COGNITIVE BEHAVIORAL THERAPY AGE EFFECTS IN CHILD AND ADOLESCENT ANXIETY: AN INDIVIDUAL PATIENT DATA METAANALYSIS: Research Article: CBT Age Effects in Child and Adolescent Anxiety
Open accessAbstract
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 ma…
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Findings in youth anxiety moderator studies often show either no significant moderators or few that fail to replicate, including in reviews and meta-analyses.
“Findings often reveal either no significant moderators or a meager number that fail to replicate, including in evaluative reviews and meta-analyses (e.g., Bennett et al., 2013; Herres et al., 2015; Nilsen et al., 2013; Norris & Kendall, 2020).”
From Boundaries on Parent Involvement in Their Child’s Anxiety Cognitive-Behavioral-Treatment Outcome: Parent Reinforcement and Relationship Behaviors Moderate Outcome (2024) · cites this paper as Bennett et al., 2013
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- Authors
- Bennett, K., Manassis, K., Walter, S. D., Cheung, A., Wilansky-Traynor, P., Diaz-Granados, N., Duda, S., Rice, M., Baer, S., Barrett, P., Bodden, D., Cobham, V. E., Dadds, M. R., Flannery-Schroeder, E., Ginsburg, G., Heyne, D., Hudson, J. L., Kendall, P. C., Liber, J., Warner, C. M., Mendlowitz, S., Nauta, M. H., Rapee, R. M., Silverman, W., Siqueland, L., Spence, S. H., Utens, E., & Wood, J. J.
- Affiliations
- McMaster University (CA)
- University of Toronto (CA)
- University of British Columbia (CA)
- Pathways Health and Research Centre, West End; Queensland; Australia
- Utrecht University (NL)
- The University of Queensland (AU)
- UNSW Sydney (AU)
- University of Rhode Island (US)
- Johns Hopkins University (US)
- Leiden University (NL)
- Macquarie University (AU)
- Temple University (US)
- Nathan Kline Institute for Psychiatric Research (US)
- Hospital for Sick Children (CA)
- University of Groningen (NL)
- Florida International University (US)
- Children's Center for OCD and Anxiety, Plymouth Meeting; Pennsylvania
- Griffith University (AU)
- Erasmus MC (NL)
- University of California, Los Angeles (US)
- Corresponding author
- Bennett, Kathryn
- ORCID
- Bennett, Kathryn
- Walter, Stephen D.
- Cheung, Amy
- 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
- Nauta, Maaike H.
- Rapee, Ronald M.
- Silverman, Wendy
- Spence, Susan H.
- Utens, Elisabeth
- Wood, Jeffrey J.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2013-05-08
- Volume
- 30
- Issue
- 9
- Pages
- 829-841
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4854623
- OpenAlex
- W2166952361
- Cited by
- 104
- References
- 71
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 11 · 2022: 7 · 2021: 6 · 2020: 12 · 2019: 5 · 2018: 14 · 2017: 9 · 2016: 10 · 2015: 10 · 2014: 6 · 2013: 2
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- VU Research Portal (publishedVersion)
- PubMed Central (acceptedVersion)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- University of Central Florida
- McGill University
- Mental Health Commission
- Dalhousie University
- Canadian Institutes of Health Research (86250_1)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cognitive behavioral therapy, age effects, childhood anxiety, adolescent anxiety, anxiety disorders, treatment effect heterogeneity, protocol modification, comorbid depression
- MeSH terms
- Adolescent, Age Factors, Anxiety Disorders, Child, Female, Humans, Male, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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