Cognitive-Behavioral Therapy for Child Anxiety Confers Long-Term Protection From Suicidality

Abstract

Objective Evidence for an independent relationship between anxiety and suicidality has been mixed. Few studies have examined this relationship in youth seeking treatment for anxiety. The present study examined the relationship between response to treatment for an anxiety disorder in childhood and suicidal ideation, plans, and attempts at a follow-up interval of 7 to 19 years. We hypothesized that successful treatment for an anxiety disorder in childhood would be protective against later suicidality. Method The present study was a 7- to 19-year (M = 16.24; SD = 3.56) follow-up study. Adults (N = 66) completed cognitive-behavioral treatment (CBT) for anxiety as children. Information regarding suicidality at follow-up was obtained via the World Mental Health Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview (CIDI) and the Beck Depression Inventory (BDI-II). Results Results indicate that participants who responded favorably to CBT during childhood were less likely to endorse lifetime, past-month, and past-two-week suicidal ideation than treatment non-responders. This was consistent across self-report and interview-report of suicidal ideation. Treatment response was not significantly associated with suicide plans or attempts, though the infrequent occurrence of both limited the ability to detect findings. Conclusion Results suggest more chronic and enduring patterns of suicidal ideation among those with anxiety in childhood that is not successfully treated. This study adds to the literature that suggests successful CBT for childhood anxiety confers long-term benefits and underscores the importance of the identification and evidence-based treatment of youth anxiety.

Mood and suicidality outcomes 3–11 years following pediatric anxiety disorder treatment

“…As for mood diagnoses, two follow‐ups of a sample of nondepressed, anxious youth previously treated with CBT found that acute treatment outcome was not associated depressive disorders many years later (Benjamin, Harrison, Settipani, Brodman, & Kendall, ; Kendall, Safford, Flannery‐Schroeder, & Webb, ); however, rates of depression 7.4 years following CBT were comparable to lifetime prevalence rates of major depression in the general population (Kendall et al, 2004). Results from the same sample showed that a positive response to CBT predicted lower rates of subsequent suicidal ideation (Wolk, Kendall, & Beidas, ). Overall, research associating youth anxiety treatment with improved mood outcomes has been limited to studies of CBT and with relatively small sample sizes, and has infrequently examined predictors of varied mood outcomes, including suicidal phenomena.…”

Recent developments in the treatment of anxiety disorders in children and adolescents

“…This high prevalence is of serious concern given that childhood anxiety disorders often run a chronic course, are associated with substantial interference in young peoples' social, educational and family lives, and are a risk for the development of other mental health problems in later life, such as depression 3–5. Effective psychological and pharmacological interventions for childhood anxiety disorders have been established, and early treatment has been found to be associated with lasting benefits, including reduced suicide ideation in adulthood 6. However, relatively few children and adolescents in need access these treatments,7 and of those that do, a significant minority do not benefit 8.…”

Accommodation and Treatment of Anxious Youth

“…Anxiety disorders affect between 10 and 20% of youth and are associated with numerous adversities, including impaired academic achievement, difficulty with social and peer relations, and increased suicidal ideation . If untreated, anxiety disorders persist into adulthood, placing youth at greater risk for anxiety, depression, substance abuse, educational underachievement, and suicidality . Given the prevalence and impact of youth anxiety disorders, there is public health importance in understanding how to best treat these debilitating disorders.…”