trial with the treatment of sertraline in youth with generalized, separation and/or social anxiety disorders.

Conditions: Anxiety Disorders

Summary: a multicenter, acute, randomized, double-blind, placebo-controlled, flexible-dose trial with the treatment of sertraline.

randomized, double-blind, placebo-controlled trial of an evidence-based antidepressant, sertraline, in youth (n=120) with generalized, separation and/or social anxiety disorders, seeks to evaluate the predictive value of plasma ev signatures. patients will be randomized to sertraline (25-200 mg/day) or placebo (3:1) and total plasma evs will be collected at baseline and serially during the course of the 12-week treatment period.

Eligibility criteria:
inclusion criteria for patients with anxiety : * written, informed assent and consent. * patients, parent/guardian/lar must be fluent in the english. * 8-17 years of age, inclusive, at visit 1, and who have a parent/guardian/lar. * patients must meet dsm-5 criteria for generalized, social and/or separation anxiety disorder, confirmed by the mini-kid with no lifetime history of mania, ocd or significant history of trauma exposure. * pars score ≥15 at visits 1 and 2. * caregiver who is willing to consent to be responsible for safety monitoring of the patient, provide information about the patient's condition, oversee the administration of the investigational product. * no clinically significant abnormalities on physical examination. * negative pregnancy test at visit 1 in females. * sexually active patients must practice a reliable method of contraception (section 15.0) that will continue for the duration of the study and within 30 days following the end of study participation. * reliable methods of contraception are defined below; other forms of contraceptives (pharmacological and/or non-pharmacological) are not accepted. * surgical sterilization * oral contraceptives (e.g., estrogen-progestin combination or progestin) * transdermally-delivered contraceptives (e.g., ortho-evra), depot injections (e.g., * depo-provera) * vaginal contraceptive ring (e.g., nuvaring), contraceptive implants (e.g., implanon, norplant * ii/jadelle) * an intrauterine device or * diaphragm plus condom. inclusion criteria for healthy controls: * written, informed assent and consent. * patients, parent/guardian/lar must be fluent in the english. * 8 to 17 years of age, inclusive, at visit 1, and who have a parent/guardian/lar. * no history of any dsm-5 disorders (nicotine use disorder is permitted, history of adjustment disorder is permitted), confirmed by the mini-kid. * caregiver who is willing to consent to be responsible for safety monitoring of the patient, provide information about the patient. * no clinically significant abnormalities on physical examination. negative pregnancy test at screening in females. * negative urine drug screen at screening. * no first-degree relatives with an affective, anxiety or psychotic disorder. exclusion criteria for patients with anxiety disorders and healthy comparison: * subjects co-occurring dsm-5 diagnosis mood (except persistent depressive disorder, unspecified depressive disorder or co- occurring anxiety disorders, provided that the primary diagnosis is generalized, social and/or separation anxiety disorder(s)), eating, bipolar, or psychotic disorders. * a history of treatment with ssris within 12 weeks of visit 2 (baseline) or current pharmacotherapy with cns effects that require \>5 half-lives for discontinuation. * a history of major neurological or medical illness or head trauma with loss of consciousness for ≥5 minutes. * lifetime history of mania, ocd, or significant history of trauma exposure. * history of hypersensitivity to sertraline. * lifetime diagnosis of intellectual disability or history of iq \<70. * history of alcohol/substance use disorder or any substance abuse within the past 6 months (nicotine dependence is permitted). * current psychotherapy stable for \<2 months prior to visit 2 (baseline). * females will not be eligible to participate if they are pregnant, breast feeding or lactating. * the subject lives \>100 miles from the university of cincinnati or \>90 minutes from the cu site or is not able to attend the follow-up visits. * patients who are unable to swallow capsules. * is currently considered at risk of suicide in the opinion of the investigator, represents an inappropriate risk to the participant and/or could confound the interpretation of the study results.