CBT for Adult ADHD: Adaptations and Hypothesized Mechanisms of Change

Ramsay, J. Russell

doi:10.1891/0889-8391.24.1.37

Cited by 56 publications

(47 citation statements)

References 28 publications

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“…The overall symptom improvements and the specific improvement on a measure of activation are consistent with the goals of and hypothesized mechanisms of change in CBT for adult ADHD Ramsay, 2010a); that is, issues related to procrastination, difficulties planning, and getting started on and following through on tasks are common complaints of adults with ADHD and are often directly associated with the functional problems that become treatment goals. Emotional self-regulation difficulties are increasingly acknowledged as a core component of ADHD (Barkley, 2010), including difficulties managing frustration and problems generating emotions about important tasks to make them salient and increasing follow-through on them (e.g., motivation).…”

Section: Discussionsupporting

confidence: 62%

CBT Without Medications for Adult ADHD: An Open Pilot Study of Five Patients

Ramsay

Rostain

2011

J Cogn Psychother

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Medications are considered the primary treatment for symptoms of adult attention-deficit/ hyperactivity disorder (ADHD), although medications alone may not produce sufficient functional improvements for many patients. Moreover, some adults with ADHD decline pharmacotherapy due to lack of response, side effects, medical contraindication, or personal choice. This article reports on the clinical outcomes of five adults with ADHD who completed cognitive behavioral therapy (CBT) without concurrent medication treatment. Nonparametric analysis of pretreatment and posttreatment clinical data indicated significant improvements on various measures of ADHD symptoms, overall functioning, depression, and anxiety. Although limited by the small sample size, the current pilot study provides preliminary evidence that CBT may be helpful for adults with ADHD who decline or are unable to take medications in cases in which their symptoms and impairments are relatively mild and uncomplicated. The limitations of this open pilot study and directions for future research also are discussed.

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Section: Discussionsupporting

confidence: 62%

CBT Without Medications for Adult ADHD: An Open Pilot Study of Five Patients

Ramsay

Rostain

2011

J Cogn Psychother

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“…In treating depression with CBT, this principle is generally supported (Garratt et al 2007;Ingram et al 2007). Consistent with the underlying rationale that maladaptive cognitions are a mechanism of change in cognitive therapy, Ramsay (2010) proposed that cognitive modification may play an important role in adult ADHD CBT. For example, thoughts that magnify negative views of oneself or incompetence based on past failures may be modified via cognitive restructuring.…”

Section: Discussionmentioning

confidence: 95%

Are Negative Automatic Thoughts Associated with ADHD in Adulthood?

et al. 2013

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Recent randomized controlled trials indicate that cognitive-behavioral therapy (CBT) for adults with attention-deficit/hyperactivity disorder (ADHD) is an efficacious treatment. Although treatments for adults with ADHD target negative automatic thoughts, there is a lack of empirical evidence demonstrating that such cognitions are associated with ADHD. The goal of this study was to assess the relationship between ADHD and negative automatic thoughts typically associated with depression in a group of adults diagnosed with ADHD (n = 81). Across the sample, self, collateral, and clinician ratings of inattentive ADHD symptom severity, but not hyperactive-impulsive symptom severity, were significantly associated with negative automatic thoughts after considering the role of current depressive symptom severity. Subsequent categorical analyses were conducted by subdividing the ADHD sample into those with (n = 34) and without (n = 47) a comorbid depression diagnosis, and adding a control group (n = 43). Analyses indicated that (a) the ADHD group with comorbid depression reported significantly more negative automatic thoughts than both controls and the ADHD group without comorbid depression, and (b) the ADHD group without comorbid depression reported significantly more negative automatic thoughts than controls. These findings provide an empirical basis for adult ADHD CBT to target negative automatic thoughts, which share a relationship with ADHD even after accounting for the confounding role of depression. Modification of negative automatic thoughts may be a mechanism of change in adult ADHD CBT and should be considered in future research. attention-deficit/hyperactivity disorder | cognitive-behavioral therapy | negative

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“…Additional hypothesized mechanisms should also be considered and assess uniqueness to mindfulness (see (Mitchell, et al, submitted) for a review). For example, a number of mechanisms of change in cognitive-behavioral therapy for adults with ADHD has been proposed (Ramsay, 2010). Future studies should consider these constructs (e.g., maladaptive cognitions) and if they mediate improvement in treatment outcome variables for adults with ADHD.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation

et al. 2013

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Introduction Mindfulness meditation training is garnering increasing empirical interest as an intervention for attention-deficit/hyperactivity disorder (ADHD) in adulthood, although no studies of mindfulness as a standalone treatment have included a sample composed entirely of adults with ADHD or a comparison group. The aim of this study was to assess the feasibility, acceptability, and preliminary efficacy of mindfulness meditation for ADHD, executive functioning (EF), and emotion dysregulation symptoms in an adult ADHD sample. Methods Adults with ADHD were stratified by ADHD medication status and otherwise randomized into an eight-week group-based mindfulness treatment (n=11) or waitlist (n=9) group. Results Treatment feasibility and acceptability were positive. In addition, self-reported ADHD and EF symptoms (assessed in the laboratory and ecological momentary assessment), clinician ratings of ADHD and EF symptoms, and self-reported emotion dysregulation improved for the treatment group relative to the waitlist group over time with large effect sizes. Improvement was not observed for EF tasks. Conclusions Findings support preliminary treatment efficacy, though require larger trials.

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CBT for Adult ADHD: Adaptations and Hypothesized Mechanisms of Change

Cited by 56 publications

References 28 publications

CBT Without Medications for Adult ADHD: An Open Pilot Study of Five Patients

CBT Without Medications for Adult ADHD: An Open Pilot Study of Five Patients

Are Negative Automatic Thoughts Associated with ADHD in Adulthood?

A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation

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