Moderators and mediators of treatment outcome for youth with ADHD: understanding for whom and how interventions work
Abstract
OBJECTIVE: To present data on moderators and mediators of treatment response from the Multimodal Treatment Study of Children With ADHD (MTA). METHODS: Moderator variables (baseline factors that define subgroups with greater vs lesser intervention response) and mediator variables (factors occurring during treatment that explain how interventions "work") are described with specific application to the outcomes of the MTA Study. RESULTS: Key moderator variables (comorbid anxiety disorder, public assistance, severity of attention-deficit/hyperactivity disorder, parental depressive symptomatology, IQ) and mediator processes (negative/ineffective parental discipline) are reviewed. CONCLUSIONS: Treatment research in the future should explicitly consider the exploration of moderator and mediator variables, which can greatly aid the explanatory power of clinical trials and specify the critical next steps for intervention research.
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Several studies in children found that ADHD outcomes of pharmacological treatment were similar among those with and without concurrent CD.
“and several studies in children found that ADHD outcomes of pharmacological treatment were similar among those with and without concurrent CD [82,83,84].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [84]
Evidence suggests that decreased negative parental discipline mediates the effect of ADHD treatment (e.g., medication and behavior therapy) on teacher-rated ADHD behavior.
“Evidence suggests that decreased negative parental discipline mediates the effect of ADHD treatment (e.g., medication and behavior therapy) on teacher-rated ADHD behavior [91].”
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- Authors
- Hinshaw, S. P.
- Affiliations
- University of California, Berkeley (US)
- Corresponding author
- Hinshaw, S. P.
- ORCID
- Hinshaw, S. P.
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-05-28
- Volume
- 32
- Issue
- 6
- Pages
- 664-675
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- OpenAlex
- W2106436734
- Cited by
- 141
- References
- 34
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 4 · 2022: 8 · 2021: 10 · 2020: 6 · 2019: 7 · 2018: 9 · 2017: 6 · 2016: 11 · 2015: 8 · 2014: 4 · 2013: 12 · 2012: 15
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R01 50461, N01 12009, R01 45064)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, youth, treatment outcomes, moderators, mediators, comorbid anxiety disorders, social assistance, parental depressive symptoms, IQ, parental discipline, intervention response
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Clinical Trials as Topic, Humans, Research Design, Risk Factors, Comorbidity, Epidemiologic Factors, Epidemiologic Measurements, Treatment Outcome
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