Curtin McGrane, Adam (2025) Socioeconomic Conditions and Youth Anxiety Treatment: A One-Stage Individual Patient Data Meta-Analysis of CBT Outcomes. Research Master thesis, Research Master.
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Abstract
Poorer Socioeconomic factors have been found to predict greater mental health problems, such as anxiety disorders in young people. However, it is less clear if socioeconomic factors may predict or moderate treatment responses for young people when randomised to high-quality Cognitive Behavioural Therapies (CBT) for anxiety disorders. We summarised and examined current socioeconomic measures included in an Individual Patient Data Meta-Analysis (IPDMA) of randomised CBT trials to estimate the main and interaction effects of socioeconomic conditions (operationalised as household income and parental education) on remission at post-treatment and 1-year follow-up. Harmonised data from 1778 children and young individuals (Mage 10.6, SDage 2.69, 49.5% female) from 21 trials with usable education measures, and 1486 (Mage = 10.6, SDage 2.8, 52.0% female) from 17 trials with usable income measures were analysed using generalised logistic mixed models. Neither income (OR = 1.12, 95%CI[0.96, 1.30], p = .14) nor education (OR = 1.01, 95%CI[0.92, 1.11], p = 0.85) predicted nor moderated (income: OR = 1.33, 95%CI[0.60, 2.94], p = 0.48; education: OR = 0.90, 95%CI[0.64, 1.27], p = 0.54) treatment outcome at post-treatment, and these effects were consistent across trials (ICC = 0.17–0.22). Neither income (OR = 1.15 [95% CI 0.88, 1.15] p = .307), nor education (OR = 1.10 [95% CI 0.97, 1.26], p = .142) predicted treatment at the one-year follow-up, but a sensitivity analysis found a marginal trend of highest parental education being less than high school completion (OR = 0.35 [0.11, 1.07], p = 0.065) predicting lower odds of remission; however, this effect was diminished (OR = 0.38 [0.12, 1.19], p = .096) when controlling for baseline Clinical Severity Rating (CSR). Consistent non-significant findings indicate that, at present, there is little to no evidence suggesting that young people living in disadvantaged socioeconomic conditions are less likely to benefit from existing CBT. Results indicate no significant impact of Socioeconomic Conditions on treatment outcomes. These findings support equitable deployment of manualized CBT.
| Item Type: | Thesis (Research Master) |
|---|---|
| Supervisor name: | Nauta, M.H. |
| Degree programme: | Research Master |
| Differentiation route: | Mental health: perspectives from Neuro- and Clinical Psychology [Research Master] |
| Date Deposited: | 28 Aug 2025 14:16 |
| Last Modified: | 28 Aug 2025 14:16 |
| URI: | http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/5902 |
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