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Cognitive behavioral therapy for anxiety symptoms in ADHD: A systematic review and meta-analysis with dose-response exploration

Forfatter(e)
Wang, X., He, H., Lan, J., Guo, Y., Zhang, Y.
År
2026
DOI
10.1080/10503307.2026.2658745
Tidsskrift
Psychotherapy Research
Sider
1–19
Kategori(er)
Angst og engstelighet (inkl. både vansker og lidelse) ADHD
Tiltakstype(r)
Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi
Abstract

OBJECTIVE

To synthesize randomized evidence on the effect of cognitive-behavioral therapy (CBT) on anxiety symptoms in individuals with attention-deficit/hyperactivity disorder (ADHD), and to explore whether intervention dose parameters moderate effects.

METHODS

A PRISMA-guided systematic review searched PubMed, Web of Science, PsycINFO, and the Cochrane Library to June 15, 2025. Multilevel random-effects models pooled Hedges' g, and subgroup/meta-regression analyses examined the effects of comparator type and intervention dose.

RESULTS

Thirteen RCTs (n = 744). Relative to control conditions, CBT-based interventions reduced anxiety at post-treatment (t(10.00) = -2.97, SMD = -0.29, 95% CI -0.52 to -0.06, P = 0.014) and follow-up (t(6.34) = -4.40, SMD = -0.42, 95% CI -0.71 to -0.13, P = 0.004). Effects were more apparent in adults; pediatric evidence was sparse. Exploratory nonlinear dose-response analyses suggested more favorable estimated effects around 2 sessions/week, ~50 min/session, over ~6 weeks (~5-9 total hours), although these study-level associations should be interpreted cautiously.

CONCLUSIONS

CBT-based interventions were associated with small-to-moderate reductions in anxiety relative to control conditions in individuals with ADHD, sustained into follow-up. Future large RCTs and meta-analyses should test dose-related hypotheses and evaluate comparative specificity against other bona fide psychotherapies and medication management.