Cognition in Anxious Children with Attention Deficit Hyperactivity Disorder: A Comparison with Clinical and Normal Children

Background: Cognition in children with anxiety disorders (ANX) and comorbid Attention DeficitDisorder (ADHD) has received little attention, potentially impacting clinical and academicinterventions in this highly disabled group. This study examined several cognitive features relativeto children with either pure condition and to normal controls.Methods: One hundred and eight children ages 8–12 and parents were diagnosed by semistructuredparent interview and teacher report as having: ANX (any anxiety disorder except OCDor PTSD; n = 52), ADHD (n = 21), or ANX + ADHD (n = 35). All completed measures of academicability, emotional perception, and working memory. Clinical subjects were compared to 35 normalcontrols from local schools.Results: Groups did not differ significantly on age, gender, or estimated IQ. On analyses ofvariance, groups differed on academic functioning (Wide Range Achievement Test, p < .001),perception of emotion (auditory perception of anger, p < .05), and working memory (backwardsdigits, p < .01; backwards finger windows, p < .05; Chipasat task, p < .001). ANX + ADHD andchildren with ADHD did poorly relative to controls on all differentiating measures except auditoryperception of anger, where ANX + ADHD showed less sensitivity than children with ANX or withADHD.Conclusion: Though requiring replication, findings suggest that ANX + ADHD relates to greatercognitive and academic vulnerability than ANX, but may relate to reduced perception of anger.