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 Timothy Walkup, Scott N. Compton, Golda S. Ginsburg, Philip C. Kendall

*Corresponding author for this work

Research output: Contribution to journalArticle

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 1 2018
Externally publishedYes

Fingerprint

Anxiety
Separation Anxiety
Therapeutics
Anxiety Disorders
Psychological Signal Detection
Panic
ROC Curve
Appointments and Schedules
Parents
Interviews

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

Cite this

Palitz, Sophie A. ; Caporino, Nicole E. ; McGuire, Joseph F. ; Piacentini, John ; Albano, Anne Marie ; Birmaher, Boris ; Walkup, John Timothy ; Compton, Scott N. ; Ginsburg, Golda S. ; Kendall, Philip C. / Defining Treatment Response and Remission in Youth Anxiety : A Signal Detection Analysis With the Multidimensional Anxiety Scale for Children. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2018 ; Vol. 57, No. 6. pp. 418-427.
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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.",
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Defining Treatment Response and Remission in Youth Anxiety : A Signal Detection Analysis With the Multidimensional Anxiety Scale for Children. / Palitz, Sophie A.; Caporino, Nicole E.; McGuire, Joseph F.; Piacentini, John; Albano, Anne Marie; Birmaher, Boris; Walkup, John Timothy; Compton, Scott N.; Ginsburg, Golda S.; Kendall, Philip C.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 57, No. 6, 01.06.2018, p. 418-427.

Research output: Contribution to journalArticle

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AU - Palitz, Sophie A.

AU - Caporino, Nicole E.

AU - McGuire, Joseph F.

AU - Piacentini, John

AU - Albano, Anne Marie

AU - Birmaher, Boris

AU - Walkup, John Timothy

AU - Compton, Scott N.

AU - Ginsburg, Golda S.

AU - Kendall, Philip C.

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AB - 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.

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