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1.
Clin Psychol Rev ; 112: 102461, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38945033

RESUMO

Demographic data from nearly 50 years of treatment research for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are synthesized. Comprehensive search identified ADHD treatment studies that were between-group designs, included a psychosocial, evidence-based treatment, and were conducted in the United States. One hundred and twenty-six studies that included 10,604 youth were examined. Reporting of demographics varied with 48% of studies (k = 61) reporting ethnicity, 73% (k = 92) reporting race, 80% (k = 101) reporting age (M age = 8.81, SD = 2.82), and 88% (k = 111) reporting gender. Most participants identified as non-Hispanic/Latine (15.99% Hispanic/Latine), White (62.54%), and boys (74.39%; 24.47% girls). Since the 1970s, zero youth in ADHD treatment studies identified as Middle Eastern/North African, 0.1% were American Indian/Alaskan Native or Native Hawaiian Pacific Islander, 1.77% were Asian, 15.10% were Black, and 3.14% were Multiracial. Based on publication year, the proportions of girls, racially minoritized youth, and Hispanic/Latine youth included in ADHD treatment research have increased over time. Girls, non-binary and non-cisgender youth, young children, adolescents, Hispanic/Latine youth, and youth from all racial groups other than White are underrepresented in ADHD treatment research. Research gaps are discussed, and recommendations for comprehensive demographic reporting in child and adolescent psychological research are provided.

2.
J Sch Psychol ; 104: 101309, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38871418

RESUMO

The long-term academic outcomes for many students with attention-deficit/hyperactivity disorder (ADHD) are strikingly poor. It has been decades since students with ADHD were specifically recognized as eligible for special education through the Other Health Impaired category under the Education for all Handicapped Children Act of 1975, and similarly, eligible for academic accommodations through Section 504 of the 1973 Rehabilitation Act. It is time to acknowledge that these school-policies have been insufficient for supporting the academic, social, and behavioral outcomes for students with ADHD. Numerous reasons for the unsuccessful outcomes include a lack of evidence-based interventions embedded into school approaches, minimizing the importance of the general education setting for promoting effective behavioral supports, and an over-reliance on assessment and classification at the expense of intervention. Contemporary behavioral support approaches in schools are situated in multi-tiered systems of support (MTSS); within this article we argue that forward-looking school policies should situate ADHD screening, intervention, and maintenance of interventions within MTSS in general education settings and reserve special education eligibility solely for students who require more intensive intervention. An initial model of intervention is presented for addressing ADHD within schools in a manner that should provide stronger interventions, more quickly, and therefore more effectively.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Instituições Acadêmicas , Estudantes , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Estudantes/psicologia , Educação Inclusiva/métodos , Adolescente
3.
Clin Child Fam Psychol Rev ; 26(2): 445-458, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36947287

RESUMO

In recent years, the prevalence rates of children's mental health disorders have increased with current estimates identifying that as many as 15-20% of children meet criteria for a mental health disorder. Unfortunately, the same robust parenting interventions which have long targeted some of the most common and the most treatable child concerns (e.g., externalizing, disruptive behavior, and aggression) have also shown consistently low rates of father engagement. This persistent issue of engagement comes in the wake of an increasingly large body of literature which highlights the unique positive contributions fathers make to children and families when they are engaged in parenting interventions. As the role fathers play in families shifts to become more inclusive of childcare responsibilities and less narrowly defined by financial contributions, it becomes increasingly important to understand how best to engage fathers in interventions that aim to enhance parenting efficacy and family outcomes such as coparenting. The current review examined intervention (e.g., format and setting) and implementation characteristics (e.g., training and agency-level changes) associated with father engagement. Particular attention is paid to studies which described father-specific engagement strategies (e.g., inviting fathers directly, father-only groups, and adapting intervention to incorporate father preferences). A total of 26 articles met inclusion criteria after screening and full-text review. Results indicate that father engagement (i.e., initiating treatment) remains low with 58% of studies either not reporting father engagement or having engagement rates below 50%. More than two-thirds of studies did not include specific father engagement strategies. Those that did focused on changes to treatment format (e.g., including recreational activities), physical treatment setting (e.g., in-home and school), and reducing the number of sessions required for father participation as the most common father-specific engagement strategies. Some studies reported efforts to target racially and ethnically diverse fathers, but review results indicated most participants identified as Non-Hispanic White. Interventions were largely standard behavioral parent training programs (e.g., PCIT and PMT) with few exceptions (e.g., COACHES and cultural adaptations), and very few agencies or programs are systematically making adjustments (e.g., extended clinic hours and changes to treatment format) to engage fathers. Recommendations for future directions of research are discussed including the impact of differential motivation on initial father engagement in treatment, the importance of continuing to support diverse groups of fathers, and the potential for telehealth to address barriers to father engagement.


Assuntos
Transtornos Mentais , Poder Familiar , Masculino , Criança , Humanos , Poder Familiar/psicologia , Pai/educação , Pai/psicologia , Instituições Acadêmicas , Saúde da Criança
4.
Sch Psychol ; 36(5): 313-324, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34591586

RESUMO

There is nationwide concern that the abrupt transition to remote instruction in response to the Coronavirus disease (COVID-19) pandemic will have detrimental impacts on student learning. As a uniquely vulnerable group within schools, students with disabilities like attention deficit hyperactivity disorder (ADHD) may be at enhanced risk for these negative outcomes. The present study features a unique examination of achievement scores, collected for two Cohorts (2018-2019, 2019-2020) of students with ADHD. By collecting achievement data in both the fall and spring for each Cohort, direct comparisons between changes in achievement for Cohort One (2018-2019) can be made to those in Cohort Two (2019-2020). Analyses summarized remote learning practices, within-group changes in achievement data over time for Cohort Two, and between-group differences in score changes over time for Cohorts One and Two. Teachers used a variety of remote learning approaches, including videoconferencing and independently completed assignments. Student achievement scores in both Cohorts significantly improved from fall to spring. No significant differences were found in score growth between the Cohorts, indicating that the move to remote instruction did not have a differentially negative impact on Cohort Two. Implications focus on the promise of well-delivered remote instruction, and the need to examine individual factors (such as poor internet access) that may exacerbate the risk of students with disabilities receiving remote instruction. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Sucesso Acadêmico , Transtorno do Deficit de Atenção com Hiperatividade/reabilitação , COVID-19 , Educação a Distância , Estudantes , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Instituições Acadêmicas
5.
Sch Psychol ; 36(4): 203-213, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34292041

RESUMO

In an effort to understand teachers' perceptions of best practices for treatment of students with attention-deficit/hyperactivity disorder (ADHD) and how those may have shifted over the past 20 years, general education elementary school teachers completed surveys regarding their opinions of evidence-based interventions in the classroom. Two independent and anonymous samples of general education, elementary school teachers were collected: One in 1999 (n = 598) and a second in 2019 (n = 661). Teachers responded to questions about their interactions with students with ADHD as well as their beliefs about best practices for these students. Across survey samples, teachers generally agreed that behavioral classroom management, medications, and the combination of the two are effective treatments for students with ADHD. Comparisons of the 1999 and 2019 survey samples suggest that teachers in 2019 perceive the use of behavioral classroom management somewhat less favorably than did teachers in 1999. Teacher perceptions of best practices for students with ADHD in 1999 and 2019 were generally consistent with professional practice guidelines. Teacher responses also highlight a critical need for training and support related to evidence-based strategies for students with ADHD in the classroom. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Atitude , Humanos , Professores Escolares , Estudantes , Inquéritos e Questionários
6.
J Sch Psychol ; 86: 133-150, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34051909

RESUMO

Engaging male caregivers within school settings is a major need within the educational field. Paternal engagement may be particularly important for children with attention-deficit/hyperactivity disorder (ADHD). Children with ADHD have increased risk for a number of poor educational outcomes, which may be attenuated by the benefits of positive male caregiver involvement. The Coaching Our Acting Out Children: Heightening Essential Skills (COACHES) program has been illustrated to be an effective approach for engaging, retaining, and improving the parenting of male caregivers of children with ADHD in clinical settings. The present study reports on the efficacy of the COACHES in Schools program, an adaptation intended for deployment in elementary school settings. Sixty-one male caregivers were randomly assigned to COACHES in Schools or a waitlist control. Results indicated that male caregivers in COACHES in Schools used significantly more praise and less negative talk in a parent-child activity relative to male caregivers in the waitlist control at post-treatment and one-month follow-up. Distal outcomes related to child behavior at home and at school were not significantly different. Implications of the results for future studies and continued efforts to engage male caregivers within school settings are discussed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Cuidadores , Criança , Comportamento Infantil , Humanos , Masculino , Poder Familiar , Instituições Acadêmicas
7.
J Child Fam Stud ; 30(12): 2966-2979, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35755320

RESUMO

Although children with ADHD continue to experience impairment well into adolescence, research exploring the experiences of their parents during late adolescence is lacking. Thus, we examined changes in parenting stress and family conflict in mothers of adolescents with ADHD during the transition to early adulthood. We also explored predictors of these changes in addition to investigating differences in these trajectories due to comorbid ODD. Forty-nine mothers of adolescents with ADHD only and thirty-seven mothers of adolescents with ADHD/ODD reported on parenting stress and perceptions of family conflict at baseline (mean age = 16.88) and at 3-month, 9-month, and 15-month follow up assessments. Growth curve modeling indicated that both groups of mothers reported relative declines in parenting stress and family conflict across time. However, the mothers of adolescents with ADHD/ODD persistently reported more stress and conflict. Furthermore, decreases in family conflict were more predictive of reduced parenting stress in families of adolescents only diagnosed with ADHD. Our findings suggest that comorbid ODD is associated with parenting stress during late adolescence. Thus, interventions should focus on further reducing this stress as adolescents with ADHD/ODD transition to adulthood.

8.
J Dev Behav Pediatr ; 41 Suppl 2S: S77-S87, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996574

RESUMO

OBJECTIVE: To inform the scope of future systematic reviews, meta-analyses, and treatment outcome studies, this review aims to describe the extent of the evidence for psychosocial interventions for children and adolescents with attention-deficit/hyperactivity disorder, with particular attention to specific types of interventions, targets of outcome assessment, and risk of bias. METHOD: A comprehensive search of relevant databases (i.e., Medline, PsychInfo, Education Resources Information Center, and ProQuest Dissertation Database) was conducted. Detailed information related to treatment type, outcome assessment, study design, and risk of bias was extracted by trained coders. Evidence and gap maps were created to summarize evidence within types of treatments and targets of outcome assessment. Indicators of risk of bias were assessed for selected combinations of treatments and outcome assessment. RESULTS: We identified 185 eligible individual studies and 3817 effect sizes. Behavioral parent training and cognitive training (COG) were the most commonly studied stand-alone interventions. Treatment versus control comparisons for stand-alone interventions (s = 70) were less common than for complex interventions involving combinations of psychosocial interventions (s = 100). Combinations of behavioral and child training (e.g., COG, organizational training) interventions were the most frequently studied. CONCLUSION: There is a considerable variability within this literature regarding combinations of treatments across outcome assessment targets. To address gaps in existing evidence, more primary studies assessing direct comparisons of isolated and combined treatment effects of specific types of psychosocial treatments relative to control and other treatments are needed. Future meta-analyses should take into account the complexity and breadth of available evidence.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapia Comportamental , Criança , Humanos , Avaliação de Resultados em Cuidados de Saúde , Intervenção Psicossocial
9.
J Abnorm Child Psychol ; 47(8): 1327-1338, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30796648

RESUMO

The purpose of the study was to estimate the burden to families of raising a child with attention-deficit/hyperactivity disorder (ADHD). Data were drawn from a longitudinal sample recruited in western Pennsylvania. When participants were between 14 and 17 years old, parents completed a questionnaire assessing economic burden over the course of raising their children. Domains of economic burden to families included direct costs related to child's behaviors (excluding treatment expenses) and indirect costs related to caregiver strain. On average, participants with ADHD incurred a total economic burden over the course of child development that was more than five times greater compared to youths without ADHD (ADHD = $15,036 per child, Control = $2,848 per child), and this difference remained significant after controlling for intellectual functioning, oppositional defiant symptoms, or conduct problems. Parents of participants with ADHD were more likely to have changed their job responsibilities or been fired and reported lower work efficiency. The current evaluation of economic burden to individual families extends previous estimates of annual societal cost of illness (COI) of ADHD. Our rough annual estimate of COI for ADHD in children and adolescents is $124.5 billion (2017 US Dollars). Findings underscore the need for interventions to reduce the costly dysfunctional outcomes in families of children with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/economia , Efeitos Psicossociais da Doença , Emprego , Pais , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino
10.
Assessment ; 26(5): 799-810, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-29214840

RESUMO

This study evaluated the fit and criterion validity of a bifactor model for 18 DSM-IV attention deficit/hyperactivity disorder (ADHD) symptoms, along with nine supplementary symptoms that represented the manifestation of inattention and hyperactivity-impulsivity in adolescence and early adulthood. Participants included N = 172 adolescents who were diagnosed with combined type ADHD and who were enrolled in a treatment study. A bifactor model provided reasonably good fit to combined parent- and teacher-reported DSM symptoms and supplemental items at baseline prior to treatment. Across models, the general factor was characterized by high reliability (ω = .93, .95), while specific inattentive and hyperactive-impulsive factors were characterized by poor reliability (ω = .30-.50). With respect to criterion validity, the general ADHD and specific inattentive factors were uniquely associated with home and school impairment (R2 = .13-.29) but not adolescent risk-tasking behavior. Results are discussed with respect to the ways in which bifactor models of ADHD inform the diagnostic criteria for ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Modelos Psicológicos , Adolescente , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Assunção de Riscos
11.
J Atten Disord ; 22(12): 1150-1157, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-26637839

RESUMO

OBJECTIVE: Youth with ADHD exhibit positive bias, an overestimation of ability, relative to external indicators. The positive bias construct is understudied in adolescents, particularly in the domain of driving. Study is needed as youth with ADHD experience greater negative outcomes in driving relative to typically developing teens. METHOD: Positive bias on a driving simulator task was investigated with 172 teenagers with ADHD, combined type. Youth participated in a driving simulation task and rated driving performance afterward. RESULTS: Compared with external ratings of driving performance, youth overestimated driving competence for specific driving behaviors as well as globally. The global rating demonstrated a greater degree of positive bias. Greater positive bias on global ratings of driving ability also predicted greater rates of risky driving behaviors during the simulator exercise independent from disruptive behavior disorder symptoms. CONCLUSION: Results inform prevention and intervention efforts for teenage drivers with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Condução de Veículo/psicologia , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Simulação por Computador , Feminino , Humanos , Masculino , Assunção de Riscos , Autoimagem
12.
J Atten Disord ; 22(13): 1255-1265, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-25555630

RESUMO

OBJECTIVE: To use a multi-method approach to examine the association of parental ADHD and gender with observed and self-reported parenting beliefs and behaviors. METHOD: Seventy-nine mother-father dyads completed measures of child behavior and impairment, parenting beliefs and behaviors, and self- and partner ratings of ADHD symptoms and functional impairment. Forty-five parents also completed structured parent-child interactions. RESULTS: A hierarchical linear model suggests impairment in functional domains may be associated with negative emotions about parenting and less effective parenting strategies. For fathers, greater severity of partner-reported symptoms of ADHD may be associated with greater frequency of negative talk during parent-child interactions. CONCLUSION: Findings suggest that higher levels of parental ADHD symptoms and functional impairment may be associated with reported beliefs and behaviors related to parenting. Differences emerged among mothers' and fathers' use of parenting strategies when self- and other-report of ADHD symptoms and impairment were assessed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Pai , Mães , Poder Familiar , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Comportamento Infantil/psicologia , Pai/psicologia , Feminino , Humanos , Masculino , Mães/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Autorrelato , Fatores Sexuais , Parceiros Sexuais
13.
Child Psychiatry Hum Dev ; 48(1): 18-31, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27165312

RESUMO

This study examined the extent to which positive and negative parenting relates to conduct problems (CP) and callous-unemotional (CU) traits among 172 adolescents (72 % males; Mage = 16.91 years, SD = .67) with attention-deficit/hyperactivity disorder and whether CU traits moderate the link between parenting and CP. Mothers reported on their adolescents' CP, CU traits, and their own parenting practices. Maternal behaviors were observed during a problem-solving communication task. Parents who engaged in more positive parenting (self-reported and observed) reported their adolescents as having lower levels of CU traits. No effect was found for negative parenting. Moderation analyses indicated that lower levels of positive maternal behavior was only associated with higher CP in the presence of higher levels of CU traits. Negative parenting was positively related to CP regardless of CU traits. Positive parenting, irrespective of measurement approach, uniquely relates to adolescents' CU traits while both positive and negative parenting relate to CP.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Emoções , Comportamento Materno/psicologia , Poder Familiar/psicologia , Comportamento Problema , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Técnicas de Observação do Comportamento , Feminino , Humanos , Masculino , Pais/psicologia , Psicopatologia , Estatística como Assunto
14.
J Consult Clin Psychol ; 84(12): 1078-1093, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27618640

RESUMO

OBJECTIVE: Teenage drivers diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at significant risk for negative driving outcomes related to morbidity and mortality. However, there are few viable psychosocial treatments for teens with ADHD and none focus on the key functional area of driving. The Supporting the Effective Entry to the Roadway (STEER) program was evaluated in a clinical trial to investigate whether it improved family functioning as a proximal outcome and driving behavior as a distal outcome. METHOD: One hundred seventy-two teenagers with ADHD, combined type, were randomly assigned to STEER or a driver education driver practice program (DEDP). RESULTS: Relative to parents in the DEDP condition, parents in STEER were observed to be less negative at posttreatment and 6-month follow-up but not at 12-month follow-up, and there were no significant differences for observed positive parenting. Relative to teens in the DEDP condition, teens in STEER reported lower levels of risky driving behaviors at posttreatment and 6-month follow-up, but not at 12-month follow-up. Groups did not differ on objective observations of risky driving or citations/accidents. CONCLUSIONS: The STEER program for novice drivers with ADHD was effective in reducing observations of negative parenting behavior and teen self-reports of risky driving relative to DEDP; groups did not significantly differ on observations of positive parenting or driving behaviors. (PsycINFO Database Record


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Condução de Veículo/psicologia , Terapia Familiar/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Pais/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino
15.
Patient ; 8(6): 483-97, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25644223

