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

Amanda L Sanchez; 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

doi:10.1007/s10578-019-00896-3

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

Child Psychiatry Hum Dev. 2019 Dec;50(6):940-949. doi: 10.1007/s10578-019-00896-3.

Authors

Affiliations

¹ Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, USA. amasanch@fiu.edu.
² Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, USA.
³ Division of Child & Adolescent Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, USA.
⁴ Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
⁵ Department of Psychiatry and Biobehavioral Sciences, Duke University, Durham, NC, USA.
⁶ Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA.
⁷ Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
⁸ Western Psychiatric Institute and Clinic-University of Pittsburgh Medical Center, Pittsburgh, USA.
⁹ Department of Psychology, Temple University, Philadelphia, PA, USA.

PMID: 31087216
DOI: 10.1007/s10578-019-00896-3

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: Adolescent; Anxiety; CAMS; CBT; Child; School impairment; Sertraline.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Academic Performance*
Adolescent
Anxiety Disorders / drug therapy
Anxiety Disorders / therapy*
Child
Clinical Studies as Topic
Cognitive Behavioral Therapy / methods*
Combined Modality Therapy
Female
Humans
Male
Outcome Assessment, Health Care*
Parents
Patient Reported Outcome Measures
Schools
Selective Serotonin Reuptake Inhibitors / pharmacology*
Sertraline / pharmacology*
Young Adult

Substances

Serotonin Uptake Inhibitors
Sertraline

Abstract

Publication types

MeSH terms

Substances

Grants and funding