Treatment of comorbid attention-deficit/hyperactivity disorder and anxiety in children: Processes of change.
Abstract
Approximately 30%-40% of children with attention-deficit/hyperactivity disorder (ADHD) meet criteria for a comorbid anxiety disorder in clinical samples (Tannock, 2009), but little is known about treatment response for this subgroup. The current study evaluated processes of change in a psychosocial treatment designed for children with ADHD and anxiety (Jarrett & Ollendick, 2012). Processes included the slope of symptom change during treatment, the temporal relations between ADHD and anxiety symptoms during treatment, and changes in neurocognitive functioning, parent-child relationships, and family functioning. Treatment involved a combination of parent management training for ADHD and family based cognitive-behavioral therapy for anxiety. Sessions lasted approximately 90 min, and the treatment consisted of 10 weekly sessions. Eight children ages 8-12 with ADHD, combined type (ADHD-C), and at least 1 of 3 anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia) were selected for the study. The study utilized a single-case design with weekly measures of ADHD and anxiety symptoms along with pretreatment, midtreatment, and 1-week posttreatment assessments. Slopes of symptom change and temporal relationships among symptom domains were examined using simulation modeling analysis (Borckardt et al., 2008), while other analyses involved standard comparisons across time points. Results generally supported declining slopes for ADHD and anxiety and greater concurrent change between anxiety and hyperactivity/impulsivity than anxiety and inattention. Few changes were found for neurocognitive functioning, but some changes were found for parent-child relationships and family functioning. Future studies are needed to better understand the treatment of ADHD and comorbid anxiety.
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After these interventions stop, lack of change in the underlying neurobiological substrate or neurocognitive performance may explain the rapid return of pre-treatment symptoms and impairments.
“Once these interventions have been terminated, lack of change in the underlying neurobiological substrate (Rubia et al., 2013) or neurocognitive performance (Dovis et al., 2012; Jarrett, 2013) may be the reason for the observed rapid return of pre-treatment symptoms/impairments.”
From Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches (2014) · cites this paper as Jarrett, 2013
Data suggest that behavioral interventions do not improve executive functioning.
“data also suggests that behavioral interventions do not result in improvements in executive functioning (Jarrett, 2013).”
From Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches (2014) · cites this paper as Jarrett, 2013
Neither medication nor behavioral interventions significantly improve executive functioning in children or adults with ADHD.
“neither medication nor behavioral interventions significantly improve executive functioning for children or adults with ADHD (Advokat, 2010; Rapport et al., 2013; Jarrett, 2013).”
From Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches (2014) · cites this paper as Jarrett, 2013
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- Authors
- Jarrett, M. A.
- Affiliations
- University of Alabama (US)
- Corresponding author
- Jarrett, Matthew A.
- ORCID
- Jarrett, Matthew A.
- Venue
- Psychological Assessment
- Published
- 2013-06
- Volume
- 25
- Issue
- 2
- Pages
- 545-555
- ISSN
- 1040-3590 (ISSN-L)
- 1939-134X
- OpenAlex
- W2313863382
- Cited by
- 12
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2021: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 2
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Assessment (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, anxiety comorbidity, children, change processes, parent management training, combined type ADHD, separation anxiety disorder, generalized anxiety disorder, social anxiety disorder, hyperactivity/impulsivity, inattention, parent-child relationship, family functioning, neurocognitive function
- MeSH terms
- Adult, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Child, Family Therapy, Female, Humans, Male, Parent-Child Relations, Parents, Time Factors, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
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