Acceptability of Behavioral and Pharmacological Treatments for Attention-Deficit/Hyperactivity Disorder: Relations to Child and Parent Characteristics

Johnston, Charlotte; Hommersen, Paul; Seipp, Carla M.

doi:10.1016/j.beth.2007.04.002

Cited by 57 publications

(62 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonpharmacological treatments are of particular interest to parents of children and adolescents with ADHD due to parental concerns regarding the use of psychoactive medications on brain and body development in children. Parents of children with ADHD prefer behavioral interventions alone in comparison to either medication alone [15] or medication combined with a behavioral treatment [16]. Contrary to public opinion, the data suggest that ADHD is often undertreated [17,18].…”

Section: Need For Improved Treatments In Adhdmentioning

confidence: 91%

Training Cognition in ADHD: Current Findings, Borrowed Concepts, and Future Directions

et al. 2012

View full text Add to dashboard Cite

With both its high prevalence and myriad of negative outcomes, Attention-Deficit/Hyperactivity Disorder (ADHD) demands a careful consideration of the efficacy of its treatment options. Although the benefits of medication have a robust empirical background, nonpharmaceutical interventions evoke particular interest, as they are often viewed more favorably by parents. This review pays special attention to the use of working memory and recent cognitive training attempts in ADHD, describing its cognitive, behavioral, and biological effects in relation to current neurological theory of the disorder. While these treatments have demonstrated positive effects on some measures, there are limitations, as studies have failed to demonstrate generalization to critical measures, such as teacher-rated classroom behaviors, and have provided limited but growing evidence of functionally significant improvements in behavior. There is also a clear lack of research on the effects of training on reward systems and self-control. These limitations may be addressed by broadening the scope and procedures of the training and incorporating research concepts from other fields of study. First, it is important to consider the developmental trajectories of brain regions in individuals with the disorder, as they may relate to the effectiveness of cognitive training. Notions from behavioral economics, including delay discounting and framing (i.e., context) manipulations that influence present orientation, also have applications in the study of cognitive training in ADHD. In considering these other domains, we may find new ways to conceptualize and enhance cognitive training in ADHD and, in turn, address current limitations of interventions that fall in this category.Keywords Attention deficit hyperactivity disorder . Treatment . Working memory training . Nonpharmacological . Delay discounting Need for Improved Treatments in ADHDAttention-deficit/hyperactivity disorder (ADHD) is a critical public health concern, given that it is the most common childhood behavioral disorder, with prevalence rates of at least 5 % [1,2]. ADHD is associated with negative outcomes in academic achievement, including lower reading and math achievement scores [3][4][5][6][7], lower high school completion rates [8] and an alarmingly high use of special education services [9]. Significantly elevated rates of antisocial behavior, increased arrests, and greater substance abuse exist in adolescents and adults with ADHD [9][10][11]. This constellation of negative outcomes underscores the need for additional ADHD treatments.There continues to be a great need to identify more effective and adjunctive interventions for ADHD. This is particularly true, given that current treatments do not appear to have long-term benefits once the intervention has been stopped. Some of the most compelling results on this issue come from the Multimodal Treatment Study of ADHD [12,13], the most comprehensive treatment study of ADHD to date. The study reported initial positive effects of med...

show abstract

Section: Need For Improved Treatments In Adhdmentioning

confidence: 91%

Training Cognition in ADHD: Current Findings, Borrowed Concepts, and Future Directions

et al. 2012

View full text Add to dashboard Cite

show abstract

“…It includes judgments of the appropriateness of the treatment for the problem, whether the treatment is just, sensible, and nonintrusive, and whether it concurs with popular notions of what constitutes treatment. A sizable literature supports the general acceptability of BPT, particularly as compared to alternatives such as pharmacological interventions (e.g., Calvert and Johnston 1990;Carter 2007;Johnston et al 2008;Reimers et al 1992;Wilson and Jennings 1996). However, there remains much to be known about what factors may contribute to the acceptability of BPT, including how treatment is presented to parents, and the match between parental expectations and desires for therapy and what is offered in BPT.…”

Section: Treatment Acceptabilitymentioning

confidence: 95%

“…Although parents may see BPT as acceptable (e.g., Boothe and Borrego 2004;Johnston et al 2008;Wilson and Jennings 1996), they still may fail to actively engage in the treatment (Nock and Ferriter 2005) or may choose less acceptable alternatives (e.g., stimulant medications; Johnston et al 2008). This failure of pre-treatment cognitions and intentions to predict actual behavior is consistent with findings across a range of health behaviors indicating that intentions engender only a small-to-medium effect on behavior (Webb and Sheeran 2006), and that other factors may operate to moderate the relation of intention to action, such as perceptions of behavioral control (Sheeran et al 2003), and habit (Ouellette and Wood 1998).…”

