Top

Gepubliceerd in:

05-02-2020 | Original Article

The Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Youth with Anxiety and Autism Spectrum Disorder

Auteurs: Nicole M. McBride, Saira A. Weinzimmer, Valérie La Buissonnière-Ariza, Sophie C. Schneider, Jill Ehrenreich May, Adam B. Lewin, Joseph F. McGuire, Wayne K. Goodman, Jeffrey J. Wood, Eric A. Storch

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 4/2020

Abstract

The impact of externalizing comorbidity on treatment outcome was examined in 104 youth ages 7–16 (M = 11.09 years) with autism spectrum disorder and primary anxiety/obsessive compulsive disorder who completed modular cognitive behavioral therapy (CBT) for anxiety/OCD. Three comorbidity profiles were utilized for group comparisons: participants with oppositional defiant or conduct disorder with attention-deficit hyperactivity disorder (ODD; CD; ADHD; group EXT, n = 25); those without ODD/CD and only ADHD (group ADHD, n = 46); and those without externalizing comorbidity (NO-EXT, n = 33). Post-treatment outcomes were measured continuously (Pediatric Anxiety Rating Scale, Clinical Global Impression-Severity) and categorically (treatment response, remission). The ADHD group was four times more likely of being a treatment responder compared to NO-EXT (OR 4.05). Comorbidity group did not impact remission. After controlling for pre-treatment scores, there was a significantly greater reduction of the CGI-S for ADHD versus NO-EXT and EXT versus NO-EXT, but results did not significantly differ for the PARS. Results suggest that a modular CBT approach yields positive impact for treatment outcomes in youth with comorbid externalizing problems, particularly among those with comorbid ADHD.

vorige artikel Latino and Non-Latino Parental Treatment Preferences for Child and Adolescent Anxiety Disorders

volgende artikel Trajectories of Observed Shyness and Psychosocial Adjustment in Children

Autism spectrum disorder (ASD) is a DSM-5 disorder which encompasses DSM-IV-TR diagnoses of autistic disorder, Asperger’s disorder, and pervasive development disorder-not otherwise specified. Though the majority of trials discussed throughout this report used DSM-IV-TR criteria, it will be collectively referred to as ASD to reflect the updated DSM-5 conceptualization of ASD.

Lecavalier L, McCracken CE, Aman MG, McDougle CJ, McCracken JT, Tierney E et al (2019) An exploration of concomitant psychiatric disorders in children with autism spectrum disorder. Compr Psychiatry 88:57–64. https://doi.org/10.1016/j.comppsych.2018.10.012 CrossRefPubMed

Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G (2008) Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 47:921–929. https://doi.org/10.1097/CHI.0b013e318179964f CrossRefPubMed

Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J et al (2006) Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 36:849–861. https://doi.org/10.1007/s10803-006-0123-0 CrossRefPubMed

Mukaddes NM, Herguner S, Tanidir C (2010) Psychiatric disorders in individuals with high-functioning autism and Asperger's disorder: similarities and differences. World J Biol Psychiatry 11:964–971. https://doi.org/10.3109/15622975.2010.507785 CrossRefPubMed

Hepburn SL, Stern JA, Blakeley-Smith A, Kimel LK, Reaven JA (2014) Complex psychiatric comorbidity of treatment-seeking youth with autism spectrum disorder and anxiety symptoms. J Ment Health Res Intellect Disabil 7:359–378. https://doi.org/10.1080/19315864.2014.932476 CrossRefPubMedPubMedCentral

Joshi G, Petty C, Wozniak J, Henin A, Fried R, Galdo M et al (2010) The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: a large comparative study of a psychiatrically referred population. J Autism Dev Disord 40:1361–1370. https://doi.org/10.1007/s10803-010-0996-9 CrossRefPubMed

Mattila ML, Hurtig T, Haapsamo H, Jussila K, Kuusikko-Gauffin S, Kielinen M et al (2010) Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: a community- and clinic-based study. J Autism Dev Disord 40:1080–1093. https://doi.org/10.1007/s10803-010-0958-2 CrossRefPubMed

