Cognitive Behavioral Treatment Outcomes in Adolescent ADHD
Abstract
Adolescent ADHD
Treatment.
Cognitive behavioral therapy (CBT) and ADHD
Rationale for project
Method
Participants
Variable | Time 1—Pretreatment | Time 2—Posttreatment | Effect size |
---|---|---|---|
Background information | |||
Number | 68 | 68 | |
Gender (percentage males) | 66.2 | 66.2 | |
Age (years) | 16.4 (1.3) | 16.9 (1.4) | |
Percentage prescribed ADHD medication | 100 | 100 | |
Percentage receiving special education services | 61 | 61 | |
WASI IQ estimate | 97.2 (18.2) | — | |
Extended release methylphenidate dose (mg) | 45.8 (8.8) | 38.6 (7.2) | 0.89 |
Extended release mixed amphetamine salts dose (mg) | 24.6 (4.4) | 20.1 (4.1) | 1.05 |
Atomoxetine dose (mg) | 37.4 (5.3) | 35.3 (3.9) | 0.45 |
Pharmacotherapy adherence | 1.4 (0.5) | 1.7 (0.3) | 0.73 |
Behavioral symptoms | |||
BASC-2 parent externalizing T-score | 69.6 (7.8) | 62.6 (8.7) | 0.85 |
BASC-2 parent internalizing T-score | 65.8 (9.7) | 60.1 (7.8) | 0.65 |
BASC-2 teacher externalizing T-score | 67.5 (7.9) | 62.4 (8.1) | 0.64 |
BASC-2 teacher internalizing T-score | 66.0 (8.3) | 64.6 (9.2) | 0.16 |
BASC-2 teacher learning problems T-score | 70.4 (11.4) | 61.8 (9.8) | 0.81 |
BASC-2 adolescent SRP school problems T-score | 72.6 (14.2) | 65.2 (11.3) | 0.58 |
BASC-2 adolescent SRP internalizing T-score | 61.5 (11.0) | 57.8 (8.6) | 0.37 |
BASC-2 adolescent SRP inattention T-score | 71.4 (8.3) | 64.7 (8.8) | 0.78 |
BASC-2 adolescent SRP hyperactivity T-score | 67.5 (9.8) | 64.8 (11.2) | 0.26 |
BASC-2 adolescent SRP emotional symptoms T-score | 63.0 (9.9) | 59.8 (11.4) | 0.30 |
BASC-2 adolescent SRP personal adjustment T-score | 37.7 (6.9) | 43.7 (7.0) | 0.86 |
ADHD-RS parent hyperactivity raw score | 14.4 (3.2) | 13.3 (2.0) | 0.41 |
ADHD-RS parent inattention raw score | 18.2 (4.4) | 14.0 (3.8) | 1.02 |
ADHD-RS teacher hyperactivity raw score | 20.0 (4.2) | 16.9 (5.8) | 0.61 |
ADHD-RS teacher inattention raw score | 23.7 (3.1) | 19.4 (3.1) | 1.39 |
Functioning | |||
Cumulative grade point average | 81.2 (6.9) | 84.2 (5.4) | 0.48 |
Average number of weekly class absences | 1.8 (0.2) | 0.3 (0.2) | 7.50 |
Average number of weekly school tardiness | 0.8 (0.2) | 0.5 (0.2) | 1.50 |
BASC-2 parent adaptive functioning T-score | 32.7 (8.6) | 38.0 (9.2) | 0.60 |
BASC-2 teacher adaptive functioning T-score | 33.7 (8.9) | 38.9 (8.1) | 0.61 |
IRS parent relationship with peers | 4.2 (0.9) | 3.1 (0.5) | 1.51 |
IRS parent relationship with sibling | 4.2 (1.1) | 4.1 (1.0) | 0.09 |
IRS parent relationship with parent | 4.1 (0.6) | 3.5 (0.9) | 0.78 |
IRS parent academic progress | 4.3 (1.0) | 3.2 (0.8) | 1.21 |
IRS parent self-esteem | 3.7 (1.0) | 3.2 (1.1) | 0.48 |
IRS parent family functioning | 4.2 (0.8) | 3.4 (0.8) | 1.00 |
IRS teacher relationship with peers | 3.3 (0.8) | 3.1 (0.4) | 0.32 |
IRS teacher relationship with teacher | 3.6 (1.2) | 3.0 (0.8) | 0.59 |
IRS teacher academic progress | 4.5 (0.5) | 3.5 (0.7) | 1.64 |
IRS teacher self-esteem | 3.3 (0.9) | 2.8 (0.5) | 0.69 |
IRS teacher influence on classroom functioning | 4.3 (0.8) | 3.7 (0.7) | 0.79 |
Measures
Psychiatric/behavioral.
Cognitive.
Functioning.
Procedures
CBT intervention
Parent involvement.
Adolescent treatment adherence
CBT adherence.
Medication adherence.
Planned analyses
Results
Treatment efficacy
Exploratory analyses
Time 1—Pretreatment | Time 2—Posttreatment | Time * Condition p | |||||||
---|---|---|---|---|---|---|---|---|---|
Variable | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | |
Background information | |||||||||
Number | 14 | 25 | 15 | 14 | 14 | 25 | 15 | 14 | .999 |
gender (number males) | 7 | 16 | 9 | 9 | 7 | 16 | 9 | 9 | .999 |
Age (years) | 16.3 (1.3) | 16.5 (1.2) | 16.5 (1.2) | 16.3 (1.4) | 16.8 (1.3) | 17.0 (1.2) | 17.0 (1.2) | 16.9 (1.4) | .984 |
Percentage prescribed ADHD medication | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 100 | .999 |
Percentage receiving special education services | 64 | 60 | 60 | 64 | 64 | 60 | 60 | 64 | .999 |
WASI IQ estimate | 96.1 (16.2) | 97.3 (17.1) | 98.9 (14.5) | 96.8 (14.35) | — | — | — | — | — |
Extended release methylphenidate dose (mg) | 44.7 (5.3) | 47.0 (5.6) | 43.9 (4.2) | 47.4 (7.4) | 42.7 (5.3) | 46.8 (5.6) | 41.6 (4.0) | 45.9 (7.2) | .104 |
Extended release mixed amphetamine salts dose (mg) | 23.8 (4.0) | 25.9 (3.4) | 22.8 (3.0) | 25.7 (3.0) | 23.3 (4.2) | 25.8 (3.0) | 20.4 (2.1) | 23.1 (1.9) | .085 |
Atomoxetine dose (mg) | 36.1 (5.8) | 38.7 (5.5) | 38.3 (5.1) | 37.2 (5.2) | 34.7 (4.1) | 38.6 (5.5) | 36.2 (5.9) | 35.8 (4.1) | .116 |
Pharmacotherapy adherence | 1.3 (0.4) | I.I (0.4) | 1.4 (0.4) | 1.4 (0.4) | 1.8 (0.4) | 1.2 (0.4) | 1.8 (0.4) | 1.8 (0.3) | .019 |
Behavioral symptoms | |||||||||
BASC-2 parent externalizing T-score | 66.6 (7.8) | 71.2 (8.9) | 67.7 (6.8) | 69.2 (9.1) | 62.8 (8.0) | 69.3 (9.1) | 60.5 (11.3) | 65.7 (8.5) | .012 |
BASC-2 parent internalizing T-score | 64.3 (9.6) | 62.1 (9.0) | 67.3 (6.9) | 68.2 (5.9) | 61.1 (8.4) | 62.8 (6.8) | 59.5 (7.8) | 60.5 (7.7) | .005 |
BASC-2 teacher externalizing T-score | 64.5 (7.6) | 72.5 (9.9) | 65.8 (10.0) | 67.4 (6.7) | 61.3 (7.9) | 68.5 (6.9) | 59.6 (7.5) | 60.5 (9.0) | .033 |
BASC-2 teacher internalizing T-score | 61.4 (8.0) | 65.4 (7.7) | 69.7 (7.3) | 71.4 (9.9) | 60.2 (7.8) | 64.8 (11.1) | 64.5 (6.7) | 64.2 (9.0) | .004 |
BASC-2 teacher learning problems T-score | 69.2 (9.0) | 69.7 (10.0) | 71.2 (11.7) | 70.3 (11.9) | 61.6 (9.4) | 66.8 (9.8) | 60.7 (9.7) | 63.5 (9.6) | .001 |
BASC-2 adolescent SRP school problems T-score | 72.8 (15.2) | 74.4 (13.2) | 71.8 (13.8) | 73.9 (17.2) | 64.8 (9.8) | 72.2 (14.8) | 64.7 (11.0) | 64.7 (10.8) | .065 |
BASC-2 adolescent SRP internalizing T-score | 60.7 (10.0) | 59.8 (8.7) | 65.7 (13.1) | 66.2 (12.2) | 59.9 (9.7) | 59.9 (9.1) | 57.1 (5.8) | 57.2 (8.0) | .004 |
BASC-2 adolescent SRP inattention T-score | 73.3 (7.8) | 66.7 (9.0) | 70.3 (6.6) | 71.5 (8.2) | 64.1 (8.9) | 66.3 (9.9) | 64.2 (7.9) | 64.5 (8.3) | .001 |
BASC-2 adolescent SRP hyperactivity T-score | 65.8 (9.6) | 66.3 (10.0) | 70.2 (14.2) | 67.5 (8.1) | 64.9 (10.2) | 65.7 (6.9) | 64.1 (10.4) | 63.9 (14.2) | .103 |
BASC-2 adolescent SRP emotional symptoms T-score | 62.2 (8.0) | 61.8 (11.1) | 66.4 (9.2) | 66.9 (9.5) | 58.9 (10.8) | 62.0 (14.2) | 58.2 (9.7) | 58.9 (13.3) | .001 |
BASC-2 adolescent SRP personal adjustment T-score | 38.9 (5.6) | 40.6 (4.0) | 36.3 (7.7) | 36.1 (9.0) | 43.8 (6.9) | 41.8 (8.8) | 45.0 (5.6) | 44.1 (7.8) | .016 |
ADHD-RS parent hyperactivity raw score | 14.6 (2.8) | 15.2 (2.2) | 15.4 (3.4) | 13.9 (3.4) | 13.5 (2.2) | 14.9 (2.8) | 13.0 (1.7) | 13.3 (1.9) | .206 |
ADHD-RS parent inattention raw score | 18.3 (4.1) | 18.6 (5.0) | 17.5 (4.0) | 17.7 (3.9) | 13.7 (3.4) | 15.3 (5.0) | 13.4 (4.1) | 13.8 (2.9) | .017 |
ADHD-RS teacher hyperactivity raw score | 19.4 (4.1) | 22.3 (5.7) | 19.9 (3.8) | 19.8 (3.4) | 15.4 (6.0) | 18.2 (7.2) | 15.3 (2.6) | 15.8 (2.0) | .104 |
ADHD-RS teacher inattention raw score | 23.9 (3.0) | 24.1 (5.1) | 23.8 (3.4) | 24.4 (2.7) | 19.3 (2.5) | 22.5 (4.0) | 19.0 (2.9) | 19.0 (2.9) | .118 |
Functioning | |||||||||
Cumulative grade point average | 82.0 (5.6) | 80.2 (7.8) | 81.9 (6.0) | 80.9 (6.7) | 85.3 (4.5) | 82.1 (6.9) | 85.1 (5.6) | 85.0 (4.9) | .027 |
Average number of weekly class absences | 1.9 (0.2) | 2.5 (0.5) | 1.2 (0.3) | 2.0 (0.1) | 0.3 (0.2) | I.I (0.4) | 0.1 (0.1) | 0.1 (0.1) | .007 |
