Abstract
Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are among the most common psychological problems in adolescence. It is not surprising that a large number of teens experience both ADHD and anxiety together. In fact, one in four teenagers with ADHD also has a co-occurring or “comorbid” anxiety disorder. While comorbidity rates vary depending on the population, the rates are estimated between 20% and 40% in epidemiological and clinical samples (Anderson JC, Williams S, McGee R, Silva PA, Arch Gen Psychiatry 44:69–76, 1987; Hammerness P, Geller G, Petty A, Lamb P, Bristol C, Biederman J, Eur Child Adolesc Psychiatry 19:107–12, 2010; Tung I, Li JJ, Meza JI, Jezior KL, Kianmahd JS, Hentschel PG, Pediatrics 138:e20160430). These rates confirm that adolescents with ADHD are at a higher risk for developing an anxiety disorder than those without ADHD. An analysis of 21 different research studies published between 1987 and 1999 found that children with ADHD were over three times more likely to have an anxiety disorder compared to children without ADHD (Angold A, Costello EJ, Erkanli A, J Child Psychol Psychiatry 40:57–87).
This chapter will explore the etiology, clinical presentation, assessment, and treatment of anxiety disorders in teens with ADHD. We will discuss recent advances in our understanding of comorbid anxiety in this population and the unique challenges involved in treating both disorders. This will include some practical tips for parents, educators, and clinicians. Treatment will cover psychotherapeutic, medication, and school-based interventions.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychological Association. Stress in America: are teens adopting adults’ stress habits? 2014. https://www.apa.org/news/press/releases/stress/2013/stress-report.pdf. Accessed 15 Feb 2019.
Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.
Biederman J, Faraone SV, Keenan K, Knee D, Tsuang MT. Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. J Am Acad Child Adolesc Psychiatry. 1990;29(4):526–33.
Tannock R. ADHD with anxiety disorders. In: Brown TE, editor. ADHD comorbidities: handbook for ADHD complications in children and adults. Arlington, VA, USA: American Psychiatric Publishing, Inc.; 2009. p. 131–55.
Biederman J, Faraone SV, Spencer T, Wilens T, Mick E, Lapey KA. Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res. 1994;53(1):13–29.
Rucklidge JJ, Tannock R. Psychiatric, psychosocial, and cognitive functioning of female adolescents with ADHD. J Am Acad Child Adolesc Psychiatry. 2001;40:530–40.
Tai YM, Gau CS, Gau SS, Chiu HW. Prediction of ADHD to anxiety disorders: an 11-year national insurance data analysis in Taiwan. J AttenDisord. 2013;17(8):660–9.
Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am. 2009;32(3):483–524.
Jarrett MA, Wolff JC, Davis TE III, Cowart MJ, Ollendick TH. Characteristics of children with ADHD and comorbid anxiety. J Atten Disord. 2016;20(7):636–44.
Maric M, Bexkens A, Bögels SM. Is clinical anxiety a risk or a protective factor for executive functioning in youth with ADHD? A meta-regression analysis. Clin Child Fam Psychol Rev. 2018;21(3):340–53.
Angold A, Costello EJ, Erkanli A. Comorbidity. J Child Psychol Psychiatry. 1999;40(1):57–87.
Bussing R, Levin GM. Methamphetamine and fluoxetine treatment of a child with attention-deficit hyperactivity disorder and obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 1993;3(1):53–8.
Newcorn JH, Miller SR, Ivanova I, Schulz KP, Kalmar J, Marks DJ. Adolescent outcome of ADHD: impact of childhood conduct and anxiety disorders. CNS Spectr. 2004;9(9):668–78.
Connolly SD, Bernstein GA. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007;46(2):267–83.
Halldorsdottir T, Ollendick TH, Ginsburg G, Sherrill J, Kendall PC, Walkup J, et al. Treatment outcomes in anxious youth with and without comorbid ADHD in the CAMS. J Clin Child Adolesc Psychol. 2015;44(6):985–91.
Houghton S, Alsalmi N, Tan C, Taylor M, Durkin K. Treating comorbid anxiety in adolescents with ADHD using a cognitive behavior therapy program approach. J Atten Disord. 2017;21(13):1094–104.
Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753–66.
Strawn JR, Welge JA, Wehry AM, Keeshin B, Rynn MA. Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety. 2014;32(3):149–57.
Pine DS. Treating children and adolescents with selective serotonin reuptake inhibitors: how long is appropriate? J Child AdolescPsychopharmacol. 2002;12(3):189–203.
Geller D, Donnelly C, Lopez F, Rubin R, Newcorn J, Sutton V, et al. Atomoxetine treatment for pediatric patients with attention-deficit/hyperactivity disorder with comorbid anxiety disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(9):1119–27.
MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal treatment study of children with ADHD. Arch Gen Psychiatry. 1999;56:1073–86.
Jensen PS, Hinshaw SP, Kraemer HC, Lenora N, Newcorn JH, Abikoff HB, et al. ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry. 2001;40:147–58.
Abikoff HB, Jensen PS, Arnold LL, Hoza B, Hechtman L, Pollack S, et al. Observed classroom behavior of children with ADHD: relationship to gender and comorbidity. J Abnorm Child Psychol. 2002;30(4):349–59.
van der Oord S, Prins PJ, Oosterlaan J, Emmelkamp PM. Treatment of attention deficit hyperactivity disorder in children.Predictors of treatment outcome. Eur Child Adolesc Psychiatry. 2008;17(2):73–81.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Carroll, D. (2020). ADHD and Anxiety Disorders. In: Schonwald, A. (eds) ADHD in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-62393-7_8
Download citation
DOI: https://doi.org/10.1007/978-3-030-62393-7_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-62392-0
Online ISBN: 978-3-030-62393-7
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)