CBT for Children with Anxiety and Attention Deficit Hyperactivity Disorder
What was the aim of the research?
The Cool Kids program is an effective cognitive behavioural treatment for children with anxiety disorders. About 25% of children who have an anxiety disorder also have attention-deficit/hyperactivity disorder (ADHD). Our aim was to determine whether Cognitive Behavioural Therapy (CBT) is effective for children who have an anxiety disorder and a secondary ADHD diagnosis. A secondary diagnosis is a condition that is less impairing than the primary diagnosis.
How did we do it?
We analysed data from 842 children aged 5 to 18 years who took part in the Cool Kids anxiety treatment program. Of these children, 94 also had mild-to-moderate ADHD. For all children in the study, an anxiety disorder was the primary diagnosis, meaning that anxiety was causing the greatest impairment in their lives prior to treatment. Children with certain secondary (less impairing) diagnoses such as ADHD were included, but those with a primary non-anxiety disorder were excluded from this study due to the focus on anxiety treatment.
What did we find
We found that there was no difference in treatment response and remission between the children with and without comorbid ADHD. That is, children who have ADHD did just as well in CBT as those children who didn't have ADHD. Around sixty percent of children with ADHD no longer met criteria for an anxiety disorder after treatment. Additionally, we found a modest but significant decrease in ADHD symptom severity for these children.
What does this mean in practice?
This means that children who have a primary anxiety disorder as well as mild-to-moderate ADHD are likely to benefit from participating in a manualised, CBT-based treatment for anxiety such as Cool Kids. We noted that Cool Kids is a treatment in which parent involvement is important, so a similar program is recommended.
Citation: Gould, K.L, Porter, M., Lyneham, H.J., Hudson, J.L. (2018), Cognitive Behavioral Therapy for Children With Anxiety and Comorbid Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry. DOI: https://doi.org/10.1016/j.jaac.2018.03.021