Mediators and moderators of outcome in the behavioral treatment of childhood social phobia

J Am Acad Child Adolesc Psychiatry. 2009 Sep;48(9):945-953. doi: 10.1097/CHI.0b013e3181af8216.

Abstract

Objective: The current study examined mediators and moderators of treatment response among children and adolescents (ages 7-17 years) with a primary diagnosis of social phobia.

Method: Participants were 88 youths participating in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children. Potential mediators included changes in observer-rated social skill and child-reported loneliness after 12 weeks of Social Effectiveness Therapy for Children. Age and depressive symptoms were examined as potential moderators.

Results: Loneliness scores and social effectiveness during a role-play task predicted changes in social anxiety and overall functioning at posttreatment. Changes in social anxiety were mediated by child-reported loneliness. Outcomes were not moderated by age or depressive symptoms.

Conclusions: Findings support the role of loneliness as an important mechanism of change during treatment for childhood social phobia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Behavior Therapy / methods*
  • Child
  • Female
  • Fluoxetine / therapeutic use
  • Humans
  • Implosive Therapy
  • Loneliness
  • Male
  • Motivation
  • Personality Assessment
  • Phobic Disorders / diagnosis
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy*
  • Problem Solving
  • Prognosis
  • Psychotherapy, Group
  • Role Playing
  • Social Adjustment
  • Socialization
  • Treatment Outcome

Substances

  • Antidepressive Agents, Second-Generation
  • Fluoxetine