Eight years later: outcomes of CBT‐treated versus untreated anxious children

Abstract

BackgroundAnxiety disorders are the most common psychiatric disorders of childhood, generate significant distress, are considered precursors to diverse psychiatric disorders, and lead to poor social and employment outcomes in adulthood. Although childhood anxiety has a significant impact on a child's developmental trajectory, only a handful of studies examined the long-term impact of treatment and none included a control group. The aim of this study was to conduct a long-term follow-up (LTFU) of anxious children who were treated with Cognitive–Behavioral Therapy (CBT) compared to a matched group of children who were not.MethodsSubjects comprised 120 children: a treatment group which included the first 60 consecutive consenting children who were diagnosed with an anxiety disorder and treated with CBT between the years 1997 and 2003 and a control group, 60 matched children who were assessed but not treated with CBT. An “ex-post-facto” design was used to compare the two groups.ResultsChildren showed lower rates of anxiety diagnosis (about 50% for both groups) and significantly improved functioning at LTFU (time effect P < 0.0001; no group difference). Anxiety levels were significantly lower in the nontreatment group at LTFU as compared to initial assessment (P = 0.02), but not in the treatment group, and a significant between-group difference was found (P = 0.01) according to child. An inverse relationship was found between self-efficacy/self-esteem and anxiety outcome ([P = 0.0008] and [P = 0.04], respectively).ConclusionsThis study supports the assumption that childhood anxiety disorders may improve without treatment and highlights self-efficacy/self-esteem as potential factors in recovery.

Directional effects of parent and child anxiety 1 year following treatment of child anxiety, and the mediational role of parent psychological control

“…No follow‐up study has examined this issue. Follow‐up studies have focused exclusively on parent baseline anxiety as a predictor of child anxiety and none found a significant association (e.g., Cobham et al, 2010; Ginsburg et al, 2014; Adler Nevo et al 2014). Gibby et al (2017) suggest these null finding may be because, “…parent and child symptomatology changes over time in a bidirectional manner that is not captured by baseline symptoms” (p. 222).…”

Anxiety in Children

“…high, moderate, low, unclear), focusing on the representativeness of the population, selection of the cohorts, ascertainment of exposure and outcomes, adequacy of follow-up land possible conflicts of interest. 28 …”

Children's experiences following a CBT intervention to reduce dental anxiety: one year on

“…16 This outcome, however, is challenged by some researchers who suggest that childhood anxiety disorders may actually improve naturally over time without any intervention. 17 Furthermore, it is recognised that CBT alone may not account for longterm reductions in anxiety as children's self-efficacy, self-esteem and social support may all be important confounders. 17,18 Longitudinal studies in the dental setting remain extremely sparse.…”

“…17 Furthermore, it is recognised that CBT alone may not account for longterm reductions in anxiety as children's self-efficacy, self-esteem and social support may all be important confounders. 17,18 Longitudinal studies in the dental setting remain extremely sparse. However, recently, Berge and colleagues 19 explored the durability of effect following five sessions of group CBT for 67 Norwegian 10-16 year olds, in terms of managing their specific fear of an intra-oral injection.…”