Psychotherapy, Atomoxetine or Both? Preliminary Evidence from a Comparative Study of Three Types of Treatment for Attent
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ORIGINAL ARTICLE
Psychotherapy, Atomoxetine or Both? Preliminary Evidence from a Comparative Study of Three Types of Treatment for Attention‑Deficit/Hyperactivity Disorder in Children Daniel David1 · Anca Dobrean1 · Costina Ruxandra Păsărelu1 · Felicia Iftene2 · Viorel Lupu3 · Elena Predescu3 · Manfred Döpfner4 Accepted: 14 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The current study aimed to investigate using a superiority framework the efficacy of a combined treatment (cognitive-behavioral therapy based on behavioral components derived from classical behavioral therapy modifications and cognitive components mainly derived from rational emotive behavior therapy, plus an attention training component in a virtual environment (CBT/REBT + ATX, N = 20) as compared to psychotherapy alone (CBT/REBT, delivered over 16 weeks, N = 18—reference treatment) and non-stimulant medication alone (atomoxetine; ATX, N = 21—reference treatment) for children with Attention-Deficit/Hyperactivity Disorder (ADHD). Methods A three-arm pilot randomized controlled trial was conducted. Fifty-nine children ( Mage = 8.46, SD = 1.57) were randomly allocated to one of the 3 conditions. Results Our preliminary findings indicated a significant difference between the CBT/REBT + ATX and ATX group at posttreatment for the total ADHD symptoms rated by parent, d = 1.30, 95% CI [0.63, 1.98], p = 0.010. Conclusions The combined treatment seems to be superior to the medication alone on parent ratings on ADHD symptoms, however, on clinical ratings on ADHD diagnosis and functioning there are no significant group differences between treatments. Future larger trials with follow-up assessments are needed to test the stability of the effects over time. Keywords ADHD · Treatment · Children · Cognitive-behavior therapy · Rational emotive behavioral therapy · Atomoxetine
Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) has a worldwide point prevalence of around 5.3% (Polanczyk et al. 2007), with some estimates even higher, as approximately 7.1% (Thomas et al. 2015). According to the Diagnostic and Statistical Manual of Mental Disorders—5th edition Daniel David and Anca Dobrean with the same principal contribution. Clinical trial registration information: ISRCTN92640175. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10157-6) contains supplementary material, which is available to authorized users. * Daniel David [email protected] Extended author information available on the last page of the article
(DSM-5; American Psychiatric Association [APA] 2013), ADHD is characterized by a persistent pattern of inattention and/or hyperactivity/impulsivity, which interferes with normal functioning, and it is more prevalent in males. There are three types of ADHD, namely: predominantly inattentive, predominantly hyperactive/impulsive, and a combined type (APA 2013). ADHD can be found across lifespan and it is associated with imp
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