A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)—A Randomized Controlled Trial

In the treatment of adult attention-deficit/hyperactivity disorder (ADHD) the importance of psychological interventions in combination with pharmacotherapy is widely accepted in contemporary clinical routine. The natural course of the disorder seems to justify additional psychological interventions because even in patients who are highly compliant to pharmacotherapy full remission is not always achieved. The aim of the present study was to analyze the contribution of psychotherapy to the treatment of adult ADHD patients. In a randomized controlled study, the efficacy of a combined treatment of psychotherapy with pharmacotherapy is compared to pharmacological intervention alone. After initiation and stabilization of treatment with methylphenidate (MPH) in all subjects randomization to the two different treatment conditions was done. Afterwards both groups underwent treatment for about 10–12 weeks, the experimental group receiving sessions of cognitive-behavioral therapy (CBT) whereas the control group only received medication and standard clinical management (SCM). ADHD symptoms differed statistically during time but not between the two different treatment conditions. This result was the same for the single ADHD symptoms—inattention, hyperactivity, impulsivity, and emotional symptoms—and also for impairment. Individual standardized ADHD specific CBT program was not able to outperform SCM

Elternschaft und Belastungserleben: Psychometrische Überprüfung des Parenting-Stress-Index (PSI) an einer deutschsprachigen Stichprobe

The Parenting Stress Index (PSI) consists of 120 items measuring the subjective burden--labelled as parenting stress--of adults in parenting children from the age of newborns up to 12 years. The PSI is a self report scale which was developed in the US in 1976. Since then the PSI has been widely used in family and parenting research and was validated in many different languages but not yet in German. Therefore we administered the PSI to a sample of 372 German speaking parents with children from newborns up to 12 years of age in Basel, Switzerland. The questionnaire was handed out to parents in schools, kindergartens and day care centers along with one other complementary questionnaire such as the Beck Depression Inventory (BDI) or the Dyadic Adjustment Scale (DAS) measuring similar or divergent constructs. Internal consistency was high with a Cronbach's alpha Coefficient of 0.95 for total stress and 0.91 and 0.92 for the subscores of the child domain and parent domain respectively. The selectivity of most items ranged from sufficient to good. In order to assess the structure of the PSI factor analysis was performed. The principle component analysis revealed a two-factor solution accounting for 58 % of variance. The factorial structure of the original scale was therefore replicated. However, a three-factor solution seemed to describe data better. Correlations with other self report scales resulted as predicted. In summary the German translation of the PSI proved to assess reliably the construct of parenting stress. This instrument will serve family researchers and clinicians in German speaking countries to detect families at risk