Table 5.
Summary of evidence for the type of potential mediators identified in psychological treatments for anxiety, depression, externalizing disorders, substance use disorders and PTSD in adolescents
| Examined studies (examined mediators)a | Significant studiesb | Global evidencec | |||
|---|---|---|---|---|---|
| Anxiety | Good | Satisfactory | Unsatisfactory | ||
| Behavioral | 6 (10) | – | 2 (3) | 3 | Moderate |
| Cognitive | 11 (19) | – | 2 (4) | 7 (10) | Moderate |
| Emotional | 3 (4) | – | – | 1 (2) | Insufficient |
| Family | 2 (3) | – | 1 (2) | 1 | Insufficient |
| Relational | 3 (5) | – | – | 2 | Insufficient |
| Therapy-related | – | – | – | – | Insufficient |
| Depression | |||||
| Behavioral | 3 | 1 | – | 2 | Moderate |
| Cognitive | 10 (11) | 1 | 3 | 6 | Moderate |
| Emotional | 2 (3) | – | 1 | 1 (2) | Insufficient |
| Family | 6 (7) | 2 | – | 3 | Moderate |
| Relational | 5 (8) | 1 (2) | 1 | 2 | Moderate |
| Therapy-related | 3 (4) | 1 | – | 2 | Moderate |
| Externalizing disorders | |||||
| Behavioral | 2 (3) | – | – | 1 (2) | Insufficient |
| Cognitive | 1 (3) | – | – | 1 (3) | Insufficient |
| Emotional | 1 (2) | – | – | – | Insufficient |
| Family | 9 (22) | 3 (6) | 2 (4) | 3 (5) | Moderate |
| Relational | 8 (10) | 1 | 1 | 4 | Moderate |
| Therapy-related | 3 | – | 1 | – | Insufficient |
| Substance use | |||||
| Behavioral | 13 (16) | 1 | 5 (7) | 6 | Moderate |
| Cognitive | 16 (22) | – | 3 | 8 (12) | Moderate |
| Emotional | – | – | – | – | Insufficient |
| Family | 4 (5) | 1 | 1 (2) | 1 | Moderate |
| Relational | 4 (5) | – | – | 2 | Insufficient |
| Therapy-related | 7 (10) | 1 | 2 (3) | 2 (3) | Moderate |
| PTSD | |||||
| Behavioral | 1 (2) | – | 1 | – | Insufficient |
| Cognitive | 7 (8) | – | 1 | 5 | Moderate |
| Emotional | – | – | – | – | Insufficient |
| Family | 1 | – | – | 1 | Insufficient |
| Relational | – | – | – | – | Insufficient |
| Therapy-related | 1 | – | – | – | Insufficient |
aAs some studies investigated more than one mediator in the particular category, the number in parentheses indicates the overall number of specific mediators investigated in the particular category
bGood: If the total score for the risk of bias in an RCT was five or six, and the study met five or six of Kazdin’s criteria. Satisfactory: If the total score for the risk of bias in an RCT was five or six, and the study met four of Kazdin’s criteria. Unsatisfactory: If the total score for the risk of bias was below five and the study met less than four of Kazdin’s criteria
cStrong: If 65% of studies found significant mediators in one category across at least three RCTs and the quality of these RCTs was rated good or satisfactory. Moderate: If 65% of studies found significant mediators in one category across at least three RCTs and the quality of these RCTs was rated good, satisfactory or unsatisfactory. Insufficient: If less than 65% of studies found significant mediators in one category in less than three RCTs and the quality of these RCTs was rated unsatisfactory