Cognitive Behavioral Therapy Age Effects in Child and Adolescent Anxiety: An Individual Patient Data Metaanalysis

Bennett, Kathryn, Manassis, Katharina, Walter, Stephen D., Cheung, Amy, Wilansky-Traynor, Pamela, Diaz-Granados, Natalia, Duda, Stephanie, Rice, Maureen, Baer, Susan, Barrett, Paula, Bodden, Denise, Cobham, Vanessa E., Dadds, Mark R., Flannery-Schroeder, Ellen, Ginsburg, Golda, Heyne, David, Hudson, Jennifer L., Kendall, Philip C., Liber, Juliette, Warner, Carrie Masia, Mendlowitz, Sandra, Nauta, Maaike H., Rapee, Ronald M., Silverman, Wendy, Siqueland, Lynne, Spence, Susan H., Utens, Elisabeth and Wood, Jeffrey J. (2013) Cognitive Behavioral Therapy Age Effects in Child and Adolescent Anxiety: An Individual Patient Data Metaanalysis. Depression and Anxiety, 30 9: 829-841. doi:10.1002/da.22099


Author Bennett, Kathryn
Manassis, Katharina
Walter, Stephen D.
Cheung, Amy
Wilansky-Traynor, Pamela
Diaz-Granados, Natalia
Duda, Stephanie
Rice, Maureen
Baer, Susan
Barrett, Paula
Bodden, Denise
Cobham, Vanessa E.
Dadds, Mark R.
Flannery-Schroeder, Ellen
Ginsburg, Golda
Heyne, David
Hudson, Jennifer L.
Kendall, Philip C.
Liber, Juliette
Warner, Carrie Masia
Mendlowitz, Sandra
Nauta, Maaike H.
Rapee, Ronald M.
Silverman, Wendy
Siqueland, Lynne
Spence, Susan H.
Utens, Elisabeth
Wood, Jeffrey J.
Title Cognitive Behavioral Therapy Age Effects in Child and Adolescent Anxiety: An Individual Patient Data Metaanalysis
Journal name Depression and Anxiety   Check publisher's open access policy
ISSN 1091-4269
1520-6394
Publication date 2013-09
Year available 2013
Sub-type Article (original research)
DOI 10.1002/da.22099
Volume 30
Issue 9
Start page 829
End page 841
Total pages 13
Place of publication Hoboken, NJ United States
Publisher John Wiley & Sons, Inc.
Collection year 2014
Language eng
Formatted abstract
Background Investigations of age effects on youth anxiety outcomes in randomized trials (RCTs) of cognitive behavior therapy (CBT) have failed to yield a clear result due to inadequate statistical power and methodologic weaknesses. We conducted an individual patient data metaanalysis to address this gap.

Question Does age moderate CBT effect size, measured by a clinically and statistically significant interaction between age and CBT exposure?

Methods
All English language RCTs of CBT for anxiety in 6-19 year olds were identified using systematic review methods. Investigators of eligible trials were invited to submit their individual patient data. The anxiety disorder interview schedule (ADIS) primary diagnosis severity score was the primary outcome. Age effects were investigated using multilevel modeling to account for study level data clustering and random effects.

Results
Data from 17 of 23 eligible trials were obtained (74%); 16 studies and 1,171 (78%) cases were available for the analysis. No interaction between age and CBT exposure was found in a model containing age, sex, ADIS baseline severity score, and comorbid depression diagnosis (power ≥ 80%). Sensitivity analyses, including modeling age as both a categorical and continuous variable, revealed this result was robust.

Conclusions Adolescents who receive CBT in efficacy research studies show benefits comparable to younger children. However, CBT protocol modifications routinely carried out by expert trial therapists may explain these findings. Adolescent CBT protocols are needed to facilitate the transportability of efficacy research effects to usual care settings where therapists may have less opportunity for CBT training and expertise development.
Keyword Anxiety disorders
Cognitive behavior therapy
Child
Adolescent
Treatment
Empirical supported treatment
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Psychology Publications
 
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