Literature DB >> 25486372

Trajectories of change in youth anxiety during cognitive-behavior therapy.

Tara S Peris1, Scott N Compton2, Philip C Kendall3, Boris Birmaher4, Joel Sherrill5, John March6, Elizabeth Gosch7, Golda Ginsburg8, Moira Rynn9, James T McCracken10, Courtney P Keeton8, Dara Sakolsky4, Cynthia Suveg11, Sasha Aschenbrand9, Daniel Almirall12, Satish Iyengar4, John T Walkup13, Anne Marie Albano9, John Piacentini10.   

Abstract

OBJECTIVE: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive-behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks.
METHOD: Four hundred eighty-eight youths ages 7-17 years (50% female; 74% ≤ 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale-Severity (CGI-S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls.
RESULTS: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self-talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self-talk, avoidance behavior).
CONCLUSIONS: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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Year:  2014        PMID: 25486372      PMCID: PMC4542090          DOI: 10.1037/a0038402

Source DB:  PubMed          Journal:  J Consult Clin Psychol        ISSN: 0022-006X


  22 in total

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