ABSTRACT
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are known to experience difficulty in peer relationships. Neither standard interventions for ADHD nor peer acceptance-oriented interventions fully remedy this problem. We propose that interventions targeting ADHD children's dyadic friendships may be more realistic strategies for improving peer relationships. Hence, a friendship intervention, implemented within the context of an intensive behavioral treatment program with 209 ADHD children, is described. A model is proposed in which the friend's antisocial behavior relates to parental compliance with the friendship intervention, and both the friend's antisocial behavior and parental compliance predict friendship quality and treatment response. Results indicate that children paired with peers lower on antisocial behavior and children whose parents had higher levels of compliance with the friendship intervention achieved higher quality friendships and were rated by teachers as more improved.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Behavior Therapy/methods , Friends , Attention Deficit Disorder with Hyperactivity/diagnosis , Child , Child, Preschool , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Interpersonal Relations , Male , Peer Group , Reproducibility of Results , Severity of Illness IndexABSTRACT
The effects of methylphenidate on the academic performance and classroom behavior of 45 adolescents with attention deficit hyperactivity disorder were studied. During a 6-week, placebo-controlled medication assessment in the context of a summer treatment program, participants received a double-blind, crossover trial of 3 doses of methylphenidate. Dependent measures included note-taking quality, quiz and worksheet scores, written language usage and productivity, teacher ratings, on-task and disruptive behavior, and homework completion. Group data showed positive effects of methylphenidate on academic measures; however, the greatest benefit came with the lowest dose. Although additional benefit did occur for some participants with higher doses, the largest increment of change usually occurred between the placebo and 10-mg dose. Many adolescents did not experience added benefit with increased dosages, and in some cases they experienced deterioration. Guidelines for assessment of medication effects are discussed.
Subject(s)
Adolescent Behavior/drug effects , Attention Deficit Disorder with Hyperactivity/drug therapy , Attention Deficit Disorder with Hyperactivity/psychology , Central Nervous System Stimulants/therapeutic use , Methylphenidate/therapeutic use , Schools , Adolescent , Central Nervous System Stimulants/administration & dosage , Central Nervous System Stimulants/adverse effects , Cross-Over Studies , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Individuality , Male , Methylphenidate/administration & dosage , Methylphenidate/adverse effects , Psychiatric Status Rating ScalesABSTRACT
As part of the behavioral treatment in the Multimodal Treatment Study of Children with ADHD (MTA9), children participated in an intensive summer treatment program (STP). This study examined the differences between 57 children in the combined treatment (Comb) group, who were medicated, and 60 children in the behavioral treatment (Beh) group, who were unmedicated throughout the STP. Comb children were significantly better than Beh on 5 measures: rule following, good sportsmanship, peer negative nominations, and STP teacher posttreatment ratings of inattention/overactivity. Groups did not differ on any of the other 30 measures, and responded similarly to the STP over time. Comparisons to normative data revealed that Comb children were more likely to fall within the normative range on 6 measures. The differences between these results and the main MTA results, in which Comb was always superior to Beh, are discussed in terms of the relative intensity of combined treatments. The implications for future studies of pharmacological and behavioral treatment for ADHD are discussed.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Behavior Therapy , Central Nervous System Stimulants/therapeutic use , Residential Treatment , Attention Deficit Disorder with Hyperactivity/drug therapy , Behavior Therapy/methods , Child , Child Day Care Centers , Combined Modality Therapy , Female , Humans , Male , Treatment Outcome , United StatesABSTRACT
Distress and ad lib alcohol consumption after interactions with child confederates were investigated in parents of children with externalizing disorders--attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD), or oppositional defiant disorder (ODD). Sixty subjects interacted with boys trained to act like either normal children or children with ADHD/CD/ODD. Interactions with deviant confederates resulted in feelings of inadequacy and produced negative affect but had no effect on alcohol consumption. Post hoc analyses showed that parents with a family history of alcohol problems (FH+) showed increased drinking after interaction with a deviant confederate, compared with FH+ parents who interacted with the normal confederate. FH- parents showed the opposite pattern of results.
Subject(s)
Alcohol Drinking/psychology , Child Behavior Disorders , Parent-Child Relations , Adult , Child , Child, Preschool , Female , Humans , Male , Risk Factors , Sex FactorsABSTRACT
Levels of adult distress and ad lib alcohol consumption following interactions with child confederates were investigated in parents of children with no diagnosable psychiatric disorders. Sixty parents (20 married couples and 20 single mothers) interacted with boys trained to enact behaviors characteristic of either normal children or "deviant" children with externalizing behavior disorders--attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD). Relative to the normal child role, interactions with deviant confederates were rated as significantly more unpleasant, resulted in feelings of role inadequacy, and produced significantly more anxiety, depression, and hostility. After the interactions, parents were given the opportunity to drink as much of their preferred alcoholic beverage as they desired while anticipating a second interaction with the same child. The participants consumed more alcohol following exposure to deviant as opposed to normal confederates.
Subject(s)
Alcohol Drinking/psychology , Attention Deficit and Disruptive Behavior Disorders/psychology , Family Health , Parents/psychology , Stress, Psychological/psychology , Adult , Analysis of Variance , Child , Child, Preschool , Female , Florida , Humans , MaleABSTRACT
We investigated the effects of background anger, provocation, and methylphenidate on emotional, physiological, and behavioral responding in children with attention-deficit hyperactivity disorder (ADHD) with and without concurrent aggression. Our study revealed that ADHD boys showed more emotional and physiological distress when exposed to an interaction in which an administrator chastised each boy's favorite counselor, compared to a friendly interaction between the two adults. The background anger manipulation did not affect the aggressive behavior of the boys against an opponent in an aggressive game. High-aggressive (HA) ADHD boys were more likely to respond to provocation with aggression than low-aggressive (LA) ADHD boys, but only LA boys showed increased physiological reactivity with increasing provocation. Methylphenidate resulted in increased heart rates under all conditions and did not interact with any of the other findings.