Cognitive behavioral therapy (CBT) can alter brain activity and lessen symptoms for children facing anxiety disorders. This effect has been demonstrated by a peer-reviewed study in the American Journal of Psychiatry (AJP).
In the study, 62 healthy children and 69 children diagnosed with anxiety disorders who had not yet received treatment participated. Over a 12-week CBT program, the young participants worked with clinicians to gradually confront situations that triggered anxiety. This exposure-based approach helps them build tolerance and reduce avoidance, aligning with CBT’s status as the leading evidence-based treatment for pediatric anxiety disorders.
Researchers used functional MRI to compare brain activity before CBT began and after the program concluded. Prior to treatment, several brain regions displayed heightened activity relative to their healthy peers. Notably, areas in the frontal and parietal cortex showed elevated activation, reflecting the mental effort involved in sustaining attention and regulating emotions. The amygdala and other subcortical regions also exhibited increased activity, consistent with stronger emotional responses such as fear and anxiety in affected children.
Following three months of therapy, the anxious group demonstrated meaningful reductions in symptom severity. Frontal and parietal hyperactivity diminished to levels typical of healthy children, or sometimes fell below them. Yet the amygdala continued to show relatively higher activity in anxious youths, suggesting that subcortical processing of fear and emotion may require longer treatment duration or additional interventions beyond standard CBT to achieve complete normalization.
Experts said that the results confirm CBT’s effectiveness and offer insight into how the therapy modulates brain function. Understanding these neural changes helps clinicians refine treatment plans and set realistic expectations for families. The study reinforces CBT as a frontline option for pediatric anxiety and points to future directions for combining behavioral approaches with targeted strategies that address subcortical activity.
Overall, the findings emphasize that early, evidence-based intervention can not only reduce symptoms but also reshape the neural pathways related to attention, emotion regulation, and fear processing. Clinicians can use this information to tailor exposure exercises and monitor progress over time, supporting children as they gain confidence and resilience in daily life.