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A randomized controlled trial of central executive training (CET) versus inhibitory control training (ICT) for ADHD.
Kofler, Michael J; Wells, Erica L; Singh, Leah J; Soto, Elia F; Irwin, Lauren N; Groves, Nicole B; Chan, Elizabeth S M; Miller, Caroline E; Richmond, Kijana P; Schatschneider, Christopher; Lonigan, Christopher J.
Afiliación
  • Kofler MJ; Department of Psychology.
  • Wells EL; Department of Psychology.
  • Singh LJ; Department of Psychology.
  • Soto EF; Department of Psychology.
  • Irwin LN; Department of Psychology.
  • Groves NB; Department of Psychology.
  • Chan ESM; Department of Psychology.
  • Miller CE; Department of Psychology.
  • Richmond KP; Department of Psychology.
  • Schatschneider C; Department of Psychology.
  • Lonigan CJ; Department of Psychology.
J Consult Clin Psychol ; 88(8): 738-756, 2020 Aug.
Article en En | MEDLINE | ID: mdl-32700955
OBJECTIVE: Executive function deficits are well-established in ADHD. Unfortunately, replicated evidence indicates that executive function training for ADHD has been largely unsuccessful. We hypothesized that this may reflect insufficient targeting, such that extant protocols do not sufficiently and specifically target the neurocognitive systems associated with phenotypic ADHD behaviors/impairments. METHOD: Children with ADHD ages 8-12 (M = 10.41, SD = 1.46; 12 girls; 74% Caucasian/Non-Hispanic) were randomized with allocation concealment to either central executive training (CET; n = 25) or newly developed inhibitory control training (ICT; n = 29). Detailed data analytic plans were preregistered. RESULTS: Both treatments were feasible/acceptable based on training duration, child-reported ease of use, and parent-reported high satisfaction. CET was superior to ICT for improving its primary intervention targets: phonological and visuospatial working memory (d = 0.70-0.84). CET was also superior to ICT for improving go/no-go (d = 0.84) but not stop-signal inhibition. Mechanisms of change analyses indicated that CET-related working memory improvements produced significant reductions in the primary clinical endpoints (objectively assessed hyperactivity) during working memory and inhibition testing (indirect effects: ß ≥ -.11; 95% CIs exclude 0.0). CET was also superior to ICT on 3 of 4 secondary clinical endpoints (blinded teacher-rated ADHD symptoms; d = 0.46-0.70 vs. 0.16-0.42) and 2 of 4 feasibility/acceptability clinical endpoints (parent-reported ADHD symptoms; d = 0.96-1.42 vs. 0.45-0.65). CET-related gains were maintained at 2-4 month follow-up; ICT-related gains were maintained for attention problems but not hyperactivity/impulsivity per parent report. CONCLUSIONS: Results support the use of CET for treating executive function deficits and targeting ADHD behavioral symptoms in children with ADHD. Findings for ICT were mixed at best and indicate the need for continued development/study. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación de Procesos y Resultados en Atención de Salud / Trastorno por Déficit de Atención con Hiperactividad / Función Ejecutiva / Remediación Cognitiva / Inhibición Psicológica Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Consult Clin Psychol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación de Procesos y Resultados en Atención de Salud / Trastorno por Déficit de Atención con Hiperactividad / Función Ejecutiva / Remediación Cognitiva / Inhibición Psicológica Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Consult Clin Psychol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos