Cognitive-motivational, interpersonal, and behavioral functioning in relationship to treatment and research engagement in forensic patients with ADHD.

Jenny A B M Houtepen,Stefan Bogaerts,Anouk Scheres,Rosalind Van Der Lem,Jelle J Sijtsema

doi:10.1002/jclp.23016

Jenny A B M Houtepen, Stefan Bogaerts + Show 3 more

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https://doi.org/10.1002/jclp.23016

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Abstract

ObjectivesTo provide more insight into treatment and research responsivity in offenders with attention‐deficit hyperactivity disorder (ADHD).MethodVia self‐reports and patients' scores on cognitive computer tasks, it was examined whether poorer cognitive‐motivational, interpersonal, and behavioral functioning were related to treatment no‐shows, longer treatment time duration intervals, and no‐show at the research appointment in 52 forensic outpatients with ADHD (M age = 35.3, SD = 9.38). Treatment adherence was tracked for 10 appointments after research participation.ResultsRegression analyses showed that higher self‐reported impulsivity was associated with research no‐show, and more alcohol use with longer treatment time intervals. Yet, self‐reported delay aversion was associated with fewer treatment no‐shows, and, uncontrolled for alcohol use, impulsivity was associated with shorter treatment time intervals in a subsample of patients.ConclusionsThese preliminary results indicate that externalizing behaviors increase the risk for nonadherence in forensic ADHD patients, but that cognitive‐motivational problems also motivate patients to be more engaged.

Highlights

Attention‐deficit hyperactivity disorder (ADHD) is a developmental disorder (American Psychiatric Association, 2013) that persists fully or partially into adulthood in the majority of patients (Faraone, Biederman, & Mick, 2006)
Via self‐reports and patients' scores on cognitive computer tasks, it was examined whether poorer cognitive‐ motivational, interpersonal, and behavioral functioning were related to treatment no‐shows, longer treatment time duration intervals, and no‐show at the research appointment in 52 forensic outpatients with attention‐deficit hyperactivity disorder (ADHD) (Mage = 35.3, SD = 9.38)
We showed that higher self‐reported impulsivity was associated with no‐show on research, and that more alcohol use was related to longer treatment time intervals in forensic patients with ADHD

Summary

Introduction

Attention‐deficit hyperactivity disorder (ADHD) is a developmental disorder (American Psychiatric Association, 2013) that persists fully or partially into adulthood in the majority of patients (Faraone, Biederman, & Mick, 2006). Patients with ADHD are at an increased risk because of comorbid externalizing disorders (e.g., antisocial personality disorder, substance use disorders; Retz & Rösler, 2010), and associated risk factors, such as attachment problems (Houtepen, Sijtsema, Van der Lem, Van Hooydonk, & Bogaerts, 2019) These risk factors are likely closely interlinked and interact throughout patients' lives. Eleven patients from the pilot study had missing data on two of the three self‐report questions on treatment motivation, and substance use. Because these variables could not reliably be replaced using information of the other measures administered in the study, we excluded these patients from all analyses including these variables. Cognitive‐motivational functioning Stopping mistakes Go/No‐Go task Reaction time go responses ms Go/No‐Go task Area under the curve in temporal reward discounting task Self‐reported impulsivity Self‐reported temporal discounting Self‐reported delay aversion

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