Multi-informant Expectancies and Treatment Outcomes for Anxiety in Youth
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Expectancies for a favorable treatment outcome have been associated with actual favorable outcomes but have been understudied in youth with anxiety. The current study applied structural equation modeling in a sample of anxious youth (N = 488; 7–17 years, M = 10.69, SD = 2.80) to examine whether a multi-informant latent expectancies factor, indicated by youth, parent, and therapist reports, predicted a latent posttreatment anxiety factor, controlling for a latent pretreatment anxiety factor. Both anxiety latent factors were indicated by youth, parent, and independent evaluator (IE) reports. Analyses also examined whether treatment condition (cognitive behavioral therapy, sertraline, combination, pill placebo) moderated the association between expectancies and outcome, and whether this association differed across development. Findings indicated that informant reports loaded similarly onto the latent factors. Results also demonstrated that treatment expectancies were positively associated with outcomes, and that this relationship held across treatment type and age group. Treatment implications and future research directions are discussed.
KeywordsAnxiety disorders Behavior therapy Cognitive therapy
This research was supported by grants from the National Institute of Mental Health (NIMH): U01 MH064089 to Dr. Walkup; U01 MH64092 to Dr. Albano; U01 MH64003 to Dr. Birmaher; U01 MH63747 to Dr. Kendall; U01 MH64088 to Dr. Piacentini; and U01 MH064003 to Dr. Compton. Views expressed within this article represent those of the authors and are not intended to represent the position of NIMH, the National Institutes of Health (NIH), or the US Department of Health and Human Services (DHHS). Sertraline and matching placebo were supplied free of charge by Pfizer.
Compliance with Ethical Standards
Conflict of interest
Dr. Piacentini has received grant or research support from NIMH, the TLC Foundation for Body-Focused Repetitive Behaviors, the Tourette Association of America, and Pfizer Pharmaceuticals through the Duke University Clinical Research Institute Network. He is a co-author of the Child OCD Impact Scale-Revised (COIS-R), the Child Anxiety Impact Scale-Revised (CAIS-R), the Parent Tic Questionnaire (PTQ), and the Premonitory Urge for Tics Scale (PUTS) assessment tools, all of which are in the public domain therefore no royalties are received. He has received royalties from Guilford Press and Oxford University Press. He has served on the speakers’ bureau of the Tourette Association of America, the International Obsessive Compulsive Disorder Foundation, and the TLC Foundation for Body-Focused Repetitive Behaviors. Dr. Albano has received royalties from Oxford University Press for the Anxiety Disorders Interview Schedule-Child and Parent Versions. Dr. Birmaher has received research support from NIMH. He has or will receive royalties from Random House, Inc., Lippincott Williams and Wilkins, and UpToDate. Dr. Ginsburg has received support from NIMH and from the US Department of Education/Institute of Education Sciences. Dr. Walkup has received research support from the Tourette Syndrome Association of America and the Hartwell Foundation. He has received honoraria and travel expenses for speaking engagements and meetings sponsored by the Tourette Association of America. He has received royalties from Guilford Press and Oxford University Press for multi-author books published about Tourette syndrome and from Wolters Kluwer for CME activity on childhood anxiety. He has served as an unpaid advisor to the Anxiety Disorders Association of America and the Trichotillomania Learning Center. He has served as a paid speaker for the Tourette Syndrome Center for Disease Control and Prevention outreach educational programs, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association. Dr. Compton has received research support from NIMH, NC GlaxoSmithKline Foundation, Pfizer, and Mursion, Inc. He has served as a consultant for Shire and Mursion, Inc. He has received honoraria from the Journal of Consulting and Clinical Psychology, the Nordic Long-Term OCD Treatment Study Research Group, and the Centre for Child and Adolescent Mental Health, Eastern and Southern Norway. He has served on the scientific advisory board of Tourette Association of America and Mursion, Inc. He has presented expert testimony for Duke University. Dr. Kendall has received royalties from the sales of materials related to the treatment of anxiety disorders in youth. Ms. Norris, Ms. Rifkin, and Drs. Olino and Gosch report no biomedical financial interests or potential conflicts of interest.
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