US Radio Interview on ADHD, Late Sleep and Health
Here is an interview by APSARD board members Sandra Kooij, M.D., Ph.D. and Vatsal Thakkar, M.D. on sleep and health issues related to living with ADHD.
CBT for Adult ADHD: Turning Intentions into Actions at the APSARD 2018 Conference
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
As part of the symposium on non-medical treatments for adult ADHD, I’ll be presenting on CBT for adult ADHD. One of the principles in framing interventions is turning “managing ADHD” into actionable steps the patient can “do” to improve functioning. Similarly, being a practicing clinician specializing in adult ADHD, it has been helpful to see how the cognitive-behavioral therapy (CBT) model has been adapted to meet the needs of these patients and, more specific to the conference session, how this framework can guide all different varieties of therapists in terms of increasing their confidence when working with this clinical population – which by definition is characterized by difficulties organizing behavior over time and following through on the coping strategies necessary to manage ADHD.
The session will highlight different domains of interventions within CBT for adult ADHD and specific examples of each, focused on promoting their actual implementation, using the clinical example of procrastination, a common area of difficulty for ADHD adults.
If you are interested:
Ramsay, J. R. (2016). “Turning intentions into actions:” CBT for adult ADHD focused on implementation. Clinical Case Studies, 15, 179-197. doi: 10.1177/1534650115611483
Ramsay, J. R., & Rostain, A. L. (2016). Adult ADHD as an implementation problem: Clinical significance, underlying mechanisms, and psychosocial treatment. Practice Innovations, 1, 36-52. doi: 10.1037/pri0000016
Dr. Ramsay will be presenting at the 2018 APSARD Annual Meeting on “Outside the Pill Bottle: Assessment and Management of Adult ADHD.”
Language of ADHD in Adults on Social Media
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
A recent, online ahead of print article in the Journal of Attention Disorders addresses the social media language and use in a sample of 1399 adults self-identified as being diagnosed with ADHD compared with matched controls. In addition to linguistic analysis of public Twitter posts regarding themes (including how these themes mapped onto the 5-factor model of personality), adults with ADHD were significantly more likely than controls to post between 12 midnight and 6 a.m. The study represents a novel use of social media to gain relevant information about the experiences and expressions of adults with ADHD not typically captured in other venues.
A benefit of your APSARD membership is free access to articles published in the Journal of Attention Disorders.
ADHD: Late Sleep and Health
J.J. Sandra Kooij, M.D., Ph.D.
Here is a video blog from Dr. Sandra Kooij, an APSARD Board-member, describing her research during the recent European College of Neuropsychopharmacology Congress in Paris.
Click here to access the video.
Psychosocial Treatment for Adult ADHD: What Do Patients Think About it?
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
The HBO series, In Treatment (2008-2010) centered on the life and practice of a psychotherapist, Paul Weston (as portrayed by Gabriel Byrne). Each nightly episode focused on a session with a different patient, with the course of therapy with each patient followed week-by-week. In a scene from a Season 1 episode (with a patient named Alex, if you want to track it down), Dr. Weston jokingly retorted, “In my profession we say that the customer is always wrong.”
Although some may argue that there is some truth in that line, clinicians and researchers who treat and study adults with ADHD seek objective measures of treatment response and improvements in symptoms and functional outcomes. Blinded assessments and other objective measures are employed toward this end, as there may be many biases in patient self-report.
However, what about patients’ subjective sense of what works for them? What do the “customers” have to say?
This question was asked as part of a separate analysis of follow up impressions gathered during a randomized controlled multi-center trial that compared the results between a specialized group psychotherapy for adult ADHD and supportive community care while either on stimulant medication or placebo (Philipsen et al., 2015). The results of this original study indicated that there were no significant differences between the specialized group treatment and community care (in either medication or placebo conditions) on blinded ratings of ADHD symptoms.
However, the study also employed a participant-rated therapy evaluation form to get their perspectives on what was most effective in the treatments they received (Groß et al., 2017). Participants rated their psychosocial treatment experience on a 5-point Likert scale (“How do you judge the effectiveness of the whole treatment in respect to your ADHD symptoms?” [with the added phrase “…until today’s date” for 18-month post-treatment follow-up].
At the end of the one-year treatment study and at 18-month follow-up, significantly (though moderately) more participants in the specialized group psychotherapy found this treatment to be more helpful when compared with those in community care. At 18 months, this difference was only found among participants receiving psychological treatment in the placebo condition of the medication arm; there was no difference between specialized group therapy with placebo and community care with stimulant. The group therapist was rated as the most helpful component of psychosocial treatment for ADHD. The presence of other group members and the information provided in sessions were viewed as next most helpful to an equal degree. The correlations with observer and blind-ratings were strong enough to support the use of this additional self-report item.
The take away message from the article is that there is potentially fruitful additional source of outcome data on the benefit of psychosocial treatments for adult ADHD, namely, “customer” feedback.
Highlighted Article
Groß, V., …. Philipsen, A. (2017). Effectiveness of psychotherapy in adult ADHD: What do patients think? Results of the COMPAS study. Journal of Attention Disorders. online ahead of print. doi: 10.1177/1087054717720718
Other reference
Philipsen, A., et al. (2015). Effects of group psychotherapy, individual counseling, methylphenidate, and placebo in the treatment of adult attention-deficit/hyperactivity disorder: A randomized clinical trial. JAMA Psychiatry, 72, 1199-1210.
The New October Issue of the Journal of Attention Disorders
J. Russell Ramsay, Ph.D.
Associate Professor of Clinical Psychology
University of Pennsylvania, Perelman School of Medicine
The October issue of the Journal of Attentions Disorders includes an article on the effects of maternal smoking during pregnancy on the risk for smoking in ADHD children grown up. The findings are based on a controlled longitudinal study of children with ADHD in adulthood. The extended effects of smoking continue to be a relevant issue in behavioral health, particularly for individuals with ADHD.
Biederman, J., Martelon, M. K., Woodworth, K. Y., Spencer, T. J., & Faraone, S. V. (2017). Is maternal smoking during pregnancy a risk factor for cigarette smoking in offspring?: A longitudinal controlled study of ADHD children grown up. Journal of Attention Disorders, 21, 975-985.
All APSARD members have access to the Journal of Attention Disorders as a benefit of their membership. The article above can be accessed at:
http://journals.sagepub.com/home/jad