Mediators and moderators of outcome in the behavioral treatment of childhood social phobia.
OBJECTIVE
The current study examined mediators and moderators of treatment response among children and adolescents (ages 7-17 years) with a primary diagnosis of social phobia.


METHODS
Participants were 88 youths participating in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children. Potential mediators included changes in observer-rated social skill and child-reported loneliness after 12 weeks of Social Effectiveness Therapy for Children. Age and depressive symptoms were examined as potential moderators.


RESULTS
Loneliness scores and social effectiveness during a role-play task predicted changes in social anxiety and overall functioning at posttreatment. Changes in social anxiety were mediated by child-reported loneliness. Outcomes were not moderated by age or depressive symptoms.


CONCLUSIONS
Findings support the role of loneliness as an important mechanism of change during treatment for childhood social phobia.
Alfano
Candice A
CA
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine. Electronic address: calfano@cnmc.org.
Pina
Armando A
AA
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine.
Villalta
Ian K
IK
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine.
Beidel
Deborah C
DC
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine.
Ammerman
Robert T
RT
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine.
Crosby
Lori E
LE
Dr. Alfano is with the Children's National Medical Center, George Washington University School of Medicine. Dr. Pina and Mr. Villalta are with Arizona State University. Dr. Beidel is with the University of Central Florida. Dr. Ammerman and Dr. Crosby are with the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine.
D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D007171:Implosive Therapy; D008132:Loneliness; D008297:Male; D009042:Motivation; D010552:Personality Assessment; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011340:Problem Solving; D011379:Prognosis; D011615:Psychotherapy, Group; D012381:Role Playing; D012917:Social Adjustment; D012951:Socialization; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine