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Cited by 337Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Remission after acute treatment in children and adolescents with anxiety disorders: Findings from the CAMS.

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Ginsburg, Golda S., Kendall, Philip C., Sakolsky, Dara, Compton, Scott N., Piacentini, John, Albano, Anne Marie, Walkup, John T., Sherrill, Joel +8 more·2011·Journal of Consulting and Clinical Psychology
DOI 10.1037/a0025933PMC PMC3371083
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Abstract

OBJECTIVE: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7-17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. RESULTS: Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. CONCLUSIONS: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children.

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  • CBT may be less beneficial for both children and adults with social anxiety disorder compared to those with non-social types of anxiety disorders.

    “For example CBT, a first-line treatment across anxiety disorders, may be less beneficial for both children and adults with social anxiety disorder compared to those with non-social types of anxiety disorders (Cuijpers 2016;Ginsburg 2011;Hudson 2015).”

    From Exercise for the treatment of anxiety in children and adolescents (2022) · cites this paper as Ginsburg 2011

    The Results (Diagnoses; page unavailable) report lower remission among youth with social phobia than among those without it. The finding covers treatment groups overall, not CBT specifically, and the Participants section includes only ages 7–17; this paper therefore does not support the claim about adults. (LLM, conf=0.86)

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  • Up to 40% of children who participate in CBT for pediatric anxiety show minimal clinical improvement.

    “Although cognitive-behavioral therapy (CBT) protocols are a highly effective, front-line treatment for pediatric anxiety disorders [3,4], up to 40% of children who participate in these interventions show minimal clinical improvement [5,6].”

    From A Qualitative Study of Participant Feedback on an Acceptance and Commitment Therapy Group-Based Intervention for Parents of Youth with Anxiety Disorders. (2026) · cites this paper as [5]

    The Results report that CBT did not lead to remission for every child and distinguish remission from clinically meaningful improvement. The cited passages do not establish that up to 40% of children receiving CBT showed minimal clinical improvement; lack of remission can include children who improved meaningfully. (LLM, conf=0.78)

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  • Rates of failure to achieve remission in pediatric anxiety disorders are 60-80%.

    “rates of failure to achieve remission are even higher (60–80%) [21, 22, 24–27, 30]”

    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 [30]

    The Abstract’s Results report 12-week remission rates of 20%–46% for CBT and 34%–46% for sertraline, implying nonremission rates that overlap the cited 60%–80% range. But combined treatment had a 46%–68% remission rate, so the paper does not support 60%–80% as a general failure-to-remit rate across treatments. Page numbers are not supplied in our copy. (LLM, conf=0.85)

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  • Different forms of anxiety may respond differently to the same efficacious treatment modality.

    “There is some evidence that different forms of anxiety may respond differently to the same efficacious treatment modality.”

    From Exercise for the treatment of anxiety in children and adolescents (2022) · cites this paper as Ginsburg 2011

  • A review by Cousins and Goodyer highlights that SSRIs can modulate the amygdala's response to fearful facial expressions.

    “Of note, a review by Cousins and Goodyer [65] highlights that SSRIs can modulate the amygdala's response to fearful facial expressions.”

    From The risks versus the benefits of pharmacological intervention in social anxiety disorder in children (2025) · cites this paper as [65]

    The Objective (page unavailable) identifies this paper as a CAMS study of remission after anxiety treatment in youth, not a review by Cousins and Goodyer. Searches for Cousins and Goodyer and for SSRI effects on amygdala responses to fearful faces found no passage in our copy addressing the attributed point. (LLM, conf=0.76)

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Authors
Ginsburg, G. S., Kendall, P. C., Sakolsky, D., Compton, S. N., Piacentini, J., Albano, A. M., Walkup, J. T., Sherrill, J., Coffey, K. A., Rynn, M. A., Keeton, C. P., McCracken, J. T., Bergman, L., Iyengar, S., Birmaher, B., & March, J.
Affiliations
  • Johns Hopkins University (US)
  • Temple University (US)
  • University of Pittsburgh (US)
  • Duke Medical Center (US)
  • University of California, Los Angeles (US)
  • Columbia University Irving Medical Center (US)
  • NewYork–Presbyterian Hospital (US)
  • National Institute of Mental Health (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2011
Volume
79
Issue
6
Pages
806-813
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/a0025933
PMC
PMC3371083
OpenAlex
W1991448989
Cited by
337
References
11
Citations by year
2026: 15 · 2025: 17 · 2024: 26 · 2023: 15 · 2022: 19 · 2021: 25 · 2020: 24 · 2019: 28 · 2018: 25 · 2017: 24 · 2016: 28 · 2015: 26 · 2014: 30 · 2013: 19 · 2012: 15
FWCI
26.77
Type
journal article
Language
en
Open access
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH64089; MH64107; MH64003; MH63747; MH064092; MH64088)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
anxiety disorders, children and adolescents, remission, sertraline, cognitive behavioral therapy, combined psychotherapy and pharmacotherapy, separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, predictors of remission, predictors of treatment response, internalizing disorders, symptom persistence
MeSH terms
Adolescent, Anxiety Disorders, Child, Combined Modality Therapy, Female, Humans, Male, Remission Induction, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Sertraline

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