Average number of weekly school tardiness | 0.6 (0.2) | 1.3 (0.2) | 0.6 (0.2) | I.I (0.3) | 0.2 (0.1) | 1.0 (0.4) | 0.2 (0.1) | 0.2 (0.1) | .001 |
BASC-2 parent adaptive functioning T-score | 32.4 (8.0) | 31.6 (10.3) | 32.9 (8.9) | 31.6 (7.0) | 38.2 (9.0) | 36.8 (14.2) | 39.4 (5.6) | 39.8 (5.8) | .218 |
BASC-2 teacher adaptive functioning T-score | 33.0 (9.3) | 32.7 (11.5) | 34.4 (5.7) | 33.7 (7.1) | 38.1 (7.6) | 36.8 (14.2) | 40.2 (5.8) | 38.7 (6.9) | .252 |
IRS parent relationship with peers | 4.0 (0.4) | 4.5 (0.9) | 4.0 (0.7) | 4.0 (1.0) | 3.0 (0.3) | 4.2 (0.7) | 3.0 (0.3) | 3.0 (0.4) | .001 |
IRS parent relationship with sibling | 3.7 (1.0) | 4.6 (0.5) | 3.9 (0.8) | 4.4 (0.8) | 3.7 (0.9) | 4.3 (1.2) | 4.0 (0.7) | 4.0 (0.9) | .858 |
IRS parent relationship with parent | 3.7 (0.5) | 4.5 (0.9) | 3.8 (0.4) | 4.2 (0.7) | 3.4 (0.7) | 4.2 (0.9) | 3.4 (0.6) | 3.4 (1.0) | .305 |
IRS parent academic progress | 4.2 (0.9) | 4.4 (1.4) | 4.0 (0.5) | 4.1 (1.2) | 3.0 (1.0) | 4.1 (1.3) | 2.9 (0.4) | 2.9 (0.8) | .001 |
IRS parent self-esteem | 3.8 (0.8) | 3.4 (0.6) | 4.1 (0.9) | 4.2 (1.2) | 3.1 (0.9) | 3.4 (0.9) | 3.0 (0.9) | 3.0 (1.3) | .001 |
IRS parent family functioning | 4.2 (1.0) | 4.2 (1.3) | 4.0 (0.8) | 4.2 (0.5) | 3.5 (0.5) | 3.9 (1.1) | 3.3 (0.5) | 3.3 (1.0) | .092 |
IRS teacher relationship with peers | 3.2 (0.7) | 3.4 (1.0) | 3.3 (0.9) | 3.4 (0.8) | 2.6 (0.3) | 3.4 (0.7) | 2.8 (0.4) | 2.7 (0.5) | .001 |
IRS teacher relationship with teacher | 3.4 (0.7) | 3.8 (1.3) | 3.1 (0.4) | 3.5 (0.5) | 2.9 (0.6) | 3.7 (1.0) | 2.6 (0.8) | 2.9 (1.0) | .001 |
IRS teacher academic progress | 4.4 (0.7) | 4.2 (0.8) | 4.5 (0.4) | 4.7 (0.9) | 3.6 (0.4) | 4.0 (0.9) | 3.4 (0.7) | 3.4 (0.6) | .001 |
IRS teacher self-esteem | 3.6 (0.7) | 3.0 (0.8) | 3.8 (1.1) | 3.9 (0.7) | 2.7 (0.6) | 3.0 (0.9) | 2.5 (1.1) | 2.6 (0.8) | .001 |
IRS teacher influence on classroom functioning | 3.8 (0.8) | 4.6 (1.0) | 3.9 (0.7) | 4.0 (0.6) | 3.3 (0.7) | 4.4 (0.6) | 3.4 (0.7) | 3.2 (0.7) | .117 |
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