Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes

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Abstract

Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains. Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety. A meta-analysis (nstudies = 42, nparticipants = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence. Randomized controlled trials were included when having a waitlist or active control condition, a youth sample (aged<19) with a primary anxiety disorder diagnosis receiving anxiety-focused CBT and reported secondary outcomes. Controlled effect sizes (Cohen's d) were calculated employing random effect models. CBT had a large effect on general functioning (-1.25[-1.59;0.90], nstudies = 17), a small to moderate effect on depressive symptoms (-0.31[-0.41;-0.22], nstudies = 31) and a small effect on externalizing behaviors (-0.23[-0.38;-0.09], nstudies = 12) from pre-to post-treatment. Effects remained or even further improved at follow-up. Social competence only improved at follow-up (nstudies = 6). Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms.

Original languageEnglish
Pages (from-to)43-57
Number of pages15
JournalJournal of Anxiety Disorders
Volume60
DOIs
Publication statusPublished - Dec-2018

Keywords

  • CBT
  • Anxiety disorder
  • Children
  • Meta-analysis
  • Secondary outcomes
  • AUTOMATIC THOUGHTS
  • SOCIAL ANXIETY
  • MENTAL-HEALTH
  • CONDUCT PROBLEMS
  • YOUTH ANXIETY
  • DEPRESSION
  • PSYCHOTHERAPY
  • COMORBIDITY
  • INVOLVEMENT
  • MEDIATORS

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