TY - JOUR
T1 - An Individual Participant Data Meta-analysis
T2 - Behavioral Treatments for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder
AU - Prof. Dr. van den Hoofdakker share last authorship and contributed equally to this work.
AU - Groenman, Annabeth P.
AU - Hornstra, Rianne
AU - Hoekstra, Pieter J.
AU - Steenhuis, Laura
AU - Aghebati, Asma
AU - Boyer, Bianca E.
AU - Buitelaar, Jan K.
AU - Chronis-Tuscano, Andrea
AU - Daley, David
AU - Dehkordian, Parisa
AU - Dvorsky, Melissa
AU - Franke, Nike
AU - DuPaul, George J.
AU - Gershy, Naama
AU - Harvey, Elizabeth
AU - Hennig, Timo
AU - Herbert, Sharonne
AU - Langberg, Joshua
AU - Mautone, Jennifer A.
AU - Mikami, Amori Yee
AU - Pfiffner, Linda J.
AU - Power, Thomas J.
AU - Reijneveld, Sijmen A.
AU - Schramm, Satyam Antonio
AU - Schweitzer, Julie B.
AU - Sibley, Margaret H.
AU - Sonuga-Barke, Edmund
AU - Thompson, Catharine
AU - Thompson, Margaret
AU - Webster-Stratton, Carolyn
AU - Xie, Yuhuan
AU - Luman, Marjolein
AU - van der Oord, Saskia
AU - van den Hoofdakker, Barbara J.
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2022/2
Y1 - 2022/2
N2 - Objective: Behavioral interventions are well established treatments for children with attention-deficit/hyperactivity disorder (ADHD). However, insight into moderators of treatment outcome is limited. Method: We conducted an individual participant data meta-analysis (IPDMA), including data of randomized controlled behavioral intervention trials for individuals with ADHD <18 years of age. Outcomes were symptoms of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) and impairment. Moderators investigated were symptoms and impairment severity, medication use, age, IQ, sex, socioeconomic status, and single parenthood. Results: For raters most proximal to treatment, small- to medium-sized effects of behavioral interventions were found for symptoms of ADHD, inattention, hyperactivity/impulsivity (HI), ODD and CD, and impairment. Blinded outcomes were available only for small preschool subsamples and limited measures. CD symptoms and/or diagnosis moderated outcome on ADHD, HI, ODD, and CD symptoms. Single parenthood moderated ODD outcome, and ADHD severity moderated impairment outcome. Higher baseline CD or ADHD symptoms, a CD diagnosis, and single parenthood were related to worsening of symptoms in the untreated but not in the treated group, indicating a protective rather than an ameliorative effect of behavioral interventions for these children. Conclusion: Behavioral treatments are effective for reducing ADHD symptoms, behavioral problems, and impairment as reported by raters most proximal to treatment. Those who have severe CD or ADHD symptoms, a CD diagnosis, or are single parents should be prioritized for treatment, as they may evidence worsening of symptoms in the absence of intervention.
AB - Objective: Behavioral interventions are well established treatments for children with attention-deficit/hyperactivity disorder (ADHD). However, insight into moderators of treatment outcome is limited. Method: We conducted an individual participant data meta-analysis (IPDMA), including data of randomized controlled behavioral intervention trials for individuals with ADHD <18 years of age. Outcomes were symptoms of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) and impairment. Moderators investigated were symptoms and impairment severity, medication use, age, IQ, sex, socioeconomic status, and single parenthood. Results: For raters most proximal to treatment, small- to medium-sized effects of behavioral interventions were found for symptoms of ADHD, inattention, hyperactivity/impulsivity (HI), ODD and CD, and impairment. Blinded outcomes were available only for small preschool subsamples and limited measures. CD symptoms and/or diagnosis moderated outcome on ADHD, HI, ODD, and CD symptoms. Single parenthood moderated ODD outcome, and ADHD severity moderated impairment outcome. Higher baseline CD or ADHD symptoms, a CD diagnosis, and single parenthood were related to worsening of symptoms in the untreated but not in the treated group, indicating a protective rather than an ameliorative effect of behavioral interventions for these children. Conclusion: Behavioral treatments are effective for reducing ADHD symptoms, behavioral problems, and impairment as reported by raters most proximal to treatment. Those who have severe CD or ADHD symptoms, a CD diagnosis, or are single parents should be prioritized for treatment, as they may evidence worsening of symptoms in the absence of intervention.
KW - ADHD
KW - behavioral interventions
KW - individual participant data meta-analyses
KW - moderator analyses
UR - https://www.scopus.com/pages/publications/85106942006
U2 - 10.1016/j.jaac.2021.02.024
DO - 10.1016/j.jaac.2021.02.024
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 33932495
AN - SCOPUS:85106942006
SN - 0890-8567
VL - 61
SP - 144
EP - 158
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 2
ER -