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Treating comorbid anxiety and aggression in children
Karyn Levy1, Caroline Hunt2, Sandra Heriot1
1Drs. Hunt is with the School of Psychology, University of Sydney, Australia; and Dr. Heriot is with Allied Health and Clinical Research, MH-Kids, Australia; at the time of this study, Dr. Levy was with the School of Psychology, University of Sydney, Australia, and she is now with MAB-Mackay Rehabilitation Center, Montreal.
Summary
Targeting both anxious and aggressive behaviors in children with anxiety disorders did not improve outcomes compared to anxiety-focused treatment. Standard cognitive-behavioral therapy effectively reduced child internalizing and externalizing problems.
Area of Science:
- Child and Adolescent Psychiatry
- Clinical Psychology
- Behavioral Therapy
Background:
- Anxiety disorders in children often present with comorbid aggression.
- Effective interventions for comorbid anxiety and aggression are needed.
Purpose of the Study:
- To evaluate a cognitive-behavioral therapy (CBT) intervention targeting both anxiety and aggression in children with anxiety disorders and comorbid aggression.
- To compare this combined intervention with standard CBT targeting anxiety only.
Main Methods:
- A 2-year randomized controlled trial involving 69 families with children aged 8-14 years.
- Interventions included a combined CBT for anxiety and aggression versus standard CBT for anxiety.
- Outcomes were assessed via parent and child reports at posttreatment and 3-month follow-up.
Main Results:
- No significant differences in overall improvement between the two conditions, except for reduced parent-reported stress, anxiety, and depression in the anxiety-only group.
- Both interventions led to significant reductions in parent-reported child externalizing and internalizing problems.
- Child-reported internalizing problems and parenting practices also improved in both groups.
Conclusions:
- Comorbidity did not significantly impact treatment outcomes for anxiety disorders.
- Combining existing treatments to address comorbid anxiety and aggression did not enhance effectiveness.
- Further research is needed for expanded combined treatment programs addressing both internalizing and externalizing problems.
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