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Applied Psychophysiology and Biofeedback

, Volume 27, Issue 4, pp 231–249 | Cite as

The Effects of Stimulant Therapy, EEG Biofeedback, and Parenting Style on the Primary Symptoms of Attention-Deficit/Hyperactivity Disorder

  • Vincent J. Monastra
  • Donna M. Monastra
  • Susan George
Article

Abstract

One hundred children, ages 6–19, who were diagnosed with attention-deficit/hyperactivity disorder (ADHD), either inattentive or combined types, participated in a study examining the effects of Ritalin, EEG biofeedback, and parenting style on the primary symptoms of ADHD. All of the patients participated in a 1-year, multimodal, outpatient program that included Ritalin, parent counseling, and academic support at school (either a 504 Plan or an IEP). Fifty-one of the participants also received EEG biofeedback therapy. Posttreatment assessments were conducted both with and without stimulant therapy. Significant improvement was noted on the Test of Variables of Attention (TOVA; L. M. Greenberg, 1996) and the Attention Deficit Disorders Evaluation Scale (ADDES; S. B. McCarney, 1995) when participants were tested while using Ritalin. However, only those who had received EEG biofeedback sustained these gains when tested without Ritalin. The results of a Quantitative Electroencephalographic Scanning Process (QEEG-Scan; V. J. Monastra et al., 1999) revealed significant reduction in cortical slowing only in patients who had received EEG biofeedback. Behavioral measures indicated that parenting style exerted a significant moderating effect on the expression of behavioral symptoms at home but not at school.

