title: Reports of Perceived Adverse Events of Stimulant Medication on Cognition, Motivation, and Mood: Qualitative Investigation and the Generation of Items for the Medication and Cognition Rating Scale.
abstract: There is no questionnaire to specifically monitor perceived adverse events of methylphenidate (MPH) on cognition, motivation, and mood. The current study therefore had two goals. First, to harvest accounts of such putative events from transcripts of interviews in samples enriched for such potential experiences. Second, to use the derived data to generate items for a new questionnaire that can be used for monitoring such events in medication trials or routine clinical care.
  
  
  
  Following a literature search aimed at identifying associations between MPH and cognition and/or motivation, a qualitative semistructured interview was designed to focus specifically on the domains of cognition (i.e., reasoning, depth/breadth of thinking, intellectual capacity, and creativity) and motivation (i.e., drive, effort, and attitudes toward rewards/incentives). Interviews were conducted with 45 participants drawn from the following four groups: (a) clinicians, child and adolescent psychiatrists, and pediatricians specializing in attention-deficit/hyperactivity disorder (ADHD) (n = 15); (2) teachers, with experience of teaching at least 10 medicated children with ADHD (n = 10); (3) parents of children with ADHD (n = 8) treated with MPH; and (4) adolescents/adults with ADHD (n = 12). Purposeful sampling was used to selectively recruit ADHD participants whose histories suggested a degree of vulnerability to MPH adverse events. Data were analyzed using a deductive approach to content analysis.
  
  
  
  While we probed purposefully for cognitive and motivational adverse events, a third domain, related to mood, emerged from the reports. Therefore, three domains, each with a number of subdomains, were identified from the interview accounts: (i) Cognition (six subdomains; attention/concentration, changes in thinking, reduced creativity, sensory overload, memory, slower processing speed); (ii) motivation (four subdomains; loss of intrinsic motivation for goal-directed activities, external locus of control, lack of effort/engagement in daily tasks, increased focus on incentives); and (iii) mood (three subdomains; dampening of spontaneity/flat affect, mood dysregulation, increased anxiety/edginess). On the basis of these reports, 34 items were specified and incorporated into a prototype questionnaire, which was piloted and refined on the basis of field-testing.
  
  
  
  Items were identified that capture potential/perceived cognitive, motivational, and mood-related adverse events of MPH. The items generated will allow us to further develop and psychometrically examine their prevalence, and the extent to which they are associated with medication adherence, treatment outcome, impairment, and other reported adverse events (e.g., loss of appetite/cardiovascular effects).
authors.affiliation: 1 Academic Unit of Psychology, University of Southampton , Southampton, United Kingdom .
authors.forename: Hanna
authors.initials: H
authors.lastname: Kovshoff
authors.affiliation: 2 Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany .
authors.forename: Tobias
authors.initials: T
authors.lastname: Banaschewski
authors.affiliation: 3 Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience & Karakter Child and Adolescent Psychiatry University Centre , Nijmegen, the Netherlands .
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.affiliation: 4 Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Science, University of Cagliari, Italy .
authors.forename: Sara
authors.initials: S
authors.lastname: Carucci
authors.affiliation: 5 Division of Neuroscience, School of Medicine, University of Dundee , Dundee, United Kingdom .|6 Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Australia .
authors.forename: David
authors.initials: D
authors.lastname: Coghill
authors.affiliation: 7 Department of Neurosciences, Research Group Psychiatry , KU Leuven, Belgium .
authors.forename: Marina
authors.initials: M
authors.lastname: Danckaerts
authors.affiliation: 8 Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Germany .
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Dittmann
authors.affiliation: 9 INSERM U1178, University Paris-Sud, University Paris-Descartes , AP-HP, Paris, France .
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.affiliation: 1 Academic Unit of Psychology, University of Southampton , Southampton, United Kingdom .
authors.forename: Dina Gojkovic
authors.initials: DG
authors.lastname: Grimshaw
authors.affiliation: 10 Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham , United Kingdom .
authors.forename: Chris
authors.initials: C
authors.lastname: Hollis
authors.affiliation: 11 Tayside Clinical Trials Unit, University of Dundee , Dundee, United Kingdom .
authors.forename: Sarah
authors.initials: S
authors.lastname: Inglis
authors.affiliation: 12 Clinical Child Neuropsychology, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH Aachen , Aachen, Germany .|13 Institute of Neuroscience & Medicine (INM3), Research Centre Juelich, Germany .
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
authors.affiliation: 10 Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham , United Kingdom .
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Liddle
authors.affiliation: 14 School of Pharmacy, University College Cork , Cork, Ireland .
authors.forename: Suzanne
authors.initials: S
authors.lastname: McCarthy
authors.affiliation: 15 Vadaskert Child and Adolescent Psychiatric Hospital , Budapest, Hungary .
authors.forename: Peter
authors.initials: P
authors.lastname: Nagy
authors.affiliation: 1 Academic Unit of Psychology, University of Southampton , Southampton, United Kingdom .
authors.forename: Margaret
authors.initials: M
authors.lastname: Thompson
authors.affiliation: 16 UCL School of Pharmacy , London, United Kingdom .|17 Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine University of Hong Kong , China .
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
authors.affiliation: 4 Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Science, University of Cagliari, Italy .
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zuddas
authors.affiliation: 1 Academic Unit of Psychology, University of Southampton , Southampton, United Kingdom .|18 Department of Experimental Clinical & Health Psychology, Ghent University , Ghent, Belgium .
authors.forename: Edmund J S
authors.initials: EJ
authors.lastname: Sonuga-Barke
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003071:Cognition / Q000187:drug effects; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects*; D009042:Motivation / Q000187:drug effects; D010865:Pilot Projects; D011795:Surveys and Questionnaires
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate