Child Psychiatry & Human Development

, Volume 46, Issue 5, pp 643–655 | Cite as

Anxiety Disorders in Caucasian and African American Children: A Comparison of Clinical Characteristics, Treatment Process Variables, and Treatment Outcomes

  • Arlene T. Gordon-Hollingsworth
  • Emily M. Becker
  • Golda S. GinsburgEmail author
  • Courtney Keeton
  • Scott N. Compton
  • Boris B. Birmaher
  • Dara J. Sakolsky
  • John Piacentini
  • Anne M. Albano
  • Philip C. Kendall
  • Cynthia M. Suveg
  • John S. March
Original Article


This study examined racial differences in anxious youth using data from the Child/Adolescent Anxiety Multimodal Study (CAMS) [1]. Specifically, the study aims addressed whether African American (n = 44) versus Caucasian (n = 359) children varied on (1) baseline clinical characteristics, (2) treatment process variables, and (3) treatment outcomes. Participants were ages 7–17 and met DSM-IV-TR criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Baseline data, as well as outcome data at 12 and 24 weeks, were obtained by independent evaluators. Weekly treatment process variables were collected by therapists. Results indicated no racial differences on baseline clinical characteristics. However, African American participants attended fewer psychotherapy and pharmacotherapy sessions, and were rated by therapists as less involved and compliant, in addition to showing lower mastery of CBT. Once these and other demographic factors were accounted for, race was not a significant predictor of response, remission, or relapse. Implications of these findings suggest African American and Caucasian youth are more similar than different with respect to the manifestations of anxiety and differences in outcomes are likely due to treatment barriers to session attendance and therapist engagement.


Anxiety Children Treatment Race 



This study was supported by National Institute of Mental Health (NIMH) Grants MH64089, MH64107, MH64003, MH63747, MH064092, and MH64088.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Arlene T. Gordon-Hollingsworth
    • 1
    • 2
  • Emily M. Becker
    • 3
  • Golda S. Ginsburg
    • 4
    Email author
  • Courtney Keeton
    • 2
  • Scott N. Compton
    • 5
  • Boris B. Birmaher
    • 6
    • 7
  • Dara J. Sakolsky
    • 6
    • 7
  • John Piacentini
    • 8
  • Anne M. Albano
    • 9
  • Philip C. Kendall
    • 10
  • Cynthia M. Suveg
    • 11
  • John S. March
    • 12
  1. 1.Department of Pediatrics, Psychology SectionBaylor College of MedicineHoustonUSA
  2. 2.Division of Child and Adolescent PsychiatryThe Johns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of PsychologyUniversity of MiamiCoral GablesUSA
  4. 4.Department of PsychiatryUniversity of Connecticut Health CenterWest HartfordUSA
  5. 5.Department of PsychiatryDuke University Medical CenterDurhamUSA
  6. 6.Department of PsychiatryUniversity of PittsburghPittsburgUSA
  7. 7.Western Psychiatric Institute & ClinicUniversity of Pittsburgh Medical CenterPittsburgUSA
  8. 8.Division of Child and Adolescent PsychiatryUCLA Semel Institute for Neuroscience and Human BehaviorLos AngelesUSA
  9. 9.Department of Psychiatry, New York State Psychiatric InstituteColumbia University Medical CenterNew YorkUSA
  10. 10.Department of PsychologyTemple UniversityPhiladelphiaUSA
  11. 11.Department of PsychologyUniversity of GeorgiaAthensUSA
  12. 12.Division of Neurosciences MedicineDuke Research InstituteDurhamUSA

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