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Champ RE, Adamou M, Tolchard B. The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review. PLoS One 2021; 16:e0261247. [PMID: 34932573 PMCID: PMC8691636 DOI: 10.1371/journal.pone.0261247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022] Open
Abstract
Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as accommodating context variability and heterogeneity. Research into alternative theoretical characterisations of ADHD is recommended to provide treatment design opportunities to better understand and address symptoms.
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Affiliation(s)
- Rebecca E. Champ
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Marios Adamou
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Barry Tolchard
- School of Health and Life Sciences, Teeside University, Middlesbrough, United Kingdom
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Solanto MV, Scheres A. Feasibility, Acceptability, and Effectiveness of a New Cognitive-Behavioral Intervention for College Students with ADHD. J Atten Disord 2021; 25:2068-2082. [PMID: 32880502 DOI: 10.1177/1087054720951865] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This purpose of this study was to assess the feasibility, acceptability, and effectiveness of a new group cognitive-behavioral treatment (CBT) to enhance executive function (EF) in college students with ADHD. METHODS Eighteen students meeting rigorous DSM-5 criteria for ADHD were enrolled in two nine-member groups. The treatment targeted time-awareness, distractibility, procrastination, and failure to plan, and included strategies to facilitate academic EF skills. RESULTS Eighty-four percent of students attended nine or more of the 12 weekly sessions. Repeated measures analyses of change from pre- to posttreatment yielded improvement in clinician- and self-ratings of DSM-5 ADHD inattentive symptoms, with robust effect sizes. Also improved were scores on standardized scales of time-management, concentration, and total EF. DISCUSSION Results provide support for the feasibility, acceptability, and effectiveness of a CBT program in reducing inattentive symptoms and enhancing EF in college students with ADHD, and warrant investigation on a larger scale.
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Affiliation(s)
- Mary V Solanto
- Zucker School of Medicine, Hofstra-Northwell, Lake Success, NY, USA
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Abstract
OBJECTIVES To review existing literature about university students with Attention Deficit Hyperactivity Disorder (ADHD). METHODS A framework for scoping studies and content analysis were used to source and review selected publications from PubMed, ScienceDirect, Google Scholar and relevant bibliographies. RESULTS Seventy-four publications were reviewed and key findings were categorised under six core themes that represent the issues germane to university students with ADHD. These themes are: academic, social and psychological functioning, giftedness, new media technologies, treatment, substance misuse and the non-medical use of prescription stimulants, and malingering. CONCLUSION In Ireland and the United Kingdom (UK) young people with ADHD are unlikely to enrol into further education, and of those who do go to university, few will graduate at the same time as their non-ADHD peers. ADHD is associated with poor educational outcomes and it may be a hidden disability within institutions of higher education (e.g. universities). Surprisingly, in this topic area, there is a paucity of research in Ireland and the UK. Most studies originate from North America were research activity in the field has been ongoing since the 1990s. These studies however, tend to use relatively small samples of college (university) students recruited at a single institution. It is difficult to generalise the findings of these studies to student populations in North America, let alone in Ireland and the UK. At the very least, these North American studies provide insights into key areas of concern. This topic area straddles education and psychiatry. This means an inter-disciplinary approach is required to examine, better understand and address the impact of ADHD on the educational outcomes of university students. The philosophies of difference, equity and self-realisation can offer a conceptual framework for conducting further research and/or developing services to deliver more personalised learning support for university students with ADHD.
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LaCount PA, Hartung CM, Shelton CR, Stevens AE. Efficacy of an Organizational Skills Intervention for College Students With ADHD Symptomatology and Academic Difficulties. J Atten Disord 2018; 22:356-367. [PMID: 26253149 DOI: 10.1177/1087054715594423] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We sought to elucidate the effects of an organization, time management, and planning (OTMP) skills training intervention for college students reporting elevated levels of ADHD symptomatology and academic impairment. METHOD Undergraduate participants enrolled in either the intervention ( n = 22) or comparison ( n = 15) condition in exchange for psychology course credit. Those in the intervention condition attended three weekly group meetings designed to improve organizational skills. Treatment effectiveness was evaluated by comparing pre- and postmeasurements of academic impairment, inattention, hyperactivity/impulsivity, and OTMP skills utilization. RESULTS Intervention group participants improved significantly on ratings of inattention, hyperactivity/impulsivity, and academic impairment, relative to the comparison group. Intervention group participants also improved in their use of OTMP skills, relative to their baseline ratings. CONCLUSION This study suggests an organizational skills intervention has the potential to ameliorating ADHD symptomatology and academic impairment among college students.
