Mediators of youth anxiety outcomes 3 to 12 years after treatment. (March 2020)

• Record Type: Journal Article
• Authors: Makover, Heather B.; Kendall, Philip C.; Olino, Thomas; Carper, Matthew M.; Albano, Anne Marie; Piacentini, John; Peris, Tara; Langley, Audra K.; Gonzalez, Araceli; Ginsburg, Golda S.; Compton, Scott; Birmaher, Boris; Sakolsky, Dara; Keeton, Courtney; Walkup, John
• Is Part Of: Journal of anxiety disorders. Volume 70(2020:Mar.)
• Publication Date: 2020-03
• Subjects: Cognitive behavior therapy -- Childhood anxiety disorders -- Interpretive biases -- Mediators -- Treatment outcomes; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; Angoisse -- Périodiques; Electronic journals; 616.8522
• DOI: 10.1016/j.janxdis.2020.102188
• Languages: English
• ISSNs: 0887-6185

Abstract

Highlights: Bias to threat was found to mediate long-term outcomes. Bias to threat mediated anxiety at follow-up for combined treatment condition. Reduction in mediator during treatment associated with lower anxiety at follow-up. Age did not significantly moderate any mediated effects. Abstract: Objective: Test changes in perceived coping efficacy, negative self-statements, and interpretive biases to threat during treatment as potential mediators of the relationship between randomly assigned treatment conditions and long-term anxiety follow-ups. Age at randomization was also tested as a moderator of mediational relationships. Method: Participants included 319 youth (ages 7–17) from the Child/Adolescent Multimodal Study (CAMS) who participated in a naturalistic follow-up beginning an average of 6.5 years after the end of the CAMS intervention. The intervention conditions included cognitive behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), combined CBT and sertraline, and pill placebo. Putative mediators were measured four times during the intervention phase. Follow-up consisted of four annual assessments of current anxiety. Results: Reductions on a measure of interpretive bias to threat over the course of the combined condition intervention, as compared to the placebo condition, mediated anxiety outcomes at the first follow-up visit. This mediated effect was not significant for the CBT-only or sertraline-only conditions when compared to the placebo condition. No other significant mediated effects were found for putative mediators. Age did not significantly moderate any mediated effects. Conclusion: Changes in youth-reported interpretive biases to threat over the course of combined youth anxiety interventions, as compared to a placebo intervention, may be associated with lower anxiety an average of 6.5 years following treatment.