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Parental Anxiety as a Predictor of Medication and CBT Response for Anxious Youth

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Abstract

The aim of this investigation was to evaluate how parental anxiety predicted change in pediatric anxiety symptoms across four different interventions: cognitive-behavioral therapy, medication (sertraline; SRT), their combination (COMB), and pill placebo. Participants were 488 youths (ages 7–17) with separation anxiety disorder, generalized anxiety disorder, and/or social phobia and their primary caregivers. Latent growth curve modeling assessed how pre-treatment parental trait anxiety symptoms predicted trajectories of youth anxiety symptom change across 12 weeks of treatment at four time points. Interactions between parental anxiety and treatment condition were tested. Parental anxiety was not associated with youth’s pre-treatment anxiety symptom severity. Controlling for parental trait anxiety, youth depressive symptoms, and youth age, youths who received COMB benefitted most. Counter to expectations, parental anxiety influenced youth anxiety symptom trajectory only within the SRT condition, whereas parental anxiety was not significantly associated with youth anxiety trajectories in the other treatment conditions. Specifically, within the SRT condition, higher levels of parental anxiety predicted a faster and greater reduction in youth anxiety over the acute treatment period compared to youths in the SRT condition whose parents had lower anxiety levels. While all active treatments produced favorable outcomes, results provide insight regarding the treatment-specific influence of parental anxiety on the time course of symptom change.

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Acknowledgments

This research was supported by Grants (U01MH064089, to Dr. Walkup; U01MH64092, to Dr. Albano; U01MH64003, to Dr. Birmaher; U01MH63747, to Dr. Kendall, U01MH64107, to Dr. March; U01MH64088, to Dr. Piacentini; U01MH064003, to Dr. Compton, and T32MH073517, supporting Dr. Gonzalez) from the National Institute of Mental Health. Sertraline and matching placebo were supplied free of charge by Pfizer. Views expressed within this article represent those of the authors, were not influenced by funding sources, and are not intended to represent the position of NIMH, NIH, or DHHS.

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Semel Room 67-467, Los Angeles, CA, 90024, USA

    Araceli Gonzalez, Tara S. Peris, Allison Vreeland, Cara J. Kiff, James McCracken & John Piacentini

  2. Department of Psychology, Temple University, Philadelphia, PA, USA

    Philip C. Kendall

  3. Department of Psychiatry and Behavioral Services, Duke University Medical Center, Durham, NC, USA

    Scott N. Compton & John March

  4. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

    Anne Marie Albano & Moira Rynn

  5. Western Psychiatric Institute and Clinics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Boris Birmaher

  6. Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Golda S. Ginsburg & Courtney P. Keeton

  7. Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA

    Joel Sherrill

  8. Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY, USA

    John T. Walkup

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  1. Araceli Gonzalez
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  2. Tara S. Peris
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  3. Allison Vreeland
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  6. Scott N. Compton
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  7. Anne Marie Albano
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Correspondence to Araceli Gonzalez.

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ClinicalTrials.gov Number NCT00052078.

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Gonzalez, A., Peris, T.S., Vreeland, A. et al. Parental Anxiety as a Predictor of Medication and CBT Response for Anxious Youth. Child Psychiatry Hum Dev 46, 84–93 (2015). https://doi.org/10.1007/s10578-014-0454-6

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