Comorbid anxiety should be considered in ADHD assessment and treatment.

Lang’s tripartite model posits that three main components characterize a fear response: physiological arousal, cognitive (subjective) distress, and behavioral avoidance. These components may occur in tandem with one another (concordance) or they may vary independently (discordance). The Behavioral Approach Test (BAT) has been used to simultaneously examine the three components of the fear response. In the present study, 73 clinic-referred children and adolescents with a specific phobia participated in a phobia-specific BAT. Results revealed an overall pattern of concordance: correlation analyses revealed the three indices were significantly related to one another in the predicted directions. However, considerable variation was noted such that some children were concordant across the response components while others were not. More specifically, based on levels of physiological arousal and subjective distress, two concordant groups (high arousal-high distress, low arousal-low distress) and one discordant (high arousal-low distress or low arousal-high distress) group of youth were identified. These concordant and discordant groups were then compared on the percentage of behavioral steps completed on the BAT. Analyses revealed that the low arousal-low distress group completed a significantly greater percentage of steps than the high arousal-high distress group, and a marginally greater percentage of steps than the discordant group. Potential group differences associated with age, gender, phobia severity, and phobia type were also explored and no significant differences were detected. Implications for theory and treatment are discussed.

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A host of factors including genetic influences, temperament characteristics, learning experiences, information processing biases, parental psychopathology, and specific parenting practices have been hypothesized to contribute to the development and expression of children's phobias. In the present study, the authors focused on parental psychopathology (phobic anxiety) and parenting behaviors (warmth, involvement) in the prediction of child performance on a behavioral approach test (BAT). All children (n = 44) experienced a phobia of animals and were clinic referred. The youth completed two BATs: the first alone and the second one with a parent present. Overall, performance was greater on the parent-present BAT (58% of steps completed) than on the child-alone BAT (38% of steps completed), although considerable variability was present. Performance on the parent-present BAT was associated with parental warmth and involvement but not parental phobic anxiety. Implications of these findings were discussed, and their implications for the use of behavioral analogues tests were explored.

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