Current Clinical Trials on Anxiety Disorders for Youth (Ages 0-17)

List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country.

Recent Journal Articles: Anxiety and Youth

References and abstracts from MEDLINE/PubMed (National Library of Medicine) on anxiety among youth published in the last five years.

Wang, Z., Whiteside, S., Sim, L., Farah, W., Morrow, A., Alsawas, M., Moreno, P. B., Tello, M., Asi, N., Beuschel, B., Daraz, L., Almasri, J., Zaiem, F., Gunjal, S., Mantilla, L. L., Ponte, O. P., LeBlanc, A., Prokop, L. J., & Murad, M. H. (2017). Anxiety in children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Aug. (Comparative Effectiveness Reviews, No. 192.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK476277/

Pairs of independent reviewers selected studies using pre-specified inclusion and exclusion criteria. Includes randomized and non-randomized comparative studies (n=206) that compare psychotherapy, pharmacotherapy, or a combination in children ages 3-18 years with panic disorder, social anxiety disorder, specific phobias, generalized anxiety disorder, or separation anxiety. Findings indicate CBT is effective in reducing anxiety symptoms and improving function. Medications, primarily those targeting serotonin, are also effective and associated with various short-term adverse events. The combination of medications and CBT is likely more effective than either treatment alone.

Wang, Z., Whiteside, S. P., Sim, L., Farah, W., Morrow, A. S., Alsawas, M., Barrionuevo, P., Tello, M., Asi, N., Beuschel, B., Daraz, L., Almasri, J., Zaiem, F., Larrea-Mantilla, L., Ponce, O. J., LeBlanc, A., Prokop, L. J., & Murad, M. H. (2017). Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders. JAMA Pediatrics, 171(11), 1049. https://doi.org/10.1001/jamapediatrics.2017.3036

This systematic review evaluated the comparative effectiveness and safety of cognitive behavioral therapy (CBT) and medications for childhood anxiety disorders (n=115 studies in the analyses). Evidence most consistently supports the effectiveness of CBT and selective serotonin reuptake inhibitors (SSRIs) for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors (SNRIs) also appear to be effective based on less consistent evidence. SSRI and SNRI use were associated with various adverse events that were mostly not serious but studies were too small or too short to assess suicidality with SSRIs or SNRIs. The choice of treatments should be based on values, preferences, availability of services, and adverse effect profile.

Crawford, E. A., Frank, H. E., Palitz, S. A., Davis, J. P., & Kendall, P. C. (2017). Process factors associated with improved outcomes in CBT for anxious youth: Therapeutic content, alliance, and therapist actions. Cognitive Therapy and Research, 42, 172–183 https://doi.org/10.1007/s10608-017-9864-7

Cognitive behavioral therapy (CBT) has been established as an empirically supported treatment for anxiety in youth. Recent efforts have been underway to elucidate the evidence-based process factors that are associated with successful outcomes. These factors have included both therapy content (homework; exposure tasks) and therapy process (therapeutic alliance; therapist actions).

de Lijster, J. M., Dieleman, G. C., Utens, E., Dierckx, B., Wierenga, M., Verhulst, F. C., & Legerstee, J. S. (2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108–117. https://doi.org/10.1016/j.jad.2018.01.008

Adolescents with anxiety disorders had a lower social competence relative to their healthy peers. They reported more negativity within interpersonal relationships, higher levels of loneliness, and victimization. Most adolescents with anxiety disorders felt impaired at school, however, findings of their average school results, compared to peers, were mixed. In addition, they had a higher risk for school refusal and entered higher education less often. Impairments in social and academic functioning differed across type and the number of anxiety disorders.

Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as Cognitive-Behavioral Therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(3), 362–372. https://doi.org/10.1016/j.jaac.2019.02.014

Examined strategy of parent involvement to augment child-based cognitive-behavioral therapy (CBT). Research implicates family accommodation in the maintenance and course of childhood anxiety. Research found SPACE is an acceptable and efficacious treatment for childhood anxiety disorders, is noninferior to CBT, and provides an alternative strategy for treating anxiety in children.

Alse refer to Supportive Parenting for Anxious Childhood Emotions (SPACE) for more on this treatment approach.

