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05-02-2020 | Original Article | Uitgave 4/2020

Child Psychiatry & Human Development 4/2020

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

Child Psychiatry & Human Development > Uitgave 4/2020
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
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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.

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