Friends or foes ? : predictors of treatment outcome of cognitieve behavioral therapy for childhood anxiety disorders

Abstract

The present dissertation had as its central focus the prediction of outcome of the treatment of childhood anxiety disorders. In the present study a selection of variables that were thought to have prognostic validity for successful cognitive behavioral treatment (CBT) outcome were explored in a population of children with anxiety disorders. Eligible for participation were children aged 8-12 years (n = 133) attending primary education and diagnosed with Separation Anxiety Disorder (SAD), Generalized Anxiety Disorder (GAD), Social Phobia (SOP) or Specific Phobia (SP). Participants were referred to the anxiety and depression outpatient clinics of the Child and Adolescent Psychiatry Department, Leiden University Medical Center and Erasmus Medical Center, Sophia Children's Hospital in Rotterdam, in the Netherlands. Children were treated with a standardized and manualized CBT protocol (FRIENDS). Treatment outcome was assessed from a multi-informant perspective and determined with a method that addresses not only statistical significance but also clinically meaningful change. Variables that showed a significant predictive value were paternal anxiety and depressive symptoms, paternal rejection, maternal emotional warmth, comorbidity status, social performance, child-therapist alliance. Treatment format did not improve the prediction of treatment outcome. Clinical implications and recommendations for future research are discussed.