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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalChild Psychiatry and Human Development
DOIs
StateAccepted/In press - Jan 1 2020

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Keywords

  • Anxiety disorders
  • Autism spectrum disorder
  • Cognitive-behavioral therapy
  • Externalizing disorders
  • Obsessive–compulsive disorder

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

McBride, N. M., Weinzimmer, S. A., La Buissonnière-Ariza, V., Schneider, S. C., Ehrenreich May, J., Lewin, A. B., McGuire, J. F., Goodman, W. K., Wood, J. J., & Storch, E. A. (Accepted/In press). The Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Youth with Anxiety and Autism Spectrum Disorder. Child Psychiatry and Human Development. https://doi.org/10.1007/s10578-020-00961-2