Attachment as a predictor of non response to CBT treatment in children with anxiety disorders

Children’s and parents’ attachment patterns have been linked with the presence of pediatric anxiety disorders. The present study examined the role of attachment in predicting cognitive behavior therapy (CBT) treatment outcomes. A total of 69 children aged 7–13 years were assessed using a semi-structured interview, and treated with CBT. Differences between responders and nonresponders with regard to pretreatment characteristics were explored, and the predictive power of factors significantly different between groups was assessed using binominal logistic regression. Responders and nonresponders did not significantly differ with regard to child’s attachment to parent. Maternal attachment anxiety was found to be the strongest predictor of treatment outcome, remaining significant after controlling for symptoms severity. Results suggest that clinicians should pay more attention to how the relationships formed between anxious children and their anxiously attached mothers may prohibit a positive treatment response, and augment treatment appropriately.