Comparison of transdiagnostic treatment and specialized social anxiety treatment for children and adolescents with social anxiety disorder: a randomized controlled trial

Ronald M. Rapee*, Lauren F. McLellan, Talia Carl, Nora Trompeter, Jennifer L. Hudson, Michael P. Jones, Viviana M. Wuthrich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objective: Pediatric social anxiety disorder consistently shows the poorest treatment response of all anxiety disorders. The current study compared a generic cognitive−behavioral therapy (CBT) treatment for pediatric anxiety against a modified (social anxiety) treatment that incorporated specific components to target theoretically important maintaining processes. Method: A total of 200 children and adolescents (mean age = 9.5 years, SD = 2.2 years; 47% boys) diagnosed with social anxiety disorder as either their principal or additional disorder were randomly allocated to either the generic or the modified treatment. Both treatments were based on a manualized, empirically validated program (Cool Kids) and comprised 10 sessions over 12 weeks. Assessments comprised structured diagnostic interview and parent and youth reports, and covered diagnoses, symptoms, life impairment, and assessment of maintaining processes at post-treatment and 6-month follow-up. Results: The treatments did not differ significantly on the primary outcome (remission of social anxiety disorder) at either post-treatment (remission in generic = 41%; modified = 44%) or follow-up (remission in generic = 51%; modified = 69%), although the latter approached significance (p = .08). They also did not differ at either time point on most secondary measures of outcome. The only maintaining process that changed more under modified treatment was attention to the current task. Conclusion: Despite some positive hints in the data, there was little evidence that the modified intervention significantly improved treatment of pediatric social anxiety disorder, despite incorporating strategies to address putative maintaining mechanisms. The similar improvement between treatments on most maintaining processes suggests that new and innovative strategies may be needed to better target these processes. Clinical trial registration information: Efficacy of Cognitive Behavioural Treatment for Socially Anxious Youth; https://www.anzctr.org.au/; 12616001065482

Original languageEnglish
Pages (from-to)646-655
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume62
Issue number6
Early online date17 Aug 2022
DOIs
Publication statusPublished - Jun 2023

Keywords

  • child anxiety
  • social anxiety
  • treatment
  • randomized
  • adolescence

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