A CRITICAL-REVIEW OF PHARMACOTHERAPY FOR YOUTH WITH ANXIETY DISORDERS- THINGS ARE NOT AS THEY SEEM

Given the increasing vend in clinical child psychology and psychiatry toward cost-effective and pharmacological treatment, a review of key f actors that influence treatment outcomes in this area seems warranted. This is especially important for the rapidly changing area of childho od anxiety disorders. In this article, we look at different change pro ducing procedures to illustrate the claim that pharmacological studies are not necessarily what they seem. Specifically, pharmacological out come studies are classified and reviewed on the basis of varying ''sec ondary'' treatments described in method sections. Three groups and eff icacy rates were determined: (a) pharmacotherapy only (42.83%), (b) ph armacotherapy plus general/supportive psychotherapy (27.74%), and (c) pharmacotherapy plus a behavior therapy component (65.28%). We also di scuss the implications of these findings for research as well as other methodological and theoretical concerns regarding the reviewed articl es. These concerns include (a) methods used to diagnose participants, (b) methods used to assess improvement, (c) emphasis on diagnostic cat egories, (d) exclusionary criteria and comorbidity, (e) participant at trition and follow-up, and (f) key developmental and social contextual variables. (C) 1998 Elsevier Science Ltd.