RESUMO

BACKGROUND: Patient preferences are an important topic of study with respect to attention-deficit hyperactivity disorder (ADHD) interventions, as there are multiple treatment choices available, multiple developmental levels to consider, and multiple potential individuals involved in treatment (children, parents, and adults with ADHD). Stated preference methods such as discrete choice experiment (DCE), best-worst scaling (BWS), and other utility value methods such as standard gamble interview (SGI) and time trade-off (TTO) are becoming more common in research addressing preferences for ADHD treatments. A synthesis of this research may facilitate improved patient-centered and family-centered treatment for ADHD. OBJECTIVE: The purpose of this review was to synthesize reports across existing DCE, BWS, TTO, and SGI studies to assess which aspects of ADHD treatment are most studied as well as most preferred and influential in treatment decisions. DATA SOURCES: MEDLINE, PsycINFO. STUDY SELECTION: A total of 41 studies referring to preferences for ADHD treatment were identified through the initial search and contact with researchers. Of these, 13 reported ADHD treatment preference data from a study using DCE, BWS, or SGI methods. No TTO studies were identified that met inclusion criteria. RESULTS: Methods and designs varied considerably across studies. Relatively few studies focused on preferences among children, adolescents, and adults compared with those that focused on the preferences of parents of children with ADHD. The majority of studies focused primarily on medication treatments, with many fewer focused on psychosocial treatments. Some studies indicated that parents of children with ADHD prefer to avoid stimulant medications in favor of behavioral or psychosocial interventions. Others report that parents see medication as a preferred treatment. Treatment outcome is a particularly salient attribute for treatment decisions for many informants. CONCLUSIONS: Potential outcomes of various treatments play a proximal role in patients' and families' decisions for ADHD treatment. Because the majority of studies focus on medication treatments for children with ADHD, more research is necessary to understand preferences related to behavioral and other psychosocial treatments both as stand-alone interventions and used in combination with medication. Additional research is also needed to assess the treatment preferences of adults with ADHD. In general, DCE, BWS, and SGI methods allow measurement of patient preferences in a manner that approximates the uncertainty and trade-offs inherent in real-world treatment decision making and provides valuable information to inform patient-centered and family-centered treatment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Comportamento de Escolha , Pais/psicologia , Preferência do Paciente/psicologia , Tomada de Decisões , Técnicas de Apoio para a Decisão , Feminino , Humanos , Masculino , Participação do Paciente
16.
Clin Child Fam Psychol Rev ; 18(1): 77-97, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25691358

RESUMO

The present report synthesizes outcomes across meta-analyses of psychosocial (i.e., non-pharmacological) treatments for ADHD. A total of 12 meta-analyses were identified that met search criteria. The meta-analyses were notable in that there was surprisingly little overlap in studies included across them (range of overlap was 2-46 %). Further, there was considerable diversity across the meta-analyses in terms of the inclusion/exclusion criteria, types of psychosocial treatments reviewed, methodological characteristics, and magnitude of reported effect sizes, making it difficult to aggregate findings across meta-analyses or to investigate moderators of outcome. Effect sizes varied across the outcomes assessed, with meta-analyses reporting positive and significant effect sizes for measures of some areas of child impairment (e.g., social impairment) and small and more variable effect sizes for distal and/or untargeted outcomes (e.g., academic achievement). Results are reviewed in light of the larger literature on psychosocial interventions for ADHD, and specific recommendations for future meta-analyses of psychosocial treatments for ADHD are offered.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapia Comportamental/métodos , Poder Familiar , Adolescente , Criança , Humanos , Psicoterapia/métodos , Resultado do Tratamento
17.
Child Adolesc Psychiatr Clin N Am ; 23(4): 757-73, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25220085

RESUMO

Children with attention-deficit/hyperactivity disorder (ADHD) require intensive treatments to remediate functional impairments and promote the development of adaptive skills. The summer treatment program (STP) is an exemplar of intensive treatment of ADHD. STP intervention components include a reward and response-cost point system, time-out, use of antecedent control (clear commands, establishment of rules and routines), and liberal praise and rewards for appropriate behavior. Parents also participate in parent management training programming to learn how to implement similar procedures within the home setting. There is strong evidence supporting the efficacy of the STP as an intervention for ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapia Comportamental/métodos , Prática Clínica Baseada em Evidências/métodos , Pais/educação , Adolescente , Terapia Comportamental/organização & administração , Criança , Pré-Escolar , Prática Clínica Baseada em Evidências/organização & administração , Humanos
18.
Behav Ther ; 45(2): 168-76, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24491192

RESUMO

Parenting practices for teen drivers with ADHD were observed via a video monitor installed in vehicles. All teens had recently completed a driver education course and were in the driving permit stage of a graduated driver-licensing program. Parent behaviors were coded during drives when teens were driving safely and during drives when teens engaged in risky driving. The overall frequency of positive parenting strategies was low, regardless of whether teens drove safely or engaged in risky driving. Although the rate of negative feedback was also low, parents engaged in significantly more criticism and were rated by an observer to appear angrier when teens were driving in a risky manner. No other differences in parent behaviors associated with the quality of teen driving were observed. The inconsistencies between observed parenting behaviors and those parenting practices recommended as effective with teens with ADHD are discussed. The need for further research addressing effective strategies for teaching teens with ADHD to drive is highlighted.


