Which treatment for whom for ADHD? Moderators of treatment response in the MTA.
Using receiver operating characteristics, the authors examined outcome predictors (variables associated with outcome regardless of treatment) and moderators (variables identifying subgroups with differential treatment effectiveness) in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD; MTA). Treatment response was determined using parent- and teacher-reported ADHD and oppositional defiant symptoms, with levels near or within the normal range indicating excellent response. Among 9 baseline child and family characteristics, none predicted but 3 moderated treatment response. In medication management and combined treatments, parental depressive symptoms and severity of child ADHD were associated with decreased rates of excellent response; when these 2 characteristics were present, below-average child IQ was an additional moderator. No predictors or moderators emerged for behavioral and community comparison treatments. The authors discuss conceptual and clinical implications of research on treatment moderators.
Owens
Elizabeth B
EB
Institute of Human Development, University of California, Berkeley 94720-1690, USA. lizowens@uclink4.berkeley.edu
Hinshaw
Stephen P
SP
Kraemer
Helen C
HC
Arnold
L Eugene
LE
Abikoff
Howard B
HB
Cantwell
Dennis P
DP
Conners
C Keith
CK
Elliott
Glen
G
Greenhill
Laurence L
LL
Hechtman
Lily
L
Hoza
Betsy
B
Jensen
Peter S
PS
March
John S
JS
Newcorn
Jeffrey H
JH
Pelham
William E
WE
Severe
Joanne B
JB
Swanson
James M
JM
Vitiello
Benedetto
B
Wells
Karen C
KC
Wigal
Timothy
T
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011897:Random Allocation; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants