Symposium 78 - Opening doors to the future of precision mental health care for anxiety disorders in children and young people (Dr. Mary Cover Jones “Partners in the Studies of Human Lives” Honorary Award)

Chair(s)

• JH

  Jennifer Hudson, Ph.D. (she/her/hers)

  Professor
  Black Dog Institute
  Sydney, New South Wales, Australia
• MN

  Maaike Nauta, M.S., Ph.D. (she/her/hers)

  Professor
  University of Groningen, the Netherlands
  Groningen, Groningen, Netherlands

Discussant(s)

• 

  Philip Kendall, ABPP, Ph.D. (he/him/his)

  Laura H. Carnell Professor of Psychology; Director: Child and Adolescent Anxiety Disorders Clinic
  Temple University
  Philadelphia, Pennsylvania, United States

Presenter(s)

• JH

  Jennifer Hudson, Ph.D. (she/her/hers)

  Professor
  Black Dog Institute
  Sydney, New South Wales, Australia
• WC

  Wenting Chen, Ph.D. (she/her/hers)

  Postdoctoral Fellow
  Black Dog Institute
  Sydney, New South Wales, Australia
• LB

  Lizel Bertie, None (she/her/hers)

  Graduate student
  Black Dog Institute, University of New South Wales
  George, Western Cape, South Africa
• BK

  Bas Kooiman, M.S. (he/him/his)

  Graduate student
  University of Groningen
  Groningen, Groningen, Netherlands
• MN

  Maaike Nauta, M.S., Ph.D. (she/her/hers)

  Professor
  University of Groningen, the Netherlands
  Groningen, Groningen, Netherlands

When children and young people receive treatment for anxiety in clinical trials, on average about 50% benefit from CBT, while 50% remain symptomatic, even with enhanced treatments. Moreover, some relapse after initial response. To date, little is known about individual differences between those who respond and those who respond sub-optimally, or relapse later. Single randomised controlled trials are often underpowered to examine (combinations of) predictors of treatment success. The iconic question asked by Gordon Paul – “What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances which treatments work for whom” – was asked 55 years ago, and we are still not much closer to the truth in the field of child mental health. We urgently need data innovations to better support clinicians and families in their treatment planning and decision making to improve outcomes for children and young people with anxiety.
In this symposium, we will present five papers, each examining the “What works for Whom” question in the context of CBT for children and young people with anxiety disorders. Central to our symposium is PADDY, a novel international Platform on Anxiety Disorder Data in Youth, that combines datasets from existing clinical trials and provides a unique opportunity to investigate individual predictors. To date, we have collected individual data from over 6800 children and their families before and after CBT, across 12 countries including the USA, Canada, UK, Australia and the Netherlands.
First, Jennifer Hudson will present the rationale and methods of the PADDY project, the largest data sharing global repository for clinical trials of paediatric anxiety: we have harnessed existing data (and subsequent power) from existing trials to identify predictors and moderators in a more convincing way, a major step in answering the WHAT works for WHOM question.

Aligned with the theme of the conference regarding community engagement, Wendy Chen will share our research conducted with parents, children and clinicians examining their views of PADDY. This will help the field move away from solely researcher driven priorities towards a more diverse perspective and examining opportunities identified by young people, parents, clinicians, and school professionals.
The next three papers will present the findings of our work so far combining datasets to answer the question “what works for whom.” Lizel Bertie will present work on clinical and demographic predictors of treatment outcome, and how these may influence individual treatment decisions.
Then, Bas Kooiman will dive into predictors of relapse, and show that depressive symptoms present after CBT are associated with worse outcome. He will discuss how relapse prevention interventions may aid in decreasing relapse rates.
Finally, Maaike Nauta will present a study on WHAT works: can we find treatment ingredients that are associated with better outcomes.
As a discussant, Phil Kendall will reflect on the potential of using an international data repository to further progress the field towards applying knowledge of predictors to personalizing treatments, in order to enhance treatment effectiveness.