School of Medicine Publications and Presentations
Document Type
Article
Publication Date
3-24-2025
Abstract
Background: Because pediatric anxiety disorders precede the onset of many other problems, successful prediction of response to the first-line treatment, cognitive-behavioral therapy (CBT), could have a major impact. This study evaluates whether structural and resting-state functional magnetic resonance imaging can predict post-CBT anxiety symptoms. Methods: Two datasets were studied: (A) one consisted of n = 54 subjects with an anxiety diagnosis, who received 12 weeks of CBT, and (B) one consisted of n = 15 subjects treated for 8 weeks. Connectome predictive modeling (CPM) was used to predict treatment response, as assessed with the PARS. The main analysis included network edges positively correlated with treatment outcome and age, sex, and baseline anxiety severity as predictors. Results from alternative models and analyses are also presented. Model assessments utilized 1000 bootstraps, resulting in a 95% CI for R2, r, and mean absolute error (MAE). Results: The main model showed a MAE of approximately 3.5 (95% CI: [3.1–3.8]) points, an R2 of 0.08 [−0.14–0.26], and an r of 0.38 [0.24–0.511]. When testing this model in the left-out sample (B), the results were similar, with an MAE of 3.4 [2.8–4.7], R2−0.65 [−2.29–0.16], and r of 0.4 [0.24–0.54]. The anatomical metrics showed a similar pattern, where models rendered overall low R2. Conclusions: The analysis showed that models based on earlier promising results failed to predict clinical outcomes. Despite the small sample size, this study does not support the extensive use of CPM to predict outcomes in pediatric anxiety.
Recommended Citation
Zugman, A., Ringlein, G. V., Finn, E. S., Lewis, K. M., Berman, E., Silverman, W. K., … Winkler, A. M. (2025). Brain functional connectivity and anatomical features as predictors of cognitive behavioral therapy outcome for anxiety in youths. Psychological Medicine, 55, e91. https://doi.org/10.1017/S0033291724003131
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Psychological Medicine
DOI
10.1017/S0033291724003131
Academic Level
faculty
Mentor/PI Department
Office of Human Genetics
Comments
© National Institutes of Health, 2025. This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.