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Athena Hayes Lickel, M.S. Nov. 7, 2008

Cognitive Behavioral Therapy for Anxiety Disorders in Children and Adolescents Review by James, Solar, & Weatherall (2005). Athena Hayes Lickel, M.S. Nov. 7, 2008. Types of anxiety disorders. Background. Separation Anxiety Disorder Simple Phobias Panic Disorder Agoraphobia

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Athena Hayes Lickel, M.S. Nov. 7, 2008

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  1. Cognitive Behavioral Therapy for Anxiety Disorders in Children and AdolescentsReview by James, Solar, & Weatherall (2005) Athena Hayes Lickel, M.S. Nov. 7, 2008

  2. Types of anxiety disorders Background Separation Anxiety Disorder Simple Phobias Panic Disorder Agoraphobia Obsessive Compulsive Disorder Social Phobia Generalized Anxiety Disorder Post Traumatic Stress Disorder (PTSD) Acute Stress Disorder • Common childhood disorder • 5-18% • Associated with: • Impairments in social and academic functioning • Depression • Substance abuse • Suicide attempts • Symptoms can persist into adulthood

  3. Background (cont.) Cognitive behavioral therapy (CBT) • Theory: The way a person thinks about an event/stimuli influences their feelings and behavior • Purpose: To modify irrational thinking patterns and eliminate avoidance behaviors • Procedures: • Cognitive techniques (cognitive coping, cognitive restructuring) • Behavioral techniques (in vivo exposure, imaginal exposure, relaxation)

  4. Review • Objectives - Examine the efficacy of CBT for youth with anxiety disorders • Search Strategy • Indentified RCTs published between 1970-2004 • Selection Criteria • Two reviewers • Inclusion criteria: RCT, children between the ages 6-19, DSM diagnosis, manualizedtx • Data Collection and Analysis • Primary outcome: +/- anxiety diagnosis • Secondary outcome: reduction in anxiety symptoms

  5. Main Results • k = 12 studies • 475 CBT participants • 290 Controls • Remission rate • ITT analysis • CBT = 56% • Controls: 28.2% • Treatment Completers • CBT = 64.6% • Controls = 21% • Reduction in symptoms • RCMAS: • SMD = -0.58 • FSSC-R: • SMD = -0.55 • Secondary analysis • Treatment format • Individual = 54.2% • Group = 56.8% • Family = 67%

  6. Conclusions • CBT appears to be effective • Methodological issues • Randomization • Attrition • Bias • Is CBT more effective than active tx? • Future directions • Examine effectiveness of tx for specific disorders • Include more cases • Dismantling studies • Longitudinal studies

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