Secondary Outcomes From the Child/Adolescent Anxiety Multimodal Study: Implications for Clinical Practice

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Evidence-Based Medicine

Background:

• Traditional youth anxiety treatment evaluations often rely on resource-intensive independent rater global assessments.
• These global ratings may lack generalizability and do not fully capture the perspectives of families undergoing treatment.
• The Child/Adolescent Anxiety Multimodal Study (CAMS) aimed to investigate treatment outcomes from the viewpoint of treated youth and their parents.

Purpose of the Study:

• To compare the effectiveness of medication, cognitive-behavioral therapy (CBT), and their combination in treating youth anxiety disorders.
• To examine treatment outcomes using parent- and youth-reported measures, focusing on anxiety symptoms, impact of anxiety, and broader psychopathology.
• To assess treatment effectiveness from a patient-centered perspective, informing collaborative decision-making.

Main Methods:

• The CAMS trial randomized 488 participants (ages 7-17) with primary anxiety diagnoses to different treatment conditions.
• Linear mixed-effects and ANCOVA models were used to analyze parent- and youth-reported outcomes.
• Data were collected throughout a 12-week acute treatment phase and a 6-month follow-up period.

Main Results:

• At 12 weeks, combination treatment surpassed placebo for parent-reported youth anxiety. Sertraline and CBT monotherapies also outperformed placebo.
• Combination therapy and sertraline showed superiority over placebo in reducing internalizing psychopathology, anxiety impact, family burden, and depressive symptoms.
• By 36 weeks, active treatment outcomes were comparable across conditions, with youth and parent reports showing significant agreement.

Conclusions:

• Brief, validated questionnaires, alongside clinician assessments, can effectively inform patient-centered care for youth anxiety.
• Findings support the use of patient and parent perspectives in evaluating treatment effectiveness and guiding clinical decisions.
• The CAMS study provides valuable insights into family-reported outcomes for youth anxiety treatments.