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12-05-2017 | Original Article | Uitgave 1/2018

Child Psychiatry & Human Development 1/2018

Examining the Mechanisms of Therapeutic Change in a Cognitive-Behavioral Intervention for Anxious Children: The Role of Interpretation Bias, Perceived Control, and Coping Strategies

Child Psychiatry & Human Development > Uitgave 1/2018
Ana Isabel Pereira, Peter Muris, Magda Sofia Roberto, Teresa Marques, Rita Goes, Luísa Barros
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The online version of this article (doi:10.​1007/​s10578-017-0731-2) contains supplementary material, which is available to authorized users.


This study examined the role of theoretically meaningful mediators of therapeutic change—interpretation bias, perceived control, and coping strategies—in a cognitive-behavioral intervention for anxious youth. This is one of the few studies that examined the change in potential mediator and outcome variables by means of a longitudinal design that included four assessment points: pretreatment, in-treatment, post-treatment, and at 4-months follow-up. Forty-seven 8- to 12-year-old children with a principal DSM-IV diagnosis of anxiety disorder participated in the study. On each assessment point, questionnaires assessing the mediator variables and a standardized anxiety scale were administered to the children. The results showed that perceived control and interpretation bias (but not coping strategies) accounted for a significant proportion in the variability of various types of anxiety symptoms, providing a preliminary support for the notion that these cognitive dimensions’ act as mechanisms of therapeutic change in cognitive-behavioral therapy for anxious children.

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