Do Comorbid Oppositional Symptoms Predict ADHD Behavioral Treatment Outcomes?

• Published in: Child psychiatry and human development 2019-12, Vol.50 (6), p.918-926
• Main Authors: Elkins, Sara R., Bond, Mark A., Curtis, David F.
• Format: Article
• Language: English
• Subjects: Attention Deficit and Disruptive Behavior Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - physiopathology; Attention Deficit and Disruptive Behavior Disorders - therapy; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - physiopathology; Attention Deficit Disorder with Hyperactivity - therapy; Attention deficit hyperactivity disorder; Behavior modification; Behavioral Science and Psychology; Child; Child & adolescent psychiatry; Child and School Psychology; Childhood; Children; Clinical outcomes; Comorbidity; Education, Nonprofessional - methods; Family Therapy - methods; Female; Humans; Intervention; Male; Management development programmes; Oppositional defiant disorder; Original Article; Outcome Assessment, Health Care; Parent management training; Parenthood education; Parents - education; Psychiatry; Psychology; Skill development; Teachers
• ISSN: 0009-398X; 1573-3327
• DOI: 10.1007/s10578-019-00894-5

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.