Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA

In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a behavioral inhibition deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.     

Towards an understanding of performative allyship: Definition,antecedents and consequences

Adding rainbow filters in support of LGBTQ+ movements or changing profile pictures to black squares to show support for the BlackLivesMatter movement have become common contemporary expressions of solidarity. However, these actions are often criticized as being ‘performative’ and falling short of genuine social change. Despite its popularity, little is known about what performative allyship is and what its pitfalls or potential benefits may be. We review the existing psychological literature on intergroup relations and allyship to provide a definition and framework for studying performative allyship and its consequences for social change. We propose that the term performative allyship refers to easy and costless actions that often do not challenge the status quo and are motivated primarily by the desire to accrue personal benefits. The literature suggests that engaging in performative allyship may have a negative impact on the physical and mental well-being of disadvantaged groups, but also on allies. We discuss negative and some positive consequences of engagement in performative allyship on disadvantaged groups, allies and society at large and provide directions for future research.     

Semi-Post algebras

In this paper, semi-Post algebras are introduced and investigated. The generalized Post algebras are subcases of semi-Post algebras. The so called primitive Post constants constitute an arbitrary partially ordered set, not necessarily connected as in the case of the generalized Post algebras examined in [3]. By this generalization, semi-Post products can be defined. It is also shown that the class of all semi-Post algebras is closed under these products and that every semi-Post algebra is a semi-Post product of some generalized Post algebras.     

Mismatching the opponent's offers in negotiation

Mismatching in negotiation involves responding with high demands to the opponent's low demands and with low demands to the opponent's high demands. Prior research has shown that the opponent's demands are often mismatched but that this effect is attenuated when information is available about the outcomes achieved by the opponent from the available alternatives. The present research showed that mismatching was also attenuated when the negotiator knew the location of the opponent's limit (the alternative beyond which the opponent would not concede). Two new interpretations of the attenuation effect were suggested on the basis of this finding. In addition, women were found to engage in more mismatching than men, being particularly likely to exploit a soft opponent.     

An Evaluation of the Concurrent Validity of the Porteous Checklist Using a Structured Interview Schedule

The concurrent validity of the Porteous Problem Checklist was examined by comparing the responses adolescents made to checklist items with their responses to similar or identical questions posed in an individual interview setting. The checklist was administered to 135 adolescents in three secondary schools. The pupils were then interviewed, using a structured interview schedule which focused on specific areas of concern to adolescents. The results supported the validity of the checklist as a means of quantifying and describing adolescent problems, and as a useful instrument in adolescent counselling and assessment.     

Extension of Feldt's approach to testing homogeneity of coefficients of reliability

Limitations and extensions of Feldt's approach to testing the equality of Cronbach's alpha coefficients in independent and matched samples are discussed. In particular, this approach is used to test equality of intraclass correlation coefficients.This work was supported by the National Institute of Mental Health Specialized Research Center Grant # MH-30854.     

Anxiety as a Predictor and Outcome Variable in the Multimodal Treatment Study of Children with ADHD (MTA)

Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly.     

Negative Halo Effects in Parent Ratings of ADHD,ODD, and CD

Attention-deficit/hyperactivity disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) are highly comorbid, with symptoms that share some similarities. The evidence-based diagnostic process for these disorders includes ratings from adults in the child’s life to assess behavior across settings, so it is important to understand how these raters think about potentially overlapping symptoms. Researchers have identified negative halo effects in ratings of ADHD and ODD symptoms, but ratings of CD have not been examined in these prior studies. Thus, the current study extended past research to examine negative halo effects in parent ratings of the predominantly hyperactive-impulsive presentation of ADHD (i.e., ADHD/HI), ODD, and CD. Parent participants read one of four vignettes that portrayed an 11-year-old boy displaying symptoms of ADHD/HI, ODD, CD, or typical development, and then completed a disruptive behavior scale. The general trend we found was that the presence of a relatively more severe disorder (i.e., CD) artificially inflated ratings of - or showed a negative halo effect for - the relatively less severe disorder (i.e., ADHD/HI), but with some nuance as discussed in the paper. These findings explain and validate how important it is that clinicians conduct evidence-based psychological assessments to decrease the chance of misdiagnosis.