Treatment of comorbid attention-deficit/hyperactivity disorder and anxiety in children: a multiple baseline design analysis.

OBJECTIVE The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. METHOD Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia). The integrated treatment protocol involved parent management training for ADHD and family-based cognitive-behavioral therapy for anxiety. Pretreatment assessments included semistructured diagnostic interviews and other standardized measures to determine study eligibility. Children were randomized to 1 of 3 baseline control conditions (i.e., 2, 3, or 4 weeks) and subsequently treated in a university-based psychosocial treatment clinic. Weekly assessments of ADHD and anxiety disorder symptoms occurred throughout treatment and comprehensive assessments were obtained at pretreatment, 1-week posttreatment, and 6-months posttreatment. RESULTS Single-case results supported greater success in the treatment phase relative to the baseline phase for both ADHD and anxiety symptoms, and ADHD and anxiety symptoms appeared to change concurrently. Pre-post group analyses revealed significant and clinically meaningful improvements in ADHD and anxiety symptoms at 1-week posttreatment, but only anxiety symptoms moved into the subclinical range. At 6-months follow-up, treatment effects were maintained with new movement into the subclinical range for ADHD. CONCLUSIONS The present study provides initial data on an integrated treatment protocol for ADHD and anxiety. Further replication and evaluation are needed. Implications of the findings are discussed.