The dynamical systems approach for studying change in youth receiving treatment for anxiety disorders

Abstract

Cognitive behavioral therapy (CBT) has been shown to be an efficacious treatment for youth anxiety, but we do not have a satisfactory understanding of how CBT achieves its beneficial effects. The present study used a dynamical systems framework to model ecological momentary assessment (EMA) data collected via a cellular telephone and to examine patterns of affective variability over time and across CBT and client-centered therapy (CCT) treatments. Dynamical systems are systems that change over time in response to input from the environment and from itself at an earlier time. Associations between pretreatment variables and patterns of affect at pretreatment and over the course of the treatments were also examined. Results revealed significant decreases in affective variability over the course of treatment for participants in the CBT condition, but not for those in the CCT condition. Several variables (i.e., emotion regulation coping related to anger, depressive symptoms, and affiliative temperament) predicted initial affective variability ratings and changes in affective variability over time. Findings provide initial support for the dynamical systems approach to examining changes that occur during treatment. Implications for the examination of mechanisms of change are discussed.