OBJECTIVE: Behavioral interventions are well established treatments for children with attention-deficit/hyperactivity disorder (ADHD). However, insight into moderators of treatment outcome is limited. METHOD: We conducted an individual participant data meta-analysis (IPDMA), including data of randomized controlled behavioral intervention trials for individuals with ADHD <18 years of age. Outcomes were symptoms of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) and impairment. Moderators investigated were symptoms and impairment severity, medication use, age, IQ, sex, socioeconomic status, and single parenthood. RESULTS: For raters most proximal to treatment, small- to medium-sized effects of behavioral interventions were found for symptoms of ADHD, inattention, hyperactivity/impulsivity (HI), ODD and CD, and impairment. Blinded outcomes were available only for small preschool subsamples and limited measures. CD symptoms and/or diagnosis moderated outcome on ADHD, HI, ODD, and CD symptoms. Single parenthood moderated ODD outcome, and ADHD severity moderated impairment outcome. Higher baseline CD or ADHD symptoms, a CD diagnosis, and single parenthood were related to worsening of symptoms in the untreated but not in the treated group, indicating a protective rather than an ameliorative effect of behavioral interventions for these children. CONCLUSION: Behavioral treatments are effective for reducing ADHD symptoms, behavioral problems, and impairment as reported by raters most proximal to treatment. Those who have severe CD or ADHD symptoms, a CD diagnosis, or are single parents should be prioritized for treatment, as they may evidence worsening of symptoms in the absence of intervention.
OBJECTIVE: Behavioral interventions are well established treatments for children with attention-deficit/hyperactivity disorder (ADHD). However, insight into moderators of treatment outcome is limited. METHOD: We conducted an individual participant data meta-analysis (IPDMA), including data of randomized controlled behavioral intervention trials for individuals with ADHD <18 years of age. Outcomes were symptoms of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) and impairment. Moderators investigated were symptoms and impairment severity, medication use, age, IQ, sex, socioeconomic status, and single parenthood. RESULTS: For raters most proximal to treatment, small- to medium-sized effects of behavioral interventions were found for symptoms of ADHD, inattention, hyperactivity/impulsivity (HI), ODD and CD, and impairment. Blinded outcomes were available only for small preschool subsamples and limited measures. CD symptoms and/or diagnosis moderated outcome on ADHD, HI, ODD, and CD symptoms. Single parenthood moderated ODD outcome, and ADHD severity moderated impairment outcome. Higher baseline CD or ADHD symptoms, a CD diagnosis, and single parenthood were related to worsening of symptoms in the untreated but not in the treated group, indicating a protective rather than an ameliorative effect of behavioral interventions for these children. CONCLUSION: Behavioral treatments are effective for reducing ADHD symptoms, behavioral problems, and impairment as reported by raters most proximal to treatment. Those who have severe CD or ADHD symptoms, a CD diagnosis, or are single parents should be prioritized for treatment, as they may evidence worsening of symptoms in the absence of intervention.
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: Jan Buitelaar; Sven Bölte; Daniel Brandeis; Arthur Caye; Nina Christmann; Samuele Cortese; David Coghill; Stephen V Faraone; Barbara Franke; Markus Gleitz; Corina U Greven; Sandra Kooij; Douglas Teixeira Leffa; Nanda Rommelse; Jeffrey H Newcorn; Guilherme V Polanczyk; Luis Augusto Rohde; Emily Simonoff; Mark Stein; Benedetto Vitiello; Yanki Yazgan; Michael Roesler; Manfred Doepfner; Tobias Banaschewski Journal: Front Behav Neurosci Date: 2022-07-06 Impact factor: 3.617
Authors: Suzanne R C de Jong; Barbara J van den Hoofdakker; Lianne van der Veen-Mulders; Betty Veenman; Jos W R Twisk; Jaap Oosterlaan; Marjolein Luman Journal: Eur Child Adolesc Psychiatry Date: 2022-07-07 Impact factor: 5.349
Authors: Anouck I Staff; Saskia van der Oord; Jaap Oosterlaan; Rianne Hornstra; Pieter J Hoekstra; Barbara J van den Hoofdakker; Marjolein Luman Journal: Res Child Adolesc Psychopathol Date: 2022-01-11