A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents.
Saved in:
| Title: | A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents. |
|---|---|
| Authors: | Sprich, Susan E., Safren, Steven A., Finkelstein, Daniel, Remmert, Jocelyn E., Hammerness, Paul |
| Source: | Journal of Child Psychology & Psychiatry. Nov2016, Vol. 57 Issue 11, p1218-1226. 9p. 1 Diagram, 2 Charts. |
| Subjects: | Treatment of attention-deficit hyperactivity disorder, Attention-deficit hyperactivity disorder, Chi-squared test, Cognitive therapy for teenagers, Crossover trials, Drugs, Patient compliance, Research funding, Statistical sampling, Randomized controlled trials, Repeated measures design, Data analysis software, Descriptive statistics, Psychoeducation, Adolescence |
| Abstract: | Objective: To test cognitive behavioral therapy (CBT) for persistent attention-deficit hyperactivity disorder (ADHD) symptoms in a sample of medication-treated adolescents. Methods: Forty-six adolescents (ages 14-18), with clinically significant ADHD symptoms despite stable medication treatment were randomly assigned to receive CBT for ADHD or wait list control in a cross-over design. Twenty-four were randomized to CBT, 22 to wait list, and 15 crossedover from wait list to CBT. A blind independent evaluator (IE) rated symptom severity on the ADHD Current Symptom Scale, by adolescent and parent report, and rated each subject using the Clinical Global Impression Severity Scale (CGI), a global measure of distress and impairment. These assessments were performed at baseline, 4-months (post-CBT or post wait list), and 8-months (post-treatment for those originally assigned to the wait list condition and 4-month follow-up for those originally assigned to CBT). Trial Registration: http://clinicaltrials.gov/show/ NCT01019252. Results: Using all available data, mixed effects modeling, and pooling for the wait list cross-over, participants who received CBT received a mean score 10.93 lower on the IE-rated parent assessment of symptom severity (95% CI: 12.93, 8.93; p < .0001), 5.24 lower on the IE-rated adolescent assessment of symptom severity (95% CI: 7.21, 3.28; p < .0001), and 1.17 lower IE-rated CGI (95% CI: 1.39, .94; p < .0001). Results were consistent across 100 multiple imputations (all p < .0001). There was a greater proportion of responders after CBT by parent (50% vs. 18%, p = .00) and adolescent (58% vs. 18% p = .02) report. Conclusions: This study demonstrates initial efficacy of CBT for adolescents with ADHD who continued to exhibit persistent symptoms despite medications. [ABSTRACT FROM AUTHOR] |
| Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| Abstract: | Objective: To test cognitive behavioral therapy (CBT) for persistent attention-deficit hyperactivity disorder (ADHD) symptoms in a sample of medication-treated adolescents. Methods: Forty-six adolescents (ages 14-18), with clinically significant ADHD symptoms despite stable medication treatment were randomly assigned to receive CBT for ADHD or wait list control in a cross-over design. Twenty-four were randomized to CBT, 22 to wait list, and 15 crossedover from wait list to CBT. A blind independent evaluator (IE) rated symptom severity on the ADHD Current Symptom Scale, by adolescent and parent report, and rated each subject using the Clinical Global Impression Severity Scale (CGI), a global measure of distress and impairment. These assessments were performed at baseline, 4-months (post-CBT or post wait list), and 8-months (post-treatment for those originally assigned to the wait list condition and 4-month follow-up for those originally assigned to CBT). Trial Registration: http://clinicaltrials.gov/show/ NCT01019252. Results: Using all available data, mixed effects modeling, and pooling for the wait list cross-over, participants who received CBT received a mean score 10.93 lower on the IE-rated parent assessment of symptom severity (95% CI: 12.93, 8.93; p < .0001), 5.24 lower on the IE-rated adolescent assessment of symptom severity (95% CI: 7.21, 3.28; p < .0001), and 1.17 lower IE-rated CGI (95% CI: 1.39, .94; p < .0001). Results were consistent across 100 multiple imputations (all p < .0001). There was a greater proportion of responders after CBT by parent (50% vs. 18%, p = .00) and adolescent (58% vs. 18% p = .02) report. Conclusions: This study demonstrates initial efficacy of CBT for adolescents with ADHD who continued to exhibit persistent symptoms despite medications. [ABSTRACT FROM AUTHOR] |
|---|---|
| ISSN: | 00219630 |
| DOI: | 10.1111/jcpp.12549 |
