Background
Anxiety in children with ADHD
CBT for anxiety in children with ADHD
Aims and hypotheses
Primary outcome
Secondary outcomes
Methods
Overall study design
Participants
Screening children for anxiety and recruiting families
Inclusion/exclusion criteria (all assessed via telephone)
Sample size
Randomization
Intervention content, training & delivery
Content
Session 1: Psychoeducation, fears list/goals, worry scale, linking thoughts and feelings. | |
Session 2: Detective/realistic thinking, rewards. | |
Session 3: Detective/realistic thinking, design of first exposure hierarchy (stepladder). | |
Session 4: Parenting an anxious child (parent only session). | |
Session 5: Review of exposure progress, creative exposure, design of further stepladders. | |
Session 6: Review of exposure progress, simplified realistic thinking, in-session exposure. | |
Session 7, 8 & 9: Troubleshooting exposure, realistic thinking, parenting, in session exposure. Additional skills to facilitate progress: problem solving, relaxation, social skills, assertiveness, dealing with bullying, surfing emotions, testing predictions and expectations. | |
Session 10: Review goals, maintenance of gains, setbacks, future plans. |
Training and delivery
Follow-up
Measures
Construct | Measure | Sourcea | T1b | T2c | T3d |
---|---|---|---|---|---|
Primary Outcome | |||||
Anxiety diagnoses | Anxiety Disorders Interview Schedule for Children V: Separation, Social, & Generalised Anxiety Disorder [27]. | P | x | x | x |
Secondary Outcomes | |||||
Anxiety symptoms and impact | Spence Children’s Anxiety Scale: Child (44-item) and parent (38-item) reported anxiety symptoms [31]. | P, C | x | x | x |
School Anxiety Scale: 16-items assessing anxiety symptoms at school [32]. | T | x | x | x | |
Child’s Anxiety Life Interference Scale: Child (9-items) and parent (16-items) report [33]. | P, C | x | x | x | |
ADHD | ADHD Rating Scale IV: 18-item validated scale measuring the core symptoms of ADHD [26]. | P, T | x | x | x |
Behavior | Strengths and Difficulties Questionnaire: 25-items assessing child behavior and peer problems [34]. | P, T, C | x | x | x |
Irritability | Affective Reactivity Index: A 6-item validated measure assessing child irritability [35]. | P | x | x | x |
QoL | P, C | x | x | x | |
Sleep | Single item primary caregiver report of whether the child’s sleep is a problem (none, mild, moderate or severe) [38]. | P | x | x | x |
School attendance | Number of days late/missed [38]. | P | x | x | x |
Cognitive function | NIH Toolbox Cognition Battery: Computer- administered assessment of cognitive and executive function, attention, episodic/working memory, and processing speed [39]. | D | x | x | x |
Parent mental health | Kessler 6 (K6): A 6-item validated measure of adult psychological stress resulting in a total score range from no distress to severe distress [40]. | P | x | x | x |
Parenting | Parenting behavior: Scales assessing parenting consistency (6-items) and warmth (6-items) [41]. | P | x | x | x |
Work attendance | Number of days late/missed [38]. | P | x | x | x |