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Cited by 131Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychological Treatments and Assessments

Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: a systematic review and meta-analysis

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Sigurvinsdóttir, Anna Lilja, Jensínudóttir, Kolbrún Björk, Baldvinsdóttir, Karen Dögg, Smárason, Orri, Skarphedinsson, Gudmundur·2020·Nordic Journal of Psychiatry
DOI 10.1080/08039488.2019.1686653
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Abstract

Aim: Pediatric Anxiety Disorders (AD) are common. Cognitive behavioral therapy (CBT) is one of two first-line treatments of youth AD and it has previously been shown to be superior to wait-list but not placebo therapy. This study consists of a systematic review and meta-analysis of the literature to assess the efficacy of CBT modalities in comparison to control contingencies for pediatric anxiety disorders.Methods: Studies were included if they were randomized controlled trials, and if CBT was manualized or modular, alone or in combination with medication. CBT was required to include behavioral treatment, exposure treatment, or cognitive elements. Eligible studies included participants aged 18 years or younger.Results: Eighty-one studies were included, with 3386 CBT participants and 2527 control participants. The overall results indicated that CBT is an effective treatment for childhood AD. The results showed that individual-based CBT is superior to wait-list and attention control. Group-based CBT is superior to wait-list control and treatment as usual. Remote-based CBT was superior to attention control and wait-list control. Family-based CBT was superior to treatment as usual, wait-list control, and attention control. Selective serotonin reuptake inhibitors were no more effective than individual-based CBT. Combination treatment was, however, more effective than individual-based CBT.Conclusion: To the best of our knowledge, no meta-analysis has thus far disentangled the effects of CBT modalities across various comparisons. This meta-analysis hence provides an important update to the literature on the efficacy of CBT for treating anxiety disorders in young people.

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Crossref · 10.1080/08039488.2019.1686653

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  • A meta-analysis of 81 randomized controlled trials tested various modalities of cognitive behavioral therapy against waitlist, attention, treatment as usual, and medication controls in children and adolescents with mixed anxiety disorders.

    “In terms of youth, a meta-analysis of 81 RCTs tested various modalities of CBT (individual, group, family-based, and remote) against waitlist, attention, TAU, and medication controls in children and adolescents (Mage = 10.9 [1.6]) with mixed anxiety disorders [118].”

    From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]

    The Abstract and Discussion describe a meta-analysis of CBT modalities for anxiety disorders in children and adolescents, with waitlist, attention, treatment-as-usual, and medication comparisons. But they report 75 included RCT studies, not 81; the Characteristics of participants section gives a mean age of 10.8 (SD 1.6), not the 10.9 stated in the citing sentence. (LLM, conf=0.94)

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  • Overall, cognitive behavioral therapy in various modalities was superior to waitlist, showed mixed beneficial effects compared to attention controls, and did not outperform treatment as usual.

    “Overall, CBT in various modalities was superior to waitlist, showed mixed beneficial effects compared to attention controls, and did not outperform TAU.”

    From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]

    The Abstract and Discussion report that several CBT modalities outperformed waitlist controls and that results against attention controls varied by modality. The claim overgeneralizes the TAU comparison: the Individual-based CBT versus TAU section finds no significant benefit, but the Group-based CBT versus TAU section reports a significant benefit; the Abstract also reports family-based CBT as superior to TAU. Page numbers are not provided in our copy. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Individual cognitive behavioral therapy was not significantly different from SSRIs, but combined treatment was superior to either treatment alone at post-test.

    “Individual CBT was not significantly different from SSRIs, but the combined treatment was superior to either treatment alone at post-test.”

    From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]

    The “CBT modalities versus SSRIs” section reports no significant difference between individual CBT and SSRIs. The “CBT modalities versus combination of CBT and SSRIs” section finds a significant benefit for combined treatment over individual CBT, but the passages do not establish that it was superior to SSRIs alone at post-test. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 1

  1. [99]99. Spielberger, C., Edwards, C., Montuori, J., & Lushene, R. (1973). State-Trait Anxiety Inventory for Children. . Palto Alto, CA.: Consulting Psychologist Press.

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Authors
Sigurvinsdóttir, A. L., Jensínudóttir, K. B., Baldvinsdóttir, K. D., Smárason, O., & Skarphedinsson, G.
Affiliations
  • Akureyri Hospital (IS)
  • University of Iceland (IS)
  • National University Hospital of Iceland (IS)
  • Faculty of Psychology, University of Iceland, Reykjavik, Iceland;
Corresponding author
Sigurvinsdóttir, Anna Lilja
ORCID
Venue
Nordic Journal of Psychiatry
Publisher
Informa UK Limited
Published
2019-11-18
Volume
74
Issue
3
Pages
168-180
ISSN
  • 0029-1455 (ISSN-L)
  • 0803-9488
  • 1502-4725
DOI
10.1080/08039488.2019.1686653
OpenAlex
W2945326664
Cited by
130
References
112
Citations by year
2026: 20 · 2025: 21 · 2024: 27 · 2023: 21 · 2022: 21 · 2021: 15 · 2020: 5
FWCI
1.51
Type
journal article
Language
en
Open access
Locations
  • Nordic Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Skemman (submittedVersion)
  • Hirsla (Landspítali University Hospital) (submittedVersion)
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
cognitive behavioral therapy, childhood anxiety disorders, child and adolescent anxiety, selective serotonin reuptake inhibitors, combination therapy, treatment efficacy, waitlist control, attentional control
MeSH terms
Adolescent, Anxiety Disorders, Child, Child Behavior Disorders, Combined Modality Therapy, Humans, Psychotherapy, Group, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Selective Serotonin Reuptake Inhibitors

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