Trajectories of change in youth anxiety during cognitive—behavior therapy.

Peris, Tara S.; Compton, Scott N.; Kendall, Philip C.; Birmaher, Boris; Sherrill, Joel; March, John; Gosch, Elizabeth; Ginsburg, Golda; Rynn, Moira; McCracken, James T.; Keeton, Courtney P.; Sakolsky, Dara; Suveg, Cynthia; Aschenbrand, Sasha; Almirall, Daniel; Iyengar, Satish; Walkup, John T.; Albano, Anne Marie; Piacentini, John

doi:10.1037/a0038402

Cited by 191Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychological Treatments and Assessments

Trajectories of change in youth anxiety during cognitive—behavior therapy.

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Peris, Tara S., Compton, Scott N., Kendall, Philip C., Birmaher, Boris, Sherrill, Joel, March, John, Gosch, Elizabeth, Ginsburg, Golda +11 more·2015·Journal of Consulting and Clinical Psychology

DOI 10.1037/a0038402PMC PMC4542090

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Abstract

OBJECTIVE: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive-behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks. METHOD: Four hundred eighty-eight youths ages 7-17 years (50% female; 74% ≤ 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale-Severity (CGI-S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls. RESULTS: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self-talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self-talk, avoidance behavior). CONCLUSIONS: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record

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Increased exposure to social activities is a treatment for SAD (e.g., CBT).
“Increased exposure to social activities is a treatment for SAD (eg CBT) (Peris et al, 2015;Roy-Byrne et al, 2010;Taylor et al, 2015;Taylor et al, 2017b)”
From Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial (2018) · cites this paper as Peris et al, 2015
The Discussion reports that exposure tasks are central to CBT and were followed by faster improvement in youth anxiety symptoms and impairment. The Methods (Participants) include youth with social phobia, but the paper does not specifically evaluate increased social activities as a treatment for social anxiety disorder; its exposure findings concern a mixed youth anxiety sample. (LLM, conf=0.85)
Experimental — accuracy not yet measured
In a large clinical trial including 488 children between 7 and 17 years, introducing exposure was associated with accelerated symptom reduction and improvement of global functioning.
“In a large clinical trial, including 488 children between 7 and 17 years, introducing exposure was associated with accelerated symptom reduction and improvement of global functioning [25].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [25]
Few studies have examined CBT for pediatric anxiety at a component level.
“However, few studies have examined CBT for pediatric anxiety at a component level.”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [25]
The reported benefits of exposure training align with previous research.
“the reported benefits of exposure training align with previous research [25, 26].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [25]

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In-Game Play Behaviours during an Applied Video Game for Anxiety Prevention Predict Successful Intervention Outcomes
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What Works in Preventing Emerging Social Anxiety: Exposure, Cognitive Restructuring, or a Combination?
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Launching Anxious Young Adults: A Specialized Cognitive-Behavioral Intervention for Transitional Aged Youth
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Exposure-Focused CBT Outperforms Relaxation-Based Control in an RCT of Treatment for Child and Adolescent Anxiety
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Authors: Peris, T. S., Compton, S. N., Kendall, P. C., Birmaher, B., Sherrill, J., March, J., Gosch, E., Ginsburg, G., Rynn, M., McCracken, J. T., Keeton, C. P., Sakolsky, D., Suveg, C., Aschenbrand, S., Almirall, D., Iyengar, S., Walkup, J. T., Albano, A. M., & Piacentini, J.
Affiliations: University of California, Los Angeles (US)
Duke Medical Center (US)
Temple University (US)
University of Pittsburgh Medical Center (US)
National Institute of Mental Health (US)
Philadelphia College of Osteopathic Medicine (US)
Johns Hopkins University (US)
Columbia University Irving Medical Center (US)
University of Georgia (US)
University of Michigan (US)
Weill Cornell Medicine (US)
ORCID: Peris, Tara S.
Compton, Scott N.
Kendall, Philip C.
Birmaher, Boris
Gosch, Elizabeth
Ginsburg, Golda
Rynn, Moira
McCracken, James T.
Keeton, Courtney P.
Sakolsky, Dara
Suveg, Cynthia
Almirall, Daniel
Iyengar, Satish
Walkup, John T.
Albano, Anne Marie
Piacentini, John
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2015
Volume: 83
Issue: 2
Pages: 239-252
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/a0038402
PMC: PMC4542090
OpenAlex: W2050484358
Cited by: 191
References: 42
Citations by year: 2026: 14 · 2025: 14 · 2024: 12 · 2023: 20 · 2022: 16 · 2021: 22 · 2020: 28 · 2019: 18 · 2018: 16 · 2017: 18 · 2016: 8 · 2015: 4
FWCI: 13.91
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Consulting and Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Digital Commons - PCOM (Philadelphia College of Osteopathic Medicine) (submittedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Mental Health (K23 MH085058, K23-MH075843)
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 › Clinical Psychology › Psychological Treatments and Assessments
Keywords: youth anxiety, cognitive behavioral therapy, cognitive restructuring, exposure therapy, relaxation training, sertraline, treatment trajectories, discontinuity analysis, somatic symptoms, avoidance behavior, childhood anxiety
MeSH terms: Adolescent, Anxiety Disorders, Child, Combined Modality Therapy, Female, Humans, Male, Relaxation Therapy, Anti-Anxiety Agents, Cognitive Behavioral Therapy, Treatment Outcome, Sertraline

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Trajectories of change in youth anxiety during cognitive—behavior therapy.

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