Gender Differences in Cognitive Behavioral Therapy Outcomes for Adolescents With ADHD: Examining the Impact of Internalizing Symptoms

Abstract

Objective:

This study investigates the effectiveness of Cognitive Behavioral Therapy (CBT) for adolescents with ADHD, while focusing on gender differences and comorbid internalizing symptoms.

Method:

A quantitative secondary data analysis was performed on 200 adolescents aged 12 to 18 years who participated in randomized control trials in either the Netherlands or Norway.

Results:

Overall, CBT significantly reduced ADHD symptoms from pretest to posttest on parent measures; however, treatment response varied based on gender, internalizing symptoms, and treatment formats. Girls with elevated depression showed significantly smaller reductions in ADHD symptoms compared to boys with similar depressive profiles (p = .02), even after controlling for baseline ADHD severity. Effect size analyses revealed that girls benefited from both CBT delivery formats, but symptom improvement was nearly twice as large in individual CBT (d = 0.90, large effect) compared to group CBT (d = 0.49, moderate effect).

Conclusion:

These findings suggest that depression may impact treatment response among girls, and that individual CBT may offer enhanced benefits for adolescent girls with ADHD.

Keywords

ADHD cognitive behavioral therapy comorbidity gender adolescents

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