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Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

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Abstract

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.

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Authors and Affiliations

  1. Duke University Medical Center, P.O. Box 3320, Durham, North Carolina

    Karen C. Wells

  2. Duke University Medical Center, Durham, North Carolina

    Jeffery N. Epstein & John Klaric

  3. University of California, Irvine, California

    Stephen P. Hinshaw & Tim Wigal

  4. Emery University, Atlanta, Georgia

    Ann Abramowitz

  5. University of Chicago, Chicago, Illinois

    Linda Pfiffner

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  1. Karen C. Wells
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  2. Jeffery N. Epstein
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  3. Stephen P. Hinshaw
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  4. C. Keith Conners
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  5. John Klaric
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  6. Howard B. Abikoff
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  7. Ann Abramowitz
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  8. L. Eugene Arnold
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  9. Glenn Elliott
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  10. Laurence L. Greenhill
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  11. Lily Hechtman
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  12. Betsy Hoza
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  13. Peter S. Jensen
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  14. John S. March
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  15. William Pelham Jr.
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  16. Linda Pfiffner
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  17. Joanne Severe
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  18. James M. Swanson
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  19. Benedetto Vitiello
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Wells, K.C., Epstein, J.N., Hinshaw, S.P. et al. Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study. J Abnorm Child Psychol 28, 543–553 (2000). https://doi.org/10.1023/A:1005131131159

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