Cognitive-behavioral therapy for children with anxiety and comorbid attention-deficit/hyperactivity disorder

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Abstract

Objective: To determine whether comorbid attention-deficit/hyperactivity disorder (ADHD) diagnosis (including subtype) predicts response to cognitive-behavior therapy (CBT) for anxiety in children and to examine change in ADHD symptoms after treatment of primary anxiety. Method: A sample of 842 children 5 to 18 years of age received CBT for a primary anxiety disorder. A subsample of 94 children met criteria for comorbid mild-to-moderate ADHD, mostly consisting of predominantly inattentive (n = 61) and combined (n = 27) subtypes. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (after treatment and 3- and/or 6-month follow-up) and analyzed using linear and logistic mixed models. Results: Neither ADHD diagnosis nor subtype predicted response or remission rates for children's primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT for anxiety. Conclusion: The present findings support the suitability of manual-based group-based CBT for anxiety treatment in children with nonprimary ADHD. Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.

LanguageEnglish
Pages481-490.e2
Number of pages12
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume57
Issue number7
DOIs
Publication statusPublished - Jul 2018

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Cognitive Therapy
Attention Deficit Disorder with Hyperactivity
Anxiety
Anxiety Disorders
Therapeutics
Logistic Models
Research

Keywords

  • anxiety
  • psychology
  • ADHD
  • mental disorders
  • therapy

Cite this

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title = "Cognitive-behavioral therapy for children with anxiety and comorbid attention-deficit/hyperactivity disorder",
abstract = "Objective: To determine whether comorbid attention-deficit/hyperactivity disorder (ADHD) diagnosis (including subtype) predicts response to cognitive-behavior therapy (CBT) for anxiety in children and to examine change in ADHD symptoms after treatment of primary anxiety. Method: A sample of 842 children 5 to 18 years of age received CBT for a primary anxiety disorder. A subsample of 94 children met criteria for comorbid mild-to-moderate ADHD, mostly consisting of predominantly inattentive (n = 61) and combined (n = 27) subtypes. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (after treatment and 3- and/or 6-month follow-up) and analyzed using linear and logistic mixed models. Results: Neither ADHD diagnosis nor subtype predicted response or remission rates for children's primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT for anxiety. Conclusion: The present findings support the suitability of manual-based group-based CBT for anxiety treatment in children with nonprimary ADHD. Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.",
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author = "Gould, {Karen L.} and Melanie Porter and Lyneham, {Heidi J.} and Hudson, {Jennifer L.}",
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AU - Porter, Melanie

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N2 - Objective: To determine whether comorbid attention-deficit/hyperactivity disorder (ADHD) diagnosis (including subtype) predicts response to cognitive-behavior therapy (CBT) for anxiety in children and to examine change in ADHD symptoms after treatment of primary anxiety. Method: A sample of 842 children 5 to 18 years of age received CBT for a primary anxiety disorder. A subsample of 94 children met criteria for comorbid mild-to-moderate ADHD, mostly consisting of predominantly inattentive (n = 61) and combined (n = 27) subtypes. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (after treatment and 3- and/or 6-month follow-up) and analyzed using linear and logistic mixed models. Results: Neither ADHD diagnosis nor subtype predicted response or remission rates for children's primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT for anxiety. Conclusion: The present findings support the suitability of manual-based group-based CBT for anxiety treatment in children with nonprimary ADHD. Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.

AB - Objective: To determine whether comorbid attention-deficit/hyperactivity disorder (ADHD) diagnosis (including subtype) predicts response to cognitive-behavior therapy (CBT) for anxiety in children and to examine change in ADHD symptoms after treatment of primary anxiety. Method: A sample of 842 children 5 to 18 years of age received CBT for a primary anxiety disorder. A subsample of 94 children met criteria for comorbid mild-to-moderate ADHD, mostly consisting of predominantly inattentive (n = 61) and combined (n = 27) subtypes. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (after treatment and 3- and/or 6-month follow-up) and analyzed using linear and logistic mixed models. Results: Neither ADHD diagnosis nor subtype predicted response or remission rates for children's primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT for anxiety. Conclusion: The present findings support the suitability of manual-based group-based CBT for anxiety treatment in children with nonprimary ADHD. Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.

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