Cognitive behavioural therapy for anxiety disorders in children and adolescents

James, Anthony; Reardon, Tessa; Soler, A. Franco; James, Georgina; Creswell, Cathy

doi:10.1002/14651858.cd013162.pub2

Cited by 130 publications

(145 citation statements)

References 201 publications

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“…The cognitive-behavioural framework conceptualises anxiety as the combination of cognitive, behavioural and physiological components. Interventions utilising this framework have also shown utility in the treatment of anxiety disorders in the general population (James et al, 2020).…”

Section: Interview Developmentmentioning

confidence: 99%

Anxiety characteristics in individuals with Williams syndrome

Royston

Oliver

Howlin

et al. 2021

Research Intellect Disabil

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Background: Williams syndrome anxiety research predominantly focuses on disorder prevalence and symptomatology, categorised using standardised mental health classifications. However, the use of these assessments may not fully capture the phenotypic features of anxiety in Williams syndrome. In this study, we examined characteristics of anxiety using a formulation framework.Method: A semi-structured interview was conducted with thirteen parents of individuals with Williams syndrome (median age: 19, age range: 12-45, 8 females).Results: Various anxiety triggers were reported, including anxiety triggered by phobias, uncertainty and negative emotions in others. The range of described behaviours was diverse with both avoidant and active coping strategies for anxiety management reported.Conclusions: Many of the characteristics described were consistent with findings in the intellectual disability and typically developing literature, although novel information was identified. The study demonstrates the utility of a formulation framework to explore anxiety characteristics in atypical populations and has outlined new avenues for research.

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Section: Interview Developmentmentioning

confidence: 99%

Anxiety characteristics in individuals with Williams syndrome

Royston

Oliver

Howlin

et al. 2021

Research Intellect Disabil

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“…They are highly distressing and are associated with a range of negative impacts, including poorer physical and interpersonal functioning (Marshall et al 2008). Although effective treatments for anxiety disorders exist for children and adolescents (James et al 2020), approximately half retain their primary anxiety disorder post-treatment. Given that panic attacks can be experienced by adolescents with a range of different anxiety disorders, a better understanding of how adolescents experience panic attacks may help to improve treatment.…”

Section: Introductionmentioning

confidence: 99%

The experience of panic attacks in adolescents: an interpretative phenomenological analysis study

Hewitt

Tomlin

Waite

2021

Emotional and Behavioural Difficulties

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Panic attacks are common in adolescents and are experienced in several mental health difficulties. In adults, cognitions during panic attacks comprise mental images as well as thoughts. No qualitative research into panic attacks has been conducted with adolescents. Better understanding of the experience of panic attacks, including the presence and nature of mental images, may improve treatments. Nine adolescents (15-18 years) completed a semi-structured interview exploring experiences of panic attacks. Data was analysed using Interpretative Phenomenological Analysis. Six superordinate themes reflected the intense nature of having a panic attack, being unable to think and fearing losing control of one's mind, a disconnect in feeling the panic attack would never end versus knowing from experience that it would, feeling completely out of control during the attack, feeling embarrassment and shame, feeling cut-off and isolated from others, and trying to find ways to cope through distraction, avoidance and learning to understand the thoughts. Mental images enhanced the intensity of panic. Several aspects of the findings were consistent with the cognitive model of panic disorder in adults. The impact of panic on normative adolescent developmental tasks is discussed. Interventions should be adapted for adolescents' developmental stage and consider any mental images.

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“…Where the trial intervention targeted mixed anxiety disorders, a generic, broad-based outcome measure of anxiety symptoms was extracted. For interventions targeting a specific anxiety disorder, disorder-specific outcome measures were extracted (if reported), consistent with previous meta-analyses (James et al, 2015(James et al, , 2020. Where the most commonly used measure was not used in a study, the next most common measure was selected (see Table 1).…”

Section: Data Extraction Processmentioning

confidence: 99%

“…CBT is the most extensively evaluated treatment for anxiety disorders among children and adolescents, with generally good outcomes, across different formats of delivery. When outcomes have been examined across broad age ranges (2–19 years of age), 49.4% of children and adolescents who have had CBT (not including cCBT) have been found to be in remission from their primary anxiety disorder at the end of treatment (James et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Reynolds et al ( 2012 ) examined the six studies in their review that recruited only adolescents (aged 14–19 years) with either elevated anxiety symptoms or an anxiety disorder diagnosis and found the reduction in symptoms post-treatment to be in the very large range ( d = − 1.38), although with very wide confidence intervals (95% CI 2.65, − 0.11). Although specific outcomes for the remission of anxiety disorders in adolescents are not reported, in two meta-analyses (Bennett et al, 2013 ; James et al, 2020 ) that have examined age as a moderator of outcome, they found no significant differences between studies comparing remission of anxiety disorders for adolescents and younger age groups. While James et al ( 2020 ) found larger treatment effects for CBT (vs. no waitlist/ no treatment) among adolescents aged 12 years or more compared to children 12 years or less, they highlighted the substantial heterogeneity in findings.…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness of Psychological Therapies for Anxiety Disorders in Adolescents: A Meta-Analysis

Baker

Lawrence

Karalus

et al. 2021

Clin Child Fam Psychol Rev

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Anxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We conducted meta-analyses to establish the effectiveness of psychological therapies for adolescent anxiety disorders in (i) reducing anxiety disorder symptoms, and (ii) remission from the primary anxiety disorder, compared with controls, and examine potential moderators of treatment effects. The protocol was registered with PROSPERO (CRD42018091744). Electronic databases (Web of Science, MEDLINE, Psycinfo, EMBASE) were searched from January 1990 to December 2019. 2511 articles were reviewed, those meeting strict criteria were included. Random effects meta-analyses were conducted. Analyses of symptom severity outcomes comprised sixteen studies (CBT k = 15, non-CBT k = 1; n = 766 adolescents), and analyses of diagnostic remission outcomes comprised nine (CBT k = 9; n = 563 adolescents). Post-treatment, those receiving treatment were significantly more likely to experience reduced symptom severity (SMD = 0.454, 95% CI 0.22–0.69) and remission from the primary anxiety disorder than controls (RR = 7.94, 95% CI 3.19–12.7) (36% treatment vs. 9% controls in remission). None of the moderators analysed were statistically significant. Psychological therapies targeting anxiety disorders in adolescents are more effective than controls. However, with only just over a third in remission post-treatment, there is a clear need to develop more effective treatments for adolescents, evaluated through high-quality randomised controlled trials incorporating active controls and follow-up data.

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Cognitive behavioural therapy for anxiety disorders in children and adolescents

Cited by 130 publications

References 201 publications

Anxiety characteristics in individuals with Williams syndrome

Anxiety characteristics in individuals with Williams syndrome

The experience of panic attacks in adolescents: an interpretative phenomenological analysis study

The Effectiveness of Psychological Therapies for Anxiety Disorders in Adolescents: A Meta-Analysis

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