Background Guided internet-based cognitive behavioral therapy (ICBT) has been found efficacious in reducing symptoms of anxiety in adolescents with anxiety disorders, but not all respond equally well. Objective In this study, we explored candidate predictors of ICBT treatment response within the frame of a randomized controlled trial. Methods Sixty-five adolescents (13–17 years) with anxiety disorders according to DSM-IV received 14 weeks of therapist-guided ICBT. Outcome was evaluated as improvement (continuous change score) from pre-treatment to 12-month follow-up according to self-reported anxiety symptoms and clinician-rated diagnostic severity. Clinical predictors included baseline self- and parent-reported anxiety symptom levels, baseline clinician-rated severity of primary diagnosis, summed baseline clinician-rated severity of all anxiety diagnoses, baseline self-rated depressive symptoms, age of onset, and primary diagnosis of social phobia. Demographic predictors included age, gender and computer comfortability. Therapy process-related predictors included number of completed modules and therapist phone calls, summed duration of therapist phone calls, degree of parent support, and therapeutic alliance. Multi-level models were used to test the prediction effects over time. Results Higher levels of self- and clinician-rated baseline anxiety and self-rated depressive symptoms, female gender, and higher levels of computer comfortability were associated with increased treatment response. None of the proposed therapy process-related predictors significantly predicted treatment response. Conclusion The present findings indicate that ICBT may be an acceptable choice of treatment for youths, even those with relative high levels of anxiety and depressive symptoms.

中文翻译：

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基于互联网的指导性青少年焦虑认知行为疗法：治疗反应的预测因素。

背景 已发现基于互联网引导的认知行为疗法（ICBT）可有效减轻患有焦虑症的青少年的焦虑症状，但并非所有疗法的反应都相同。目的 在本研究中，我们在随机对照试验的框架内探讨了 ICBT 治疗反应的候选预测因子。方法 根据 DSM-IV，65 名患有焦虑症的青少年（13-17 岁）接受了 14 周治疗师指导的 ICBT。根据自我报告的焦虑症状和临床医生评定的诊断严重程度，结果被评估为从治疗前到 12 个月随访的改善（持续变化评分）。临床预测因素包括基线自我和家长报告的焦虑症状水平、基线临床医生评定的初步诊断严重程度、基线临床医生评定的所有焦虑诊断的严重程度总和、基线自评抑郁症状、发病年龄和初步诊断的社交症状。恐怖症。人口预测因素包括年龄、性别和计算机舒适度。与治疗过程相关的预测因素包括已完成的模块和治疗师电话的数量、治疗师电话的总持续时间、家长的支持程度和治疗联盟。使用多级模型来测试随时间变化的预测效果。结果 较高水平的自我评价和临床医生评价的基线焦虑和自评抑郁症状、女性性别以及较高水平的计算机舒适度与治疗反应的增强相关。所提出的与治疗过程相关的预测因子均未显着预测治疗反应。结论 目前的研究结果表明，ICBT 可能是青少年可接受的治疗选择，即使是那些焦虑和抑郁症状水平相对较高的青少年。