Depressive and externalizing comorbidity and the relations to child anxiety treatment response time-course

Abstract

Objective: The present study examined the potential roles of externalizing and depressive co-occurring psychopathology on the time-course to anxiety treatment response among youth receiving different treatment conditions. Method: Participants were 488 youth (aged 7-17 years) who received either Cognitive-Behavioral Therapy (CBT) (N = 139), sertraline (SRT) (N = 133), CBT+sertraline (COMB; N = 140), or pill placebo (PLB; N = 76) in the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008). Results: Findings did not demonstrate a significant relation of comorbid psychopathology with treatment response time-course. Participants in CBT and SRT had significantly different overall treatment response trajectories, though comorbid psychopathology did not significantly relate to the observed treatment response trajectories. Exploratory analyses revealed that parental treatment assignment reaction to CBT was positively associated with more favorable treatment response time course, whereas parental treatment assignment reaction to SRT did not significantly relate to treatment response time course. Conclusions: Our results are consistent with the notion that current interventions (CBT, SRT) produce improvements that generalize across co-occurring depressive and externalizing psychopathology. Clinical implications for the treatment of anxious youth with regard to comorbidity and contextual factors are discussed and suggestions for future research are offered.