary anxiety symptoms. Benzodiazepines and tricyclics were not found to significantly reduce anxiety symptoms. When CBT was compared with wait-listing/no treatment, CBT significantly improved primary anxiety symptoms, remission, and response. Cognitive behavioral therapy reduced primary anxiety symptoms more than fluoxetine. The combination of sertraline and CBT significantly reduced clinician-reported primary anxiety symptoms and response more than either treatment alone. Head-to-head comparisons were sparse, and network meta-analysis estimates were imprecise. Adverse events were common with medications but not with CBT and were not severe. Studies were too small or too short to assess suicidality with SSRIs or SNRIs. One trial showed a statistically nonsignificant increase in suicidal ideation with venlafaxine. Cognitive behavioral therapy was associated with fewer dropouts than pill placebo or medications. CONCLUSIONS AND RELEVANCEEvidence supports the effectiveness of CBT and SSRIs for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors also appear to be effective based on less consistent evidence. Head-to-head comparisons between various medications and comparisons with CBT represent a need for research in the field.

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Academic Impairment and Impact of Treatments Among Youth with Anxiety Disorders

Cited by 68 publications

References 32 publications

Fear and missing out: Youth anxiety and functional outcomes.

Fear and missing out: Youth anxiety and functional outcomes.

Anxiety in Children

Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders

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