Keith Mcburnett

Keith Mcburnett
University of California, San Francisco | UCSF · Department of Psychiatry

PhD

About

142
Publications
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12,142
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Publications

Publications (142)
Article
Full-text available
Objective (1) Evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT) and (2) arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. Method Convened an international Work Group that...
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This study evaluated the factor structure of the scores from a parent rating scale, the Parent Cognitive Error Questionnaire (PCEQ), which measures parents' attributions of child misbehavior and problems. The factor structure of the scores of the PCEQ was examined among 199 children (ages 7-11; mean age: 8.64 years, 58.30% boys, 53.80% White) with...
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Nearly half of all youth with Attention-Deficit Hyperactivity Disorder (ADHD) have at least one parent who also meets criteria for the disorder, and intergenerational ADHD is a significant risk factor for poor outcomes following evidence-based behavioral parent training (BPT) programs. Given that BPT is predicated on consistent parental involvement...
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Objective To determine whether theta/beta-ratio (TBR) electroencephalographic biofeedback (neurofeedback, NF) has a specific effect on attention-deficit/hyperactivity disorder (ADHD) beyond nonspecific benefit. Method In a 2-site double-blind randomized clinical trial, 144 children age 7-10 with rigorously diagnosed moderate/severe ADHD and theta/...
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Classroom observations have long been considered a necessary component of Attention-Deficit/Hyperactivity Disorder (ADHD) evaluations. Yet, research evaluating the utility of observational ratings in ADHD assessment is limited. This study examined the contributions of the Behavioral Observation of Students in Schools (BOSS) to ADHD assessment by in...
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Attention deficit/hyperactivity disorder–predominantly inattentive presentation (ADHD-I) and specific learning disorder (SLD) are commonly co-occurring conditions. Despite the considerable diagnostic overlap, the effect of SLD comorbidity on outcomes of behavioral interventions for ADHD-I remains critically understudied. The current study examines...
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The present study investigated whether academic, social, emotional, and behavioral factors mediated disparities in teachers' identification of boys and girls from different racial/ethnic backgrounds in need of family-based prevention services. Teachers (n = 157) from regular education classrooms at 17 public elementary schools anonymously nominated...
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This study examined the psychometric properties, convergent validity, and divergent validity of a Japanese translation of Barkley (The Barkley adult ADHD rating scale–IV, Guilford Press, New York, 2011) rating scale for assessing sluggish cognitive tempo (SCT) in adults. In total, 429 Japanese adults participated across three samples: 26 diagnosed...
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Background Tourette's Syndrome (TS) is a childhood‐onset movement disorder marked by the chronic presence of motor and vocal tics. Research shows that tics associated with TS tend to fade in severity for some (but not all) affected youth, though psychiatric comorbidities that commonly accompany TS may be more persistent. The long‐term outcomes of i...
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We conducted a cost-effectiveness analysis (CEA) of two behavioral psychosocial interventions for children with ADHD-inattentive type: Child Life and Attention Skills (CLAS) program and parent-focused treatment (PFT) compared to community-based treatment as usual (TAU). The CEA evaluated cost per ADHD case resolved measured by parent and teacher re...
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The present study investigated whether symptom reduction in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) treated with guanfacine extended release (GXR) can be explained by sedative effects of the medication. Data from four double-blind, randomized, placebo-controlled, phase 3 trials of GXR monotherapy (1-7 mg/day; m...
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Objectives The Collaborative Life Skills (CLS) program is a school-home intervention for students with Attention Deficit Hyperactivity Disorder (ADHD) symptoms and impairment. CLS integrates school, parent, and student treatments followed by booster sessions during a maintenance period into the subsequent school year. The program is delivered by sc...
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We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I). In a randomized controll...
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Neuropsychological functioning underlies behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Children with all forms of ADHD are vulnerable to working memory deficits and children presenting with the inattentive form of ADHD (ADHD-I) appear particularly vulnerable to processing speed deficits. As ADHD-I is the most common form o...
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Objectives: To evaluate effects of atomoxetine versus placebo on sluggish cognitive tempo (SCT) and determine factors affecting improvement of SCT in children with attention-deficit/hyperactivity disorder (ADHD) with dyslexia (ADHD+D) or dyslexia only. Methods: This is a post hoc analysis of a 16-week placebo-controlled, double-blind randomized...
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We examined the effects of parent adherence on child outcomes in two treatment strategies for the Predominantly Inattentive Presentation of attention deficit/hyperactivity disorder (ADHD-I): behavioral parent training adapted for ADHD-I (Parent-Focused Therapy [PFT]) and a multicomponent intervention that combined PFT, a child life skills group, an...
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The goal of the study was to examine baseline characteristics-child gender, IQ, age, internalizing problems, symptoms of hyperactivity/impulsivity (HI), oppositional defiant disorder, and sluggish cognitive tempo, and parent income, education, attention deficit/hyperactivity disorder (ADHD) severity, and anxiety/depression (A/D)-associated with res...
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We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I) and whether parenting improvements mediate child outcomes. We analyzed data from a randomized clinical trial investigating the efficacy of a multicomponent psycho...
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We investigate the Depression-Distortion Hypothesis in a sample of 199 school-aged children with ADHD-Predominantly Inattentive presentation (ADHD-I) by examining relations and cross-sectional mediational pathways between parental characteristics (i.e., levels of parental depressive and ADHD symptoms) and parental ratings of child problem behavior...
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Objectives: Evaluated the effects of atomoxetine on the reading abilities of children with dyslexia only or attention-deficit/hyperactivity disorder (ADHD) and comorbid dyslexia. Methods: Children aged 10-16 years (N = 209) met Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria for dyslexia onl...
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Objective: This study evaluated the efficacy of a novel psychosocial intervention (Collaborative Life Skills [CLS]) for primary-school students with attention-deficit/hyperactivity disorder (ADHD) symptoms. CLS is a 12-week program consisting of integrated school, parent, and student treatments delivered by school-based mental health providers. Us...
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OBJECTIVE To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. METHOD Electronic databases were searched through...
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Introduction Guanfacine extended release (GXR) is a non-stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). Objective To separate efficacy and sedative treatment-emergent adverse events (TEAEs) associated with GXR in four randomized, controlled trials in children (6–12 years) and adolescents (13–17 years) with ADHD. Methods S...
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Objectives: Much of what is currently known about the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) is based on samples of children with ADHD combined type, and no study to date has examined the association between sluggish cognitive tempo (SCT) and sleep functioning in children diagnosed with ADHD. Accordingly...
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The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with attention-deficit/hyperactivity disorder, Predominantly Inattentive Type (ADHD-I). Participants included 199...
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Objective: In this post hoc analysis, we assessed whether guanfacine extended-release (GXR) adjunctive to a psychostimulant resulted in greater response and remission rates than placebo + psychostimulant in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: In this 9-week, double-blind, placebo-controlled dose...
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Objective: The purpose of this study was to assess the effect of guanfacine extended release (GXR) adjunctive to a psychostimulant on oppositional symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: A multicenter, double-blind, placebo-controlled dose-optimization study of GXR (1-4 mg/d) or placebo...
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Objective: This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with attention-deficit/hyperactivity disorder-inattentive type (ADHD-I). Method: In a 2-site randomized controlled trial, 199 children (ages 7-11 years) were randomiz...
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To determine if ADHD/ODD symptoms are better represented by a bifactor model of disruptive behavior [general disruptive behavior factor along with specific inattention (IN), specific hyperactivity/impulsivity (HI), and specific oppositional defiant disorder (ODD) factors] than an ADHD-IN, ADHD-HI, and ODD three-factor model. Mothers' and fathers' r...
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Clinical psychology training for research-oriented scientist-practitioners tends to have a gap in research training during the predoctoral internship year. In 1982, the Clinical Psychology Training Program (CPTP) at the University of California, San Francisco (UCSF) began a 2-year clinical and clinical research training program combining an America...
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There has recently been a resurgence of interest in Sluggish Cognitive Tempo (SCT) as an important construct in the field of abnormal child psychology. Characterized by drowsiness, daydreaming, lethargy, mental confusion, and slowed thinking/behavior, SCT has primarily been studied as a feature of Attention-Deficit/Hyperactivity Disorder (ADHD), an...
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We evaluated the latent structure and validity of an expanded pool of Sluggish Cognitive Tempo (SCT) items. An experimental rating scale with 44 candidate SCT items was administered to parents and teachers of 165 children in grades 2-5 (ages 7-11) recruited for a randomized clinical trial of a psychosocial intervention for Attention-Deficit/Hyperac...
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Objective: The purpose of this study was to evaluate atomoxetine treatment effects in attention-deficit/hyperactivity disorder (ADHD-only), attention-deficit/hyperactivity disorder with comorbid dyslexia (ADHD+D), or dyslexia only on ADHD core symptoms and on sluggish cognitive tempo (SCT), working memory, life performance, and self-concept. Meth...
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Guanfacine extended release (GXR) has reported efficacy for the treatment of attention-deficit/hyperactivity disorder (ADHD) as monotherapy and adjunctive therapy to psychostimulant medications. The objective of this article was to review the efficacy, safety profile, mechanism of action, pharmacokinetics, and appropriate dosing of GXR in children...
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Objective: To examine efficacy and safety of adjunctive guanfacine extended release (GXR) on morning and evening ADHD symptoms using the Conners' Global Index-Parent (CGI-P) and Before-School Functioning Questionnaire (BSFQ). Method: Participants 6 to 17 years with ADHD ( N = 461) and suboptimal psychostimulant response were maintained on curren...
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The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school-home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fif...
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Despite distinct peer difficulties, less is known about the peer functioning of children with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I) in comparison to the peer functioning of children with ADHD combined type. Our purpose was to examine whether child sex moderated the relations between negative social...
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This article reviews the current use of stimulants in adolescents. The evidence base for treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescents is meager compared with that of ADHD in children, and much recent research of older populations with ADHD has been directed toward adults rather than adolescents. The structure of psych...
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Objective: Additional treatments with persisting benefit are needed for ADHD. Because ADHD often shows excessive theta electroencephalogram (EEG) power, low beta, and excessive theta-beta ratio (TBR), a promising treatment is neurofeedback (NF) downtraining TBR. Although several nonblind randomized clinical trials (RCTs) show a medium-large benefit...
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This study evaluated educationally relevant outcomes from a newly developed collaborative school-home intervention (Collaborative Life Skills Program [CLS]) for youth with attention and/or behavior problems. Participants included 17 girls and 40 boys in second through fifth grades (mean age = 8.1 years) from diverse ethnic backgrounds. CLS was impl...
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This study examined the validity of the sluggish cognitive tempo (SCT) symptom dimension in children. Ten symptom domains were used to define SCT (i.e., (1) daydreams; (2) attention fluctuates; (3) absent-minded; (4) loses train of thought; (5) easily confused; (6) seems drowsy; (7) thinking is slow; (8) slow-moving; (9) low initiative; and (10) ea...
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This chapter reviews what is currently known about the developmental precursors to conduct disorder (CD). Specifically, it summarizes current findings on the potential developmental relations between attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) on the one hand, and CD on the other hand. Although ODD appear...
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The purpose of this review is to discuss issues in the prevention of serious conduct problems among children and adolescents with attention deficit/hyperactivity disorder (ADHD). The authors began by reviewing research on the common genetic and environmental etiological factors, developmental trajectories, characteristics and impairments associated...
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The number of publications on attention deficit hyperactivity disorder (ADHD) has increased sharply over the last 10 years, with more than 700 likely for 2012. Consequently, it is difficult to stay apprised of this literature. This issue of Neurotherapeutics includes 12 comprehensive reviews of topics related to ADHD.
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Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for attention deficit/hyperactivity disorder (ADHD) specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-...
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This study examined the latent structure and validity of inattention, hyperactivity-impulsivity, and sluggish cognitive tempo (SCT) symptomatology. We evaluated mother and teacher ratings of ADHD and SCT symptoms in 140 Puerto Rican children (55.7% males), ages 6 to 11 years, via factor and regression analyses. A three-factor model (inattention, hy...
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In an attempt to address the gaps in evidence-based school services for ADHD, we adapted a research-supported clinic-based behavioral intervention for ADHD for delivery by school-based mental health professionals within an urban public school district. We applied a collaborative iterative development process in which we trained existing school-base...
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Prior research has established links between child social functioning and both parenting and child ADHD severity; however, research examining the way that these variables work together is lacking. The current article aims to test three possible models (main effects, mediation, and moderation) by which ADHD severity and positive and negative parenti...
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Introduction: Attention deficit/hyperactivity disorder (ADHD) is estimated to affect 4-5% of adults. Impairment across multiple domains of daily living can be mild to serious. OROS methylphenidate (MPH) was evaluated in two large adult clinical trials, and in 2008 it was approved in the USA to treat ADHD in adults aged up to 65 years. Areas cover...
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Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder with significant functional impairment. ADHD is frequently complicated by oppositional symptoms, which are difficult to separate from comorbidity with oppositional defiant disorder, conduct disorder, and aggressive symptoms. This review addresses the impact...
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Primary care physicians who treat attention-deficit/hyperactivity disorder (ADHD) may expect to encounter oppositional defiant disorder (ODD) in about half of patients with ADHD. Up to 20% of patients with ADHD may meet criteria for conduct disorder (CD), and a higher percentage will exhibit aggressiveness or other symptoms of CD without meeting fu...
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This study examined the ability of executive functions (EF) to account for the relationship between Attention Deficit Hyperactivity Disorder (ADHD) status and social adjustment as indexed by parent and teacher report and by performance on a standardized observational "chat room" task. Children with the Combined subtype (ADHD-C; n = 23), the Primari...
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Guanfacine is a noradrenergic agonist that is believed to improve symptoms of attention-deficit/hyperactivity disorder (ADHD) through selective actions at alpha2A-adrenoceptors in the prefrontal cortex. A recent double-blind, multicenter trial supports the efficacy and safety of guanfacine extended release (GXR) for pediatric ADHD. This long-term,...
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With this study we assessed the efficacy and safety of an extended-release formulation of guanfacine compared with placebo for the treatment of children and adolescents with attention-deficit/hyperactivity disorder. In this multicenter, double-blind, placebo-controlled, fixed-dosage escalation study, patients aged 6 to 17 years were randomly assign...