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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Predicting outcomes following cognitive behaviour therapy in child anxiety disorders: The influence of genetic, demographic and clinical information
Journal of Child Psychology and Psychiatry and Allied Disciplines, Volume 54, No. 10, Year 2013
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Description
Background Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; 5HTTLPR and marker rs6330 in Nerve Growth Factor gene; NGF is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety disorders. The aim of this study was to explore one potential means of extending the translational reach of G × E data in a way that may be clinically informative. We describe a 'risk-index' approach combining genetic, demographic and clinical data and test its ability to predict diagnostic outcome following CBT in anxious children. Method DNA and clinical data were collected from 384 children with a primary anxiety disorder undergoing CBT. We tested our risk model in five cross-validation training sets. Results In predicting treatment outcome, six variables had a minimum mean beta value of 0.5:5HTTLPR, NGF rs6330, gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder. A risk index (range 0-8) constructed from these variables had moderate a predictive ability (AUC =.62-.69) in this study. Children scoring high on this index (5-8) were approximately three times as likely to retain their primary anxiety disorder at follow-up as compared with those children scoring 2 or less. Conclusion Significant genetic, demographic and clinical predictors of outcome following CBT for anxiety-disordered children were identified. Combining these predictors within a risk index could be used to identify which children are less likely to be diagnosis-free following CBT alone and require longer or enhanced treatment. The 'risk-index' approach represents one means of harnessing the translational potential of G × E data. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Authors & Co-Authors
Hudson, Jennifer L.
Australia, Sydney
Macquarie University
Lester, Kathryn J.
United Kingdom, London
King's College London
Lewis, Cathryn M.
United Kingdom, London
King's College London
Tropeano, Maria
United Kingdom, London
King's College London
Creswell, Catharine S.
United Kingdom, Reading
University of Reading
Collier, David Andrew
United Kingdom, London
King's College London
Cooper, Peter J.M.
United Kingdom, Reading
University of Reading
South Africa, Stellenbosch
Stellenbosch University
Lyneham, Heidi J.
Australia, Sydney
Macquarie University
Morris, Talia M.
Australia, Sydney
Macquarie University
Rapee, Ronald M.
Australia, Sydney
Macquarie University
Roberts, Susanna
United Kingdom, London
King's College London
Donald, Jennifer A.
Australia, Sydney
Macquarie University
Eley, Thalia C.
United Kingdom, London
King's College London
Statistics
Citations: 79
Authors: 13
Affiliations: 4
Identifiers
Doi:
10.1111/jcpp.12092
Research Areas
Genetics And Genomics
Maternal And Child Health
Mental Health
Study Design
Cohort Study