Mediators of Treatment Outcomes for Anxious Children and Adolescents

The Role of Somatic Symptoms

Amy E. Hale, Golda S. Ginsburg*, Grace Chan, Philip C. Kendall, James T. McCracken, Dara Sakolsky, Boris Birmaher, Scott N. Compton, Anne Marie Albano, John T. Walkup

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors are effective treatments for pediatric anxiety disorders. However, the mechanisms of these treatments are unknown. Previous research indicated that somatic symptoms are reduced following treatment, but it is unclear if their reductions are merely a consequence of treatment gains. This study examined reductions in somatic symptoms as a potential mediator of the relationship between treatment and anxiety outcomes. Participants were 488 anxious youth ages 7–17 (M = 10.7), 50.4% male, 78.9% Caucasian, enrolled in Child/Adolescent Anxiety Multimodal Study, a large randomized control trial comparing 12-week treatments of CBT, sertraline, a combination of CBT and sertraline, and a pill placebo. Causal mediation models were tested in R using data from baseline, 8-, and 12-week evaluations. Somatic symptoms were assessed using the Panic/Somatic subscale from the Screen for Child Anxiety Related Emotional Disorders. Youth outcomes were assessed using the Pediatric Anxiety Rating Scale and Children’s Global Assessment Scale. Reductions in somatic symptoms mediated improvement in anxiety symptoms and global functioning for those in the sertraline-only condition based on parent report. Conditions involving CBT and data based on child reported somatic symptoms did not show a mediation effect. Findings indicate that reductions in somatic symptoms may be a mediator of improvements for treatments including pharmacotherapy and not CBT. Although the overall efficacy of sertraline and CBT for anxiety may be similar, the treatments appear to function via different mechanisms.

Original languageEnglish (US)
Pages (from-to)94-104
Number of pages11
JournalJournal of Clinical Child and Adolescent Psychology
Volume47
Issue number1
DOIs
StatePublished - Jan 2 2018

Fingerprint

Cognitive Therapy
Sertraline
Anxiety
Therapeutics
Pediatrics
Panic
Serotonin Uptake Inhibitors
Medically Unexplained Symptoms
Anxiety Disorders
Placebos
Drug Therapy
Research

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology

Cite this

Hale, Amy E. ; Ginsburg, Golda S. ; Chan, Grace ; Kendall, Philip C. ; McCracken, James T. ; Sakolsky, Dara ; Birmaher, Boris ; Compton, Scott N. ; Albano, Anne Marie ; Walkup, John T. / Mediators of Treatment Outcomes for Anxious Children and Adolescents : The Role of Somatic Symptoms. In: Journal of Clinical Child and Adolescent Psychology. 2018 ; Vol. 47, No. 1. pp. 94-104.
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Hale, AE, Ginsburg, GS, Chan, G, Kendall, PC, McCracken, JT, Sakolsky, D, Birmaher, B, Compton, SN, Albano, AM & Walkup, JT 2018, 'Mediators of Treatment Outcomes for Anxious Children and Adolescents: The Role of Somatic Symptoms', Journal of Clinical Child and Adolescent Psychology, vol. 47, no. 1, pp. 94-104. https://doi.org/10.1080/15374416.2017.1280804

Mediators of Treatment Outcomes for Anxious Children and Adolescents : The Role of Somatic Symptoms. / Hale, Amy E.; Ginsburg, Golda S.; Chan, Grace; Kendall, Philip C.; McCracken, James T.; Sakolsky, Dara; Birmaher, Boris; Compton, Scott N.; Albano, Anne Marie; Walkup, John T.

In: Journal of Clinical Child and Adolescent Psychology, Vol. 47, No. 1, 02.01.2018, p. 94-104.

Research output: Contribution to journalArticle

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