EEG biofeedback ADHD Ritalin parenting style outcome studies 

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REFERENCES

  1. Alhambra, M. A., Fowler, T. P., & Alhambra, A. A. (1995). EEG biofeedback: A new treatment option for ADD/ADHD. Journal of Neurotherapy, 1, 39-43.CrossRefGoogle Scholar
  2. Amen, D. G., Paldi, J. H., & Thisted, R. A. (1993). Evaluating ADHD with brain SPECT imaging. Journal of the American Academy of Child and Adolescent Psychiatry, 32(5), 1080-1081.CrossRefPubMedGoogle Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  4. Anastopoulos, A. D., Shelton, T., DuPaul, G. J., & Guevremont, D. C. (1993). Parent training for attention deficit hyperactivity disorder: Its impact on parent functioning. Abnormal Child Psychology, 20, 581-596.CrossRefGoogle Scholar
  5. Anastopoulos, A. D., Smith, J. M., & Wien, E. E. (1998). Counseling and training parents. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed., pp. 373-393). New York: Guilford Press.Google Scholar
  6. Barkley, R. A. (1996). Attention-deficit hyperactivity disorder. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 63-112). New York: Guilford Press.Google Scholar
  7. Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford Press.Google Scholar
  8. Barkley, R. A., & Murphy, K. R. (1998). Attention-deficit hyperactivity disorder: A clinical workbook. New York: Guilford Press.Google Scholar
  9. Bennett, F. C., Brown, R. T., Craver, J., & Anderson, D. (1999). Stimulant medication for the child with attention-deficit/hyperactivity disorder. Pediatric Clinics of North America, 46(5), 929-943.CrossRefPubMedGoogle Scholar
  10. Breggin, P. R. (1998). Talking back to Ritalin. Monroe, ME: Common Courage Press.Google Scholar
  11. Brown, R. T., & Sawyer, M. (1988). Medications for school-age children: Effects on learning and behavior. New York: Guilford Press.Google Scholar
  12. Casey, B. J., Castellanos, F. X., Geidd, J. N., Marsh, W. L., Hamburger, S. D., Schubert, A. B., et al. (1997). Implication of right frontostriatal circuitry in response inhibition and attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 374-383.CrossRefPubMedGoogle Scholar
  13. Chabot, R. A., Merkin, H., Wood, L. M., Davenport, T. L., & Serfontein, G. (1996). Sensitivity and specificity of QEEG in children with attention deficit or specific developmental learning disorders. Clinical Electroencephalography, 27, 26-34.PubMedGoogle Scholar
  14. Chabot, R. A., & Serfontein, G. (1996). Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological Psychiatry, 40, 951-963.CrossRefPubMedGoogle Scholar
  15. Clarke, A. R., Barry, R. J., McCarthy, R., & Selikowitz, M. (2001). Excess beta activity in children with attention-deficit/hyperactivity disorder: An atypical electrophysiological group. Psychiatry Research, 103, 205-218.CrossRefPubMedGoogle Scholar
  16. Ernst, M., Zametkin, A. J., Matochik, J. A., Liebenauer, L. Fitzgerald, G. A., & Cohen, R. M. (1994). Effects of intravenous dextroamphetamine on brain metabolism in adults with attention-deficit/hyperactivity disorder (ADHD): Preliminary findings. Psychopharmacology Bulletin, 30, 219-225.PubMedGoogle Scholar
  17. Greenberg, L. M. (1996). T.O.V.A. continuous performance test manual. Los Alamitos, CA: Universal Attention Disorders.Google Scholar
  18. Hinshaw, S. P. (1992). Externalizing behavior problems and academic underachievement in childhood and adolescence: Causal relationships and underlying mechanisms. Psychological Bulletin, 111, 127-155.CrossRefPubMedGoogle Scholar
  19. Hynd, G. W., Hern, K. L., Novey, E. S., Eliopulos, D., Marshall, R., Gonzalex, J. J., et al. (1993). Attention-deficit hyperactivity disorder and asymmetry of the caudate nucleus. Journal of Child Neurology, 8, 339-357.CrossRefPubMedGoogle Scholar
  20. Jensen, P. S., Bhatara, V. S., Vitiello, B., Hoagwood, K., Feil, M., & Burke, L. B. (1999). Psychoactive medication prescribing practices for U.S. children: Gaps between research and clinical practice. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 557-565.PubMedGoogle Scholar
  21. Kaiser, D. A., & Othmer, S. (2000). Effect of neurofeedback on variables of attention in a large multi-center trial. Journal of Neurotherapy, 4, 5-15.CrossRefGoogle Scholar
  22. Linden, M., Habib, T., & Radojevic, J. (1996). A controlled study of the effects ofEEGbiofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback and Self Regulation, 2, 35-49.CrossRefGoogle Scholar
  23. Lubar, J. F. (1995). Neurofeedback treatment of attention-deficit disorders. In M. S. Schwartz (Ed.), Biofeedback: A practitioner's guide (2nd ed., pp. 493-522). New York: Guilford Press.Google Scholar
  24. Lubar, J. F., & Shouse, M. N. (1976). EEG and behavioral changes in a hyperactive child concurrent with training of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback and Self-Regulation, 1, 293-306.CrossRefPubMedGoogle Scholar
  25. Lubar, J. F., Swartwood, M. O., Swartwood, J. N., & O'Donnell, P. H. (1995). Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings and WISC-R performance. Biofeedback and Self-Regulation, 20,83-99.CrossRefPubMedGoogle Scholar
  26. Lubar, J. F., Swartwood, M. O., Swartwood, J. N., & Timmermann, D. L. (1996). Quantitative EEG and auditory event-related potentials in the evaluation of attention-deficit/hyperactivity disorder: Effects of methylphenidate and implications for neurofeedback training. [Monograph: Assessment of Attention-Deficit/Hyperactivity Disorders]. Journal of Psychoeducational Assessment, 143-204.Google Scholar
  27. Mann, C. A., Lubar, J. F., Zimmerman, A. W., Miller, C. A., & Muenchen, R. A. (1992). Quantitative analysis of EEG in boys with attention-deficit/hyperactivity disorder: Controlled study with clinical implications. Pediatric Neurology, 8, 30-36.CrossRefPubMedGoogle Scholar
  28. Matochik, J. A., Liebenauer, L. L., King, A. C., Szymanski, H. V., Cohen, R. M., & Zametkin, A. J. (1994). Cerebral glucose metabolism in adults with attention deficit hyperactivity disorder after chronic stimulant treatment. American Journal of Psychiatry, 151, 658-664.PubMedGoogle Scholar
  29. McCarney, S. B. (1995). Attention Deficit Disorders Evaluation Scale. Columbia, MO: Hawthorne Press.Google Scholar
  30. Monastra, V. J., Lubar, J. F., & Linden, M. K. (2001). The development of a quantitative electroencephalographic scanning process for attention deficit/hyperactivity disorder: Reliability and validity studies. Neuropsychology, 15, 136-144.CrossRefPubMedGoogle Scholar
  31. Monastra, V. J., Lubar, J. F., Linden, M. K., VanDeusen, P., Green, G., Wing, et al. (1999). Assessing attention deficit hyperactivity disorder via quantitative electroencephalography: An initial validation study. Neuropsychology, 13, 424-433.CrossRefPubMedGoogle Scholar
  32. MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strateties for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073-1086.CrossRefGoogle Scholar
  33. Nash, J. K. (2000). Treatment of attention deficit hyperactivity disorder with neurotherapy. Clinical Electroencephalography, 31, 30-37.PubMedGoogle Scholar
  34. National Institutes of Health. (1998). Consensus statement on the diagnosis and treatment of attention-deficit/hyperactivity disorder. Bethesda, MD: Author.Google Scholar
  35. Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psychosocial treatments for attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 27, 190-205.CrossRefPubMedGoogle Scholar
  36. Pisterman, S., McGrath, P., Firestone, P., & Goodman, J. T. (1989). Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity. Journal of Consulting and Clinical Psychology, 57, 636-643.CrossRefGoogle Scholar
  37. Pollard, S., Ward, E. M., & Barkley, R. A. (1983). The effects of parent training and Ritalin on the parent-child interactions of hyperactive boys. Child and Family Therapy, 5, 51-69.CrossRefGoogle Scholar
  38. Robin, A. L. (1998). Training families with ADHD adolescents. In R. A. Barkley (Ed.), Attention-deficit/hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed., pp. 413-457). New York: Guilford Press.Google Scholar
  39. Rossiter, T. R., & LaVaque, T. J. (1995). A comparison of EEG biofeedback and psychostimulants in treating attention deficit/hyperactivity disorders. Journal of Neurotherapy, 1, 48-59.CrossRefGoogle Scholar
  40. Sanford, J. A., Brown, R. J., & Turner, A. (1996). The Captain's log cognitive training system. Richmond, VA: Braintrain.Google Scholar
  41. Shouse, M. N., & Lubar, J. F. (1979). Operant conditioning of EEG rhythms and Ritalin in the treatment of hyperkinesis. Biofeedback and Self-Regulation, 4, 301-312.CrossRefGoogle Scholar
  42. Spencer, T., Biederman, J., & Wilens, T. (1999). Attention-deficit/hyperactivity disorder and comorbidity. Pediatric Clinics of North America, 46(5), 915-944.CrossRefPubMedGoogle Scholar
  43. Spencer, T., Biederman, J., Wilens, T., Harding, M., O'Donnell, D., & Griffin, S. (1996). Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 409-432.PubMedGoogle Scholar
  44. StatSoft. (1995). Statistica. Tulsa, OK: Author.Google Scholar
  45. Sterman, M. B. (1996). Physiological origins and functional correlates of EEG rhythmic activities: Implications for self-regulation. Biofeedback and Self-Regulation, 21, 3-33.CrossRefPubMedGoogle Scholar
  46. Swanson, J. M., McBurnett, K., Wigal, T., Pfiffner, L. J., Williams, L., Christian, D. L., et al. (1993). The effect of stimulant medication on children with attention deficit disorder: A "reviewof reviews." Exceptional Children, 60, 154-162.Google Scholar
  47. Tansey, M. A. (1993). Ten-year stability of EEG biofeedback results for a hyperactive boy who failed the fourth grade perceptually impaired class. Biofeedback and Self-Regulation, 18, 33.CrossRefPubMedGoogle Scholar
  48. Thompson, L., & Thompson, M. (1998). Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Applied Psychophysiology and Biofeedback, 23, 243-263.CrossRefPubMedGoogle Scholar
  49. Zametkin, A. J., Nordahl, T. E., Gross, M., King, A. C., Semple, W. E., Rumsey, J., et al. (1990). Cerebral glucose metabolism in adults with hyperactivity of childhood onset. New England Journal of Medicine, 323, 1361-1366.PubMedCrossRefGoogle Scholar
  50. Zametkin, A. J., & Rapoport, J. L. (1987). Noradrenergic hypothesis of attention deficit disorder with hyperactivity: A critical review. In H. V. Metsler (Ed.), Psychopharmacology: The third generation of progress (pp. 837-842). New York: Raven Press.Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Vincent J. Monastra
    • 1
  • Donna M. Monastra
    • 1
  • Susan George
    • 1
  1. 1.FPI Attention Disorders ClinicEndicott

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