Parental Involvement and Residual Symptoms as Predictors of Relapse after Cognitive Behavioural Therapy for Anxiety in Youth: an Individual Patient Data Meta-Analysis

Boelens, Hedwich (2023) Parental Involvement and Residual Symptoms as Predictors of Relapse after Cognitive Behavioural Therapy for Anxiety in Youth: an Individual Patient Data Meta-Analysis. Bachelor thesis, Psychology.

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Abstract

Background and objectives: Anxiety disorders affect 4.7-9.1% of children. Cognitive Behavioural Therapy (CBT) is effective, but 8-10% relapses. Parents behaviours of anxious children may reinforce children’s anxiety symptoms. Children reporting residual anxiety symptoms after CBT, may still exhibit anxiety and avoidance behavior, which may spiral down to relapse. Therefore, I investigated whether parental involvement and residual symptoms are predictors of relapse and if parental involvement buffers the effect of residual symptoms on relapse. Methods: A sample of 105 children with anxiety disorders was utilized, derived from an individual patient data meta-analysis (IPDMA). Authors of systematically identified RCTs on CBT for anxious children were invited to submit data. Seven trials, consisting 653 participants, were harmonized, 105 treatment responders were analyzed. The semi-structured diagnostic Anxiety Disorder Interview Schedule for DSM-IV was used to establish diagnoses, and thus remission and relapse. Trials were coded for intensity of parental involvement in CBT. Anxiety symptoms were assessed with the Spence Children’s Anxiety Scale. Parental involvement, residual anxiety symptoms and their interaction were investigated using a logistic regression analysis. Results: The relapse rate was 22.9% and the regression model statistically significant predicted relapse. Only residual symptoms was statistically significant associated with relapse: holding parental involvement constant, a one unit increase in residual symptoms was associated with 1.05 higher odds on relapse. Limitations: The power for parental involvement as predictor is small, because of the number of included trials. Combined with the nature of an IPDMA, there were limited possibilities to control for confounding variables. Conclusions: Despite the theoretical support for parental involvement, current study found no empirical support. Residual symptoms did predict relapse. This study may be replicated with a higher sample size, after all datasets of the IPDMA are ready for analysis. Keywords: childhood anxiety disorders, anxious children, parental involvement, residual anxiety symptoms, subclinical anxiety symptoms, cognitive behavior therapy, relapse.

Item Type:	Thesis (Bachelor)
Supervisor name:	Nauta, M.H. and Wessel, J.P.
Degree programme:	Psychology
Differentiation route:	None [Bachelor Psychology]
Date Deposited:	24 Jul 2023 10:06
Last Modified:	24 Jul 2023 10:06
URI:	http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/2554

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