Moderators of cognitive and behaviour therapies for prevention and treatment of anxiety disorders in children and adolescents: A systematic review and meta-analysis
Bibliographic record
Abstract
Previous studies have indicated wide variation in the effectiveness of cognitive and behaviour therapies (CBTs) for preventing and treating anxiety disorders in children and adolescents, indicating the presence of moderators influencing outcomes. This meta-analysis investigated whether sample characteristics (child age, child baseline anxiety levels, parental baseline anxiety levels) and intervention characteristics (intervention duration, facilitator contact time, facilitator background, delivery formats, parental involvement) moderate the effectiveness of CBTs for universal prevention, targeted prevention, and treatment of anxiety disorders in children and adolescents. We identified 86 eligible randomized controlled trials (RCTs) assessing the effectiveness of 98 CBTs versus non-active controls. Effect sizes were the post-intervention standardized mean difference of children's broad anxiety symptoms between CBT and non-active controls. Moderation analyses were conducted separately on child- and parent-reported outcomes using meta-regression and subgroup analyses. We found some evidence for (1) a moderating role of child age, facilitator background, and parental involvement on the effectiveness of CBTs for universal prevention; (2) a moderating role of child age and intervention duration on the effectiveness of CBTs for targeted prevention; (3) a moderating role of child age, facilitator contact time, and delivery formats on the effectiveness of CBTs for treatment. There was no evidence for a moderating role of child baseline anxiety levels on the effectiveness of CBTs for universal/targeted prevention or treatment. The moderating role of parental baseline anxiety levels and its potential interaction with parental involvement was not tested given the limited available data. Although these findings provide insights into the question of what works for whom, they should be interpreted cautiously given the limited available data, wide variation in outcomes, potential confounders, and discrepancies between child- and parent-reported outcomes. • Evidence showed CBT effects for prevention and treatment might differ by child age. • CBT effects might also vary according to prevention or treatment characteristics. • There was no evidence for the moderating effect of child or parent baseline anxiety. • Most moderation effects were found on child-reported, not parent-reported outcomes. • Limited data, study variation, confounders reduce certainty of review findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".