Can attentional biases predict outcome of CBT in children with social anxiety disorder?

Background: Many studies have investigated differences in attention allocation to threat between socially anxious individuals and healthy controls in adult and child samples. The extent to which differences exist within the group of socially anxious individuals and whether these have a predictive value for the extent of symptom reduction after cognitive-behavioral therapy (CBT) has been studied less until to date and yielded inconsistent findings, particularly in child samples.

Methods: The present study investigated whether three different indices of biased attention, measured at pretreatment by eye-tracking, were associated with differences in response to a 12-session exposure-based group CBT in a sample of 41 children with social anxiety disorder (SAD).

Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder.

A considerable number of children and adolescents with social anxiety disorder (SAD) do not benefit from treatment as much as expected. However, treatment success should not be measured with social anxiety reports alone; the cognitive, behavioral, and physiological components of social stress should also be assessed. The authors examined an exposure-based SAD-specific group cognitive behavioral therapy (CBT) in a randomized controlled trial (N = 67, age 9-13 years, blind randomized allocation to treatment [CBT; n = 31] and waitlist control [WLC; n = 36] groups).

Repeated stress leads to enhanced cortisol stress response in child social anxiety disorder but this effect can be prevented with CBT.

Social anxiety disorder (SAD) is associated with continual social stress in everyday life. Two physiological components of stress are the hypothalamus-pituitary-adrenal axis, as captured by cortisol reactivity, and the autonomous nervous system, as captured by salivary alpha amylase (sAA) reactivity. In children with SAD, initial evidence points to dysregulated physiological stress reactivity for both systems.

[The performance of children with AD(H)D according to the HAWIK-IV].

The focus of the present study were performances of N = 433 children and adolescents with AD(H)D on the German version of the Wechsler Intelligence Scale for children (HAWIK-IV). Furthermore, we investigated whether test results depend on comorbid disorders based on subgroups (n = 212, n = 262, n = 217) composed by excluding individuals based on comorbidities on either (a) the first, (b) the second, and (c) the first and the second axis of the multiaxial classification scheme for mental disorders in childhood and adolescents. The specificity of the AD(H)D profile was investigated by comparing it against a clinical control group of children with anxiety or other emotional disorders (N = 41).