White SW, Oswald D, Ollendick T, Scahill L (2009) Anxiety in children and adolescents with autism spectrum disorders. Clin Psychol Rev 29:216–229. https://doi.org/10.1016/j.cpr.2009.01.003 CrossRefPubMedPubMedCentral

van Steensel FJA, Bögels SM, Perrin S (2011) Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis. Clin Child Fam Psychol Rev 14:302–317. https://doi.org/10.1007/s10567-011-0097-0 CrossRefPubMedPubMedCentral

10.

Leitner Y (2014) The co-occurrence of autism and attention deficit hyperactivity disorder in children—what do we know? Front Hum Neurosci 8:268. https://doi.org/10.3389/fnhum.2014.00268 CrossRefPubMedPubMedCentral

11.

Antshel KM, Zhang-James Y, Faraone SV (2013) The comorbidity of ADHD and autism spectrum disorder. Expert Rev Neurother 13:1117–1128. https://doi.org/10.1586/14737175.2013.840417 CrossRefPubMed

12.

Joshi G, Faraone SV, Wozniak J, Tarko L, Fried R, Galdo M et al (2014) Symptom profile of ADHD in youth with high-functioning autism spectrum disorder: a comparative study in psychiatrically referred populations. J Atten Disord. https://doi.org/10.1177/1087054714543368 CrossRefPubMedPubMedCentral

13.

Ung D, Selles R, Small BJ, Storch EA (2015) A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry Hum Dev 46:533–547. https://doi.org/10.1007/s10578-014-0494-y CrossRefPubMed

14.

Sukhodolsky DG, Bloch MH, Panza KE, Reichow B (2013) Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. Pediatrics 132:e1341–1350. https://doi.org/10.1542/peds.2013-1193 CrossRefPubMedPubMedCentral

15.

Perihan C, Burke M, Bowman-Perrott L, Bicer A, Gallup J, Thompson J et al (2019) Effects of cognitive behavioral therapy for reducing anxiety in children with high functioning ASD: a systematic review and meta-analysis. J Autism Dev Disord. https://doi.org/10.1007/s10803-019-03949-7 CrossRef

16.

Sung M, Ooi YP, Goh TJ, Pathy P, Fung DSS, Ang RP et al (2011) Effects of cognitive-behavioral therapy on anxiety in children with autism spectrum disorders: a randomized controlled trial. Child Psychiatry Hum Dev 42:634–649. https://doi.org/10.1007/s10578-011-0238-1 CrossRefPubMed

17.

Storch EA, Schneider SC, De Nadai AS, Selles RR, McBride NM, Grebe SC et al (2019) A pilot study of family-based exposure-focused treatment for youth with autism spectrum disorder and anxiety. Child Psychiatry Hum Dev. https://doi.org/10.1007/s10578-019-00923-3 CrossRefPubMed

18.

Chalfant AM, Rapee R, Carroll L (2007) Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial. J Autism Dev Disord 37:1842–1857. https://doi.org/10.1007/s10803-006-0318-4 CrossRefPubMed

19.

Ehrenreich-May J, Storch EA, Queen AH, Hernandez Rodriguez J, Ghilain CS, Alessandri M et al (2014) An open trial of cognitive-behavioral therapy for anxiety disorders in adolescents with autism spectrum disorders. Focus Autism Other Dev Disabil 29:145–155CrossRef

20.

Russell AJ, Jassi A, Fullana MA, Mack H, Johnston K, Heyman I et al (2013) Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial. Depress Anxiety 30:697–708. https://doi.org/10.1002/da.22053 CrossRefPubMed

21.

Sofronoff K, Attwood T, Hinton S (2005) A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. J Child Psychol Psychiatry 46:1152–1160. https://doi.org/10.1111/j.1469-7610.2005.00411.x CrossRefPubMed

22.

