(PS3-14) Identifying Predictors of Response to Group Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children

Abstract Text: Youth with internalizing disorders tend to show a greater response to group cognitive behavioral therapy compared to those with externalizing disorders. Notably, caregiver involvement has been identified as a key predictor in treatment outcomes; however, the involvement of a second caregiver remains unclear. Additionally, demographic predictors of CBT outcomes remain mixed. These various predictors remain underexplored in the context of group treatment using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). The present study aims to examine diagnostic predictors of differential treatment outcomes, the role of second caregiver involvement, and demographic predictors of treatment outcomes.
Participants included 37 youth ages 6-11 (M = 8.38, SD = 1.28) receiving group UP-C at a university clinic specializing in emotional disorders. Treatment outcomes were assessed pre- and post-treatment using child- and parent-reported Revised Child Anxiety and Depression Scale (RCADS-C/P respectively) and the Strengths and Difficulties Questionnaire (SDQ), with difference scores created for these measures. Linear regression analyses were conducted to examine predictors of treatment outcomes. Predictors included diagnostic group, number of diagnoses, involvement of a second caregiver, and demographic variables such as gender, ethnicity, income, and age. Data collection is ongoing and sample size will be larger at the time of presentation.
Results revealed significant differences in treatment response based on ethnicity, diagnosis, age, and gender (p’s < 0.05). Hispanic youth demonstrated greater difference scores on the RCADS-P Total, panic, and social anxiety subscales (p’s < 0.05). Similar patterns emerged on the SDQ-P total, hyperactivity, and externalizing subscales (p’s < 0.05). Regarding behavioral diagnoses, SDQ Parent subscales yielded mixed results, as youth with behavioral disorders exhibiting greater reductions on the hyperactivity and externalizing subscales (p’s < 0.05), whereas the prosocial subscale showed the opposite trend. Youth without behavioral diagnoses had greater difference scores on the RCADS-P OCD subscale (p = 0.040). Significant age differences were also observed, with younger children demonstrating greater reductions in anxiety and mood symptoms, as reflected in RCADS-P Total and separation anxiety scores (p’s < 0.05). Results show females reporting greater reduction on the RCADS-C Total and social subscale (p < 0.05), whereas males exhibited greater reductions on the SDQ Conduct subscale (p = 0.038). The involvement of a second caregiver yielded mixed results.
Results of the present study suggest that response to UP-C group treatment may be influenced by various diagnostic and demographic variables. The limited significant differences based on diagnosis, further supports the efficacy of the transdiagnostic nature of the UP-C. However, the UP-C may have greater reduction on behavioral concerns in youth with behavioral diagnosis, likely due to higher pre -treatment externalizing concerns. Notably, the significant effects of ethnicity underscore the need for further exploration of cultural influences on treatment outcomes.