title: A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents.
abstract: To test cognitive behavioral therapy (CBT) for persistent attention-deficit hyperactivity disorder (ADHD) symptoms in a sample of medication-treated adolescents.
  
  
  
  Forty-six adolescents (ages 14-18), with clinically significant ADHD symptoms despite stable medication treatment were randomly assigned to receive CBT for ADHD or wait list control in a cross-over design. Twenty-four were randomized to CBT, 22 to wait list, and 15 crossed-over from wait list to CBT. A blind independent evaluator (IE) rated symptom severity on the ADHD Current Symptom Scale, by adolescent and parent report, and rated each subject using the Clinical Global Impression Severity Scale (CGI), a global measure of distress and impairment. These assessments were performed at baseline, 4-months (post-CBT or post wait list), and 8-months (post-treatment for those originally assigned to the wait list condition and 4-month follow-up for those originally assigned to CBT).
  
  
  
  http://clinicaltrials.gov/show/NCT01019252.
  
  
  
  Using all available data, mixed effects modeling, and pooling for the wait list cross-over, participants who received CBT received a mean score 10.93 lower on the IE-rated parent assessment of symptom severity (95% CI: -12.93, -8.93; p < .0001), 5.24 lower on the IE-rated adolescent assessment of symptom severity (95% CI: -7.21, -3.28; p < .0001), and 1.17 lower IE-rated CGI (95% CI: -1.39, -.94; p < .0001). Results were consistent across 100 multiple imputations (all p < .0001). There was a greater proportion of responders after CBT by parent (50% vs. 18%, p = .00) and adolescent (58% vs. 18% p = .02) report.
  
  
  
  This study demonstrates initial efficacy of CBT for adolescents with ADHD who continued to exhibit persistent symptoms despite medications.
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Sprich
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. ssafren@miami.edu.|Harvard Medical School, Boston, MA, USA. ssafren@miami.edu.|Department of Psychology, University of Miami, Miami, FL, USA. ssafren@miami.edu.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Finkelstein
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jocelyn E
authors.initials: JE
authors.lastname: Remmert
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Hammerness
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index
keywords: 
  ADHD
  ; adolescence; behavior therapy; cognitive therapy