Development of a statistical approach to classifying treatment response in individual children with ADHD

Human Psychopharmacology - Tập 19 Số 7 - Trang 445-456 - 2004
C Mollica1, Paul Maruff2,1, Alasdair Vance3,4
1School of Psychological Science, LaTrobe University, Bundoora, Victoria, Australia
2CogState Ltd, Carlton South, Victoria, Australia
3Academic Child Psychiatry Unit, Department of Paediatrics, Royal Children's Hospital, Parkville, Victoria, Australia
4Alfred Hospital Child and Adolescent Mental Health Service, Victoria, Australia

Tóm tắt

AbstractThe use of cognitive tests as measures of treatment response in individual children with ADHD has not been adequately evaluated or commonly applied by clinicians. This is most likely due to a lack of suitable assessment tasks as well as clinicians' limited awareness of the appropriate statistical techniques for analysing cognitive change in individuals. This study investigated the application of statistical decision rules to the cognitive and behavioural measures of individual children with ADHD in order to classify a significant, positive response to medication. The previously reported data of 14 children with ADHD (combined type; ADHD‐CT) were re‐analysed to investigate changes in function following a low‐ and high‐dose of stimulant medication (2.5 mg and 7.5 mg dexamphetamine, respectively). The performances of 14 age‐, gender‐ and IQ‐matched controls was also analysed to provide an estimate of the false‐positive classification rate. Overall, the decision rule yielded a high sensitivity and high specificity to treatment response. In the high‐dose condition, 71% of children with ADHD demonstrated improvements in both cognitive and behavioural function. This study demonstrates an evidence‐based approach to evaluating concurrent cognitive and behavioural improvement in individual children with ADHD following treatment with stimulant medication. Copyright © 2004 John Wiley & Sons, Ltd.

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Tài liệu tham khảo

Achenbach TM, 1991, Manual for the Child Behaviour Checklist/4–18 and 1991 Profile

10.1007/BF02284761

American Psychiatric Association, 1994, Diagnostic and Statistical Manual of Mental Disorders

Barnett R, 2004, An investigation of non‐verbal memory impairment in ADHD: the effects of psychostimulant medication encoding and strategy, Dev Neuropsychol

Barnett R, 2004, Executive and cognitive dysfunction in ADHD, J Clin Child Psychol

10.1023/A:1023285614844

Bergman A, 1991, Ritalin: Theory and Patient Management, 223

10.1136/bmj.313.7059.744

10.1097/00004583-199508000-00012

10.1007/s002210100890

10.1038/nrn896

10.1016/S0003-4975(01)03375-6

10.1097/00042752-200301000-00006

10.1017/S1355617703930074

Conners CK, 1985, Parent Symptom Questionnaire, Psychopharmacology, 21, 816

Conners CK, 2002, Forty years of methylphenidate treatment in Attention‐Deficit/Hyperactivity Disorder, J Attent Disord, 5, S17, 10.1177/070674370200601S04

10.1097/00004583-200102000-00010

10.1097/00004583-199904000-00011

10.1080/01688639408402700

10.1007/978-1-4615-4881-2_5

10.1097/00004583-199507000-00011

10.1111/j.1469-7610.1986.tb02330.x

10.1097/00004583-199407000-00016

10.1542/peds.100.6.e6

10.1016/0165-1781(91)90126-A

10.1016/S0193-3973(00)00050-2

10.1111/j.1469-7610.1993.tb01105.x

Greenhill LL, 2001, Stimulant Drugs and ADHD, 31

10.1097/00004583-200002000-00020

10.1037/0894-4105.10.1.120

10.1037/0022-006X.59.1.12

10.1001/archpedi.153.12.1292

10.1016/0028-3932(96)00035-8

10.1007/BF02214762

Mollica CM, 2004, The effects of age and practice on the stability of performance on a computerized assessment of cognitive change in children, Child Neuropsychol

Mollica CM, 2004, The effects of stimulant medication on the cognitive and behavioural function of children with attention‐deficit/hyperactivity disorder‐combined type (ADHD‐CT), J Clin Psychiatry

10.1097/00004583-200201000-00012

10.1016/S0892-0362(00)00095-7

Rapport MD, 2000, Ritalin: Theory and Practice, 45

Rapport MD, 1993, Handbook of Hyperactivity in Children, 97

10.1034/j.1399-6576.2001.045003275.x

10.1136/adc.88.2.147

10.1192/bjp.114.510.563

10.1093/bja/aeh157

10.1126/science.337493

Swanson JM, 1978, Time‐response analysis of stimulant medication on the learning ability of children referred for hyperactivity, Pediatrics, 61, 21, 10.1542/peds.61.1.21

10.1177/001440299306000209

10.1097/00004583-199507000-00012

10.1017/S0033291700013039

Vance A, 2002, Children's Impulsiveness Scale

Winer BJ, 1971, Statistical Principles in Experimental Design

Wood K, 1999, Covert orienting of visual attention in children with attention deficit disorder: does comorbidity make a difference?, Arch Neuropsychol, 14, 179