title: Predictors and moderators of treatment response in childhood anxiety disorders: results from the CAMS trial.
abstract: OBJECTIVE
  We sought to examine predictors and moderators of treatment outcomes among 488 youths ages 7-17 years (50% female; 74% ≤ 12 years) meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) criteria for diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavioral therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS).
  
  
  METHODS
  Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale-Improvement; CGI-I) outcome measures.
  
  
  RESULTS
  Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict Week 12 responder status (CGI-I). Participants' principal diagnosis moderated treatment outcomes but only on the PARS. No baseline variables were found to moderate treatment outcomes on Week 12 responder status (CGI-I).
  
  
  CONCLUSIONS
  Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
authors.forename: Scott N
authors.initials: SN
authors.lastname: Compton
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
authors.forename: Tara S
authors.initials: TS
authors.lastname: Peris
authors.affiliation: Survey Research Center, Institute for Social Research, University of Michigan.
authors.forename: Daniel
authors.initials: D
authors.lastname: Almirall
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: Division of Services and Intervention Research, National Institute of Mental Health.
authors.forename: Joel
authors.initials: J
authors.lastname: Sherrill
authors.affiliation: Department of Psychology, Temple University.
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
authors.forename: John S
authors.initials: JS
authors.lastname: March
authors.affiliation: Department of Psychology, Philadelphia College of Osteopathic Medicine.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Gosch
authors.affiliation: Division of Child and Adolescent Psychiatry, The Johns Hopkins Hospital.
authors.forename: Golda S
authors.initials: GS
authors.lastname: Ginsburg
authors.affiliation: Department of Child Psychiatry, Columbia University Medical Center.
authors.forename: Moira A
authors.initials: MA
authors.lastname: Rynn
authors.affiliation: John C. Piacentini and James T. McCracken, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
authors.forename: John C
authors.initials: JC
authors.lastname: Piacentini
authors.affiliation: John C. Piacentini and James T. McCracken, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
authors.affiliation: Division of Child and Adolescent Psychiatry, The Johns Hopkins Hospital.
authors.forename: Courtney P
authors.initials: CP
authors.lastname: Keeton
authors.affiliation: Department of Psychology, University of Georgia.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Suveg
authors.affiliation: Department of Child Psychiatry, Columbia University Medical Center.
authors.forename: Sasha G
authors.initials: SG
authors.lastname: Aschenbrand
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center.
authors.forename: Dara
authors.initials: D
authors.lastname: Sakolsky
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center.
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.affiliation: Division of Child and Adolescent Psychiatry, Weill Cornell Medical College.
authors.forename: John T
authors.initials: JT
authors.lastname: Walkup
authors.affiliation: Department of Child Psychiatry, Columbia University Medical Center.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Albano
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline