Behavioral parent training for children with ADHD : effectiveness in clinical practice and moderators of treatment response

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The primary aim of the study that has been described in the present thesis was to investigate the effectiveness of BPT in clinical practice as an adjunct to ongoing Routine Clinical Care (RCC). To our knowledge, this is the first randomized controlled trial in children with ADHD that allowed patient selection in a naturalistic way. We offered our BPT program to a clinically representative, refferd sample of children with ADHD (4-12 years)m in which exclusionary criteria were minimized.
Chapter 2 describes our findings regarding the effectiveness of the BPT program as an adjunct to ongoing RCC. Outcome domains included ADHD symptoms, behavioral problems, internalizing problems, parenting stress, frequency of RCC contacts, and prescription of multiple medications (polypharmaceutical treatment) during RCC.
Secondary aims of the study were to identify predictor and/or moderator variables of BPT and/or RCC treatment response. In chapter 2, in addition to the effectiveness findings, analyses of differential treatment effects for children with and without medication at study entry are included. Chapter 3 investigates the role of a number of child variable (IQ, age, and comorbidity) and maternal variables (paternal ADHD, depression, and self-efficacy) on treatment outcome. In chapter 5, the role of three dopamine related genetic polymorphisms in treatment success was examined. Genes that were included in this study were the dopaminetransporter gene (DAT1), the dopamine receptor D5 (DRD5), and the dopamine beta hydroxylase gene (DBH TaqI A2).

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