title: Treatment Outcomes in Anxious Youth with and without Comorbid ADHD in the CAMS.
abstract: The purpose of this study is to examine the influence of Attention-Deficit/Hyperactivity Disorder (ADHD), independent of Oppositional Defiant Disorder (ODD), on acute treatment response, remission rates and maintenance of gains at 6-month follow-up in anxious youth (ages 7-17, 76% Caucasian, 52% female) who received cognitive-behavioral therapy (CBT) alone, pharmacotherapy alone, the combination of CBT and pharmacotherapy or placebo pill in the Child/Adolescent Multimodal Study. Treatment response was defined as independent evaluator rated meaningful improvement in anxiety. Remission was operationalized as the absence of targeted anxiety disorders. ADHD and ODD were examined as moderators of outcomes at a diagnostic level. In the CBT group only, an ADHD diagnosis predicted poorer immediate treatment response and remission rates. However, these associations were not obtained for the pharmacotherapy groups. Participants with comorbid ODD were not less likely to achieve acute treatment response and remission rates than their counterparts across treatment conditions. Due to small sample size of the comorbid subgroups, our analyses must be considered preliminary. Nevertheless, our initial findings suggest further exploration of the separate roles of ADHD and ODD are worth pursuing, as they may be differentially associated with treatment outcomes in anxious youth treated with CBT but not youth treated with pharmacotherapy. If confirmed, findings may indicate that anxious youth with comorbid ADHD are less likely to benefit from CBT strategies alone and raise the possibility that these youth need adjunctive pharmacotherapy or psychosocial interventions.
authors.affiliation: a Department of Psychology , Virginia Polytechnic Institute and State University.
authors.forename: Thorhildur
authors.initials: T
authors.lastname: Halldorsdottir
authors.affiliation: a Department of Psychology , Virginia Polytechnic Institute and State University.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Ollendick
authors.affiliation: b Division of Child and Adolescent Psychiatry, John Hopkins University School of Medicine.
authors.forename: Golda
authors.initials: G
authors.lastname: Ginsburg
authors.affiliation: c Division of Services and Intervention Research, National Institute of Mental Health.
authors.forename: Joel
authors.initials: J
authors.lastname: Sherrill
authors.affiliation: d Department of Psychology , Temple University.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: e Department of Psychiatry , Weill Cornell Medical College and New York-Presbyterian Hospital.
authors.forename: John
authors.initials: J
authors.lastname: Walkup
authors.affiliation: f Department of Psychiatry , University of Pittsburgh.
authors.forename: Dara J
authors.initials: DJ
authors.lastname: Sakolsky
authors.affiliation: g UCLA Psychiatry and Behavioral Science, Semel Institute.
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000628:therapy*; D016022:Case-Control Studies; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D020280:Sertraline / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline