Defining Treatment Response and Remission in Youth Anxiety: A Signal Detection Analysis With the Multidimensional Anxiety Scale for Children

Sophie A. Palitz, Nicole E. Caporino, Joseph F. McGuire, John Piacentini, Anne Marie Albano, Boris Birmaher, John T. Walkup, Scott N. Compton, Golda S. Ginsburg, Philip C. Kendall

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the percent reduction cutoffs on the Multidimensional Anxiety Scale for Children (MASC) that optimally predict treatment response and remission in youth with anxiety disorders. Method: Youths and their parents completed the MASC-C/P before and after treatment, and the Anxiety Disorders Interview Schedule for DSM-IV–Child and Parent Versions (ADIS-IV-C/P) and the Clinical Global Impression–Improvement Scale (CGI-I) were administered by independent evaluators. Treatment response and remission were defined by post-treatment ratings on the CGI-I and the ADIS-IV-C/P, respectively. Quality receiver operating characteristic methods determined the optimal cutoff on the MASC-P for predicting overall remission (loss of all study entry diagnoses) and optimal percent reductions on the MASC-P for predicting treatment response and remission of separation anxiety, social anxiety, and generalized anxiety. Results: A post-treatment raw score of 42 optimally predicted remission. A reduction of 35% on the total MASC-P predicted treatment response. A reduction of 30% on the Separation Anxiety/Panic subscale of the MASC-P predicted separation anxiety remission. A reduction of 35% on the Social Anxiety subscale of the MASC-P predicted social anxiety remission. The MASC did not evidence a cutoff for remission of generalized anxiety disorder. Conclusion: MASC cutoffs can facilitate comparison across studies and guide practice, aiding clinicians in assessing progress and informing treatment plans.

Original languageEnglish (US)
Pages (from-to)418-427
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume57
Issue number6
DOIs
StatePublished - Jun 2018

Keywords

  • Multidimensional Anxiety Scale for Children
  • child anxiety
  • clinical assessment
  • measurement
  • treatment outcome

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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