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Child Psychiatry & Human Development

, Volume 50, Issue 6, pp 940–949 | Cite as

The Effects of Youth Anxiety Treatment on School Impairment: Differential Outcomes Across CBT, Sertraline, and their Combination

  • Amanda L. SanchezEmail author
  • Jonathan S. Comer
  • Stefany Coxe
  • Anne Marie Albano
  • John Piacentini
  • Scott N. Compton
  • Golda S. Ginsburg
  • Moira A. Rynn
  • John T. Walkup
  • Dara J. Sakolsky
  • Boris Birmaher
  • Philip C. Kendall
Original Article
  • 212 Downloads

Abstract

Youth anxiety disorders are highly prevalent and are associated with considerable school impairment. Despite the identification of well-supported strategies for treating youth anxiety, research has yet to evaluate the differential effects of these treatments on anxiety-related school impairment. The present study leveraged data from the Child/Adolescent Anxiety Multimodal Study to examine differential treatment effects of CBT, sertraline, and their combination (COMB), relative to placebo (PBO), on anxiety-related school impairment among youth (N = 488). Latent growth modeling revealed that all three active treatments demonstrated superiority over PBO in reducing anxiety-related school impairment over time, with COMB showing the most robust effects. According to parent report, medication strategies may have stronger effects on anxiety-related school impairment among males than among females. Results were discrepant across parents and youth. Findings are discussed in terms of clinical implications for anxious youth and the need for continued research to examine treatment effects on anxiety-related school impairment.

Keywords

Child Adolescent Anxiety School impairment CAMS CBT Sertraline 

Notes

Funding

This research was supported by NIMH Grants U01 MH64088, U01 MH064003, U01 MH63747, U01 MH64003, U01 MH64092, U01 MH64107, U01 MH064089, and K23 MH090247. Sertraline and matching placebo were supplied free of charge by Pfizer.

Compliance with Ethical Standards

Conflict of interest

Ms. Sanchez reports nothing to disclose. Dr. Comer reports Grant Support from NIMH, NICHD, NSF, PCORI, the Charles H. Hood Foundation, the Andrew Kukes Foundation for Social Anxiety, and the International Obsessive–Compulsive Disorder Foundation, as well as personal fees from Oxford University Press and Worth Publishing/Macmillan Learning. Dr. Albano reports royalties from Oxford University Press and has received honorarium from American Psychological Association. Dr. Piacentini reports grant support from NIMH, Tourette Association of America, TLC Foundation for BFRBs, Pettit Family Foundation, and Pfizer Pharmaceuticals. He reports royalties from Guilford Press and Oxford University Press and has received honorarium and travel support from the Tourette Association of America, and the International OCD Foundation. Dr. Compton reports research support from NIMH and has served as a consultant to Shire Pharmaceuticals. He has received honoraria from the Nordic Long-Term Obsessive–Compulsive Disorder (OCD)-Treatment Study Research Group and Journal of Consulting and Clinical Psychology (JCCP). He has provided expert testimony at Duke Forensic Group. Dr. Walkup reports grant support from the Hartwell Foundation and the Tourette Syndrome Association. He has served on the advisory board and speaker’s bureau of the Tourette Syndrome Association. He reports royalties from Guilford Press and Oxford University Press and has received honorarium and travel support from the Tourette Syndrome Association. He is an unpaid member of the Scientific Advisory Board of the Trichotillomania Learning Center, the Scientific Council of the Anxiety and Depression Association of America, and a Scientific Advisor to the American Foundation of Suicide Prevention. Dr. Ginsburg reports research support from NIMH and DOE. Dr. Rynn research support from NIMH, personal fees from Oxford University Press, and royalties from UpToDate. Dr. Birmaher reports grant support from NIMH and personal fees from Random House, Inc., Lippincott Williams and Wilkins, and UpToDate. Dr. Kendall reports grant support from NIMH and NICHD, as well as personal fees from Oxford University Press, Guilford Press, Ericsson, and Workbook Publishing. Dr. Kendall receives royalties from the sales of materials related to the treatment of anxiety in youth, such as the materials used in the CAMS report.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Amanda L. Sanchez
    • 1
    Email author
  • Jonathan S. Comer
    • 1
  • Stefany Coxe
    • 1
  • Anne Marie Albano
    • 2
  • John Piacentini
    • 3
  • Scott N. Compton
    • 4
  • Golda S. Ginsburg
    • 5
  • Moira A. Rynn
    • 4
  • John T. Walkup
    • 6
  • Dara J. Sakolsky
    • 7
  • Boris Birmaher
    • 7
  • Philip C. Kendall
    • 8
  1. 1.Center for Children and Families and Department of PsychologyFlorida International UniversityMiamiUSA
  2. 2.Division of Child & Adolescent Psychiatry, Department of PsychiatryColumbia University Medical Center, New York State Psychiatric InstituteNew YorkUSA
  3. 3.Department of Psychiatry and Biobehavioral SciencesUCLA Semel Institute for Neuroscience and Human BehaviorLos AngelesUSA
  4. 4.Department of Psychiatry and Biobehavioral SciencesDuke UniversityDurhamUSA
  5. 5.Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonUSA
  6. 6.Anne and Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  7. 7.Western Psychiatric Institute and Clinic—University of Pittsburgh Medical CenterPittsburghUSA
  8. 8.Department of PsychologyTemple UniversityPhiladelphiaUSA

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