Browsing by Author "Halldorsdottir, Thorhildur"
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- Co-Occurring Conduct Problems and Anxiety: Implications for the Functioning and Treatment of Youth with Oppositional Defiant DisorderHalldorsdottir, Thorhildur; Fraire, Maria G; Drabick, Deborah A. G.; Ollendick, Thomas H. (MDPI, 2023-02-15)Conduct problems and anxiety symptoms commonly co-occur among youths with oppositional defiant disorder (ODD); however, how these symptoms influence functioning and treatment outcomes remains unclear. This study examined subtypes based on these co-occurring symptoms in a clinical sample of 134 youths (Mage = 9.67, 36.6% female, 83.6% white) with ODD and the predictive power of these subgroups for youth functioning and psychosocial treatment outcomes. The latent profile analysis (LPA) was used to identify subgroups based on parent- and self-reported conduct problems and anxiety symptoms. Differences among the subgroups in clinician-, parent-, and/or self-reported accounts of symptom severity, school performance, underlying processing known to be impaired across ODD, conduct and anxiety disorders, self-concept, and psychosocial treatment outcomes were examined. Four distinct profiles were identified: (1) Low Anxiety/Moderate Conduct Problems (n = 42); (2) High Anxiety/Moderate Conduct Problems (n = 33); (3) Moderate Anxiety/Moderate Conduct Problems (n = 40); and (4) Moderate Anxiety/High Conduct Problems (n = 19). The Moderate Anxiety/High Conduct Problems group exhibited more severe behavioral problems, greater difficulties with negative emotionality, emotional self-control, and executive functioning; they also demonstrated worse long-term treatment outcomes than the other subgroups. These findings suggest more homogeneous subgroups within and across diagnostic categories may result in a deeper understanding of ODD and could inform nosological systems and intervention efforts.
- Comorbid ADHD: Implications for Cognitive-Behavioral Therapy of Youth with a Specific PhobiaHalldorsdottir, Thorhildur (Virginia Tech, 2014-03-04)Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed.
- Comorbid Oppositional Defiant Disorder and Anxiety Disorders in Boys and Girls: Relations to Perceptual BiasHalldorsdottir, Thorhildur (Virginia Tech, 2011-02-28)The current study examined relations among perceptual bias, measured by comparing self performance ratings to those of an independent rater, and gender and comorbid Oppositional Defiant Disorder and Anxiety Disorder (ODD/AD) status in school-aged children with primary diagnoses of ODD. Specifically, perceptual bias of boys (N=61) and girls (N=39) with ODD with (N=43) and without comorbid AD (N=57) were examined after completing a problem solving activity with their parent(s). Measures of global functioning, executive functioning, and severity of the disorders were also examined. Based on previous findings, it was predicted that boys with ODD without AD would exhibit the greatest positive perceptual bias, followed by girls with ODD without AD, boys with ODD and AD, and, finally, girls with ODD and AD. No significant group differences emerged on the related dimensions of global functioning, executive functioning, or severity of behavioral problems. However, systematic differences in age, ADHD diagnosis, and intellectual ability were revealed among the groups, consequently they were controlled for in the final analyses. Overall, children in all groups displayed positive perceptual bias when compared to observer ratings. However, the main hypotheses were not supported. That is, children with ODD evaluated their performance higher than that of observers, independent of comorbid anxiety and gender, when controlling for the effects of age, ADHD, and intellectual ability. Implications and future directions in examining perceptual bias are discussed.