ArticleJournal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
Monotherapy Insufficient in Severe Anxiety? Predictors and Moderators in the Child/Adolescent Anxiety Multimodal Study.
Article in Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00052078 (Child/Adolescent Anxiety Multimodal Treatment Study), which is not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Child/Adolescent Anxiety Multimodal Treatment Study
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management.Clinical child and family psychology review · 2020Pooled it
- A Systematic Review of Pharmacologic Treatments for School Refusal Behavior.Journal of child and adolescent psychopharmacologyPooled it
- Brief, Non-Pharmacological, Interventions for Pediatric Anxiety: Meta-Analysis and Evidence Base Status.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53Pooled it
- Predictors and Moderators of Treatment Outcomes for Anxious Children Randomized to Computer-Assisted Cognitive Behavioral Therapy or Standard Community Care.Journal of child and adolescent psychopharmacology · 2023Trial
- Moderators of Response to Personalized and Standard Care Cognitive-Behavioral Therapy for Youth with Autism Spectrum Disorder and Comorbid Anxiety.Journal of autism and developmental disorders · 2022Trial
- A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders.BMC psychiatry · 2021Trial
- Escitalopram in Adolescents With Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study.The Journal of clinical psychiatry · 2020Trial
- Streamlined Prevention and Early Intervention for Pediatric Anxiety Disorders: A Randomized Controlled Trial.Prevention science : the official journal of the Society for Prevention Research · 2020Trial
- Parent-Based Treatment as Efficacious as Cognitive-Behavioral Therapy for Childhood Anxiety: A Randomized Noninferiority Study of Supportive Parenting for Anxious Childhood Emotions.Journal of the American Academy of Child and Adolescent Psychiatry · 2020Trial
- Brain circuitry, behavior, and cognition: A randomized placebo-controlled trial of donepezil in fragile X syndrome.Journal of psychopharmacology (Oxford, England) · 2019Trial
- Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2018Trial
- Moving Beyond Moderation to Identify Differential Treatment Effects of Cognitive Behavioural Therapy for Childhood Anxiety: A Systematic Review.Clinical child and family psychology review · 2026Review
- The Kids FACE FEARS Pragmatic Randomized Trial of Therapist-Led vs Guided Internet Cognitive Behavioral Therapy for Pediatric Anxiety: Rationale and Methods.JAACAP open · 2026Article
- Article
- Clinician-Reported Person-Centered Culturally Responsive Practices for Youth with OCD and Anxiety.Children (Basel, Switzerland) · 2025Article
- Virtual Reality and Relaxation for the Treatment of Generalized Anxiety Disorder: A Randomized Comparative Study with Standard Intervention.Journal of clinical medicine · 2025Article
- The therapeutic effects ofGut microbiome (Cambridge, England) · 2025Review
- Boundaries on Parent Involvement in Their Child's Anxiety Cognitive-Behavioral-Treatment Outcome: Parent Reinforcement and Relationship Behaviors Moderate Outcome.Clinical psychological science : a journal of the Association for Psychological Science · 2024Article
- Current and Future Approaches to Pediatric Anxiety Disorder Treatment.The American journal of psychiatry · 2024Review
- The Added Value of Crosstalk Between Developmental Circuit Neuroscience and Clinical Practice to Inform the Treatment of Adolescent Anxiety.Biological psychiatry global open science · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
This secondary analysis of the Child/Adolescent Anxiety Multimodal Study (CAMS) used baseline patient characteristics to identify prognostic subgroups of children based on likelihood of remission. We also investigated predictors and moderators of outcome. CAMS randomized 488 youths with generalized, social, and separation anxiety disorders to cognitive behavioral therapy (CBT), sertraline, both, or pill placebo. Outcomes were Week 12 child, parent, and independent evaluator (IE) ratings of child anxiety. We used receiver operating characteristics analysis and stepwise regression to identify predictors and moderators of outcome. Severe anxiety, lower socioeconomic status, and comorbid obsessive-compulsive disorder predicted higher IE-rated anxiety posttreatment; child-rated social anxiety predicted poorer outcomes reported by all informants. Regarding moderators, Hispanic ethnicity predicted higher IE-rated anxiety after CBT and higher parent-rated anxiety after sertraline. In youths with severe anxiety (Pediatric Anxiety Rating Scale ≥ 20, <italic>n</italic> = 220), combination treatment increased remission (relative risk [RR] = 2.85, <italic>p</italic> < .001), 95% confidence interval (CI) [1.51, 5.39], whereas CBT (RR = 1.55, <italic>p</italic> = .20), 95% CI [0.77, 3.10], and sertraline (RR = 1.27, <italic>p</italic> = .53), 95% CI [0.59, 2.73], did not significantly increase remission relative to placebo. These are the first findings demonstrating that a combination of CBT and a selective serotonin reuptake inhibitor, not monotherapy, is likely key for achieving remission in severe anxiety. CAMS was not powered to detect treatment efficacy after stratification by anxiety severity, so further research is needed regarding effective treatments in severe anxiety. Our main effect findings suggest youth with severe anxiety (especially social phobia), low socioeconomic status and obsessive-compulsive disorder benefit less from current first-line treatments relative to other anxious youth. ClinicalTrials.gov: NCT00052078.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.