Susan E Sprich1,2, Steven A Safren3,4,5, Daniel Finkelstein2,6, Jocelyn E Remmert1, Paul Hammerness2,7. 1. Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 2. Harvard Medical School, Boston, MA, USA. 3. Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. ssafren@miami.edu. 4. Harvard Medical School, Boston, MA, USA. ssafren@miami.edu. 5. Department of Psychology, University of Miami, Miami, FL, USA. ssafren@miami.edu. 6. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA. 7. Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA.
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 toCBT, 22 to wait list, and 15 crossed-over 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.
RCT Entities:
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 crossed-over 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.
Authors: S Young; M Khondoker; B Emilsson; J F Sigurdsson; F Philipp-Wiegmann; G Baldursson; H Olafsdottir; G Gudjonsson Journal: Psychol Med Date: 2015-05-29 Impact factor: 7.723
Authors: Julia M Geissler; Timo D Vloet; Nora Strom; Charlotte Jaite; Erika Graf; Viola Kappel; Andreas Warnke; Christian Jacob; Klaus Hennighausen; Barbara Haack-Dees; Katja Schneider-Momm; Swantje Matthies; Michael Rösler; Wolfgang Retz; Susann Hänig; Alexander von Gontard; Esther Sobanski; Barbara Alm; Sarah Hohmann; Luise Poustka; Michael Colla; Laura Gentschow; Christine M Freitag; Alexander Häge; Martin Holtmann; Katja Becker; Alexandra Philipsen; Thomas Jans Journal: Eur Child Adolesc Psychiatry Date: 2019-12-05 Impact factor: 4.785
Authors: Margaret H Sibley; Christopher R Shelton; Ilan Garcia; Jessica M Monroy; Devin M Hill; Margaret Johansson; Kara Link; Lydia Greenwood; Gissell Torres Antunez; Juan Carlos Reyes Francisco Journal: Child Psychiatry Hum Dev Date: 2022-01-18
Authors: Margaret H Sibley; Margaret Johansson; Jessica M Monroy; Devin Hill; Patrick LaCount; Samantha Barney; Natalie Molina; Andy Delgado Journal: Behav Ther Date: 2021-06-10
Authors: Benjamin Zablotsky; Matthew D Bramlett; Susanna N Visser; Melissa L Danielson; Stephen J Blumberg Journal: J Dev Behav Pediatr Date: 2018-01 Impact factor: 2.225
Authors: Timothy E Wilens; Benjamin M Isenberg; Tamar A Kaminski; Rachael M Lyons; Javier Quintero Journal: Curr Psychiatry Rep Date: 2018-09-17 Impact factor: 5.285
Authors: Marc J Weintraub; Danielle Keenan-Miller; Christopher D Schneck; Marcy Forgey Borlik; Robert L Suddath; Sarah E Marvin; Manpreet K Singh; Kiki D Chang; David J Miklowitz Journal: Early Interv Psychiatry Date: 2021-02-08 Impact factor: 2.732
Authors: George J DuPaul; Matthew J Gormley; Arthur D Anastopoulos; Lisa L Weyandt; Jeffrey Labban; Aliza Jaffe Sass; Chelsea Z Busch; Melanie K Franklin; Kaicee B Postler Journal: J Clin Child Adolesc Psychol Date: 2021-02-02
Authors: Margaret H Sibley; Stefany J Coxe; Mark A Stein; Michael C Meinzer; Matthew J Valente Journal: J Am Acad Child Adolesc Psychiatry Date: 2021-06-05 Impact factor: 13.113
Authors: Margaret H Sibley; Paulo A Graziano; Stefany Coxe; Leonard Bickman; Pablo Martin Journal: J Am Acad Child Adolesc Psychiatry Date: 2020-08-28 Impact factor: 13.113