Objective
This study investigated the role of self-regulation of emotion in relation to functional impairment and comorbidity among children with and without AD/HD.
Method
A total of 358 probands and their siblings participated in the study, with 74% of the sample participants affected by AD/HD. Parent-rated levels of emotional lability served as a marker for self-regulation of emotion.
Results
Nearly half of the children affected by AD/HD displayed significantly elevated levels of emotional lability versus 15% of those without this disorder. Children with AD/HD also displayed significantly higher rates of functional impairment, comorbidity, and treatment service utilization. Emotional lability partially mediated the association between AD/HD status and these outcomes.
Conclusion
Findings lent support to the notion that deficits in the self-regulation of emotion are evident in a substantial number of children with AD/HD and that these deficits play an important role in determining functional impairment and comorbidity outcomes.
The present report synthesizes outcomes across meta-analyses of psychosocial (i.e., non-pharmacological) treatments for ADHD. A total of 12 meta-analyses were identified that met search criteria. The meta-analyses were notable in that there was surprisingly little overlap in studies included across them (range of overlap was 2%-46%). Further, there was considerable diversity across the meta-analyses in terms of the inclusion/exclusion criteria, types of psychosocial treatments reviewed, methodological characteristics, and magnitude of reported effect sizes, making it difficult to aggregate findings across meta-analyses or to investigate moderators of outcome. Effect sizes varied across the outcomes assessed, with meta-analyses reporting positive and significant effect sizes for measures of some areas of child impairment (e.g., social impairment) and small and more variable effect sizes for distal and/or untargeted outcomes (e.g., academic achievement). Results are reviewed in light of the larger literature on psychosocial interventions for ADHD, and specific recommendations for future meta-analyses of psychosocial treatments for ADHD are offered.
Potential outcomes of various treatments play a proximal role in patients' and families' decisions for ADHD treatment. Because the majority of studies focus on medication treatments for children with ADHD, more research is necessary to understand preferences related to behavioral and other psychosocial treatments both as stand-alone interventions and used in combination with medication. Additional research is also needed to assess the treatment preferences of adults with ADHD. In general, DCE, BWS, and SGI methods allow measurement of patient preferences in a manner that approximates the uncertainty and trade-offs inherent in real-world treatment decision making and provides valuable information to inform patient-centered and family-centered treatment.
Objective
Teenage drivers diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at significant risk for negative driving outcomes related to morbidity and mortality. However, there are few viable psychosocial treatments for teens with ADHD and none focus on the key functional area of driving. The Supporting the Effective Entry to the Roadway (STEER) program was evaluated in a clinical trial to determine whether it improved family functioning as a proximal outcome and driving behavior as a distal outcome.
Method
One hundred seventy-two teenagers with ADHD, combined type, were randomly assigned to STEER or a driver education driver practice program (DEDP).
Results
Relative to parents in the DEDP condition, parents in STEER were observed to be less negative at post-treatment and 6-month follow-up, but not at 12-month follow-up and there were no significant differences for observed positive parenting. Relative to teens in the DEDP condition, teens in STEER reported lower levels of risky driving behaviors at post-treatment and six-month follow-up, but not at 12-month follow-up. They were not observed to differ on objective observations of risky driving or citations/accidents.
Conclusions
The STEER program for novice drivers with ADHD was effective in reducing observations of negative parenting behavior and teen self reports of risky driving relative to DEDP; groups did not significantly differ on observations of positive parenting or driving behaviors.
Public Health Significance Statement
Families with a teenager with ADHD may benefit from engaging in behavioral parent training around the transition to independent driving, especially via reductions in negative parenting. Teenagers with ADHD self-reported fewer risky driving behaviors within the family-focused intervention, but these findings were not replicated on objective observations of driving.
Synopsis
Children with ADHD require intensive treatments to remediate functional impairments and promote the development of adaptive skills. The summer treatment program (STP) is an exemplar of intensive treatment for ADHD. In the STP, evidence-based interventions are embedded into academic and recreational activities, and the treatment program occurs throughout the summer months. STP intervention components include a reward and response cost point system, time out, use of antecedent control (i.e., clear commands, establishment of rules and routines), and liberal praise and rewards for appropriate behavior. Parents also participate in parent management training programming to learn how to implement similar treatment procedures within the home setting. There have been a number of studies of the STP and its component parts. There is a strong evidence base in support of the efficacy of the STP as an intervention for ADHD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.