Abstract
Objective
The present study investigated the predictive power of anxiety, IQ, severity of ADHD and parental depression on the outcome of treatment in children with ADHD.
Method
Fifty children with ADHD (ages 8–12) were randomized to a 10-week treatment of methylphenidate or to a treatment of methylphenidate combined with multimodal behavior therapy. Prior to treatment predictors were assessed. Outcome was assessed separately for parents and teachers on a composite measure of inattentive, hyperactive, oppositional- and conduct disorder symptoms.
Results
There was neither a significant difference between the two treatments at baseline nor did treatment condition predict outcome. Therefore the data were collapsed across the two treatments. A combination of anxiety and IQ predicted teacher-rated outcome, explaining 18% of the variance. Higher anxiety and higher IQ’s indicated better treatment outcome. There were no significant predictors of the parent-rated outcome.
Conclusion
This study showed a small but significant predictive effect of IQ and anxiety on treatment outcome in children with ADHD.
Clinical implications
This study supports the idea that for the treatment of ADHD children with comorbid anxiety and higher IQ respond better to the two most used treatments for ADHD.
Similar content being viewed by others
References
Antrop I, Roeyers H, Oosterlaan J, Van Oost P (2002) Agreement between parent and teacher ratings of disruptive behavior disorders in children with clinically diagnosed ADHD. J Psychopathol Behav Assess 24 (1):67–73
Bakker FC, Van Wieringen PCW, Van der Ploeg HM, Spielberger CD (1989) Handleiding bij de Zelf-Beoordelings-Vragenlijst voor Kinderen [Manual for the self-evaluation questionnaire for children]. Swets & Zeitlinger, Lisse, the Netherlands
Barkley RA (1987) Defiant children: a clinicians’ manual for parent training. Guilford Press, New York
Barkley RA (1998) Attention Deficit Hyperactivity Disorder: a handbook for diagnosis and treatment, 2nd edn. Guilford Press, New York
Biederman J, Faraone SV, Keenan K, Steingard R, Tsuang T (1991) Familial association between attention deficit hyperactivity disorder and anxiety disorders. Am J Psychiatry 148:564–577
Bouma J, Ranchor AV, Sanderman R, van Sonderen E (1995) Het meten van symptomen van depressie met de CES-D, een handleiding. Groningen, Rijksuniversiteit Groningen
Buitelaar JK, Van der Gaag RJ, Swaab-Barneveld H, Kuiper M (1995) Prediction of clinical response to methylphenidate in children with Attention-Deficit Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 34:1025–1032
Chronis AM, Chacko A, Fabiano GA, Wymbs BT, Pelham WE (2004) Enhancements to the behavioural parent training paradigm for families of children with ADHD: review and future directions. Clin Child Fam Psychol Rev 7:1–27
Denney CB, Rapport MD (1999) Predicting methylphenidate repsonse in children with ADHD: theoretical, empirical, and conceptual models. J Am Acad of Child Adolesc Psychiatry 38:393–401
DuPaul GJ, Barkley RA, McMurray MB (1994) Response of children with ADHD to methylphenidate: Interaction with internalizing symptoms. J Am Acad Child Adolesc Psychiatry 33:894–903
Ferdinand RF, van der Ende J, Mesman J (1998) Diagnostic Interview Schedule for Children, DISC-IV. Nederlandse vertaling [Dutch translation]. Unpublished manuscript. Sophia Kinderziekenhuis, Rotterdam
Gray JR, Kagan J (2000) The challenge of predicting which children with Attention Deficit-Hyperactivity Disorder will respond positively to methylphenidate. J Appl Dev Psychol 21:471–489
Greenhill LL, Abikoff HB, Arnold E, Cantwell DP, Conners CK, Elliot G, Hechtman L, Hinshaw SP, Hoza B, Jensen PS, March J, Newcorn J, Pelham WE, Severe JB, Swanson JM, Vitiello B, Wells K (1996) Medication treatment strategies in the MTA study: relevance to clinicians and researchers. J Am Acad Child Adolesc Psychiatry 34:1–9
Groth-Marnat G (1997) Handbook of psychological assessment, 3rd edn. John Wiley And Sons, New York
Hoza B, Owens JS, Pelham WE, Swanson JM, Conners CK, Hinshaw SP, Arnold LE, Kraemer HC (2000) Parent cognitions as predictors of child treatment response in Attention-Deficit/Hyperactivity Disorder. J Abnormal Child Psychol 28:569–583
Jensen PS, Hinshaw SP, Kraemer HC, Lenora N, Newcorn JH, Abikoff HB, March JS, Arnold LE, Cantwell DP, Conners CK, Elliot GR, Greenhill LL, Hechtman L, Hoza B, Pelham WE, Severe JB, Swanson JM, Wells KC, Wigal T, Vitiello B (2001) ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry 40:147–158
Kazdin AE, Crowley MJ (1997) Moderators of treatment outcome in cognitively based treatment of antisocial children. Cognit Ther Res 21:185–207
Kendall PC, Braswell L (1985) Cognitive-behavioral therapy for impulsive children. Guilford Press, New York
