Child Psychiatry & Human Development

, Volume 49, Issue 1, pp 73–85 | Cite as

Examining the Mechanisms of Therapeutic Change in a Cognitive-Behavioral Intervention for Anxious Children: The Role of Interpretation Bias, Perceived Control, and Coping Strategies

  • Ana Isabel Pereira
  • Peter Muris
  • Magda Sofia Roberto
  • Teresa Marques
  • Rita Goes
  • Luísa Barros
Original Article


This study examined the role of theoretically meaningful mediators of therapeutic change—interpretation bias, perceived control, and coping strategies—in a cognitive-behavioral intervention for anxious youth. This is one of the few studies that examined the change in potential mediator and outcome variables by means of a longitudinal design that included four assessment points: pretreatment, in-treatment, post-treatment, and at 4-months follow-up. Forty-seven 8- to 12-year-old children with a principal DSM-IV diagnosis of anxiety disorder participated in the study. On each assessment point, questionnaires assessing the mediator variables and a standardized anxiety scale were administered to the children. The results showed that perceived control and interpretation bias (but not coping strategies) accounted for a significant proportion in the variability of various types of anxiety symptoms, providing a preliminary support for the notion that these cognitive dimensions’ act as mechanisms of therapeutic change in cognitive-behavioral therapy for anxious children.


Cognitive-behavioral treatment Anxiety disorders Children Mediators of change 



This study was supported by one grant by Fundação para a Ciência e Tecnologia (PTDC/PSI-PCL/122007/2010). The authors thank all the schools, families and children for participating in this study and making it possible.

Compliance with Ethical Standards

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation.

Informed Consent

Informed consent was obtained from all participants included in the study.

Supplementary material

10578_2017_731_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 KB)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.CICPSI, Faculdade de PsicologiaUniversidade de LisboaLisboaPortugal
  2. 2.Faculty of Psychology and NeuroscienceMaastricht University, NetherlandsMaastrichtThe Netherlands
  3. 3.Alameda da UniversidadeLisboaPortugal

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