Feasibility trial of the dialectical behavior therapy skills training group as add‐on treatment for adults with attention‐deficit/hyperactivity disorder

Moritz, Guilherme Rodrigues; Pizutti, Leandro Timm; Cancian, Ana Carolina Maciel; Dillenburg, Mariana S.; Souza, Lucas André Schuster de; Lewgoy, Laura Baptista; Basso, Patrícia; Andreola, Michel M. P.; Bau, Claiton Henrique Dotto; Victor, Marcelo M.; Teche, Stefania Pigatto; Grevet, Eugênio H.; Philipsen, Alexandra; Rohde, Luís Augusto

doi:10.1002/jclp.23049

Cited by 7 publications

(12 citation statements)

References 11 publications

(16 reference statements)

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“…The effect on self-reported ADHD core symptoms was larger in our study than in other controlled trials based on the same treatment manual [ 28 , 31 , 50 ]. The larger effect size found in our study may be due to slight differences in the actual delivered treatment, i.e.…”

Section: Discussioncontrasting

confidence: 74%

“…Although these patients were not judged clinically as having a depressive episode that would interfere with treatment, this finding may however motivate future studies to assess the predictive role of depressive symptoms on the effect of this group treatment. The effect on self-reported ADHD core symptoms was larger in our study than in other controlled trials based on the same treatment manual [28,31,50]. The larger effect size found in our study may be due to slight differences in the actual delivered treatment, i.e.…”

Section: Discussioncontrasting

confidence: 73%

“…After all, the explicit goal of this treatment is to learn how to live with and manage symptoms rather than symptom reduction per se [28]. In line with this, a recent feasibility trial of this group treatment found no significant difference on self-reported core symptoms of ADHD, although 88% of the participants reported that they could control their symptoms better after ended group treatment [50].…”

Section: Discussionmentioning

confidence: 90%

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Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial

et al. 2022

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Background Studies on structured skills training groups have indicated beneficial, although still inconclusive, effects on core symptoms of ADHD in adults. This trial examined effects of Dialectical Behavioral Therapy-based group treatment (DBT-bGT) on the broader and clinically relevant executive functioning and emotional regulation in adults with ADHD. Methods In a multicenter randomized controlled trial, adult patients with ADHD were randomly assigned to receive either weekly DBT-bGT or treatment as usual (TAU) during 14 weeks. Subsequently, participants receiving TAU were offered DBT-bGT. All were reassessed six months after ended DBT-bGT. Primary outcomes were the Behavior Rating Inventory of Executive Function (BRIEF-A) and the Difficulties in Emotion Regulation Scale (DERS). Secondary outcomes included self-reported ADHD-symptoms, depressive and anxiety symptoms, and quality of life. We used independent samples t- tests to compare the mean difference of change from pre- to post-treatment between the two treatment groups, and univariate linear models adjusting for differences between sites. Results In total, 121 participants (68 females), mean age 37 years, from seven outpatient clinics were included, of whom 104 (86%) completed the 14-week trial. Entering the study, 63% used medication for ADHD. Compared to TAU (n = 54), patients initially completing DBT-bGT (n = 50) had a significantly larger mean reduction on the BRIEF-A (-12.8 versus -0.37, P = 0.005, effect size 0.64), and all secondary outcomes, except for symptoms of anxiety. All significant improvements persisted at 6 months follow-up. Change on DERS did not differ significantly between the groups after 14 weeks, but scores continued to decrease between end of group-treatment and follow-up. Conclusions This DBT-bGT was superior to TAU in reducing executive dysfunction, core symptoms of ADHD and in improving quality of life in adults with ADHD. Improvements sustained six months after ended treatment. The feasibility and results of this study provide evidence for this group treatment as a suitable non-pharmacological treatment option for adults with ADHD in ordinary clinical settings. Trial registrations The study was pre-registered in the ISRCTN registry (identification number ISRCTN30469893, date February 19th 2016) and at the ClinicalTrials.gov (ID: NCT02685254, date February 18th 2016).