Kraemer HC, Wilson GT, Fairburn CG, Agras WS (2002) Mediators and moderators of treatment effects in randomized clinical trails. Arch Gen Psychiatry 59:877–1000
Loeber R, Green SM, Lahey BB (1990) Mental Health professionals’ perception of the utility of children, mothers, and teachers as informants on childhood psychopathology. J Clin Child Psychol 19:136–143
March JS, Swanson JM, Arnold LE, Hoza B, Conners KC, Hinshaw SP, Hechtman L, Kraemer HC, Greenhill LL, Abikoff HB, Elliot LG, Jensen PS, Newcorn JH, Vitiello B, Severe J, Wells KC, Pelham WE (2000) Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD. J Abnorm Child Psychol 28:527–541
MTA Cooperative Group (1999a) A 14-month randomized clinical trail of treatment strategies for Attention Deficit Hyperactivity Disorder. Arch Gen Psychiatry 56:1073–1086
MTA Cooperative Group (1999b) Moderators and mediators of treatment response for children with Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry 56:1088–1097
Oosterlaan J, Scheres A, Antrop I, Roeyers H, Sergeant JA (2000) Handleiding bij de vragenlijst voor gedragsproblemen bij kinderen [Manual of the Rating Scale for Disruptive Behavior Disorders in Children-DBDRS]
Owens EB, Hinshaw SP, Kraemer HC, Arnold LE, Abikoff HB, Cantwell DP, Conners CK, Elliott G, Greenhill LL, Hechtman L, Hoza B, Jensen PS, March JS, Newcorn JH, Pelham WE, Severe JB, Swanson JM, Vitiello B, Wells KC, Wigal T (2003) Which treatment for whom with ADHD? Moderators of treatment response in the MTA. J Consult Clin Psychol 71:540–552
Pelham WEG, Gnagny EM, Greenslade KE, Milich R (1992) Teacher ratings of DSM-III-R symptoms for disruptive behaviour disorder. J Am Acad Child Adolesc Psychiatry 31:210–218
Pelham WE (1997) Attention Deficit Hyperactivity Disorder: diagnosis, nature, etiology, and treatment. State University of New York at Buffalo, Buffalo
Pfiffner LJ, McBurnett K (2006) Family correlates of comorbid anxiety disorders in children with Attention Deficit/ Hyperactivity Disorder. J Abnorm Child Psychol 34:725–735
Pliszka S (1989) Effects of anxiety on cognition, behavior and stimulant response in ADHD. J Am Acad Child Adolesc Psychiatry 28:882–887
Power TJ, Andrews TJ, Eiraldi RB, Doherty BJ, Ikeda MJ, DuPaul GJ, Landau GJ (1998) Evaluating Attention Deficit Hyperactivity Disorder using multiple informants: the incremental utility of combining teacher with parent reports. Psychol Assess 10:250–260
Scheres A, Oosterlaan J, Swanson J, Morein-Zamir S, Meiran N, Schut H, Vlasveld L, Sergeant JA (2003) The effect of methylphenidate on three forms of response inhibition in boys with AD/HD. J Abnorm Child Psychol 31:105–120
Schwab-Stone ME, Shaffer D, Dulcan MK, Jensen PS, Fisher P, Bird HR, Goodman SH, Lahey BB, Lichtman JH, Canino G, Rubio-Stipec M, Rae DS (1996) Criterion validity of the NIMH Diagnostic Interview Schedule for Children Version 2.3. (DISC-2.3). J Am Acad Child Adolesc Psychiatry 35:878–888
Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME (2000) NIMH Diagnostic Interview Schedule for Children version IV (NIMH DISC-IV): Description, differences from previous versions and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry 39:28–38
Sonuga-barke EJS, Daley D, Thompson M (2002) Does maternal ADHD reduce the effectiviness of parent training for preschool children’s ADHD. J Am Acad Child Adolesc Psychiatry 41:696–702
Spielberger CD, Edwards CD, Lushene RE, Montuori J, Platzek D (1973) The state-trait anxiety inventory for children (preliminary manual). Consulting Psychologists, Palo Alto, CA
Taylor E, Schachar R, Thorley G, Wieselberg HM, Everitt B, Rutter M (1987) Which boys respond to stimulant medication? a controlled trial of methylphenidate in boys with disruptive behavior. Psychol Med 17:121–143
Thiruchelvam D, Charach A, Schachar RJ (2001) Moderators and mediators of long-term adherence to stimulant treatment in children with ADHD. J Am Acad Child Adolesc Psychiatry 40:922–928
Van der Oord S, Prins PJM, Oosterlaan J, Emmelkamp PMG (2007) Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD? Eur Child Adolesc Psychiatry 16:48–57
Van der Oord S, Prins PJM, Oosterlaan J, Emmelkamp PMG (2006) The association between parenting stress, depressed mood and informant agreement in ADHD and ODD. Behav Res Ther 44:1585–1595
Wechsler D (1974) Wechsler intelligence scale for children-revised manual. Psychological Corporation, New York
Weiss M, Hechtman L, Weiss G (2000) ADHD in parents. J Am Acad Child Adolesc Psychiatry 39:1059–1061
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
van der Oord, S., Prins, P.J.M., Oosterlaan, J. et al. Treatment of attention deficit hyperactivity disorder in children. Eur Child Adolesc Psychiatry 17, 73–81 (2008). https://doi.org/10.1007/s00787-007-0638-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-007-0638-8