Person-Centered Profiles Among Treatment-Seeking Children and Adolescents with Anxiety Disorders.

Perfis Centrados na Pessoa em Crianças e Adolescentes com Transtornos de Ansiedade em Busca de Tratamento.

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ID: 101611
2019
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Abstract
Latent profile analysis (LPA) was used to derive homogeneous subgroups within the Child/Adolescent Anxiety Multimodal Study sample (N = 488; 7-17 years, M = 10.69, SD = 2.80) and examine whether class membership predicted or moderated treatment response. Subgroups were identified on baseline multi-informant measures of variables most consistently associated with outcome (youth anxiety/diagnosis, impairment, family psychopathology/functioning). Subgroup membership was examined as a predictor/moderator of outcome across the four treatment conditions (CBT, Sertraline, CBT+Sertraline, pill placebo) at posttreatment (12 weeks) and open-extension follow-up (24 weeks). Four subgroups emerged: mild symptoms/impairment, moderate symptoms/impairment, moderate symptoms/impairment with family dysfunction/parental psychopathology, and severe symptoms/impairment. There were significant between-class differences on socioeconomic status (SES; lower reported SES in the moderate with family dysfunction/parental psychopathology class compared to the mild and moderate class) and age (older age in the severe symptoms class compared to the other three classes). Youth in the mild symptoms/impairment class showed lower posttreatment anxiety across conditions but reported significantly lower symptom severity at baseline. Controlling for demographic differences, response to treatment type did not differ across classes. Analyses indicate that elevated family dysfunction/parental psychopathology clusters primarily within one subgroup of anxious youth rather than mapping onto symptom severity, highlighting the utility of LPA for clarifying within-person combinations of predictor/moderator variables. Implications for development of interventions targeting class-relevant variables are discussed.
A análise de perfil latente (LPA) foi utilizada para derivar subgrupos homogêneos na amostra do Child/Adolescent Anxiety Multimodal Study (N = 488; 7–17 anos, M = 10,69, DP = 2,80) e examinar se o pertencimento à classe predisse ou moderou a resposta ao tratamento. Os subgrupos foram identificados com base em medidas de múltiplos informantes na linha de base das variáveis mais consistentemente associadas ao desfecho (ansiedade/diagnóstico dos jovens, prejuízo funcional, psicopatologia/funcionamento familiar). O pertencimento ao subgrupo foi examinado como preditor/moderador do desfecho nas quatro condições de tratamento (TCC, Sertralina, TCC+Sertralina, pílula placebo) no pós-tratamento (12 semanas) e no seguimento de extensão aberta (24 semanas). Quatro subgrupos emergiram: sintomas/prejuízo leves, sintomas/prejuízo moderados, sintomas/prejuízo moderados com disfunção familiar/psicopatologia parental e sintomas/prejuízo graves. Houve diferenças significativas entre as classes no nível socioeconômico (NSE; menor NSE relatado na classe moderada com disfunção familiar/psicopatologia parental em comparação com as classes leve e moderada) e na idade (idade mais avançada na classe de sintomas graves em comparação com as outras três classes). Os jovens na classe de sintomas/prejuízo leves apresentaram menor ansiedade pós-tratamento em todas as condições, mas relataram gravidade de sintomas significativamente menor na linha de base. Controlando-se as diferenças demográficas, a resposta ao tipo de tratamento não diferiu entre as classes. As análises indicam que a disfunção familiar/psicopatologia parental elevada agrupa-se primariamente em um subgrupo de jovens ansiosos, em vez de se alinhar diretamente à gravidade dos sintomas, destacando a utilidade da LPA para esclarecer combinações intraindividuais de variáveis preditoras/moderadoras. Discutem-se as implicações para o desenvolvimento de intervenções direcionadas a variáveis relevantes para cada classe.
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norris2019personcenteredjournal Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Norris, Lesley A;Olino, Thomas M;Gosch, Elizabeth A;Compton, Scott N;Piacentini, John;Ginsburg, Golda S;Albano, Anne Marie;Walkup, John T;Birmaher, Boris;Kendall, Philip C;
Journal journal of clinical child and adolescent psychology : the official journal for the society of clinical child and adolescent psychology, american psychological association, division 53
Year 2019
DOI
10.1080/15374416.2019.1602839
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