Storch EA, Arnold EB, Lewin AB, Nadeau JM, Jones AM, De Nadai AS et al (2013) The effect of cognitive-behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 52:132–142.e132. https://doi.org/10.1016/j.jaac.2012.11.007 CrossRefPubMed

23.

Storch EA, Lewin AB, Collier AB, Arnold E, De Nadai AS, Dane BF et al (2015) A randomized controlled trial of cognitive-behavioral therapy versus treatment as usual for adolescents with autism spectrum disorders and comorbid anxiety. Depress Anxiety 32:174–181. https://doi.org/10.1002/da.22332 CrossRefPubMed

24.

Wood JJ, Drahota A, Sze K, Har K, Chiu A, Langer DA (2009) Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Child Psychol Psychiatry 50:224–234. https://doi.org/10.1111/j.1469-7610.2008.01948.x CrossRefPubMedPubMedCentral

25.

Wood JJ, Ehrenreich-May J, Alessandri M, Fujii C, Renno P, Laugeson E et al (2015) Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial. Behav Ther 46:7–19. https://doi.org/10.1016/j.beth.2014.01.002 CrossRefPubMed

26.

Drmic IE, Aljunied M, Reaven J (2017) Feasibility, acceptability and preliminary treatment outcomes in a school-based CBT intervention program for adolescents with ASD and anxiety in Singapore. J Autism Dev Disord 47:3909–3929. https://doi.org/10.1007/s10803-016-3007-y CrossRefPubMed

27.

Kose LK, Fox L, Storch EA (2018) Effectiveness of cognitive behavioral therapy for individuals with autism spectrum disorders and comorbid obsessive-compulsive disorder: a review of the research. J Dev Phys Disabil 30(1):69–87CrossRef

28.

Weston L, Hodgekins J, Langdon PE (2016) Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: a systematic review and meta-analysis. Clin Psychol Rev 49:41–54. https://doi.org/10.1016/j.cpr.2016.08.001 CrossRefPubMed

29.

Vasa RA, Carroll LM, Nozzolillo AA, Mahajan R, Mazurek MO, Bennett AE et al (2014) A systematic review of treatments for anxiety in youth with autism spectrum disorders. J Autism Dev Disord 44:3215–3229. https://doi.org/10.1007/s10803-014-2184-9 CrossRefPubMed

30.

Lundkvist-Houndoumadi I, Hougaard E, Thastum M (2014) Pre-treatment child and family characteristics as predictors of outcome in cognitive behavioural therapy for youth anxiety disorders. Nord J Psychiatry 68:524–535. https://doi.org/10.3109/08039488.2014.903295 CrossRefPubMed

31.

Olatunji BO, Cisler JM, Tolin DF (2010) A meta-analysis of the influence of comorbidity on treatment outcome in the anxiety disorders. Clin Psychol Rev 30:642–654. https://doi.org/10.1016/j.cpr.2010.04.008 CrossRefPubMed

32.

Storch EA, Merlo LJ, Larson MJ, Geffken GR, Lehmkuhl HD, Jacob ML et al (2008) Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 47:583–592. https://doi.org/10.1097/CHI.0b013e31816774b1 CrossRefPubMed

33.

Hudson JL, Keers R, Roberts S, Coleman JRI, Breen G, Arendt K et al (2015) Clinical predictors of response to cognitive-behavioral therapy in pediatric anxiety disorders: the genes for treatment (GxT) study. J Am Acad Child Adolesc Psychiatry 54:454–463. https://doi.org/10.1016/j.jaac.2015.03.018 CrossRefPubMedPubMedCentral

34.

Halldorsdottir T, Ollendick TH (2016) Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms. J Consult Clin Psychol 84:465–471. https://doi.org/10.1037/ccp0000088 CrossRefPubMed

35.