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Section: Discussioncontrasting

confidence: 74%

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 90%

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Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial

et al. 2022

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“…In the remaining 69 works, 50 were excluded because they were non-randomized controlled studies, lack of required data, non-Chinese and non-English works, and meeting abstracts. Finally, 19 RCTs (Amiri et al, 2022; Bachmann et al, 2018; Behbahani et al, 2018; Chen & Cheng, 2016; Converse et al, 2020; Fritz & O’Connor, 2022; Gu et al, 2018; Hepark et al, 2019; Hoxhaj et al, 2018; Janssen et al, 2019; Kiani et al, 2017; Lo et al, 2020; Mitchell et al, 2017; Moritz et al, 2021; Rezaei et al, 2018; Robe & Dobrean, 2022; Schoenberg et al, 2014; Siebelink et al, 2022; Valero et al, 2022) met the inclusion conditions and were synthesized for effectiveness.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Meditation-Based Mind-Body Interventions on Symptoms and Executive Function in People With ADHD: A Meta-Analysis of Randomized Controlled Trials

et al. 2023

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Objective: This study aims to perform a systematic review and meta-analysis of the effect of MBIs (Mindfulness, Tai Chi, Yoga, and Qigong) on symptoms and executive function (EF) in ADHD. Method: PubMed, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Embase, and CNKI databases were searched to collect randomized controlled trials (RCTs) on the effects of MBIs on symptoms and EF in ADHD. Data extraction and methodological quality evaluation were conducted by two researchers, and a meta-analysis was conducted by Stata SE. Results: The pooled meta-analyses of MBIs revealed a positive and small effect on inattention ( g = −0.26), hyperactivity/impulsivity ( g = −0.19), and EF ( g = −0.35). Conclusion: Results suggest that MBIs have a significant improvement relative to the control condition. Although some results show that symptoms are affected by age, interventions, and total time of moderators, while EF is not affected by age and measurement, it needs to be supported by more research evidence. ( J. of Att. Dis. XXXX; XX(X) XX-XX)

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“…The language dimension was the most common cultural adaptation reported, with 15 (83%) studies adapting this dimension. Studies reported translating DBT handouts and materials and delivering therapy in Portuguese (Cancian et al, 2019; Moritz et al, 2021), Mandarin (Cheng & Merrick, 2017; Yang et al, 2020), Cantonese (Fan & Leung, 2015), Spanish (Gomez et al, 2017; McFarr et al, 2014; Mercado & Hinojosa, 2017; Montero Fernández et al, 2013; Padilla Torres et al, 2017), and Nepali (Ramaiya et al, 2018). One study specified that language translation included conducting DBT consultation group fully in Spanish (Mercado & Hinojosa, 2017).…”

Section: Resultsmentioning

confidence: 99%

Cultural adaptations of dialectical behavior therapy: A systematic review.

Haft¹,

O’Grady²,

Shaller³

et al. 2022

Journal of Consulting and Clinical Psychology

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Objective: Adapting mental health-care interventions to the race, ethnicity, or culture of the target group can enhance the acceptance and effectiveness of the treatment. Dialectical behavior therapy (DBT) is an evidence-based treatment that is principle-driven, rendering it well-suited for adaptations across cultural contexts. This article conducts a systematic review of the literature to determine the nature and extent of cultural adaptations of DBT to date. Method: We searched databases for original articles describing cultural adaptations of DBT, as applied to both (a) people of color within Western countries and (b) populations within non-Western countries. Consistent with the focus on descriptively characterizing extant DBT cultural adaptations, we included both published and nonpublished studies, as well as both observational and experimental studies. Results: Our search yielded 18 articles that met inclusion criteria. Of these articles, half described adaptations made with people and communities of color within the U.S. Most adaptations involved modifications to language, metaphors, methods, and context. Conclusions: Culturally adapted DBT has been implemented and accepted among several racial, ethnic, and cultural groups, although there is insufficient evidence to determine whether culturally adapted DBT is more efficacious than nonadapted DBT. We conclude with recommendations for best practices for DBT researchers and clinicians, and situate our findings among larger efforts to render existing evidence-based psychotherapies more optimal for people of color and people from non-Western countries.What is the public health significance of this article? Dialectical behavior therapy (DBT) may require cultural adaptation to be efficacious and accepted by all racial, ethnic, and cultural groups. The studies reviewed detail a number of cultural adaptations of DBT, most commonly in terms of language translation and addition of culturally congruent metaphors and sayings. The field must continue to both train culturally competent DBT clinicians and further adapt DBT to different cultural contexts.

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Feasibility trial of the dialectical behavior therapy skills training group as add‐on treatment for adults with attention‐deficit/hyperactivity disorder

Cited by 7 publications

References 11 publications

Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial

Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial

The Effect of Meditation-Based Mind-Body Interventions on Symptoms and Executive Function in People With ADHD: A Meta-Analysis of Randomized Controlled Trials

Cultural adaptations of dialectical behavior therapy: A systematic review.

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