Cited by 371Attention Deficit Hyperactivity DisorderBehavioral and Psychological StudiesObsessive-Compulsive Spectrum Disorders

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Efficacy of Meta-Cognitive Therapy for Adult ADHD

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Solanto, Mary V., Marks, David J., Wasserstein, Jeanette, Mitchell, Katherine, Abikoff, Howard, Alvir, Jose Ma. J., Kofman, Michele D.·2010·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2009.09081123PMC PMC3633586

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Abstract

OBJECTIVE: The authors investigated the efficacy of a 12-week manualized meta-cognitive therapy group intervention designed to enhance time management, organization, and planning in adults with attention deficit hyperactivity disorder (ADHD). METHOD: Eighty-eight clinically referred adults who met DSM-IV criteria for ADHD according to clinical and structured diagnostic interviews and standardized questionnaires were stratified by ADHD medication use and otherwise randomly assigned to receive meta-cognitive therapy or supportive psychotherapy in a group modality. Meta-cognitive therapy uses cognitive-behavioral principles and methods to impart skills and strategies in time management, organization, and planning and to target depressogenic and anxiogenic cognitions that undermine effective self-management. The supportive therapy condition controlled for nonspecific aspects of treatment by providing support while avoiding discussion of cognitive-behavioral strategies. Therapeutic response was assessed by an independent (blind) evaluator via structured interview before and after treatment as well as by self-report and collateral informant behavioral ratings. RESULTS: General linear models comparing change from baseline between treatments revealed statistically significant effects for self-report, collateral report, and independent evaluator ratings of DSM-IV inattention symptoms. In dichotomous indices of therapeutic response, a significantly greater proportion of members of the meta-cognitive therapy group demonstrated improvement compared with members of the supportive therapy group. Logistic regression examining group differences in operationally defined response (controlling for baseline ADHD severity) revealed a robust effect of treatment group (odds ratio=5.41; 95% CI=1.77-16.55). CONCLUSIONS: Meta-cognitive therapy yielded significantly greater improvements in dimensional and categorical estimates of severity of ADHD symptoms compared with supportive therapy. These findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention.

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Authors: Solanto, M. V., Marks, D. J., Wasserstein, J., Mitchell, K., Abikoff, H., Alvir, J. M. J., & Kofman, M. D.
Affiliations: Icahn School of Medicine at Mount Sinai (US)
ORCID: Solanto, Mary V.
Marks, David J.
Abikoff, Howard
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2010-08-01
Volume: 167
Issue: 8
Pages: 958-968
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2009.09081123
PMC: PMC3633586
OpenAlex: W2106508714
Cited by: 370
References: 33
Citations by year: 2026: 14 · 2025: 14 · 2024: 11 · 2023: 13 · 2022: 9 · 2021: 22 · 2020: 15 · 2019: 19 · 2018: 18 · 2017: 28 · 2016: 32 · 2015: 34 · 2014: 47 · 2013: 27 · 2012: 34
FWCI: 20.77
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5r34mh071721-03)
National Institute of Mental Health (R34 MH071721, 1R34MH071721)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords: adult ADHD, attention deficit hyperactivity disorder, group therapy, time management, inattentive symptoms, supportive therapy, psychosocial interventions, cognitive behavioral therapy, ADHD medication use, treatment efficacy
MeSH terms: Adult, Attention Deficit Disorder with Hyperactivity, Double-Blind Method, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotherapy, Psychotherapy, Group, Surveys and Questionnaires, Self Care, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders

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Efficacy of Meta-Cognitive Therapy for Adult ADHD

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