Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD), a neuropsychiatric condition characterized by attention and impulsivity problems, is one of the most common behavioral disorders. The first line of treatment for ADHD is psychostimulant medication, but this has limited effectiveness, particularly in adults, and is often associated with adverse side-effects. Thus, it is imperative that new non-pharmaceutical approaches to treatment are developed. This study aims to evaluate the impact of a non-pharmacological Self-Alert Training (SAT) intervention on ADHD symptom prevalence, psychological and cognitive functioning, and on everyday functional impairment in adults with ADHD. Fifty-one adult participants with a current diagnosis of ADHD were randomized to either SAT or a Control Training (CT) program. They were assessed at baseline, immediately following the 5-week training period, and after 3-months using ADHD symptoms scales, as well as a series of neuropsychological tests and psychological questionnaires. Subjective ratings of everyday life attention and memory problems were also collected. The SAT group showed significant improvements in ADHD inattentive and impulsive symptoms, depressive symptoms and in self-efficacy ratings compared to the CT group at both post-training and at the 3-month assessment. Pre-post improvements in SAT participants on untrained cognitive tasks measuring selective attention and executive functions were also observed. Finally, the SAT group reported improved subjective ratings of everyday life attention at both assessment points. This pattern of results suggests that SAT may be beneficial in treating ADHD symptoms as well as psychological and cognitive impairments in adult ADHD. A large-scale randomized controlled trial (RCT) is needed.
Highlights
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neuropsychiatric condition characterized by difficulties with attention, impulsivity and overactivity
A significant Time × group interaction was found for ADHD Index (F(2.56) = 7.81, p = 0.001; η2 = 0.22), driven by significantly lower scores in the Self-Alert Training (SAT) group compared to the Control Training (CT) group at post-training and at the 3-month follow up
The results of the study showed that adults with ADHD who received SAT exhibited significantly reduced ADHD inattentive and impulsive symptoms, as measured by the Conners’ Adult ADHD Rating Scale (CAARS)—Self Report questionnaire both immediately post-training and at the three-month follow up, while adults with ADHD allocated to the CT group showed no significant changes in ADHD symptoms at either of the two time points
Summary
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neuropsychiatric condition characterized by difficulties with attention, impulsivity and overactivity. Used alone, pharmacological approaches to treatment have a number of disadvantages, including side effects, high associated costs for long-term prescriptions and limited effectiveness, especially in adults (Asherson, 2005; Biederman, 2005) Behavioral interventions, such as Cognitive Behavioral Therapy (CBT), based on operant conditioning principles have been shown to reduce primary and secondary behavioral symptoms of ADHD (Safren, 2006; Solanto et al, 2008). Previous research on psychosocial interventions and psychoeducation in adults with ADHD have shown that these behavioral treatments can improve adult ADHD symptoms and reduce associated psychiatric symptoms, such as anxiety and depression (Stevenson et al, 2003; Vidal et al, 2013) These positive effects can be short-term and these behavioral treatments can be difficult to implement. This may explain why, despite long-term treatments, behavioral and Frontiers in Human Neuroscience www.frontiersin.org
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