title: Socioeconomic status as a moderator of ADHD treatment outcomes.
abstract: OBJECTIVE
  To explore whether socioeconomic status (SES) variables moderate treatment response of attention-deficit/hyperactivity disorder (ADHD) to medication management (MedMgt), behavioral treatment (Beh), combined intervention (Comb), and routine community care (CC).
  
  
  METHODS
  The MTA Cooperative Group's intent-to-treat (ITT) analyses were repeated, covarying for composite Hollingshead SES, education, occupation, income, and marital status.
  
  
  RESULTS
  Individual SES variables were more informative than the composite Hollingshead Index. Treatment response of children from less educated households paralleled ITT outcomes: no significant difference was found between Comb and MedMgt (both better than Beh and CC) for core ADHD symptoms. However, children from more educated families showed superior reduction of ADHD symptoms with Comb. For oppositional-aggressive symptoms, children from blue-collar, lower SES households benefited most from Comb, whereas those from white-collar, higher SES homes generally showed no differential treatment response. Household income and marital status failed to influence outcomes. Controlling for treatment attendance attenuated the moderating effects of the SES variables only for MedMgt.
  
  
  CONCLUSIONS
  Investigators are encouraged to use independent SES variables for maximal explanation of SES effects. Clinicians should prioritize target symptoms and consider the mediating role of treatment adherence when determining an ADHD patient's optimal intervention plan.
authors.affiliation: Department of Psychology, St. Johns University, Jamaica, NY 11439, USA. rriep477@stjohns.edu
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rieppi
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Greenhill
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Ford
authors.forename: Shirley
authors.initials: S
authors.lastname: Chuang
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.forename: Mark
authors.initials: M
authors.lastname: Davies
authors.forename: Howard B
authors.initials: HB
authors.lastname: Abikoff
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.forename: C Keith
authors.initials: CK
authors.lastname: Conners
authors.forename: Glen R
authors.initials: GR
authors.lastname: Elliott
authors.forename: Lily
authors.initials: L
authors.lastname: Hechtman
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hinshaw
authors.forename: Betsy
authors.initials: B
authors.lastname: Hoza
authors.forename: Peter S
authors.initials: PS
authors.lastname: Jensen
authors.forename: Helena C
authors.initials: HC
authors.lastname: Kraemer
authors.forename: John S
authors.initials: JS
authors.lastname: March
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Newcorn
authors.forename: William E
authors.initials: WE
authors.lastname: Pelham
authors.forename: Joanne B
authors.initials: JB
authors.lastname: Severe
authors.forename: James M
authors.initials: JM
authors.lastname: Swanson
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
authors.forename: Karen C
authors.initials: KC
authors.lastname: Wells
authors.forename: Timothy
authors.initials: T
authors.lastname: Wigal
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011897:Random Allocation; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome