Mediators of Change in the Child/Adolescent Anxiety Multimodal Treatment Study

Philip C. Kendall, Colleen M. Cummings, Marianne A. Villabø, Martina K. Narayanan, Kimberli Treadwell, Boris Birmaher, Scott Compton, John Piacentini, Joel Sherrill, John Walkup, Elizabeth Gosch, Courtney Keeton, Golda Ginsburg, Cindy Suveg

Research output: Contribution to journalArticle

Abstract

Objective: Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). Method: Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. Results: Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. Conclusions: The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.

Original languageEnglish (US)
Pages (from-to)1-14
Number of pages14
JournalJournal of Consulting and Clinical Psychology
Volume84
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • anxiety
  • anxious self-talk
  • coping
  • mediators
  • youth

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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    Kendall, P. C., Cummings, C. M., Villabø, M. A., Narayanan, M. K., Treadwell, K., Birmaher, B., Compton, S., Piacentini, J., Sherrill, J., Walkup, J., Gosch, E., Keeton, C., Ginsburg, G., & Suveg, C. (2016). Mediators of Change in the Child/Adolescent Anxiety Multimodal Treatment Study. Journal of Consulting and Clinical Psychology, 84(1), 1-14. https://doi.org/10.1037/a0039773