Anxiety disorders are the most common psychiatric illnesses in youth with prevalence rates averaging 5-20%. These disorders are associated with significant short- and long-term impairment in academic, familial, social, and psychological functioning. Although medication and cognitive-behavioral therapy (CBT) have been found to be effective in the short term, questions remain regarding the durability of treatment effects and the relative impact of intervention on long-term functioning. This competing continuation application (in response to PAR- 09-153) will continue the successful multi-site collaboration of the Child/Adolescent Anxiety Multi-modal Study (CAMS) group to conduct a 5-year follow-up of the sample of youth with anxiety disorders that participated in the CAMS trial. The six sites are: New York State Psychiatric Institute;Duke University Medical Center;Johns Hopkins University;Temple University;University of California at Los Angeles;and Western Psychiatric Institute and Clinic. The central questions of the proposed study, entitled the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), are to examine the long-term psychiatric, physical, and functional outcomes of youth with anxiety disorders who were randomized to one of four treatment conditions (i.e., CBT, sertraline [SRT], pill placebo, or combined CBT + SRT). CAMS succeeded in randomizing 488 children/adolescents. The CAMELS is critical in light of the need for additional information about the effects of successful treatment on the course of anxiety symptoms and their sequelae and the NIMH priority to understand the developmental trajectories of mental illness (US DHHS, 2008). CAMELS will enroll the largest sample of carefully characterized youth with anxiety disorders and will inform the field about: 1) the preventive effects of successful treatment (psychosocial;medication) on the development of later psychopathology, 2) treatment durability, 3) potential long-term adverse effects (e.g., from chronic use of medication), and 4) predictors of relapse or long-term maintenance. Findings will also be used to refine current treatments, shedding light on how existing interventions may need to be augmented or personalized to target specific distal psychopathology and/or functional outcomes for specific children.

Public Health Relevance

This five-year study, entitled the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), proposes to follow up the sample of children and adolescents (N=488) with anxiety disorders that participated in the successful multi-site collaboration of the Child/Adolescent Anxiety Multi-modal Study (CAMS;U01MH64089). The central question of the proposed study is to examine the long-term psychiatric, physical, and functional outcomes of youth with anxiety disorders who were randomized to one of four treatment conditions (i.e., cognitive behavioral therapy (CBT), sertraline (SRT), pill placebo, or combined CBT + SRT. Key findings will inform the field about the preventive effects of successful treatment (both psychosocial and medication) on the development of later psychopathology and treatment durability.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH064089-09
Application #
8272664
Study Section
Special Emphasis Panel (ZMH1-ERB-E (01))
Program Officer
Goldstein, Amy B
Project Start
2001-07-01
Project End
2015-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
9
Fiscal Year
2012
Total Cost
$186,596
Indirect Cost
$72,818
Name
Johns Hopkins University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Schleider, Jessica L; Ginsburg, Golda S; Keeton, Courtney P et al. (2015) Parental psychopathology and treatment outcome for anxious youth: roles of family functioning and caregiver strain. J Consult Clin Psychol 83:213-24
Ginsburg, Golda S; Becker, Emily M; Keeton, Courtney P et al. (2014) Naturalistic follow-up of youths treated for pediatric anxiety disorders. JAMA Psychiatry 71:310-8