The role of exposure in the treatment of anxiety in children and adolescents: protocol of a systematic review and meta-analysis.


Journal

Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575

Informations de publication

Date de publication:
27 04 2020
Historique:
received: 08 08 2019
accepted: 18 03 2020
entrez: 29 4 2020
pubmed: 29 4 2020
medline: 25 6 2021
Statut: epublish

Résumé

In children and adolescents, anxiety disorders (ADs) are among the most prevalent mental disorders. While there is a solid empirical foundation to support CBT as an evidence-based treatment for childhood ADs, the mechanisms underlying the efficacy of CBT are not well explored. Exposure is assumed to be vital to the efficacy of CBT in ADs, but empirical evidence (e.g., dismantling studies) showing that exposure is indeed a vital element of effective treatments is relatively scarce. The proposed meta-analysis aims to investigate the role of exposure in reducing symptoms of anxiety among children and adolescents. A systematic search of several electronic databases including PubMed/MEDLINE, PsycINFO, Psyndex plus, Web of Science, Scopus, and EMBASE will be conducted (from inception onwards). We will include randomized and non-randomized clinical trials examining exposure and anxiety among children and adolescents. If feasible, we will also include experimental, quasi-experimental, and observational studies. The primary outcome will be improvement in anxiety levels (recovery or change in anxiety rating scale) after exposure. Three reviewers will independently screen all citations, abstract data, and full-text articles. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. If feasible, we will conduct mixed effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., dose of exposure, age group, methodological quality). This systematic review and meta-analysis will examine the role of exposure in reducing symptoms of anxiety among youth. The review will provide information on the working mechanisms underlying the efficacy of CBT. Our findings will be of interest to mental health professionals, researchers, and policy makers who wish to support children and adolescents with anxiety disorders by guiding well-informed treatment decisions. PROSPERO (CRD42019128667).

Sections du résumé

BACKGROUND
In children and adolescents, anxiety disorders (ADs) are among the most prevalent mental disorders. While there is a solid empirical foundation to support CBT as an evidence-based treatment for childhood ADs, the mechanisms underlying the efficacy of CBT are not well explored. Exposure is assumed to be vital to the efficacy of CBT in ADs, but empirical evidence (e.g., dismantling studies) showing that exposure is indeed a vital element of effective treatments is relatively scarce. The proposed meta-analysis aims to investigate the role of exposure in reducing symptoms of anxiety among children and adolescents.
METHODS
A systematic search of several electronic databases including PubMed/MEDLINE, PsycINFO, Psyndex plus, Web of Science, Scopus, and EMBASE will be conducted (from inception onwards). We will include randomized and non-randomized clinical trials examining exposure and anxiety among children and adolescents. If feasible, we will also include experimental, quasi-experimental, and observational studies. The primary outcome will be improvement in anxiety levels (recovery or change in anxiety rating scale) after exposure. Three reviewers will independently screen all citations, abstract data, and full-text articles. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. If feasible, we will conduct mixed effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., dose of exposure, age group, methodological quality).
DISCUSSION
This systematic review and meta-analysis will examine the role of exposure in reducing symptoms of anxiety among youth. The review will provide information on the working mechanisms underlying the efficacy of CBT. Our findings will be of interest to mental health professionals, researchers, and policy makers who wish to support children and adolescents with anxiety disorders by guiding well-informed treatment decisions.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42019128667).

Identifiants

pubmed: 32340628
doi: 10.1186/s13643-020-01337-2
pii: 10.1186/s13643-020-01337-2
pmc: PMC7187487
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

96

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Auteurs

Kathrin Schopf (K)

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany. kathrin.schopf@rub.de.

Cornelia Mohr (C)

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany. cornelia.mohr@rub.de.

Michael W Lippert (MW)

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany.

Katharina Sommer (K)

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany.

Andrea Hans Meyer (AH)

Faculty of Psychology, University of Basel, Missionsstrasse 62A, 4055, Basel, Switzerland.

Silvia Schneider (S)

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany.

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Classifications MeSH