Treating comorbid anxiety and aggression in children.
OBJECTIVE
The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report.


METHODS
The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared with a standard cognitive-behavioral therapy intervention targeting anxiety only. The study was conducted over a period of 2 years, and 69 families were included, with participating children ranging in age from 8 to 14 years. Intervention effects were evaluated at posttreatment and 3 months following treatment.


RESULTS
An intent-to-treat analysis identified few significant differences between conditions in level of improvement following treatment and at follow-up, with the exception of parent-reported stress, anxiety, and depression, which improved in the anxiety treatment condition. Both treatment programs led to significant reductions in parent-reported child externalizing and internalizing problems and child-reported internalizing problems and to improved parenting practices.


CONCLUSIONS
Comorbidity did not appear to significantly affect treatment outcome for anxiety disorders, and combining existing treatments to address comorbid problems did not enhance treatment effectiveness. Further trials are required to assess the effectiveness of an expanded combined treatment program that allows adequate time to address both internalizing and externalizing problems.
Levy
Karyn
K
Drs. Hunt is with the School of Psychology, University of Sydney, Australia; and Dr. Heriot is with Allied Health and Clinical Research, MH-Kids, Australia; at the time of this study, Dr. Levy was with the School of Psychology, University of Sydney, Australia, and she is now with MAB-Mackay Rehabilitation Center, Montreal.
Hunt
Caroline
C
Drs. Hunt is with the School of Psychology, University of Sydney, Australia; and Dr. Heriot is with Allied Health and Clinical Research, MH-Kids, Australia; at the time of this study, Dr. Levy was with the School of Psychology, University of Sydney, Australia, and she is now with MAB-Mackay Rehabilitation Center, Montreal.. Electronic address: caroline@psych.usyd.edu.au.
Heriot
Sandra
S
Drs. Hunt is with the School of Psychology, University of Sydney, Australia; and Dr. Heriot is with Allied Health and Clinical Research, MH-Kids, Australia; at the time of this study, Dr. Levy was with the School of Psychology, University of Sydney, Australia, and she is now with MAB-Mackay Rehabilitation Center, Montreal.
D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male