A self-guided internet-delivered intervention for adults with ADHD: Results from a randomized controlled trial

Background

Attention-deficit/hyperactivity disorder (ADHD) in adulthood, with an estimated prevalence of 2–3 %, is associated with several challenges in daily life functioning. Still, the availability of evidence-based psychological interventions for adults with ADHD is limited. Interventions delivered over the Internet on smartphones or personal computers may help to increase the availability of and access to effective psychological interventions.

Objective

This study reports on the efficacy of a self-guided psychological Internet-delivered intervention on severity levels of ADHD symptomatology and quality of life in adults with ADHD.

Methods

Adults with a self-reported ADHD diagnosis (N = 120) were included in a randomized controlled trial with two arms: 1) self-guided Internet-delivered intervention for managing symptoms and impairments related to ADHD (n = 61); 2) online psychoeducation module (control group, n = 59). The primary clinical outcome was severity levels of ADHD as measured with the Adult ADHD Self-Report Scale. Secondary outcomes were quality of life as measured with the Adult ADHD Quality of Life scale and stress as measured with the Perceived Stress Scale. Measures were obtained at three time points: before (baseline), immediately after (8 weeks) and 3 months after the intervention. The secondary objective of the study was to explore user satisfaction with and adherence to the intervention.

Results

Linear Mixed Model analysis revealed moderate to large between group effect-size improvements on self-report measures of ADHD symptomatology (d = 0.70) and quality of life (d = 0.53). Importantly, effects were maintained at 3-month follow-up (d = 0.76 and d = 0.52). In terms of adherence, 29 % completed all modules, while 59 % completed at least five modules (out of 7). Treatment satisfaction was adequate, with n = 34 (79 %) indicating that they were very satisfied or satisfied with the intervention, and n = 37 (88 %) indicating that they would recommend the intervention to a friend.

Discussion

The study demonstrated the efficacy of a self-guided Internet-delivered intervention by showing reliable and statistically significant improvements in self-reported ADHD symptomatology and quality of life. The intervention may be suitable for better managing ADHD symptoms in primary care and as a low intensity intervention population wide.

Trial registration

ClinicalTrials.gov, Identifier NCT04726813, January 27, 2021.

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The intervention significantly reduced ADHD symptoms and increased quality of life.

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Between group effect sizes were moderate to large on the primary outcome.

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Within group effect sizes were large for the intervention group.

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Fifty-eight percent of intervention group participants demonstrated reliable change.

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The majority of the participants were satisfied with the intervention.

A self-guided Internet-delivered intervention for adults with ADHD: a protocol for a randomized controlled trial

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) in adulthood, with an estimated prevalence of 2-3%, is associated with several challenges in daily life functioning. The availability of evidence-based psychological interventions for adults with ADHD is still poor. Interventions delivered over the Internet on smartphones or personal computers may help to increase the availability of effective psychological interventions. The primary aim of this randomized controlled trial is to examine the efficacy of a self-guided Internet-delivered intervention on severity levels of ADHD symptomatology and quality of life.

METHODS

We aim to include 118 participants with a self-reported ADHD diagnosis in a randomized controlled trial with two arms: 1) self-guided Internet-delivered intervention for coping with ADHD (N = 59); 2) self-guided online psychoeducation (control group, N = 59). After 3 months, the control group will be given access to the intervention. The primary clinical outcomes are inattention and quality of life. Secondary clinical outcomes are hyperactivity, stress and depression. Measures will be obtained at three time points: before (baseline), immediately after (8 weeks) and 3 months after the intervention. Uptake, usage, adherence and satisfaction will be explored.

DISCUSSION

This RCT will provide valuable information on the clinical effectiveness of an Internet-delivered intervention for adults with ADHD. This study is, to our knowledge, one of the first randomized control trials that investigates the effects of a self-guided Internet-delivered psychological intervention in a fairly large group of adults with ADHD.

TRIAL REGISTRATION

ClinicalTrials.gov, Identifier NCT04726813, January 27, 2021.

Psychometric Properties of the Weiss Functional Impairment Rating Scale: Evidence for Utility in Research, Assessment, and Treatment of ADHD in Emerging Adults

Objective: The current study examines psychometric properties of the Weiss Functional Impairment Rating Scale (WFIRS), a measure of adult ADHD-related impairment. It is a self-report questionnaire that provides a metric of overall life impairment and domain-specific dysfunction. Method: Using data from a large (N = 2,093), multi-institution sample of college students and including a subsample of collateral informants (n = 262), a series of analyses were conducted. Results: The WFIRS demonstrated robust internal reliability, cross-informant agreement on par or superior to other measures of ADHD symptomatology and impairment, and concurrent validity. The WFIRS was not shown to be uniquely associated with ADHD, as internalizing symptoms also associated with the total and domain scores. Conclusion: The use of the WFIRS in identifying ADHD-related impairment in emerging adults appears to be psychometrically supported, and will prove useful to clinicians and researchers.

Severity of symptoms and quality of life in medical students with ADHD

OBJECTIVE

In this study, the authors examined the severity of ADHD symptoms and related quality of life in 1st and 2nd year medical students diagnosed with ADHD.

METHOD

The sample consists of 33 preclinical medical students previously diagnosed with ADHD. The Adult ADHD Quality of Life Scale (AAQoL) and Adult ADHD Self-Reported Checklist were administered.

RESULTS

Participants' ADHD-related quality of life and life productivity were negatively correlated with the severity of their ADHD symptoms. Students receiving academic accommodations reported significantly higher ADHD symptoms. The presence of a comorbid condition contributed to significantly lower psychological health scores. Unexpectedly, women had significantly lower quality of life (AAQoL total score) and significantly lower psychological health scores than men.

CONCLUSION

Since the majority of the sample reported severe ADHD symptoms while receiving medication treatment, the authors have concluded that it is important to develop psychosocial treatments to manage the associated distress from residual symptoms in medical students with ADHD.