Changes in idiographic coping in youth treated for an anxiety disorder

Youth anxiety disorders are highly prevalent and associated with adverse outcomes. Prior research demonstrated improvement in anxiety symptoms following evidence-based treatment; however, not all youth experience symptom remission, nor do they consistently maintain gains. We examined idiographic changes in youths' perceived ability to cope with individualized anxiety-provoking situations from pretreatment to six-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study.

Youth diagnosed with a principal anxiety disorder (N = 488; ages 7-17; 50.4% male) were randomized to cognitive-behavioral therapy (CBT), pharmacotherapy (SRT), combination of CBT and SRT, or pill placebo. Youth's perceived ability to cope (i.e., perceived coping efficacy) was assessed independently using youth self-reports and caregiver-reports on the Coping Questionnaire, an idiographic measure with anxiety-provoking situations individualized to each youth. Changes in perceived coping efficacy were examined across treatment conditions using multilevel models, assessed across six timepoints. Models estimating the quadratic effect of time fit better than models estimating the linear effect.

There was a significant interaction between the quadratic effect of time and treatment condition, indicating perceptions of youth coping efficacy increase from pretreatment to six-month follow-up, yet at different times across treatment based on treatment condition; this finding was observed per both youth- and caregiver-reports. Perceptions of coping efficacy did not differ based on treatment condition for either informant at pretreatment or six-month follow-up; however, post hoc analyses revealed significant differences in perceptions of youth coping efficacy at all interim assessments.

Results demonstrate that effective treatments for youth anxiety disorders improved youth- and caregiver-reports of perceived coping with youths' individualized anxiety-provoking situations. Future efforts could prioritize idiographic assessments to facilitate effective treatments.