Anger control in response to verbal provocation: Effects of stimulant medication for boys with ADHD

Although stimulant medication reduces hyperactive children's aggression in naturalistic settings, stimulant effects on anger control have not been demonstrated. We therefore assessed the role of methylphenidate in enhancing response to verbal provocation from familiar peers and from role-playing adults. Twenty-four boys with attention deficithyperactivity disorder (ADHD), aged 6–12, received small-group cognitivebehavioral intervention in anger management skills. During posttraining assessments, the children were randomly assigned to placebo versus. 6 mg/kg of methylphenidate. In the peer provocations, methylphenidate enhanced self-control, decreased physical retaliation, and marginally increased the display of coping strategies. Medication and prompting were minimally beneficial in the delayed, adult-administered generalization assessments. Among the issues discussed are (a) differences between peer and adult provocation and (b) the roles of medication dosage and multimodality intervention for promoting socially competent behavior in children with ADHD.We gratefully acknowledge the Fernald Child Study Center of the University of California, Los Angeles, which provided major support for this research. In addition, we acknowledge the dedication of the small-group trainers, too numerous to mention individually, who led the intervention procedures for the children, and the experimenters who performed the individual provocation assessments. The careful behavior observations of Linda Douglas, Rebecca Eiser, Deborah Gibson, Mike Glenn, Melissa Michaelson, Jon Rafuse, Fauzia Simjee, Leslie Sherman, and Madelin Tundidor were central to the study. Finally, our colleagues Barbara Henker and Carol K. Whalen were instrumental in facilitating all aspects of this investigation.