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

Forfatter(e)
Kreuze, L. J. Pijnenborg, G. H. M. de Jonge, Y. B. Nauta, M. H.
År
2018
DOI
10.1016/j.janxdis.2018.10.005
Tidsskrift
Journal of Anxiety Disorders
Sider
43-57
Kategori(er)
Angst og engstelighet (inkl. både vansker og lidelse) Sosiale ferdigheter (inkl. vennerelasjoner)
Tiltakstype(r)
Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi
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.