Fig. 1

Postulated Causal Pathways CBT-Specific Factors include exposure and development of coping skills. Common factors include the strength of the therapeutic alliance, clinician relatedness, and rewards associated with treatment. Medication-Specific Factors include direct effects of fluoxetine on brain circuits. Functional Outcomes include improved social relationships, better family and academic functioning, and improved self-esteem, which also function as natural reinforcers, or rewards. Vertical arrows from the Contextualizing Factors represent moderation of the association (shown as an oblique arrow) of a treatment modality with the indicated set of mediators. These contextual factors include Illness Factors such as comorbid illnesses, baseline anxiety severity, and family history of anxiety, as well as Cultural Factors, which include ethnicity and SES