title: Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms.
abstract: OBJECTIVE
  The objectives were twofold: (a) examine long-term treatment effects in youth receiving 1-session treatment (OST) or educational support (EST) for a specific phobia (SP) and (b) examine the differential predictive and moderation effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on immediate and long-term outcomes following the interventions.
  
  
  METHODS
  Eighty-three children (ages 6-15, 47% female, 89% White) with a SP were randomly assigned to receive OST or EST. Follow up assessments occurred at 1 week, 6 months, 1 year, and 4 years. Hierarchical linear growth modeling (HLGM) was used to explore the association of parent-reported ADHD symptoms, the 2 treatment conditions (i.e., OST vs. EST), and the trajectory of change in the severity of the SP from pretreatment to the 4-year follow-up. Age, conduct problems and learning problems were controlled for in all analyses.
  
  
  RESULTS
  A greater immediate reduction in severity rating of the SP was observed in the OST compared to EST, whereas the trajectory of long-term outcomes was similar across conditions over time. Higher levels of ADHD symptoms predicted poor immediate and long-term treatment outcomes across treatment conditions. ADHD symptoms, however, did not moderate the relationship between treatment condition and immediate or long-term treatment outcomes.
  
  
  CONCLUSIONS
  The results of the study need to be interpreted in light of several study limitations. However, if confirmed, the findings suggest that anxious youth with comorbid ADHD symptoms are less likely to benefit from brief, intensive psychotherapy and may require either longer, standard CBT treatment or adjunctive pharmacotherapy.
authors.affiliation: Child Study Center, Department of Psychology, Virginia Tech.
authors.forename: Thorhildur
authors.identifier: 0000-0002-8855-3843
authors.initials: T
authors.lastname: Halldorsdottir
authors.affiliation: Child Study Center, Department of Psychology, Virginia Tech.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Ollendick
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome