24- and 36-Week Outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS)
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The CAMS authors did not report evidence of differential study attrition by assigned study condition, participation in maintenance treatment, or responder status.
“Of note, the CAMS authors did not report evidence of differential study attrition by assigned study condition, participation in maintenance treatment, or responder status.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
The Results section, “Attrition at Weeks 24 and 36” (page unavailable), reports no significant difference in attrition by assigned treatment group at either assessment. The passages addressing maintenance treatment and responder status do not report attrition comparisons for those groups, so those parts of the claim are not established by our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThere is an absence of data indicating whether sequencing of treatment impacts treatment satisfaction, well-being, peer relationships, parent and family functioning, school functioning, or comorbid psychiatric symptoms.
“Complicating the selection of initial treatment is the absence of data indicating whether sequencing of treatment impacts treatment satisfaction, well-being, peer relationships, parent and family functioning, school functioning, or comorbid psychiatric symptoms [5, 42–44].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
After the acute phase, in Phase 2, responders were offered 6 months of continuing monthly maintenance treatment in their originally assigned condition.
“After this acute phase, in Phase 2, responders were offered 6 months of continuing monthly maintenance treatment in their originally assigned condition.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
The CAMS maintenance treatment consisted of 6 additional CBT sessions delivered over 6 months, focusing on additional exposure practice and coaching in the application of CBT skills to emerging life stressors.
“This maintenance treatment consisted of 6 additional CBT sessions to be delivered over 6 months, focusing on additional exposure practice and coaching in the application CBT skills to emerging life stressors [42].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
In the post-acute phase of CAMS, patients in the CBT arm were offered 6 additional CBT sessions over 6 months, focusing on additional exposure practice and coaching to maintain application of CBT skills.
“In the post-acute phase of CAMS, patients in the CBT arm were offered 6 additional CBT sessions to be delivered over 6 months, focusing on additional exposure practice and coaching to maintain application of CBT skills in the face of emerging life stressors [42].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
Non-responders in the treatment arms were referred to community providers for general outpatient treatment, and non-responders to the placebo condition were offered their choice of active study interventions.
“Non-responders in the treatment arms were referred to community providers for general outpatient treatment, and non-responders to the placebo condition were offered their choice of active study interventions.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
During Phase 2 of CAMS, outcomes were assessed at week 24 and 36, mapping onto the post-intervention assessment for the second half of the SMART study.
“During Phase 2, outcomes were assessed at week 24 and 36, mapping onto our post-intervention assessment for the second half of our SMART study.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
CAMS found large effect sizes for combined medication+CBT compared to monotherapy, with a somewhat larger difference compared to CBT alone than medication alone.
“However, CAMS did find large ESs for combined medication+CBT compared to monotherapy, with a somewhat larger difference compared to CBT alone than medication alone.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
In the CAMS sample, youths had excellent retention over this follow-up period, with nearly 80% of youths completing study assessments.
“In the CAMS sample, youths had excellent retention over this follow-up period, with nearly 80% of youths completing study assessments.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
In CAMS, outcomes did not differ significantly in CBT alone vs medication alone (though group mean differences on the PARS slightly favored medication over CBT).
“Outcomes did not differ significantly in CBT alone vs medication alone (though group mean differences on the PARS slightly favored medication over CBT).”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
In Phase 1 of CAMS, youths were randomized to CBT, SSRI, Combination (COMB), or placebo and clinical outcomes assessed at 12 weeks.
“In Phase 1 of the CAMS anxiety trial, youths were randomized with either CBT, SSRI, Combination (COMB), or placebo and clinical outcomes assessed at 12 weeks.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
Even within efficacy trials for CBT, crisis management sessions are built into the design of the protocol, as they represent good clinical care, compliance with legal requirements, and appropriate adherence to evidence-based treatment.
“Note that even within efficacy trials for CBT, crisis management sessions are built into the design of the protocol, as they represent good clinical care, compliance with legal requirements (e.g., mandated reporting), and appropriate adherence to evidence-based treatment [42].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
In CAMS, the 12-week remission rate was approximately 10% higher in medication-only compared to CBT-only.
“In CAMS, the 12-week remission rate was also approximately 10% higher in medication-only compared to CBT-only.”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [42]
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- Authors
- Piacentini, J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., March, J., Sherrill, J., Sakolsky, D., Ginsburg, G., Rynn, M., Bergman, R. L., Gosch, E., Waslick, B., Iyengar, S., McCracken, J., & Walkup, J.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 53
- Issue
- 3
- Pages
- 297-310
- ISSN
- 0890-8567
- PMC
- PMC3982864
- Cited by
- 145
- References
- 14
- Language
- en
- Funders
- National Institute of Mental Health (U01 MH064089, U01 MH63747, U01 MH064003, U01 MH64088, U01 MH64092, U01 MH64107)
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