Abstract
In the following grant report, we describe initial and planned work supported by our National Institute of Mental Health R01-funded, Research Domain Criteria (RDoc) informed project, “Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety”. This project examines response to cognitive behavioral therapy (CBT) in a large sample of anxiety-affected and low-anxious youth ages 7 to 18 years using multiple levels of analysis, including brain imaging, behavioral performance, and clinical measures. The primary goal of the project is to understand how brain-behavioral markers of anxiety-relevant constructs, namely acute threat, cognitive control, and their interaction, associate with CBT response in youth with clinically significant anxiety. A secondary goal is to determine whether child age influences how these markers predict, and/or change, across varying degrees of CBT response. Now in its fourth year, data from this project has informed the examination of (1) baseline (i.e., pre-CBT) anxiety severity as a function of brain-behavioral measures of cognitive control, and (2) clinical characteristics of youth and parents that associate with anxiety severity and/or predict response to CBT. Analysis of brain-behavioral markers before and after CBT will assess mechanisms of CBT effect, and will be conducted once the data collection in the full sample has been completed. This knowledge will help guide the treatment of clinically anxious youth by informing for whom and how does CBT work.
Highlights
BackgroundAnxiety disorders are among the most prevalent of childhood psychopathologies and tend to emerge early in childhood, and can become chronic, leading to depression, substance abuse, and school-drop out [1,2,3,4]
This study provides some of the first evidence that cognitive behavior therapy (CBT) without relaxation can be more effective than relaxation strategies in relieving anxiety symptoms among clinically anxious youth
We report on current findings and planned research from our grantfunded project, “Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety”
Summary
Anxiety disorders are among the most prevalent of childhood psychopathologies and tend to emerge early in childhood, and can become chronic, leading to depression, substance abuse, and school-drop out [1,2,3,4]. By studying brain-behavioral indices of cognitive control, acute threat and their interaction before and after CBT delivery, we believe we can establish objective measures to (1) predict CBT outcome in patients presenting with anxiety and (2) quantify mechanistic changes underlying CBT response to accelerate the development of more effective treatments. By bridging developmental neuroscience and randomized clinical trial research, this project will clarify the relationship between frontolimbic brainbehavioral functions (CC, AT, and CC-AT interaction), CBT effect and developmental stage This knowledge will pave the way towards (1) use of brain-behavioral predictors to identify children most likely to be benefit from CBT and (2) customization of generation, hypothesis-driven therapy for pediatric anxiety (e.g., cognitive training) targeted to marker profiles of different patients, at different ages
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