The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic,
and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article,
the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child’s
gender, type of anxiety disorder, initial severity and comorbidity, and parents’ psychopathology would significantly predict
A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT
across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis)
at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models.
Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance
of predictors at these time points.
Individuals with social anxiety disorder (SoAD) had significantly
poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although
individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were
not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment
and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly
predicted response (although not remission) at follow-up.
SoAD, nonanxiety comorbidity, and parental
psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for
children at risk for poorer outcomes.
anxiety disorders; treatment; predictors; cognitive-behavioral