Adults with ADHD experience significant impairment in social, emotional, occupational and academic functioning as a result of problems with the control of attention and impulses, as well as related impairment in everyday self-management functions of time-management, organization, and planning. There has been very little controlled investigation of the efficacy of psychosocial treatments to treat ADHD-related problems in adults. Stimulant and non-stimulant (atomoxetine) medications alleviate core symptoms of ADHD in adults. However, there is little evidence concerning the impact of these drugs on everyday self-management (""""""""meta-cognitive"""""""") functions and clinical experience indicates that drug treatment is inadequate to remedy these problems. Furthermore, as many as one-third or more of adults may have an inadequate response to drug treatment, necessitating other forms of intervention.
The specific aims of the proposed research, therefore, are to (a) develop and assess the efficacy of a focused 12-week manualized cognitive-behavioral group intervention to treat problems of time-management, organization, and planning in adults with ADHD; (b) to assess the indirect effects of the treatment on depression, anxiety, and self-esteem, (c) to examine maintenance of gains 6-months post-treatment. Eight-four adults with DSM-IV diagnoses of ADHD will be randomly assigned to receive either group CBT or a support (control) group. Outcome will be assessed on the basis of self- and observer report on the relevant scales of the Conners Adult Attention Rating Scale, the Brown ADD Scale, and ratings by a clinician blind to group status. This treatment development study will serve as the basis for an R01 application for a larger-scale assessment of the effects and mechanisms of cognitive-behavioral treatment (CBT) for the treatment of self-management problems that will also examine efficacy in different subgroups of AD/HD adults - with and without concurrent medication for AD/HD, those with and without comorbid anxiety or depression, and those differing in AD/HD subtype. ? ? ?
| Solanto, Mary V; Wasserstein, Jeanette; Marks, David J et al. (2012) Diagnosis of ADHD in adults: what is the appropriate DSM-5 symptom threshold for hyperactivity-impulsivity? J Atten Disord 16:631-4 |
| Solanto, Mary V; Marks, David J; Wasserstein, Jeanette et al. (2010) Efficacy of meta-cognitive therapy for adult ADHD. Am J Psychiatry 167:958-68 |
