Treatment motivation in child anxiety treatment – Factor structure and associations with outcomes

Autor: Krister W. Fjermestad, Sofie F. Arnevåg, Lars-Göran Öst, Arne Kodal, Jon F. Bjaastad, Einar Heiervang, Gro Janne Wergeland
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Psychiatry Research Communications, Vol 3, Iss 4, Pp 100142- (2023)
Druh dokumentu: article
ISSN: 2772-5987
DOI: 10.1016/j.psycom.2023.100142
Popis: Motivation is associated with cognitive behavioral treatment (CBT) outcomes. We examined the factor structure of a motivation measure, and if motivation factors were differentially associated with CBT outcomes for children with anxiety. The sample comprised 179 children aged 8–15 years (M age = 11.5 years, SD = 2.1; 53.0% girls) with anxiety disorders who received CBT in a randomized controlled community clinic trial. Participants completed the Nijmegen Motivation List – child version (NML-C) at treatment onset. Outcomes were diagnostic recovery, anxiety/depression symptom and clinical severity change from pre-treatment to post-treatment, one-, and 3.9-years follow-up, and treatment dropout. Principal component analysis showed that the NML-C comprised two factors, preparedness (beliefs that CBT is useful and willingness to engage in treatment; 36.4% explained variance) and distress (discomfort from symptoms and perceived urgency to be helped; 12.7% explained variance). Higher preparedness predicted larger clinical severity reduction at post-treatment, alongside pre-treatment clinical severity. Higher distress predicted larger depression reduction at one-year follow-up, alongside pre-treatment depression. Higher preparedness predicted lower dropout. In conclusion, the NML-C comprises two factors that are differentially associated with CBT outcomes, but not above the effects of pre-treatment symptoms. Clinicians' focus on children's distress and preparedness could enhance CBT outcomes and reduce dropout.
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