Assuntos
Comportamento do Adolescente/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Condução de Veículo/psicologia , Poder Familiar/psicologia , Assunção de Riscos , Ensino , Adolescente , Ira , Retroalimentação Psicológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Atten Disord ; 15(7): 583-92, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20686097

RESUMO

OBJECTIVE: This study investigated the role of self-regulation of emotion in relation to functional impairment and comorbidity among children with and without AD/HD. METHOD: A total of 358 probands and their siblings participated in the study, with 74% of the sample participants affected by AD/HD. Parent-rated levels of emotional lability served as a marker for self-regulation of emotion. RESULTS: Nearly half of the children affected by AD/HD displayed significantly elevated levels of emotional lability versus 15% of those without this disorder. Children with AD/HD also displayed significantly higher rates of functional impairment, comorbidity, and treatment service utilization. Emotional lability partially mediated the association between AD/HD status and these outcomes. CONCLUSION: Findings lent support to the notion that deficits in the self-regulation of emotion are evident in a substantial number of children with AD/HD and that these deficits play an important role in determining functional impairment and comorbidity outcomes.


Assuntos
Adaptação Psicológica , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Emoções , Ajustamento Social , Controles Informais da Sociedade , Ansiedade/complicações , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Criança , Pré-Escolar , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Irmãos , Comportamento Social
20.
Cancer Res ; 70(13): 5368-78, 2010 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-20551051

RESUMO

Epidermal growth factor receptor (EGFR) overexpression and activation are hallmarks of non-small cell lung carcinoma (NSCLC). Although EGFR-targeted therapies are used, the prognosis of NSCLC remains poor. ADAM17 induces activation of the EGFR through ligand cleavage. However, we show that inhibition or knockdown of ADAM17 markedly reduces tumorigenesis and survival to a large part independently from EGFR ligand shedding in NSCLC cells. These findings strongly indicate additional oncogenic mechanisms regulated by ADAM17. We identified Notch1 signaling as an ADAM17-controlled pathway and a critical regulator of anchorage-independent growth by using both Notch1 shRNA and ectopic expression of the active intracellular Notch1 fragment. Strikingly, Notch1 knockdown led to a strong reduction of EGFR expression in all analyzed cell lines. Proliferation, survival, and colony formation of Notch1-deficient cells were insensitive to EGF stimulation. Moreover, targeting Notch1 or ADAM17 resulted in substantial cell death, whereas EGFR inhibition predominantly induced cell cycle arrest. Immunohistochemical analysis of primary human tissue revealed a significant correlation between ADAM17, Notch1 signaling, and high EGFR expression levels. In conclusion, this article describes a novel molecular circuitry in NSCLC, incorporating ADAM17 as a regulator of EGFR expression through the activation of Notch1. Due to their central role in tumorigenesis and survival of NSCLC cells, both ADAM17 and Notch1 constitute promising targets for the treatment of NSCLC.


Assuntos
Proteínas ADAM/metabolismo , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Receptores ErbB/biossíntese , Neoplasias Pulmonares/metabolismo , Receptor Notch1/metabolismo , Proteínas ADAM/biossíntese , Proteína ADAM17 , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/biossíntese , Carcinoma Pulmonar de Células não Pequenas/patologia , Processos de Crescimento Celular/fisiologia , Linhagem Celular Tumoral , Sobrevivência Celular/fisiologia , Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Fator de Crescimento Epidérmico/farmacologia , Proteínas de Homeodomínio/biossíntese , Humanos , Neoplasias Pulmonares/patologia , Camundongos , Receptor Notch1/biossíntese , Transdução de Sinais , Fatores de Transcrição HES-1 , Transplante Heterólogo
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