The moderating role of externalizing behavior problems as a predictor of treatment outcome for children with phobic disorders

Document Type



Master of Science (MS)



First Advisor's Name

Jonathan Tubman

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

William K. Kurtines

Third Advisor's Name

Wendy K. Silverman

Date of Defense



This study examined the role of impulsive and oppositional behaviors in the treatment of phobic disorders. Children and adolescents with phobic disorders were randomly assigned to one of three treatment conditions: 1) Self- Control, which focused on training the child in the use of appropriate cognitive strategies to facilitate child exposure toward feared stimuli; 2) Contingency Management, which focused on training the parent in the use of appropriate contingencies to facilitate child exposure toward feared stimuli and 3) Education/Support, a control condition. Children were assessed for externalizing behavior problems using the CBCL externalizing sub-scale. It was hypothesized that children who were rated as having high externalizing behavior problems will show less treatment success for anxiety, particularly within the self-control treatment condition, than children without high externalizing behavior problems. Significant moderating effects on treatment effectiveness were found for high externalizing behaviors with respect to severity of clinical diagnosis, as well as on child-report measures. Furthermore, an examination of means indicated that children with high externalizing behavior problems showed less improvement in treatment across all treatment conditions.



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