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

IF 3 1区心理学 Q2 PSYCHOLOGY, CLINICAL

Psychotherapy Research Pub Date : 2026-04-22 DOI:10.1080/10503307.2026.2658745

Xin Wang, Haoran He, Jiajun Lan, Ying Guo, Yongpeng Zhang

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引用次数: 0

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.

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认知行为疗法治疗ADHD患者的焦虑症状：一项系统回顾和剂量反应探索的荟萃分析。

目的：综合认知行为疗法（CBT）对注意缺陷多动障碍（ADHD）患者焦虑症状影响的随机证据，探讨干预剂量参数是否对其影响有调节作用。方法：在prisma引导下，检索PubMed、Web of Science、PsycINFO和Cochrane Library，检索时间截止到2025年6月15日。多水平随机效应模型汇集了Hedges' g，亚组/元回归分析检验了比较物类型和干预剂量的影响。结果：13项rct （n = 744）。与对照组相比，cbt干预在治疗后（t(10.00) = -2.97, SMD = -0.29, 95% CI -0.52至-0.06,P = 0.014）和随访时（t(6.34) = -4.40, SMD = -0.42, 95% CI -0.71至-0.13,P = 0.004）减少了焦虑。这种效果在成人中更为明显；儿科证据很少。探索性非线性剂量-反应分析表明，约2次疗程/周，约50分钟/次，约6周（约5-9小时）的估计效果更有利，尽管这些研究水平的关联应谨慎解释。结论：与对照组相比，基于cbt的干预与ADHD患者焦虑程度的轻度至中度降低相关，并持续至随访。未来的大型随机对照试验和荟萃分析应该检验剂量相关的假设，并评估与其他真正的心理治疗和药物管理的比较特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy Research PSYCHOLOGY, CLINICAL-

CiteScore

7.80

自引率

10.30%

发文量

期刊介绍： Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.