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SOCIAL FUNCTIONING AND CORE SYMPTOMATOLOGY AS PREDICTORS OF RESPONSE TO A SUMMER TREATMENT PROGRAM FOR YOUTH WITH COMBINED TYPE ATTENTION DEFICIT HYPERACTIVITY DISORDER
Title
SOCIAL FUNCTIONING AND CORE SYMPTOMATOLOGY AS PREDICTORS OF RESPONSE TO A SUMMER TREATMENT PROGRAM FOR YOUTH WITH COMBINED TYPE ATTENTION DEFICIT HYPERACTIVITY DISORDER
Creator
Uribe, Roberto Alejandro
Date
2015, 2015-12
Description
The study was a retrospective repeated measures analysis of 108 youth (age 6-12) who took part in the 2008-2012 Camp STAR (Summer Treatment...
Show moreThe study was a retrospective repeated measures analysis of 108 youth (age 6-12) who took part in the 2008-2012 Camp STAR (Summer Treatment Program for ADHD and Related Disorders) Summer Treatment Program. Developed by William E. Pelham in 1980, the Summer Treatment Program (STP) is an intensive psychosocial intervention delivered to children ages 6-12 in natural settings through the medium of summer camp. A recognized evidence base for the STP has steadily developed and evolved leading to improved stabilization of ADHD associated issues and treatment satisfaction. The following investigation sought to address questions about the efficacy of the STP with respect to predicting treatment responses for a subgroup of ADHD youth presenting with complex clinical presentations of combined type ADHD. The study built on prior evaluations of predictor importance by utilizing socio-emotional measures from the daily behavioral data of the STP, as well as more typically used ADHD dimensional symptom severity measures to inform treatment fit. As anticipated, because the heterogeneity of the disorder suggests that response to treatment is multifaceted, no combination of predictor variables produced a regression equation model that significantly explained variance across all of the treatment outcome variables. After controlling for concurrent pharmacotherapy and age, the combined effects of pretreatment core ADHD symptom severity and social functioning measures were found to significantly explain variance in a criterion variable corresponding with camp objectives (e.g., developing social competencies and coping skills, decreased functioning; Overall STP Improvement Index), as well as positive and negative socio-emotional behaviors measured directly by the STP Point System at the end of the camp. Change in R2 statistics confirmed the study hypothesis in which, the pretreatment socio-emotional factor sets significantly improved the prediction of multiple treatment outcomes over and above DSM-IV ADHD symptom dimensions and control variables. Ten percent of unique variance when predicting informant ratings of improvement made while at camp, 4% unique variance when predicting positive social behavior at the conclusion of Camp STAR, and 2% unique variance when predicting negative social behavior at the conclusion of Camp STAR were among the results. Observed negative behaviors at baseline demonstrated predictive utility whereas results pertaining to hyperactivity/impulsivity and inattention symptom dimensions did not significantly influence behavior, and subsequently, revealed little about the observed variation in outcomes in this particular dataset. While each of the core DSM-IV symptom dimensions are known to be differently associated with a variety of domain specific impairments in the general population (Lahey, & Willcutt, 2010), the results from this study suggest that with ADHD subgroups featuring severe symptom and impairment profiles, the core symptom dimensions did not appear to be as differentially associated with functional impairment. In cases of severe combined type ADHD, decisions about treatment fit should be based more on the socio-emotional impact of symptoms rather than their mere presence. The findings underscore the value in identifying socio-emotional impairments for individuals diagnosed with severe and complicated ADHD as early as possible and to intervene with intensive modalities specifically aimed at developing skills and cognitive faculties that enhance abilities to maintain healthy relationships.
Ph.D. in Psychology, December 2015
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