Treatment effectiveness of combined medication/behavioural treatment with chinese ADHD children in routine practice.
ABSTRACT The effectiveness of a combined methylphenidate/behavioural treatment (BT) versus methylphenidate-only for Chinese children with Attention-Deficit/Hyperactivity Disorder (ADHD) was tested in routine clinical practice in Hong Kong.
A randomized group comparison design was adopted with two treatment conditions (methylphenidate-only; methylphenidate/BT), which lasted for 6 months. There were four assessment time points (pre-treatment, post-treatment, and 6-month and 12-month follow-ups), using the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviours (SWAN) Rating Scale. Parental attitude toward different treatment options of ADHD was also assessed at pre-treatment and post-treatment. Participants included 90 Chinese ADHD children (mean age=8 years, SD=.95).
The combination of BT and a low-dose methylphenidate was significantly more effective than methylphenidate-only in reducing ADHD and ODD symptoms at post-treatment. At follow-ups, the benefits of the combined treatment were maintained, while the methylphenidate-only group caught up in improvement in ADHD symptoms. Parents in both treatment conditions showed improved attitude toward medication after the 6-month treatment phase, while their attitude toward BT was positive all along.
This study supported the added benefits of BT, on top of medication, for Chinese ADHD children in routine practice with treatments conducted by regular medical and paramedical staffs.
- SourceAvailable from: Peter S Jensen[show abstract] [hide abstract]
ABSTRACT: ObjectivesTo develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA).MethodEnd-of-treatment status was summarized by averaging the parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms on the Swanson, Nolan, and Pelham, version IV (SNAP-IV) scale, and low symptom-severity (“Just a Little”) on this continuous measure was set as a clinical cutoff to form a categorical outcome measure reflecting successful treatment. Three orthogonal comparisons of the treatment groups (combined treatment [Comb], medication management [MedMgt], behavioral treatment [Beh], and community comparison [CC]) evaluated hypotheses about the MTA medication algorithm (“Comb + MedMgt versus Beh + CC”), multimodality superiority (“Comb versus MedMgt”), and psychosocial substitution (“Beh versus CC”).ResultsThe summary of SNAP-IV ratings across sources and domains increased the precision of measurement by 30%. The secondary analyses of group differences in success rates (Comb = 68%; MedMgt = 56%; Beh = 34%; CC = 25%) confirmed the large effect of the MTA medication algorithm and a smaller effect of multimodality superiority, which was now statistically significant (p < .05). The psychosocial substitution effect remained negligible and nonsignificant.ConclusionThese secondary analyses confirm the primary findings and clarify clinical decisions about the choice between multimodal and unimodal treatment with medication.Journal of the American Academy of Child & Adolescent Psychiatry 02/2001; · 6.97 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Utilizing a double-blind, placebo design, the effects of a high (0.8 mg/kg) and a low (0.4 mg/kg) dose of methylphenidate alone and in combination with behavioral parent training plus child self-control instruction were evaluated with 96 attention deficit hyperactivity disorder children. No evidence of the superiority of the combined conditions relative to medication alone was found. Some limited support was found for the hypothesis that the effects of a high dose of psychostimulant medication could be achieved by combining the low dose with a behavioral intervention. The importance of the latter finding is highlighted by the fact that both the benefits and untoward effects of the psychostimulants appear to increase with the dose.Journal of the American Academy of Child & Adolescent Psychiatry 04/1991; 30(2):233-40. · 6.97 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Within- and between-nations differences in norms for experiencing emotions were analyzed in a cross-cultural study with 1,846 respondents from 2 individualistic (United States, Australia) and 2 collectivistic (China, Taiwan) countries. A multigroup latent class analysis revealed that there were both universal and culture-specific types of norms for experiencing emotions. Moreover, strong intranational variability in norms for affect could be detected, particularly for collectivistic nations. Unexpectedly, individualistic nations were most uniform in norms, particularly with regard to pleasant affect. Individualistic and collectivistic nations differed most strongly in norms for self-reflective emotions (e.g., pride and guilt). Norms for emotions were related to emotional experiences within nations. Furthermore, there were strong national differences in reported emotional experiences, even when norms were held constant.06/2009: pages 169-202;