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COMPARISON OF BEHAVIORAL PROFILES FOR ANXIETY-RELATED COMORBIDITIES INCLUDING ADHD AND SELECTIVE MUTISM IN CHILDREN

Authors

  • Tal Levin-Decanini Ph.D.,

    1. Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC)
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  • Sucheta D. Connolly M.D.,

    1. Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC)
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  • David Simpson Ph.D.,

    1. Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC)
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  • Liza Suarez Ph.D.,

    1. Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC)
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  • Suma Jacob M.D., Ph.D.

    Corresponding author
    1. Department of Psychiatry and Pediatrics, University of Minnesota, Twin Cities Campus, Minnesota
    • Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC)
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Correspondence to: Suma Jacob M.D., Ph.D. University of Minnesota, 2101 6th Street SE, Minneapolis, MN 55455 E-mail: sjacob@umn.edu

Abstract

Background

Elucidating differences in social-behavioral profiles of children with comorbid presentations, utilizing caregiver as well as teacher reports, will refine our understanding of how contextual symptoms vary across anxiety-related disorders.

Methods

In our pediatric anxiety clinic, the most frequent diagnoses and comorbidities were mixed anxiety (MA; ≥ 1 anxiety disorder; N = 155), anxiety with comorbid attention-deficit hyperactivity disorder (MA/ADHD, N = 47) and selective mutism (SM, N = 48). Behavioral measures (CPRS, CTRS) were analyzed using multiple one-way multivariate analyses of covariance tests. Differences between the three diagnostic groups were examined using completed parent and teacher reports (N = 135, 46, and 48 for MA, MA/ADHD, and SM groups, respectively).

Results

Comparisons across the MA, MA/ADHD, and SM groups indicate a significant multivariate main effect of group for caregiver and teacher responses (P < 0.01). Caregivers reported that children with SM are similar in profile to those with MA, and both groups were significantly different from the MA/ADHD group. Teachers reported that children with SM had more problems with social behaviors than with the MA or MA/ADHD groups. Further comparison indicates a significant main effect of group (P < 0.001), such that children with SM have the greatest differences in behavior observed by teachers versus caregivers.

Conclusions

Clinical profiles between MA/ADHD, MA, and SM groups varied, illustrating the importance of multi-rater assessment scales to capture subtle distinctions and to inform treatment planning given that comorbidities occur frequently in children who present with anxiety.

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