Cognitive behavioral therapies have been identified as evidence-based treatments for anxiety-related disorders. However, data supporting the effectiveness of these treatments have been largely collected from participants with majoritized identities, potentially limiting the extent to which they can be considered “evidence-based” for clients from minoritized groups. The current review examined sociodemographic representation and quality of sociodemographic reporting in randomized controlled trials for anxiety-related disorders in the U.S. between 1993 and 2023. We conducted a systematic literature review of U.S.-based randomized controlled trials of cognitive behavioral therapies for anxiety-related disorders, extracted data on sociodemographic variables, and rated quality of reporting. Data from 55 eligible studies ( = 4492) indicated that white and female identities were overrepresented relative to the U.S. population, with variables like disability status, sexual orientation, and religious identification consistently ignored. In addition, quality of reporting was generally poor (mean = 3.6 out of 10), with many studies failing to account for demographic variables in their analyses or description of study limitations. Publication year, sample size, and NIH funding status did not significantly predict gender representation (% women), ethnoracial representation (% white), or quality of reporting. These findings underscore the importance of critically evaluating to whom “evidence-based” treatments apply and increasing diversity of clinical samples, to ensure that evidence-based treatments are inclusive. Recommendations for future research, clinical implications, and limitations are discussed.

中文翻译：

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美国焦虑相关疾病随机对照试验中的社会人口统计学代表性：系统评价（1993-2023）


认知行为疗法已被确定为针对焦虑相关疾病的循证治疗方法。然而，支持这些治疗有效性的数据主要是从具有多数身份的参与者那里收集的，这可能限制了这些治疗对于少数群体客户来说“基于证据”的程度。当前的综述检查了 1993 年至 2023 年间美国焦虑相关障碍随机对照试验中的社会人口统计学代表性和社会人口统计学报告的质量。我们对美国焦虑相关障碍认知行为疗法的随机对照试验进行了系统的文献综述，提取社会人口变量的数据，并对报告质量进行评级。 55 项符合条件的研究 (= 4492) 的数据表明，相对于美国人口，白人和女性身份的比例过高，残疾状况、性取向和宗教认同等变量始终被忽视。此外，报告质量普遍较差（平均值 = 3.6/10），许多研究未能在分析或研究局限性描述中考虑人口变量。发表年份、样本量和 NIH 资助状况并不能显着预测性别代表性（女性百分比）、种族代表性（白人百分比）或报告质量。这些发现强调了批判性评估“循证”治疗适用对象和增加临床样本多样性的重要性，以确保循证治疗具有包容性。讨论了对未来研究、临床意义和局限性的建议。