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Do Comorbid Oppositional Symptoms Predict ADHD Behavioral Treatment Outcomes?

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Abstract

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.

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Funding

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

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Authors and Affiliations

  1. Department of Clinical, Health, and Applied Sciences, University of Houston – Clear Lake, 2700 Bay Area Blvd, MC 22, Houston, TX, 77058, USA

    Sara R. Elkins

  2. Texas Child Study Center/Dell Children’s Medical Center and the Department of Educational Psychology, University of Texas, Austin, TX, USA

    Mark A. Bond & David F. Curtis

Authors
  1. Sara R. Elkins
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  2. Mark A. Bond
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Correspondence to Sara R. Elkins.

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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.

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

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Elkins, S.R., Bond, M.A. & Curtis, D.F. Do Comorbid Oppositional Symptoms Predict ADHD Behavioral Treatment Outcomes?. Child Psychiatry Hum Dev 50, 918–926 (2019). https://doi.org/10.1007/s10578-019-00894-5

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