Longer term effects of stimulant treatments for Attention-Deficit/Hyperactivity Disorder

Of pharmacological options available for Attention-Deficit/Hyperactivity Disorder (ADHD), stimulant medications are the most studied, the most commonly used, the most effective, and the first-line choice for treatment. Evidence of the short-term efficacy of methylphenidate (MPH) and other stimulants as well as behavioral treatments in the management of symptoms of ADHD is abundant This paper reviews therapeutic trials with a duration or follow-up period of 12 months or more and evaluates the longer term outcomes of available treatments for ADHD. The trials were reported by Ialongo et al. (1993), Horn et al. (1991), Schachar, Tannock, Cunningham, and Corkum (1997), Gillberg et al. (1997), Hechtman and Abikoff (1995), and the National Institute of Mental Health (MTA Cooperative Group, 1999a, 1999b).     

Development of lower extremity kinetics for balance control in infants and young children

Developmental changes in the kinematics and kinetics underlying balance control were studied in 61 children, 9 months to 10 years of age. The children were classified according to developmental milestones as standers; new, intermediate, and advanced walkers; runners-jumpers; hoppers; gallopers; and skippers. The children experienced support-surface translations of varying size and speed. Children with greater locomotor experience withstood larger balance threats without collapsing or stepping. Analyses of scaled trials (perturbations normalized in size to foot length and center of gravity height) revealed that improvement in balance was not related to initial configuration parameters surrounding the task (degree of crouch or lean). Children with advanced locomotor skills had faster recovery times and relatively larger muscle torques than children with less experience. Relative torque-time histories of the more experienced children began to match the adult response to similar perturbations. With increased experience and changing muscle torque regulatory abilities, balance skills became more robust.     

A Socioecological Approach to Relational Demography: How Relative Representation and Respectful Coworkers Affect Job Attitudes

Purpose

This paper advances a socioecological perspective toward understanding the relationship between demography and job attitudes by considering the joint effects of individual ethnicity and ethnic group relative representation—the degree to which an individual’s own demographic group is represented similarly in their organization and the community in which the organization is located.

Design/Methodology/Approach

Hierarchical polynomial regression analyses of census and survey data from 57,000 employees of 142 hospitals in the United Kingdom suggest that ethnic group relative representation is related to ethnic minority employees’ job satisfaction and turnover intentions.

Findings

An asymmetric pattern emerged wherein the effect of under-representation on turnover intentions was stronger than the effect of over-representation. Moreover, the effects of relative representation varied with respectful treatment by coworkers; relative representation had little effect on attitudes of employees who reported low levels of coworker respect but generally enhanced attitudes when respect was high.

Originality/Value

This work points to the meaningful role that socioecological factors can play in what are typically considered to be intraorganizational phenomena, thereby highlighting the need for organizational research to assess relevant aspects of the communities in which organizations are embedded.

     

The national institutes of health attention-deficit/hyperactivity disorder consensus statement: implications for practitioners and scientists

Although the concept of pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD) was first introduced more than 60 years ago, treatment of this disorder remains more controversial than ever. It is hoped, however, that the recent Consensus Development Conference (CDC) Statement on the diagnosis and treatment of ADHD will not only help answer some of the questions surrounding management of this disorder, but also lend needed scientific weight to debate in this area. While more research in ADHD is needed, the CDC participants pointed to a solid body of evidence showing that careful medication management can result in noticeable improvement in several measures, with little risk of adverse events.     

Parental Involvement and Adolescents’ Academic Achievement: Latent Profiles of Mother and Father Warmth as a Moderating Influence

Parental involvement in their adolescents’ education plays an important role in promoting their children's academic outcomes. Yet, more research is needed to examine the relationship between parenting practices and parental warmth as well as to consider the potential joint contribution of warmth from both fathers and mothers. Thus, the primary purpose of the current study is to examine the extent to which patterns of parental warmth across fathers and mothers moderate the association between parental involvement and adolescents’ grade point average (GPA) and school engagement behaviors. Latent profile analysis was conducted to identify disparate profiles of fathers’ and mothers’ warmth within a nationally representative sample of 2,306 youths (51% male; mean age = 15.31 years, SD = 1.50; 77% non-Hispanic White) residing in opposite-sex, two-parent families from Wave I and II of the National Longitudinal Study of Adolescent to Adult Health. Latent-class enumeration processes support a five-profile solution characterized by differences in levels of parental warmth and congruency across parents: (a) Congruent High Warmth, (b) Congruent Moderate Warmth, (c) Congruent Low Warmth, (d) Incongruent High Mother/Low Father Warmth, and (e) Incongruent Low Father/Lower Mother Warmth. Subsequent multiple linear regression analyses reveal a moderating effect for Congruent Low Warmth on the relationship between parental involvement and adolescents’ GPA. Ultimately, the results show that variation in parental warmth exists across fathers and mothers with differing impact on adolescents’ outcomes. Excluding one parent without considering the joint effects of both parents will not produce an accurate and precise understanding of parenting in research or practice.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.