Anxiety and conduct problems in children and adolescents : the role of executive functioning in a dual-pathway model
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Although anxiety disorders and conduct problems often co-occur in children and adolescents, literature describing the effects of such co-occurrence is mixed. There is evidence that symptoms of anxiety disorders may mitigate symptoms of conduct problems (buffering hypothesis) or may exacerbate symptoms of conduct problems (multiple problem hypothesis). A dual-pathway model has been proposed that suggests several possible etiological or risk processes that may differentiate these pathways (i.e., the buffering hypothesis or the multiple problem hypothesis) (Drabick, Ollendick, & Bubier, 2010). Executive functioning is one factor that has been identified that may differentially confer risk to the proposed pathways; however, little research has been done investigating its role. The purpose of the present study was to evaluate the dual-pathway model by determining whether executive functioning abilities contribute to differentiating those youth for whom anxiety exacerbates conduct problems from those for whom anxiety mitigates conduct problems. Specifically, the study sought to examine if executive functioning moderated the effect of anxiety symptom severity on conduct problems. Latent variable structural equation modeling (SEM) was used to analyze the data of 221 youth aged 9 to 16 in a residential treatment center who completed a full neuropsychological evaluation. Results of the study failed to support the hypothesis that executive functioning moderates the effect of anxiety on conduct problems. Furthermore, a structural equation model without an interaction between executive functioning and anxiety was found to fit the data better than a model with an interaction between those variables. Overall, the study found that executive functioning abilities could not distinguish youth for whom anxiety exacerbates conduct problems from youth for whom anxiety mitigates conduct problems. Recommendations for future research in light of the limitations of the current study, as well as remaining gaps in the literature, are discussed.