Behavioral Inhibition and Social Anxiety Disorder as Predictors of Long-Term Outcomes of Cognitive Behavioral Therapy for Youth Anxiety Disorders

Res Child Adolesc Psychopathol. 2024 Sep;52(9):1427-1439. doi: 10.1007/s10802-024-01215-8. Epub 2024 Jun 5.

Abstract

The temperamental trait behavioral inhibition (BI) is related to the development and maintenance of anxiety, particularly much so to social anxiety disorder. We investigated if BI and social anxiety disorder predicted cognitive behavioral therapy (CBT) outcomes for youth anxiety. Youth (N = 179; Mage = 11.6 years) were assessed 4 years following a randomized controlled CBT effectiveness trial. BI was measured by the parent-reported Behavioral Inhibition Questionnaire at baseline. The outcomes were diagnostic recovery, youth- and parent-reported anxiety symptoms, and clinical severity at post-treatment, 1-year, and 4-year follow-up. Having social anxiety disorder negatively predicted diagnostic recovery and predicted higher clinical severity at all assessment points and was the only significant predictor of outcomes at 4-year follow-up. Higher BI negatively predicted diagnostic recovery and predicted higher clinical severity and parent-reported symptom levels at post-treatment and 1-year follow-up, and predicted higher youth-reported anxiety levels at 1-year follow-up. Higher BI was the only predictor of youth- and parent-reported anxiety symptoms. BI and social anxiety disorder seem to be unique predictors of CBT outcomes among youth with anxiety disorders. CBT adaptations may be indicated for youth with high BI and social anxiety disorder.

Keywords: Anxiety Disorders; Behavioral Inhibition; CBT; Social Anxiety Disorder; Youth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Child
  • Cognitive Behavioral Therapy* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Inhibition, Psychological
  • Male
  • Phobia, Social* / therapy
  • Treatment Outcome