Are young people with primary social anxiety disorder less likely to recover following generic CBT compared to young people with other primary anxiety disorders? A systematic review and meta-analysis
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Background: Social anxiety disorder (SoAD) in youth is often treated with a generic form of cognitive behavioural therapy (CBT). Some studies have suggested that primary SoAD is associated with lower recovery rates following generic CBT compared with other anxiety disorders. Aims: This systematic review and meta-analysis investigated recovery rates following generic CBT for youth with primary SoAD versus other primary anxiety disorders. Method: Five databases (PsycINFO, Web of Science, PubMed, Embase, Medline) were searched for randomised controlled trials of generic CBT for child and/or adolescent anxiety. Results: Ten trials met criteria for inclusion in the systematic review, six of which presented sufficient data for inclusion in the meta-analysis. Sixty-seven did not report data on recovery rates relative to primary diagnosis. While most individual studies included in the systematic review were not sufficiently powered to detect a difference in recovery rates between diagnoses, there was a pattern of lower recovery rates for youth with primary SoAD. Across the trials included in the meta-analysis, the post-CBT recovery rate from primary SoAD (35%) was significantly lower than the recovery rate from other primary anxiety disorders (54%). Conclusions: Recovery from primary SoAD is significantly less likely than recovery from any other primary anxiety disorder following generic CBT in youth. This suggests a need for research to enhance the efficacy of CBT for youth SoAD.
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Young people with social anxiety disorder have shown poorer outcomes from generic forms of cognitive behavioural therapy than other anxiety disorders, with recovery rates of 35% for SAD versus 54% for other anxiety disorders.
“However, notably, young people with SAD have shown poorer outcomes from generic forms of CBT than other anxiety disorders (e.g., recovery rates of 35% for SAD vs. 54% for other anxiety disorders; Evans, Clark, and Leigh 2021;Hudson et al. 2015).”
From Negative Flashforward Imagery in Adolescent Social Anxiety Disorder: A Pilot Study of Imagery Reports and a Short EMDR Intervention. (2024) · cites this paper as Evans, Clark, and Leigh 2021
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- Authors
- Evans, R., Clark, D. M., & Leigh, E.
- Affiliations
- King's College London (GB)
- University of Oxford (GB)
- Corresponding author
- Leigh, Eleanor
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-12-10
- Volume
- 49
- Issue
- 3
- Pages
- 352-369
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- PMC
- PMC8293629
- OpenAlex
- W3093946010
- Cited by
- 52
- References
- 19
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 12 · 2023: 9 · 2022: 13 · 2021: 4
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (102176/Z/13/Z, WT069777, 10132, 102176, 102176/Z, 102176/Z/13)
- National Institute for Health and Care Research (102176/Z/13/Z, NF-SI-0512-10132, SI-0512-10132)
- King's College London
- 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
- social anxiety disorder, youth, cognitive behavioral therapy, recovery rate, child and adolescent anxiety, treatment efficacy
- MeSH terms
- Phobia, Social, Adolescent, Anxiety, Anxiety Disorders, Child, Family, Humans, Cognitive Behavioral Therapy
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