Attention deficit hyperactivity disorder (ADHD) is a common condition with a high societal burden. The present guidelines summarise current literature, generating expert consensus recommendations for the treatment of ADHD in children and adults. These guidelines also provide a review of recent research in the fields of neuroimaging, neuropsychology and genetics of ADHD. Novel discoveries in these areas have informed physiological models for the disease. Since the publication of the previous British Association for Psychopharmacology guidelines in 2008, new drugs have been licensed and further compounds are being investigated. The publication of randomised controlled trials of psychological interventions has contributed to the range of treatment options for ADHD. As the disorder has been diagnosed more frequently there has been greater focus on comorbid conditions and how they impact treatment. Services have continued to develop for the treatment of ADHD in adults and care agreements have been introduced to facilitate access to treatment.

Significant public health concerns exist regarding our current level of success in treating ADHD. Medication management is very helpful in 60-70% of patients. Side effects, lack of compliance and the fact that stimulant medications cannot be given late in the day limit the benefits largely to school hours. While stimulants improve behavior and attention, less of an effect has been noted on academic and social performance. Continuing concerns exist about long-term safety, and studies on long-term cardiovascular and neurophysiological effects have not been carried out. Neurotherapy for ADHD offers an effective alternate for patients whose treatment is limited by side effects, poor medication response and in cases in which the patients and/or their parents refuse to consider medications. Studies indicate clinical improvement is largely related to measurable improvements in the EEG signature, evidenced by declining theta/beta ratios over frontal/central cortex and/or reduced theta/alpha band amplitudes.

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Several possible conceptualizations of neurotherapy are discussed: EEG operant conditioning; EEG homeostatic normalization; and utilization of EEG biofeedback as a means of accessing particular states of consciousness. Attention is given to how neurotherapy is actually done and when it may be a useful adjunct to psychological or medical therapies. Integration of neurotherapy with the larger framework of cognitive behavior therapy and the biopsychosocial model is discussed. Three case studies of adults involving the use of neurotherapy are described.

Experimental control over five degrees of cognitive (as opposed to organismic) arousal has been developed by hypnotic programming techniques. Previously, these posthypnotic manipulations have been applied to the investigation of diverse topics such as visual discrimination, performance on the Stroop test, selective concentration on color vs, form of consonants, and cognitive "reverberation." The present study explored electroencephalographic (EEG) correlates of the five degrees of cognitive arousal in a task requiring participants to visualize objects for l-min periods while lying on a couch with their eyes closed. Analysis of data from the occipital area in left and right hemispheres revealed that the highest degree of arousal was accompanied by larger amplitudes of alpha and beta power and smaller amplitudes of theta. This pattern of results was similar in both hemispheres, although more marked in the left. The findings, which provide an independent source of support for validity of the hypnotic programming, are discussed in relation to EEG literature on cognitive activity. This investigation was undertaken to provide independent electroencephalographic (EEG) evidence bearing on the validity of posthypnotically controlled degrees of cognitive arousal. In the past, a conceptual distinction between "cognitive" and "organismic" arousal was drawn to separate mental from somatic components of arousal, and a hypnotic programming technique was first used to operationalize the distinction in the context of a visual discrimination task (Blum, Geiwitz, & Stewart, 1967). In the course of their hyp