Halldorsdottir T, Ollendick TH, Ginsburg G, Sherrill J, Kendall PC, Walkup J et al (2015) Treatment outcomes in anxious youth with and without comorbid ADHD in the CAMS. J Clin Child Adoles Psychol 53(44):985–991. https://doi.org/10.1080/15374416.2014.952008 CrossRef

36.

Rapee RM (2003) The influence of comorbidity on treatment outcome for children and adolescents with anxiety disorders. Behav Res Ther 41:105–112CrossRef

37.

Ollendick TH, Jarrett MA, Grills-Taquechel AE, Hovey LD, Wolff JC (2008) Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders. Clin Psychol Rev 28:1447–1471. https://doi.org/10.1016/j.cpr.2008.09.003 CrossRefPubMed

38.

Ollendick TH, Ost LG, Reuterskiold L, Costa N (2010) Comorbidity in youth with specific phobias: impact of comorbidity on treatment outcome and the impact of treatment on comorbid disorders. Behav Res Ther 48:827–831. https://doi.org/10.1016/j.brat.2010.05.024 CrossRefPubMedPubMedCentral

39.

Kendall PC, Brady EU, Verduin TL (2001) Comorbidity in childhood anxiety disorders and treatment outcome. J Am Acad Child Adolesc Psychiatry 40:787–794. https://doi.org/10.1097/00004583-200107000-00013 CrossRefPubMed

40.

Rapee RM, Lyneham HJ, Hudson JL, Kangas M, Wuthrich VM, Schniering CA (2013) Effect of comorbidity on treatment of anxious children and adolescents: results from a large, combined sample. J Am Acad Child Adolesc Psychiatry 52:47–56. https://doi.org/10.1016/j.jaac.2012.10.002 CrossRefPubMed

41.

Gould KL, Porter M, Lyneham HJ, Hudson JL (2018) Cognitive-behavioral therapy for children with anxiety and comorbid attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 57:481–490.e482. https://doi.org/10.1016/j.jaac.2018.03.021 CrossRefPubMed

42.

Antshel KM, Polacek C, McMahon M, Dygert K, Spenceley L, Dygert L et al (2011) Comorbid ADHD and anxiety affect social skills group intervention treatment efficacy in children with autism spectrum disorders. J Dev Behav Pediatr 32:439–446. https://doi.org/10.1097/DBP.0b013e318222355d CrossRefPubMed

43.

Pellecchia M, Connell JE, Kerns CM, Xie M, Marcus SC, Mandell DS (2016) Child characteristics associated with outcome for children with autism in a school-based behavioral intervention. Autism 20:321–329. https://doi.org/10.1177/1362361315577518 CrossRefPubMed

44.

Storch EA, Arnold EB, Jones AM, Ale CM, Wood JJ, Ehrenreich-May J et al (2012) The role of co-occurring disruptive behavior in the clinical presentation of children and adolescents with anxiety in the context of autism spectrum disorders. Child Psychiatry Hum Dev 43:734–746. https://doi.org/10.1007/s10578-012-0294-1 CrossRefPubMed

45.

Wood JJ, McLeod B (2008) Child anxiety disorders: a family-based treatment manual for practitioners. Boydell & Brewer, Woodbridge

46.

RUPP (2002) The pediatric anxiety rating scale (PARS): development and psychometric properties. J Am Acad Child Adolesc Psychiatry 41:1061–1069CrossRef

47.

Wechsler D (2003) Wechsler intelligence scale for children, Fourth Edition (WISC-IV). The Psychological Corporation, San Antonio, TX

48.

Silverman WK, Albano AM (1996) The anxiety disorders interview schedule for DSM-IV-Child and parent versions. Oxford University Press, London

49.

Storch EA, Ehrenreich May J, Wood JJ, Jones AM, De Nadai AS, Lewin AB et al (2012) Multiple informant agreement on the anxiety disorders interview schedule in youth with autism spectrum disorders. J Child Adolesc Psychopharmacol 22:292–299. https://doi.org/10.1089/cap.2011.0114 CrossRefPubMedPubMedCentral

50.

