(PS5-16) Changes in Idiographic Coping Outcomes for Youth with Anxiety Disorders: Results from the Child/adolescent Anxiety Multimodal Study (CAMS)

Youth anxiety disorders are highly prevalent and continuing to rise, associated with adverse outcomes (e.g., disrupted academic and social functioning), and predictive of adult psychopathology when untreated. Prior research demonstrated improvement in anxiety symptoms following evidence-based treatment (e.g., cognitive behavioral therapy: CBT); however, not all youth experience symptom remission, nor are gains consistently maintained. Treatment outcomes are often measured using a nomothetic approach, assessing an individual’s responses relative to a larger sample on the same set of prompts. Idiographic measures assess an individual’s responses relative to oneself on constructs with personalized relevance. Perceived coping efficacy (one’s appraisal of one’s ability to cope) is assessed in reference to personalized anxiety-provoking situations. We examined idiographic changes in youths’ perceived ability to cope with anxiety-provoking situations at six timepoints from pretreatment to six-month follow-up in CAMS. Youth diagnosed with a principal anxiety disorder (N = 488; ages 7–17; 50.4% male; 78.9% White) were randomized to 12 weeks of CBT, Sertraline (SRT), both CBT and SRT, or pill placebo. Youth’s perceived ability to cope was assessed using youth and caregiver reports on the Coping Questionnaire (CQ), a three-item idiographic measure with anxiety-provoking situations individualized to each youth. In separate forms, youth reported perceptions of their own coping efficacy, and caregivers independently reported perceptions of the youth’s coping efficacy for the same situations. Items were rated on a 7-point scale from 1 (not at all able to help myself [or] him/herself) to 7 (completely able to help myself [or] him/herself). Responses were summed to create a total score. Higher scores indicate greater coping efficacy. Changes in perceived coping efficacy were examined across treatment conditions using multilevel models. Models estimating the quadratic effect of time fit better than models estimating the linear effect. There was a significant interaction between the quadratic effect of time and treatment condition, suggesting similar improvements in perceptions of youth coping efficacy from pretreatment to six-month follow-up, yet perceptions increase at different times across treatment based on condition per youth (F(3,1712.5)=8.24, p</em>< .001) and caregiver (F(3,1729.1)=21.13, p</em>< .001). There were no significant treatment condition differences on CQ for either informant at baseline or six-month follow-up. However, posthoc analyses at the interim assessments showed significant treatment condition differences in perceived coping efficacy. Results demonstrate treatments for youth anxiety disorders improve both youth and caregiver reports of perceived coping efficacy with youths’ personalized anxiety-provoking situations. Future work could prioritize idiographic assessments to expand understanding of symptom severity and associated functioning abilities among youth with anxiety, as well as the respective changes based on form of treatment.