Behavioral Parent Training as an Adjunct to Routine Care in Children with Attention-Deficit/Hyperactivity Disorder: Moderators of Treatment Response

Hoofdakker, Barbara J. van den; Nauta, Maaike; Veen-Mulders, Lianne van der; Sytema, Sjoerd; Emmelkamp, P.M.G.; Minderaa, Ruud B.; Hoekstra, Pieter J.

doi:10.1093/jpepsy/jsp060

Cited by 77 publications

(73 citation statements)

References 23 publications

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“…The findings in Table 2 indicate that effects of time and Time ϫ Treatment Group were statistically significant, which is in line with our earlier findings ( Van den Hoofdakker et al, 2007, 2010. In addition, a statistically significant interaction effect between time, treatment group, and DAT1 genotype was present.…”

Section: Resultssupporting

confidence: 90%

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: A pilot study.

Hoofdakker¹,

Nauta²,

Dijck-Brouwer³

et al. 2012

Developmental Psychology

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There is great variability in the degree to which children with attention deficit/hyperactivity disorder (ADHD) improve through behavioral treatments. This study investigates the influence of the dopamine transporter gene (SCL6A3/DAT1) on outcome of behavioral parent training (BPT). Study subjects were a subsample (n = 50, for whom DAT1 genotypes were available) of a randomized controlled BPT effectiveness study (N = 94) comparing BPT plus ongoing routine clinical care (RCC) versus RCC alone in referred children (4-12 years old) with ADHD. Treatment outcome was based on parent-reported ADHD symptoms and behavioral problems. Presence of 2 versus no or 1 DAT1 10-repeat allele served as moderator variable. Time × Treatment × Genotype effect was analyzed with repeated-measures analysis of variance, controlling for baseline medication status. Results indicate that DAT1 moderated treatment response (p = .009). In children with no or 1 DAT1 10-repeat allele, superior treatment effects of BPT + RCC compared with RCC alone were present (p = .005), which was not the case in children with 2 DAT1 10-repeat alleles (p = .57). Our findings suggest that genetic differences in DAT1 in children with ADHD influence their susceptibility to a behavioral intervention directed at shaping their environment through their parents. The role of the dopamine system in motivation and learning and in the aberrant sensitivity to reinforcement in children with ADHD may explain this moderating effect, given that the management of contingencies is typically addressed in BPT.

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Section: Resultssupporting

confidence: 90%

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: A pilot study.

Hoofdakker¹,

Nauta²,

Dijck-Brouwer³

et al. 2012

Developmental Psychology

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“…Johnston et al (2010) report that mothers with higher parenting efficacy view behavioural strategies as more likely to being effective, which predicts positive treatment experience. In the same line are the results of Van den Hoofdakker et al (2010) who have reported that behavioural parent training is most useful when mothers have high parenting self-efficacy and when children have no or just one single type of co-morbidity. Thus, the management of the child's behaviour and parental intervention could be useful in the promotion of more positive parental functioning.…”

Section: Discussionmentioning

confidence: 78%

Mothers of children with attention deficit/hyperactivity disorder: relationship among parenting stress, parental practices and child behaviour

Pimentel

Vieira-Santos

Santos

et al. 2011

ADHD Atten Def Hyp Disord

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This study focuses on mothers of children diagnosed with attention deficit/hyperactivity disorder (ADHD) and sets out (1) to characterize dimensions of both parental functioning (parenting stress and parental practices) and child characteristics (behaviour) and (2) to determine predictors of parenting stress, namely parental rearing practices or perceived behaviour of the child, in order to plan intervention with the families. Fifty-two mothers of children diagnosed with ADHD and aged 6-12 years participated in the study. The Portuguese versions of the Parenting Stress Index (Abidin and Santos 2003), EMBU-P (Canavarro and Pereira 2007) and Child Behaviour Checklist (Albuquerque et al. 1999) were used. Results showed that mothers of children with ADHD experience higher levels of parenting stress (emerging essentially from the child's characteristics) and report more behavioural problems in their children (for girls and boys), but use parental practices similar to those of the mothers of the Portuguese validation sample. Results also indicate that child behaviour (both internalized and externalized) and parental practices dominated by rejection predict parenting stress. These findings have implications for intervention with children diagnosed with ADHD and their families.

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“…41 Randomized controlled trials in children with ADHD have shown good effi cacy with a number of behavioral interventions and parent-training programs, including those that target organizational and timemanagement skills, externalizing behaviors (eg, aggression and defiance), and social skills. 7,8,[42][43][44][45] Additionally, the effectiveness of behavioral treatment, either alone or in combination with pharmacotherapy, was evaluated in the Multimodal Treatment Study of Children with ADHD (MTA). 46 While rates of successful treatment response were lower with behavioral treatment alone than with pharmacotherapy alone, almost three-fourths of the behavioral treatment group were treated for 14 months without acute exacerbations or other situations requiring the administration of pharmacotherapy.…”

Section: Case 1: John Ymentioning

confidence: 99%

Managing ADHD across the Lifespan in the Primary Care Setting

Goodman

Lasser

Babcock

et al. 2011

Postgraduate Medicine

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Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobehavioral condition that affects most patients throughout their lives and is associated with occupational underachievement, psychiatric comorbidity, and substance abuse. Primary care physicians (PCPs) are at the forefront of helping patients with ADHD manage symptoms and overcome functional impairments. In this article, the problems of recognizing and effectively managing ADHD are explored through the presentation of 2 composite patient cases based on real patients in the authors' practices. Both cases highlight maturational changes in ADHD-related problems as patients develop through childhood, adolescence, and into adulthood. The striking differences between the cases serve to illustrate the highly varied clinical presentation and developmental trajectories of ADHD, moderated by family environment, patient characteristics, and life events. Emphasis is placed on understanding the crucial developmental turning points from early childhood through adulthood at which patients with ADHD are most likely to need increased support and specialized behavioral interventions. Diagnosis of adult ADHD is also reviewed, including an overview of potentially clinically relevant patient characteristics that should alert PCPs to the possible presence of ADHD and use of the World Health Organization's rapid 6-item adult ADHD Self-Report Scale as a screening device. The present discussion challenges PCPs to recognize the varied presentations of what ADHD "looks like," and describes the need for PCPs to establish and maintain working partnerships with families, patients, and mental health care professionals in their local communities to successfully treat ADHD across the lifespan.

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Behavioral Parent Training as an Adjunct to Routine Care in Children with Attention-Deficit/Hyperactivity Disorder: Moderators of Treatment Response

Abstract: Adjunctive BPT is most useful when mothers have high parenting self-efficacy and in children with no or single-type comorbidity.

Cited by 77 publications

References 23 publications

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: A pilot study.

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: A pilot study.

Mothers of children with attention deficit/hyperactivity disorder: relationship among parenting stress, parental practices and child behaviour

Managing ADHD across the Lifespan in the Primary Care Setting

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