ERIC Number: EJ1026095
Record Type: Journal
Publication Date: 2013-Oct
Abstractor: As Provided
Reference Count: 27
Predicting Outcomes Following Cognitive Behaviour Therapy in Child Anxiety Disorders: The Influence of Genetic, Demographic and Clinical Information
Hudson, Jennifer L.; Lester, Kathryn J.; Lewis, Cathryn M.; Tropeano, Maria; Creswell, Cathy; Collier, David A.; Cooper, Peter; Lyneham, Heidi J.; Morris, Talia; Rapee, Ronald M.; Roberts, Susanna; Donald, Jennifer A.; Eley, Thalia C.
Journal of Child Psychology and Psychiatry, v54 n10 p1086-1094 Oct 2013
Background: Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; "5HTTLPR" and marker rs6330 in Nerve Growth Factor gene; "NGF" is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety disorders. The aim of this study was to explore one potential means of extending the translational reach of G × E data in a way that may be clinically informative. We describe a "risk-index" approach combining genetic, demographic and clinical data and test its ability to predict diagnostic outcome following CBT in anxious children. Method: DNA and clinical data were collected from 384 children with a primary anxiety disorder undergoing CBT. We tested our risk model in five cross-validation training sets. Results: In predicting treatment outcome, six variables had a minimum mean beta value of 0.5:"5HTTLPR," "NGF" rs6330, gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder. A risk index (range 0-8) constructed from these variables had moderate a predictive ability (AUC = 0.62-0.69) in this study. Children scoring high on this index (5-8) were approximately three times as likely to retain their primary anxiety disorder at follow-up as compared with those children scoring 2 or less. Conclusion: Significant genetic, demographic and clinical predictors of outcome following CBT for anxiety-disordered children were identified. Combining these predictors within a risk index could be used to identify which children are less likely to be diagnosis-free following CBT alone and require longer or enhanced treatment. The "risk-index" approach represents one means of harnessing the translational potential of G × E data.
Descriptors: Prediction, Outcomes of Treatment, Therapy, Cognitive Restructuring, Behavior Modification, Genetics, Children, Anxiety Disorders, Correlation, Gender Differences, Comorbidity, Severity (of Disability), Depression (Psychology), Risk, Scores, Clinical Diagnosis
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
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