{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:00:44Z","timestamp":1785150044273,"version":"3.55.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute of Child Health & Development"},{"name":"The Yung Family Foundation"},{"DOI":"10.13039\/100005337","name":"American Academy of Child and Adolescent Psychiatry","doi-asserted-by":"crossref","award":["Drs. Gabrielle and Harold Carlson Psychopharmacolo"],"award-info":[{"award-number":["Drs. Gabrielle and Harold Carlson Psychopharmacolo"]}],"id":[{"id":"10.13039\/100005337","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify early markers of acute treatment response among youth with anxiety disorders receiving cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitor (SSRI) monotherapy, or their combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although many youth with anxiety disorders benefit from CBT or SSRIs, response trajectories vary. Identifying early indicators of nonresponse may guide sequencing strategies and improve timely treatment delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Using data from the Child\/Adolescent Anxiety Multimodal Study, improvement trajectories were modeled for youth (age 7\u201317) randomized to sertraline monotherapy (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 133), CBT monotherapy (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 139), their combination (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 140), and placebo (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 76). Patients were stratified by percent change in Pediatric Anxiety Rating Scale (PARS) scores at multiple time points, and logarithmic and logistic time-trend regression models were used to estimate the probability of response. Receiver operating characteristic (ROC) analyses were used to identify thresholds of improvement for predicting response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the sertraline group, \u226525% improvement in PARS score at week 4 had a higher probability of response by week 12 (60.8%) than &lt;25% improvement (31.7%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001). In CBT-treated youth, week 4 PARS improvement was less predictive of response, with \u226525% improvement predicting a 47.9% chance of response compared with 28.6% for &lt;25% improvement (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.025). In the combined treatment, \u226525% improvement predicted a73.3% probability of response, whereas &lt;25% improvement yielded a 51.3% likelihood of response (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). ROC analyses similarly suggested that week 4 improvement in PARS scores in the CBT group had near equivocal predictive value, though this improved by week 6 to levels comparable to those of the other treatment groups. At week 6, roughly 25% improvement in PARS score in the combined treatment had the best sensitivity and specificity for predicting response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Early improvement can predict treatment response in youth with anxiety disorders receiving sertraline monotherapy or combination treatment (sertraline and CBT). Conversely, the absence of early improvement in CBT-treated youth does not reliably predict treatment nonresponse. Treatment-specific thresholds may inform clinical decision making, and support earlier SSRI optimization while allowing more time to observe CBT-related gains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10445463261462882","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:37:07Z","timestamp":1782895027000},"page":"414-422","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Wait-and-See: Data-Driven Decision Points for Guiding Selective Serotonin Reuptake Inhibitor Treatment and Cognitive Behavioral Therapy in Pediatric Anxiety Disorders"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6395-9010","authenticated-orcid":false,"given":"Julia N.","family":"Stimpfl","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Division of Child and Adolescent Psychiatry, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine K.","family":"Dahlsgaard","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara S.","family":"Peris","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Piacentini","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Walkup","sequence":"additional","affiliation":[{"name":"Prtizker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Strawn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Division of Child and Adolescent Psychiatry, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA."},{"name":"Department of Pediatrics, Divisions of Clinical &amp; Translational Pharmacology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-133X(96)80055-8"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-015-0184-8"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12792"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2014.04.001"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13796"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881105059253"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.8.903"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.177"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1137\/141000671"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v65n0505"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.0730"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.17r12064"},{"key":"e_1_3_2_14_1","first-page":"1682","volume-title":"Proceedings of the Twenty-First International Conference on Artificial Intelligence and Statistics","author":"Ge H","year":"2018","unstructured":"Ge H, , Xu K, , Ghahramani Z. 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