Cognitive‐behavioral therapy (CBT) is regarded as an effective treatment for anxiety disorders in childhood. Researchers have begun to investigate potential mechanisms of change that drive these positive outcomes, including shifts in cognitions, behavior, and affect. However, few studies have established the mediational effects of these factors as a proxy for establishing mechanistic change. This meta‐analysis attempts to synthesize the literature on potential mechanisms of change in CBT for childhood anxiety and investigates the mediational effects of these factors on treatment outcomes. Seventeen studies met the inclusion criteria. Across studies, five potential mediators were identified: externalizing difficulties, negative self‐talk, coping, fear, and depression. Results indicated that CBT was effective in improving outcomes on all potential mediators, except for fear. Mediational analyses showed that externalizing difficulties, negative self‐talk, coping, and depression mediated anxiety following treatment. Fear did not mediate the relationship. Implications for future mechanisms of change research are proposed.

中文翻译：

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儿童焦虑认知行为疗法改变的潜在机制：一项荟萃分析

认知行为疗法（CBT）被认为是儿童焦虑症的有效治疗方法。研究人员已经开始研究驱动这些积极结果的潜在变化机制，包括认知，行为和情感的转移。但是，很少有研究确定这些因素的介导作用来代替建立机械变化。这项荟萃分析试图综合有关儿童焦虑症中CBT改变的潜在机制的文献，并研究这些因素对治疗结果的介导作用。十七项研究符合纳入标准。在所有研究中，确定了五种潜在的介体：外在的困难，负面的自我对话，应对，恐惧和沮丧。结果表明，除恐惧外，CBT对改善所有潜在调解人的疗效均有效。中介分析显示，治疗后外在的困难，负面的自我交谈，应对和抑郁介导了焦虑。恐惧没有调解关系。提出了对未来变化研究机制的启示。