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Prevatt F, Smith SM, Diers S, Marshall D, Coleman J, Valler E, Miller N. ADHD Coaching With College Students: Exploring the Processes Involved in Motivation and Goal Completion. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2017. [DOI: 10.1080/87568225.2016.1240597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Frances Prevatt
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Shannon M. Smith
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Sarah Diers
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Diana Marshall
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Jennifer Coleman
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Emilee Valler
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Nathan Miller
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
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Abstract
Evidence suggests that ADHD can impair academic achievement in college students and throughout the life span. College students with ADHD are an at-risk population who might benefit from interventions. An offshoot of CBT-oriented therapy that has grown significantly and gained popularity in recent years is ADHD coaching. ADHD coaching is a psychosocial intervention that helps individuals develop skills, strategies, and behaviors to cope with the core impairments associated with ADHD. Most coaching programs are primarily based on a CBT approach and target planning, time management, goal setting, organization, and problem solving. This paper describes ADHD coaching for college students and discusses how coaching is different from standard CBT treatment. This is followed by a review of empirical studies of the effectiveness of ADHD coaching for college students. Finally, some specific considerations and procedures used in coaching are described.
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Affiliation(s)
- Frances Prevatt
- Florida State University, 1114 West Call Street, Tallahassee, FL, 32306-4453, USA.
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Thomas M, Rostain A, Corso R, Babcock T, Madhoo M. ADHD in the College Setting: Current Perceptions and Future Vision. J Atten Disord 2015; 19:643-54. [PMID: 24743974 DOI: 10.1177/1087054714527789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess perceptions concerning ADHD among U.S. college healthcare providers. METHOD A 37-question survey was conducted from October 4 to December 2, 2010. Participants were contacted via mail or telephone and compensated for participation. RESULTS Thirty-eight percent of the respondents (physicians, n = 59; nurses, n = 138; directors, n = 101) viewed ADHD as a "problem"/"very much a problem" at their institution. Referrals for evaluation came from students (84%), psychologists/counselors (68%), or the institution (68%). Although 48% of respondents felt "comfortable"/"very comfortable" in their ability to recognize ADHD, 92% referred students for evaluation. Most respondents (>90%) agreed medication use may be warranted; 52% of respondents who treat ADHD or consult with a specialist (from 95% of physicians to 31% of directors) prescribed pharmacotherapy. CONCLUSION Although college healthcare providers recognize the importance of treating ADHD, their discomfort in diagnosing and treating ADHD represents a barrier to care for college students.
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Affiliation(s)
- Mark Thomas
- University of Alabama, Tuscaloosa, USA; Tuscaloosa Focus MD, Northport, AL; Clinical-affiliate assistant professor, University of Alabama, Tuscaloosa, AL, USA
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Abstract
OBJECTIVE This study evaluated a program for ADHD coaching in a sample of college students. METHOD ADHD coaching was conducted with 148 college students over a 5-year period. The theoretical orientation combined cognitive-behavioral therapy with psychoeducational techniques. Executive functioning served as a way of viewing both initial problem areas and outcomes. RESULTS Clients who received an 8-week coaching program showed significant improvement in all 10 areas of study and learning strategies, on self-esteem, and on measures of symptom distress and satisfaction with school and work. These results were consistent across different semesters and time of semester, and with a variety of different coaches, all of whom were novice coaches. CONCLUSION This study provides important preliminary information about ADHD coaching, including coaching structure, processes, efficacy, and correlates of positive outcomes. Additional evaluations utilizing a randomized controlled design are needed.
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Prevatt F, Young JL. Recognizing and Treating Attention-Deficit/Hyperactivity Disorder in College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2014. [DOI: 10.1080/87568225.2014.914825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Research on ADHD in college students began in the 1990s and has been steadily increasing in recent years. Because young adults with ADHD who attend college have experienced greater academic success during high school than many peers with the disorder, which is likely to be associated with better overall functioning, the degree to which they experience similar patterns of adjustment difficulties was not initially known. Accumulating research suggests that college students with ADHD experience less academic success and greater psychological and emotional difficulties than other students and use alcohol and drugs at higher rates. However, conclusions to be drawn from this research are limited by the use of small samples that may not be representative of the wider population of students with ADHD, and a lack of diagnostic rigor in identifying students with ADHD to be included in such research. Studies of the effectiveness of psychosocial treatments, medication treatment, and academic accommodations are extremely limited or nonexistent. Issues particularly germane to college students include feigning ADHD and the misuse and diversion of stimulant medication. Given that at least 25 % of college students with disabilities are diagnosed with ADHD, methodologically sound investigations are clearly needed in order to better understand the impact of ADHD on college students' adjustment and to develop and implement interventions that can enhance students' success.
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Affiliation(s)
| | - David L. Rabiner
- Department of Psychology and Neuroscience and Center for Child and Family Policy, Duke University, Durham, NC 27708 USA
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Therapy-relevant factors in adult ADHD from a cognitive behavioural perspective. ACTA ACUST UNITED AC 2010; 2:59-72. [DOI: 10.1007/s12402-010-0023-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 03/22/2010] [Indexed: 10/19/2022]
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