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Leaning heavily on news release, story on anxiety therapy for children lacks crucial context

Rating

2 Star

Kids With Anxiety Disorders ‘Significantly’ Benefit From Mindfulness Exercises By Changing Brain Activity

Our Review Summary

The story addresses the use of mindfulness-based cognitive therapy as a means of treating anxiety disorders in children, focusing on a recent study of nine children who had been diagnosed with an anxiety disorder and who had a parent with bipolar disorder. The story reports that the study found cognitive therapy was effective at reducing anxiety in study participants. The story does a good job of highlighting that these findings are preliminary, and that additional research is needed to determine how effective cognitive therapy may be as a treatment option for the general population. However, the story does not discuss the extent of the therapy’s benefits in this study, the availability and cost of such cognitive therapy for children, or whether the study participants were also being treated with medications while undergoing cognitive therapy. The story also appears to draw heavily on a news release, and does not incorporate input from independent experts.

 

Why This Matters

Anxiety disorders are not uncommon in children. According to the National Institute of Mental Health, approximately 25 percent of 13-18 year olds will experience an anxiety disorder — and approximately 6 percent of 13-18 year olds will experience a severe anxiety disorder. These disorders may include obsessive-compulsive disorder, post-traumatic stress disorder, and phobias, among others. A 2010 paper published in the Archives of Pediatrics and Adolescent Medicine Journal notes that pediatric anxiety disorders can cause “considerable functional impairment,” impose significant economic costs, adversely affect a child’s education, and increase a child’s risk for adult psychiatric disorders. In other words, pediatric anxiety disorders affect a great many people and can have long-term consequences for both children and their families. Research on new treatment options that can ameliorate the effects of anxiety disorders in children is well worth covering. However, as always, it is important to note both the limitations of new research, and the extent to which potential patients will have access to any treatment options being discussed. A more fundamental question may be: what’s new here? This isn’t the first study to address mindfulness-based cognitive therapy for treating either children or anxiety disorders.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Cost is not discussed at all. How much does cognitive therapy cost for children with anxiety disorders? Does it require long-term treatment with multiple sessions? Is it usually covered by health insurance providers? These are all important questions for families who have a child experiencing an anxiety disorder — and this story doesn’t address them.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story does a good job of not “over-selling” the benefits seen in the cognitive therapy study on children with anxiety disorders. It refers to “integrative approaches” and expanding treatment options. When discussing study results, the story talks about “the potential that mindfulness therapy could bring to the table,” and notes that “If nothing else, it might allow people who would be reluctant to take medication more treatments to choose from.” That sort of cautious language is all to the good. However, when it comes to describing the study’s findings, the language is extremely vague: “Cotton noted the anxiety of [study] patients was significantly reduced following treatment, and the more mindfulness they practiced, the less anxious they felt.” What does “significantly reduced” mean? Even a tiny improvement can be statistically “significant” — is that what we’re talking about here? It’s not clear. This is why the criterion asks for quantified benefits, and that’s lacking here.

Does the story adequately explain/quantify the harms of the intervention?

Not Applicable

The story doesn’t address harms. However, that may be because there are few (if any) risks associated with cognitive therapy for anxiety disorders. We’ll rate this not applicable.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story does a fair job of describing the study and, as noted above, stresses both that this is an early study with a small number of patients and that a lot of additional work needs to be done in this field before we will have a decent understanding of cognitive therapy’s effects on children with anxiety disorders. But some important limitations were not specifically addressed that should have been, such as the fact that there was no control group. This raises the possibility that the benefits seen are due to a placebo effect that might also occur with any similar caregiver-led intervention.  Moreover, the story would have been stronger if it had addressed a threshold issue: were the patients in the study also being treated with medications? The story itself notes in its opening paragraph that “many” adolescents are “treated with antidepressants and other medications to try and help them live a relatively normal childhood.” That raises the issue of pharmaceutical treatment for readers who, naturally enough, may wonder if the patients in the study being discussed were receiving medication. That said, it’s easy to see why the story doesn’t address this issue: the paper the story is reporting doesn’t address the issue either. But the use of medication in treating these disorders in children is particularly relevant, given that recent research (also with a small number of patients, and with some of the same authors as the cognitive therapy study) suggests that many children respond adversely to anxiety disorder medication. So, even though the cognitive therapy paper may not clearly state whether study participants were receiving pharmaceutical treatment, the reporter should have either pressed the researchers for an answer, or stated that it’s not clear what sort of treatment the study participants were receiving.

Does the story commit disease-mongering?

Satisfactory

No disease mongering here.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story quotes only two researchers — and both were authors of the paper being discussed.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story mentions pharmaceutical interventions, but doesn’t actually offer a comparison. How might mindfulness-based cognitive therapy be better or worse? And how does mindfulness-based cognitive therapy compare to (or differ from) other forms of cognitive therapy for children with anxiety disorders?

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

It’s not clear to readers whether mindfulness-based cognitive therapy for children with anxiety disorders is still in experimental development by a select group of researchers or is widely available. Can local therapists learn this technique?

Does the story establish the true novelty of the approach?

Not Satisfactory

The story does note that mindfulness-based therapy for children with anxiety isn’t new, stating that “there is some encouraging, if early, evidence showing that these techniques can be used to prevent relapses of depression or anxiety.” However, that doesn’t quite capture the amount of work that has already been done in the field. For example, the book Mindfulness-based cognitive therapy for anxious children: A manual for treating childhood anxiety came out five years ago. We’re not saying that there’s nothing new in this study; we are saying that it is very difficult to determine what is new, when it is not placed in the context of previous research.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story gets a Satisfactory grade here but fails in spirit. It draws extensively from a University of Cincinnati news release. However, because it acknowledges the source of the quotes used and doesn’t appear to plagiarize any other content from the release, it technically meets the standard for this criterion.

Total Score: 2 of 9 Satisfactory

Comments (1)

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Jo Ann Cook

August 1, 2016 at 5:42 am

There Are no evidence based studies that show that up to twenty-give per cent of children have an anxiety disorder. You appear to accept the status quo instead of questioning it. To me that goes against what you are trying to accomplish. After reading why it matters, a reader would come away with the mistaken notion that there is an epidemic of anxiety disorders in children and treatment is needed Today it he public is told that it requires a doctor’s help
and often medication. That is what is happening in schools in the United States and Canada It is disease mongering.

Reply