National Institute of Mental Health. (2021, February 12). Study identifies risk factors for elevated anxiety in young adults during COVID-19 pandemic [Press release].

Identified early risk factors that predicted heightened anxiety in young adults during the coronavirus pandemic.

Cobham, V. E., Hickling, A., Kimball, H., Thomas, H. J., Scott, J. G., & Middeldorp, C. M. (2020). Systematic review: Anxiety in children and adolescents with chronic medical conditions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(5), 595–618. https://doi.org/10.1016/j.jaac.2019.10.010

Youth with chronic medical conditions (CMCs) have been reported to be at increased risk for developing anxiety disorders. Importantly, suffering from anxiety may also have an impact on their disease-related outcomes. This study set out to systematically review the literature on anxiety and seven CMCs (asthma, congenital heart disease, diabetes, epilepsy, inflammatory bowel disease, juvenile idiopathic arthritis, and sickle cell disease) among youth.

Mian, N. D., Pincus, D. B., Perrin, E. C., & Bair-Merritt, M. (2020). Identifying and making recommendations for pediatric anxiety disorders in primary care settings: A video-based training. The Association of American Medical Colleges Journal of Teaching and Learning Resources, 16, 11033. https://doi.org/10.15766/mep_2374-8265.11033

Pediatric anxiety disorders have high rates of prevalence and confer risk for later disorders if they go undetected. In primary care, they are underdiagnosed, partly because pediatricians often lack relevant training. The authors developed a brief, video-based training program for pediatric residents aimed at improving early identification of anxiety disorders in primary care. Results suggested that residents participating in this training improved their evaluation skills and that residents found the training beneficial. Video-based trainings can significantly supplement existing education.

Vogt, M. (2021, September 1). Under pressure: Are the stresses of social media too much for teens and young adults? Everyday Health.

For teens and young adults, social media can play a defining role in forming an identity. But research finds there are concerning associations between social media use and depression, anxiety, loneliness, self-esteem, and sleep issues among young people.

Christ, C., Schouten, M. J., Blankers, M., van Schaik, D. J., Beekman, A. T., Wisman, M. A., Stikkelbroek, Y. A., & Dekker, J. J. (2020). Internet and computer-based Cognitive Behavioral Therapy for anxiety and depression in adolescents and young adults: Systematic review and meta-analysis. Journal of Medical Internet Research, 22(9), e17831. https://doi.org/10.2196/17831

Computerized cognitive behavior therapy (cCBT) may provide an accessible alternative to face-to-face treatment for adolescents and young adults. Meta-analysis found cCBT is beneficial for reducing post-treatment anxiety and depressive symptoms in adolescents and young adults compared with passive controls. Compared with active treatment controls, cCBT yielded similar effects regarding anxiety symptoms.

Toscos, T., Coupe, A., Flanagan, M., Drouin, M., Carpenter, M., Reining, L., Roebuck, A., & Mirro, M. J. (2019). Teens using screens for help: Impact of suicidal ideation, anxiety, and depression levels on youth preferences for telemental health resources. Journal of Medical Internet Research Mental Health, 6(6), e13230. https://doi.org/10.2196/13230

Mental health treatment rates for teens remain low, partially because of barriers that could be mitigated with tech-based telemental health (TMH) resources, separate from or in addition to traditional care. This study analyzed TMH resource usage by high school students to establish current user characteristics and provide a framework for future development. Youth struggling with mental health symptoms, some of whom lack real-life confidants, are using existing TMH support, with resource preferences related to symptoms. Future research should consider these preferences and assist in the creation of specialized, evidence-based TMH resources.

Smith, P., Dalgleish, T., & Meiser-Stedman, R. (2019). Practitioner review: Posttraumatic stress disorder and its treatment in children and adolescents. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 60(5), 500–515. https://doi.org/10.1111/jcpp.12983

Synthesizes selected recent research findings, with a focus on their relevance to clinical practice. Authors address: findings on the epidemiology of trauma exposure and PTSD; recent changes to diagnostic classification; implications for screening and assessment of traumatic stress reactions; and treatment outcome studies including interventions for acute and chronic PTSD, dissemination of effective treatments into community settings, and early interventions. Article concludes with recommendations for clinical practice and suggestions for future areas of research.