TY - JOUR
T1 - The Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Youth with Anxiety and Autism Spectrum Disorder
AU - McBride, Nicole M.
AU - Weinzimmer, Saira A.
AU - La Buissonnière-Ariza, Valérie
AU - Schneider, Sophie C.
AU - Ehrenreich May, Jill
AU - Lewin, Adam B.
AU - McGuire, Joseph F.
AU - Goodman, Wayne K.
AU - Wood, Jeffrey J.
AU - Storch, Eric A.
N1 - Funding Information:
This work was supported by grants from John Hopkins-All Children’s Hospital Research Foundation, National Institute of Child Health and Human Development (Grant Nos. R34 HD6528 and HD65270), and internal funding from the last author. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Acknowledgements
Funding Information:
Nicole McBride, Dr. Jeffrey Wood, and Saira Weinzimmer have nothing to disclose. Dr. Wayne K. Goodman receives research funding from NIH, the Simons Foundation and Biohaven Pharmaceuticals and also received compensation from Biohaven Pharmaceuticals for providing training. Dr. Jill Ehrenreich-May receives royalties from Oxford University Press and Guilford Press regarding her transdiagnostic treatment work and receive stipends for consultation services from Children's Hospitals of Minnesota and Kinark Child and Family Services at the present time. Dr. Valerie La Buissonniere Ariza received a scholarship from the Canadian Institutes of Health Research. Dr. Sophie C. Schneider receives funding from the Texas Higher Education Coordinating Board and the American Red Cross. Dr. Joseph McGuire receives research support from the Tourette Association of America, American Brain Foundation, and the American Academy of Neurology. Dr. McGuire is a consultant for Bracket, and also receives book royalties from Elsevier. Dr. Eric Storch receives research support from NIH, International OCD Foundation, ReBuild Texas, Red Cross, and Texas Higher Education Coordinating Board. Dr. Storch has received royalties from Elsevier Publications, Springer Publications, American Psychological Association, Wiley, Inc, and Lawrence Erlbaum. Dr. Storch is a consultant for Levo Therapeutics. Dr. Storch is on the Speaker’s Bureau and Scientific Advisory Board for the International OCD Foundation. Dr. Lewin receives research support from All Children’s Hospital Research Foundation, the Centers for Disease Control and Prevention, and the International OCD Foundation. Dr. Lewin is on the speaker’s bureau for the Tourette Association of America and the International OCD Foundation. Dr. Lewin has received travel support from Tourette Association of America, American Psychological Association, Anxiety and Depression Association of America, NIMH, and Rogers Memorial Hospital. He has received consulting fees from Bracket and Prophase, Inc. He receives book royalties from Springer, and has received honoraria from Oxford University Press, Children’s Tumor Foundation, and University of Central Oklahoma. Dr. Lewin is on the Scientific & Clinical Advisory Board for the International OCD Foundation and the Board of Directors for the Society for Clinical Child and Adolescent Psychology and the American Board of Clinical Child and Adolescent Psychology.
Funding Information:
The authors thank each family who participated. The authors also acknowledge the contributions of Lindsay Brauer, P. Jane Mutch, Amanda Collier, Elysse Arnold, Alessandro De Nadai, Brittney Dane, Tanya Murphy, Anna Jones, Josh Nadeau, Michael Alessandri, Cori Fujii, Patricia Renno, Elizabeth Laugeson, John C. Piacentini, Alexander H. Queen, Juventino Hernandez Rodriguez, Christine S. Ghilain, Karen Berkman, Michael Hernandez, Carly Schwartzman, Ilana Seager, C. Enjey Lin, Kelly Decker, Erika Crawford, Anna Jones, Michael Sulkowski, Robert Selles, Danielle Ung, Monica Wu, Gregory Simpson, Amelia Rowley, Amy Beaumont, Carly Johnco, and Megan Toufexis.
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - Anxiety disorders
KW - Autism spectrum disorder
KW - Cognitive-behavioral therapy
KW - Externalizing disorders
KW - Obsessive–compulsive disorder
UR - http://www.scopus.com/inward/record.url?scp=85079497747&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079497747&partnerID=8YFLogxK
U2 - 10.1007/s10578-020-00961-2
DO - 10.1007/s10578-020-00961-2
M3 - Article
C2 - 32026260
AN - SCOPUS:85079497747
SN - 0009-398X
VL - 51
SP - 625
EP - 635
JO - Child Psychiatry and Human Development
JF - Child Psychiatry and Human Development
IS - 4
ER -