Document Type




First Advisor's Name

Wendy K. Silverman

First Advisor's Committee Title

Co-Committee Chair

Second Advisor's Name

James Jaccard

Second Advisor's Committee Title

Co-Committee Chair

Third Advisor's Name

William M. Kurtines

Fourth Advisor's Name

Maureen Kenny


mediation, anxiety, children, longitudinal, adolescents, cognitive behavioral treatment, anxiety disorders

Date of Defense



The current study examined whether variables that have been found to influence treatment outcome serve as mediators of a child and adolescent cognitive behavioral treatment (CBT) anxiety program at multiple time points throughout the intervention. The study also examined mediating variables measured at multiple time points during treatment to determine the time lags necessary for changes in the mediator variable to translate into changes on treatment gains. Participants were 168 youth (ages 6 to 16 years; 54% males) and their mothers who presented to the Child Anxiety and Phobia Program (CAPP) at Florida International University (FIU). Overall, results indicate that the mediators at multiple time points influenced youth anxiety in a fluctuating manner, such that a decrease in skills at one given session caused changes in youth anxiety at a later session. This dynamic between the mediator and outcome may be reflective of the process of therapeutic change and suggests that skills gained from session to session took time to exert their effect on youth anxiety. The methodology employed helps to elucidate how variables mediate treatment outcome in youth anxiety disorders.