Category: Child / Adolescent - Anxiety

Symposium

Brief Behavioral Therapy for Anxiety and Depression in Pediatric Primary Care: Predictors and Moderators of Effects

Saturday, November 18
3:30 PM - 5:00 PM
Location: Indigo Ballroom B, Level 2, Indigo Level

Keywords: Child Anxiety | Depression | Primary Care
Presentation Type: Symposium

In this presentation, we examine predictors and moderators of clinical response to a brief transdiagnostic behavioral treatment (BBT) for pediatric anxiety and depression. In this randomized clinical trial, a total of 185 youth (aged 8 to 16) were randomly assigned to BBT (n=95) or a comparison group, assisted referral to specialty mental health care (ARC; n=90). The original trial design included a priori tests of moderation for youth and parent depression severity and Latino/a ethnicity. In the current analyses, we further examine additional putative predictors and moderators of treatment response previously identified in the literature: age, youth and parent-rated symptom severity, youth suicidality, youth functioning, parental anxiety, and family conflict. At post-intervention (week 16), clinical response was defined as a CGI-I score ≤ 2. Logistic regression with conditional backward stepping revealed youth anxiety (PARS total score; β = -0.90, SE = .04, p = .015) and degree of suicidal ideation at baseline (CDRS suicidality item; β = -0.69, SE = .35, p = .038) were significant predictors of response. Specifically, youths endorsing less severe anxiety and low frequency/intensity of suicidal ideation at baseline were more likely to improve, irrespective of condition. These variables were not significant moderators of response. Moreover, youth age, abuse history, parental anxiety, and family conflict did not emerge as either significant predictors or moderators of response. Ethnicity remained a significant moderator of effects, with Latino/a youth responding better within BBT and worse within the referral control than non-Hispanic youth (52.1% BBT versus 33.9% ARC). Overall, these findings support the conceptualization of BBT as a transdiagnostic internalizing intervention, with particular promise for treating Latino/a youths and reducing disparities in care. These findings also suggest that the advantage of BBT over ARC was robust across a range of demographic characteristics and clinically complicating factors. The final presentation will include additional multivariate exploration of predictors and moderators and analysis of secondary outcomes and functioning.

Michelle Rozenman

Assistant Clinical Professor of Psychiatry & Biobehavioral Sciences
UCLA Semel Institute for Neuroscience & Human Behavior

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