Child Psychiatry & Human Development

, Volume 50, Issue 6, pp 918–926 | Cite as

Do Comorbid Oppositional Symptoms Predict ADHD Behavioral Treatment Outcomes?

  • Sara R. ElkinsEmail author
  • Mark A. Bond
  • David F. Curtis
Original Article


Parent management training (PMT) is considered a best-practice for treating childhood ADHD. However, the magnitude of change in response to PMT differs across individuals. This study examined comorbid oppositional symptoms as a predictor of ADHD treatment outcomes. We predicted children with more severe baseline oppositionality would exhibit greater improvements in externalizing behaviors overall, including core ADHD symptoms. Participants consisted of 67 children aged 7–10 diagnosed with ADHD-Combined Type. Participants and their families received a manualized ten-session intervention, Family Skills Training for ADHD-Related Symptoms (Family STARS), combining PMT with a simultaneously occurring child skills training intervention. Pre- and post-treatment parent and teacher rating scales were collected to assess changes in ADHD and oppositional symptoms. Results demonstrated that children with more severe ratings of oppositional behaviors achieved commensurate ADHD symptom outcomes compared to those with less severe oppositionality. Implications are discussed with regard to the utilization of ADHD impairment-specific treatment targets.


ADHD Oppositional behaviors Parent management training Family skills training 



This project was supported by internal funding for patient care by the Psychology Service at Texas Children’s Hospital. (PI: Curtis).

Compliance with Ethical Standards

Conflicts of interest

On behalf of all authors, the corresponding author declares no conflicts of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Clinical, Health, and Applied SciencesUniversity of Houston – Clear LakeHoustonUSA
  2. 2.Texas Child Study Center/Dell Children’s Medical Center and the Department of Educational PsychologyUniversity of TexasAustinUSA

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