Lecavalier L, Wood JJ, Halladay AK, Jones NE, Aman MG, Cook EH et al (2014) Measuring anxiety as a treatment endpoint in youth with autism spectrum disorder. J Autism Dev Disord 44:1128–1143. https://doi.org/10.1007/s10803-013-1974-9 CrossRefPubMedPubMedCentral

51.

Ginsburg GS, Keeton CP, Drazdowski TK, Riddle MA (2011) The utility of clinicians ratings of anxiety using the Pediatric Anxiety Rating Scale (PARS). In: child & youth care forum. Springer, New York pp 93–105.

52.

Caporino NE, Brodman DM, Kendall PC, Albano AM, Sherrill J, Piacentini J et al (2013) Defining treatment response and remission in child anxiety: signal detection analysis using the pediatric anxiety rating scale. J Am Acad Child Adolesc Psychiatry 52:57–67. https://doi.org/10.1016/j.jaac.2012.10.006 CrossRefPubMed

53.

Guy W (1976) Clinical Global Impressions ECDEU Assessment Manual for Psychopharmacology-revised. National Institute of Mental Health, Rockville

54.

Kern JK, Geier DA, Sykes LK, Geier MR, Deth RC (2015) Are ASD and ADHD a continuum? A comparison of pathophysiological similarities between the disorders. J Atten Disord 19:805–827. https://doi.org/10.1177/1087054712459886 CrossRefPubMed

55.

Johnco C, Salloum A, De Nadai AS, McBride N, Crawford EA, Lewin AB et al (2015) Incidence, clinical correlates and treatment effect of rage in anxious children. Psychiatry Res 229:63–69CrossRef

56.

Bloemsma JM, Boer F, Arnold R, Banaschewski T, Faraone SV, Buitelaar JK et al (2013) Comorbid anxiety and neurocognitive dysfunctions in children with ADHD. Eur Child Adolesc Psychiatry 22:225–234. https://doi.org/10.1007/s00787-012-0339-9 CrossRefPubMed

57.

Lavigne JV, LeBailly SA, Hopkins J, Gouze KR, Binns HJ (2009) The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol 38:315–328CrossRef

58.

Wei C, Kendall PC (2014) Parental involvement: contribution to childhood anxiety and its treatment. Clin Child Fam Psychol Rev 17:319–339. https://doi.org/10.1007/s10567-014-0170-6 CrossRefPubMed

59.

Storch EA, Zavrou S, Collier AB, Ung D, Arnold EB, Mutch PJ et al (2015) Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: incidence, clinical correlates, and behavioral treatment response. J Anxiety Disord 34:94–99. https://doi.org/10.1016/j.janxdis.2015.06.007 CrossRefPubMed

Titel: The Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Youth with Anxiety and Autism Spectrum Disorder
Auteurs: Nicole M. McBride
Saira A. Weinzimmer
Valérie La Buissonnière-Ariza
Sophie C. Schneider
Jill Ehrenreich May
Adam B. Lewin
Joseph F. McGuire
Wayne K. Goodman
Jeffrey J. Wood
Eric A. Storch
Publicatiedatum: 05-02-2020
Uitgeverij: Springer US
Gepubliceerd in: Child Psychiatry & Human Development / Uitgave 4/2020
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI: https://doi.org/10.1007/s10578-020-00961-2

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 4/2020

Parental Emotion-Focused Behaviors Moderate the Relationship Between Perceptual Sensitivity and Fear Reactivity in Anxious Children

Latino and Non-Latino Parental Treatment Preferences for Child and Adolescent Anxiety Disorders

Profiles of Antisocial Behavior in School-Based and At-Risk Adolescents in Singapore: A Latent Class Analysis

Confirming the Factor Structure and Validity of the Distress Tolerance Scale (DTS) in Youth

Stress Exposure and Maternal Depression as Risk Factors for Symptoms of Anxiety and Depression in Adolescents

Variants of Children with Psychopathic Tendencies in a Community Sample