Section: Treatment Engagementmentioning

confidence: 99%

Parental Social Cognitions: Considerations in the Acceptability of and Engagement in Behavioral Parent Training

Mah

Johnston

2008

Clin Child Fam Psychol Rev

Self Cite

View full text Add to dashboard Cite

Behavioral parent training (BPT) is a widely used, evidence-based treatment for externalizing child behaviors. However, the ability of BPT programs to be maximally effective remains limited by relatively low rates of acceptance, attendance, and adherence to treatment. Previous reviews have focused on a variety of demographic and mental health characteristics of parents and children that are predictive of poor outcomes in BPT. This paper focuses instead on consideration of parental social cognitions, and how incorporation of these cognitions may, or may not, be useful in advancing the effectiveness of BPT. We first review evidence suggesting limited incremental effects to incorporating parental cognitions within the context of BPT programs. Then, we examine the role of two particular types of parental social cognitions, attributions and parenting efficacy, in relation to the initial stages of accepting and engaging in BPT. We conclude by noting limitations in available research on the links between parental social cognitions and BPT, and we outline a number of potentially useful directions that may clarify whether or not parental social cognitions should be accorded greater attention either in the initial stages or throughout BPT programs.

show abstract

“…Our analysis of parent comments corroborates previous work in this area and provides a far more comprehensive collection of factors than previous studies. [4][5][6][7][23][24][25][26][27][28][29][30][31][32][33][34][35] Previous efforts implementing the American Academy of Pediatrics clinical practice guidelines for the diagnosis and treatment of ADHD demonstrated a need to augment the time-constrained efforts of physicians to educate and support parents. 36 Future studies are needed to develop and test systems to support parents facing treatment decisions for their child newly diagnosed with ADHD.…”

Section: Table 4 Domain 3: Continued Doubt and Uncertaintymentioning

confidence: 99%

Parental Angst Making and Revisiting Decisions About Treatment of Attention-Deficit/Hyperactivity Disorder

Sherman²,

et al. 2009

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT:Initiation of medication for ADHD is variable and persistence with therapeutic regimens is poor. Parents play a key role in managing medication use for their child with ADHD. WHAT THIS STUDY ADDS:This study identifies factors that influence parent decision-making about the initiation and continuation of medication treatment. Awareness of these factors may help physicians address the concerns of families while managing ADHD.abstract BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral conditions of childhood and adolescence. Despite availability of effective treatment options, initiation of treatment is variable and persistence with therapeutic regimens is poor. OBJECTIVE:We sought to better understand how parents make decisions about treatment for their child or adolescent with ADHD. METHODS:We conducted a qualitative study among parents of children and adolescents; 52 parents participated in 1 of 12 focus groups. Parents answered questions about decision-making, information sharing, and sources of conflict and uncertainty. Sessions were audiotaped and transcribed verbatim. Themes were coded independently by 4 of the investigators, who then agreed on common themes. RESULTS:Parents in our study made decisions about treatment for their child with ADHD in the midst of experiencing a variety of emotions as they witnessed child functional impairments at home and at school. In addition, parents felt stress as a result of their daily efforts to manage their child's struggles. Multiple factors influenced the decision to initiate medication. Subsequently, revisiting the decision to give their child medicine for ADHD was common. Many parents contrasted time on and off medicine to help inform management decisions. Trials stopping medication were almost always parent-or child-initiated. CONCLUSIONS:Decisions about medication use for children and adolescents with ADHD are made and frequently revisited by their parents. Choices are often made under stressful conditions and influenced by a variety of factors. Striking a balance between benefits and concerns is an ongoing process that is often informed by contrasting time on and off medication. Development of strategies to support families across the continuum of decisions faced while managing ADHD is warranted.

show abstract

Acceptability of Behavioral and Pharmacological Treatments for Attention-Deficit/Hyperactivity Disorder: Relations to Child and Parent Characteristics

Cited by 57 publications

References 32 publications

Training Cognition in ADHD: Current Findings, Borrowed Concepts, and Future Directions

Training Cognition in ADHD: Current Findings, Borrowed Concepts, and Future Directions

Parental Social Cognitions: Considerations in the Acceptability of and Engagement in Behavioral Parent Training

Parental Angst Making and Revisiting Decisions About Treatment of Attention-Deficit/Hyperactivity Disorder

Contact Info

Product

Resources

About