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

Abstract

Objective To examine predictors and moderators of treatment outcomes among 488 youth ages 7-17 years (50% female; 74% ≤ 12 years) with DSM-IV diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavior 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). Participant's 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.

Placebo Response in Pediatric Anxiety Disorders: Implications for Clinical Trial Design and Interpretation

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Predictors Associated With Improved Cognitive-Behavioral Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

“…[15][16][17][18] However, in studies of non-OCD pediatric anxiety disorders, higher baseline symptom severity and poorer family function have consistently been shown to predict poorer outcomes. 19 In this article, we present results of a systematic analysis of predictors of treatment response using data from the Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (NordLOTS). NordLOTS is a multinational, multi-site treatment trial evaluating a steppedcare treatment model in pediatric OCD.…”

Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

“…Cognitive behaviour therapy (CBT) is an effective treatment (Cartwright-Hatton, Roberts, Chitsabesan, Fothergill, & Harrington, 2004;Compton et al, 2014;James, James, Cowdrey, Soler, & Choke, 2013); however, it typically requires specialist resources and is often not available to those who might benefit from it (Stallard, Udwin, Goddard, & Hibbert, 2007).…”