Children with Anxiety Disorder Radically Benefit from Therapy

Using cognitive behavioral therapy (CBT) to treat children with anxiety disorders is an effective way to reduce their symptoms, new research has found.

Unmedicated children with anxiety disorders have overactivation in many brain regions, according to new research from the National Institutes of Health (NIH) — and treatment with CBT was found to be highly effective at reducing their symptoms and improving brain function.

The new study, published in the American Journal of Psychiatry Wednesday, presents evidence of the effectiveness of CBT, which is the current gold standard for treating anxiety disorders in children.

“The findings can help our understanding of how and for which children CBT works, a critical first step in personalizing anxiety care and improving clinical outcomes,” said senior author Melissa Brotman, Ph.D., chief of the Neuroscience and Novel Therapeutics Unit in the NIMH Intramural Research Program, in a news release.

To conduct the study, 69 children who were diagnosed with an anxiety disorder and were not medicated received 12 weeks of CBT. The treatment, most commonly used to treat anxiety and depression, is a form of talk therapy that involves changing thought patterns and behaviors.

The researchers analyzed changes in the children’s anxiety symptoms and brain activity throughout the treatment while comparing the results with the brain activity of 62 children without anxiety.

Before treatment, the children diagnosed with anxiety disorders showed altered activation of several brain regions compared to the healthy children. When the three months of treatment were complete, the children with anxiety demonstrated a significant improvement in their symptoms, and overactivation of many frontal and parietal brain regions also improved dramatically.

Eight brain regions continued to show higher than normal activity, however, suggesting that a longer CBT treatment period, additional forms of treatment, or direct targeting of the subcortical brain areas may be needed.

“Anxiety disorders are common in children and can cause them significant distress in social and academic situations. They are also chronic, with a strong link into adulthood when they become harder to treat,” says the NIH. “Despite the effectiveness of CBT, many children continue to show anxiety symptoms after treatment. Enhancing the therapy to treat anxiety more effectively during childhood can have short- and long-term benefits and prevent more serious problems later in life.”

The next step for this research, Brotman said, is to understand which children are most likely to respond to the treatment.

“Are there factors we can assess before treatment begins to make the most informed decisions about who should get which treatment and when?” said Brotman. “Answering these questions would further translate our research findings into clinical practice.”