Which treatment for whom for ADHD? Moderators of treatment response in the MTA.

Owens, Elizabeth B.; Hinshaw, Stephen P.; Kraemer, H C; Arnold, L. Eugene; Abikoff, Howard; Cantwell, Dennis P.; Conners, C. Keith; Elliott, Glen R.; Greenhill, Laurence L.; Hechtman, Lily; Hoza, Betsy; Jensen, Peter S.; March, John S.; Newcorn, Jeffrey H.; Pelham, William E.; Severe, Joanne B.; Swanson, James M.; Vitiello, Benedetto; Wells, Karen C.; Wigal, Timothy

doi:10.1037/0022-006x.71.3.540

Cited by 247 publications

(225 citation statements)

References 54 publications

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“…Owens et al [48] investigated moderators of treatment response for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/ Hyperactivity Disorder (MTA). They found that, for medication management and combined treatment, greater initial severity of the child predicted an inferior treatment response [57].…”

Section: Discussionmentioning

confidence: 99%

“…Empirical findings are ambiguous. Some studies found that treatment type was not related to treatment outcome and treatment response [4,48]. Other studies found that girls had a better outcome than boys [12] and, conversely, further studies reported that boys had better outcomes than girls [25].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, children of younger mothers sometimes had better outcomes [4]. Lower parental psychopathology had predicted greater therapeutic change in some studies [33], but was not related to treatment outcome [48] or therapeutic change in other studies [41].…”

Section: Introductionmentioning

confidence: 99%

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The severely impaired do profit most: short-term and long-term predictors of therapeutic change for a parent management training under routine care conditions for children with externalizing problem behavior

Hautmann¹,

Eichelberger²,

Hanisch³

et al. 2009

Eur Child Adolesc Psychiatry

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Short-term and long-term predictors of therapeutic change due to parent management training were investigated. Therapeutic change was defined as the change in outcome measures [externalizing problem behavior and parenting self-efficacy (PSE)] from before treatment to afterward. Three different types of predictors were analyzed: child variables (gender, age, and initial externalizing and internalizing behavior), parent variables (age, initial PSE and parental psychopathology) and socioeconomic status and other sociodemographic characteristics of the family (parental school education, employment, family status, language). The parent management training was part of the Prevention Program for Externalizing Problem Behavior, which was evaluated as an effectiveness trial under routine care conditions using a within-subject control group design. Between 78 and 270 families were included in the analysis, which investigated therapeutic change over two time intervals: (1) immediate change from the pre-treatment to the post-treatment assessments, and (2) long-term-change from pre-treatment to 1-year follow-up. Throughout several analyses, the only predictor of therapeutic change that was consistently significant over the two time periods for the externalizing problem behavior of the child was the initial externalizing problem behavior. More impaired children improved more. Similarly, the only predictor of therapeutic change for the two time periods in PSE was the initial level of PSE. Parents with less PSE gained more during the course of the training

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The severely impaired do profit most: short-term and long-term predictors of therapeutic change for a parent management training under routine care conditions for children with externalizing problem behavior

Hautmann¹,

Eichelberger²,

Hanisch³

et al. 2009

Eur Child Adolesc Psychiatry

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“…Maternal depression is assumed to have a negative impact on parent training outcomes for children with conduct problems (Reyno & McGrath, 2006) and children with ADHD: In the Multimodal Treatment Study of Children with ADHD (MTA), parental depressive symptoms were associated with decreased response rates across treatment modalities (Owens et al, 2003). On the other hand, Zachor, Hodgens, and Patterson (2009) found no relationship between maternal depression and decreased effectiveness of parent training in families of children with ADHD.…”

Section: Interventions Targeting Children With Cp and Adhdmentioning

confidence: 99%

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

Bjørnebekk

Kjøbli

Ogden

2015

Child & Family Behavior Therapy

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“…Since lower IQ is known to moderate stimulant response (Owens et al, 2003), all analyses reported below were covaried for IQ. Since dose was at the discretion of the treating clinician, all analyses were also covaried for dose.…”

Section: Dat1 Variants Influence the Effect Of Stimulant Medications mentioning

confidence: 99%

Spatial Attentional Bias as a Marker of Genetic Risk, Symptom Severity, and Stimulant Response in ADHD

Bellgrove

Barry

Johnson

et al. 2007

Neuropsychopharmacol

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Attention-deficit hyperactivity disorder (ADHD) is a heritable childhood onset disorder that is marked by variability at multiple levels including clinical presentation, cognitive profile, and response to stimulant medications. It has been suggested that this variability may reflect etiological differences, particularly, at the level of underlying genetics. This study examined whether an attentional phenotypespatial attentional bias could serve as a marker of symptom severity, genetic risk, and stimulant response in ADHD. A total of 96 children and adolescents with ADHD were assessed on the Landmark Task, which is a sensitive measure of spatial attentional bias. All children were genotyped for polymorphisms (3 0 untranslated (UTR) and intron 8 variable number of tandem repeats (VNTRs)) of the dopamine transporter gene (DAT1). Spatial attentional bias correlated with ADHD symptom levels and varied according to DAT1 genotype. Children who were homozygous for the 10-repeat allele of the DAT1 3 0 -UTR VNTR displayed a rightward attentional bias and had higher symptom levels compared to those with the low-risk genotype. A total of 26 of these children who were medication naive performed the Landmark Task at baseline and then again after 6 weeks of stimulant medication. Left-sided inattention (rightward bias) at baseline was associated with an enhanced response to stimulants at 6 weeks. Moreover, changes in spatial bias with stimulant medications, varied as a function of DAT1 genotype. This study suggests an attentional phenotype that relates to symptom severity and genetic risk for ADHD, and may have utility in predicting stimulant response in ADHD.

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Which treatment for whom for ADHD? Moderators of treatment response in the MTA.

Cited by 247 publications

References 54 publications

The severely impaired do profit most: short-term and long-term predictors of therapeutic change for a parent management training under routine care conditions for children with externalizing problem behavior

The severely impaired do profit most: short-term and long-term predictors of therapeutic change for a parent management training under routine care conditions for children with externalizing problem behavior

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

Spatial Attentional Bias as a Marker of Genetic Risk, Symptom Severity, and Stimulant Response in ADHD

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