CBT for childhood anxiety and substance use at 7.4-year follow-up: A reassessment controlling for known predictors

A previous report suggested that successful cognitive behavioral therapy (CBT) for child anxiety reduced substance use problems at 7.4-year follow-up, but that report did not include predictors of: (a) substance use disorder (SUD; e.g., attention deficit-hyperactivity disorder symptoms, negative life events, family substance abuse, additional treatment), or (b) treatment outcome (e.g., severity of internalizing pathology, age). Analyses incorporating these factors tested previously reported findings in 72 participants (ages 15–22 at follow-up; 84% of the 7.4-year follow-up sample), using parent and youth diagnostic interviews and report measures. The majority of previously reported associations between less successful treatment and later substance use problems remained significant after controlling for known predictors of SUD and treatment outcome. Our findings bolster previous conclusions that effective CBT for child anxiety may have ameliorative effects on the target disorder and later substance use problems.

Research highlights
► CBT for child anxiety reduces substance use problems at 7.4-year follow-up.
► Treatment responders use smaller amounts at 7.4-year follow-up.
► Responders have less negative social and physical drug use consequences.
► Treatment response predicts later drug use after controlling for SUD risk.
► Predictors of CBT outcome do not explain links between outcome and later drug use.