caa a22 4500 475739795 CHVBK 20180406123456.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1023/A:1005179014321 doi (NATIONALLICENCE)springer-10.1023/A:1005179014321 Anxiety as a Predictor and Outcome Variable in the Multimodal Treatment Study of Children with ADHD (MTA) [Elektronische Daten] [John March, James Swanson, L. Arnold, Betsy Hoza, C. Conners, Stephen Hinshaw, Lily Hechtman, Helena Kraemer, Laurence Greenhill, Howard Abikoff, L. Elliott, Peter Jensen, Jeffrey Newcorn, Benedetto Vitiello, Joanne Severe, Karen Wells, William Pelham] Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly. Plenum Publishing Corporation, 2000 ADHD nationallicence attention deficit nationallicence anxiety nationallicence comorbidity nationallicence treatment nationallicence outcomes nationallicence classification nationallicence diagnosis nationallicence March John Department of Psychiatry, DUMC, Box 3527, 27710, Durham, NC aut Swanson James aut Arnold L. aut Hoza Betsy aut Conners C. aut Hinshaw Stephen aut Hechtman Lily aut Kraemer Helena aut Greenhill Laurence aut Abikoff Howard aut Elliott L. aut Jensen Peter aut Newcorn Jeffrey aut Vitiello Benedetto aut Severe Joanne aut Wells Karen aut Pelham William aut Journal of Abnormal Child Psychology Kluwer Academic Publishers-Plenum Publishers 28/6(2000-12-01), 527-541 0091-0627 28:6<527 2000 28 10802 https://doi.org/10.1023/A:1005179014321 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1005179014321 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- March John Department of Psychiatry, DUMC, Box 3527, 27710, Durham, NC aut NATIONALLICENCE 700 1- Swanson James aut NATIONALLICENCE 700 1- Arnold L. aut NATIONALLICENCE 700 1- Hoza Betsy aut NATIONALLICENCE 700 1- Conners C. aut NATIONALLICENCE 700 1- Hinshaw Stephen aut NATIONALLICENCE 700 1- Hechtman Lily aut NATIONALLICENCE 700 1- Kraemer Helena aut NATIONALLICENCE 700 1- Greenhill Laurence aut NATIONALLICENCE 700 1- Abikoff Howard aut NATIONALLICENCE 700 1- Elliott L. aut NATIONALLICENCE 700 1- Jensen Peter aut NATIONALLICENCE 700 1- Newcorn Jeffrey aut NATIONALLICENCE 700 1- Vitiello Benedetto aut NATIONALLICENCE 700 1- Severe Joanne aut NATIONALLICENCE 700 1- Wells Karen aut NATIONALLICENCE 700 1- Pelham William aut NATIONALLICENCE 773 0- Journal of Abnormal Child Psychology Kluwer Academic Publishers-Plenum Publishers 28/6(2000-12-01), 527-541 0091-0627 28:6<527 2000 28 10802 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer