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Methylphenidate and attributions in boys with attention-deficit hyperactivity disorder
William E Pelham1, Debra A Murphy, Kathryn Vannatta
1U Pittsburgh, Western Psychiatric Inst & Clinic, PA.
Abstract:
In Experiment 1, 28 attention-deficit hyperactivity disorder (ADHD) boys underwent a double-blind, placebo-controlled medication assessment in a summer day-treatment program. Daily, boys were asked questions to assess their attributions for and evaluations of their behavior. Objective measures showed improved behavior with methylphenidate; however, boys tended to attribute their performance to effort rather than to medication, particularly when medicated. Experiment 2 involved 38 ADHD boys the following summer and replicated the procedures in Experiment 1, with the addition of a no-pill condition and a comparison of attributions for success and failure outcomes. Simply taking a pill (no-pill vs. placebo comparison) did not show significant effects, whereas the results of Experiment 1 were replicated with placebo-methylphenidate comparisons. Across drug conditions a self-enhancing attributional pattern was obtained; the majority of attributions for success were to ability or effort, whereas attributions for failure were to the pill or to counselors.
Insights
Boys with attention-deficit hyperactivity disorder (ADHD) attributed behavioral improvements from methylphenidate to effort, not medication. This self-enhancing attributional pattern persisted across studies, impacting how ADHD boys perceived treatment success.
Area of Science:
- Child and Adolescent Psychiatry
- Behavioral Psychology
- Neurodevelopmental Disorders
Background:
- Attention-deficit hyperactivity disorder (ADHD) affects behavior and academic performance.
- Understanding attributions in ADHD is crucial for effective interventions.
- Methylphenidate is a common medication for managing ADHD symptoms.
Purpose of the Study:
- To investigate how ADHD boys attribute behavioral improvements during methylphenidate treatment.
- To examine the impact of medication versus effort attributions on perceived treatment outcomes.
- To compare attributional patterns for success and failure in ADHD boys.
Main Methods:
- Two experiments involving boys diagnosed with ADHD in a day-treatment program.
- Double-blind, placebo-controlled medication assessments with methylphenidate.
- Daily questionnaires assessing attributions for behavior and performance outcomes.
Main Results:
- Objective measures showed behavioral improvement with methylphenidate.
- Boys attributed success to effort or ability, and failure to external factors like medication or counselors.
- No significant difference was found in a no-pill versus placebo condition, but placebo-methylphenidate comparisons replicated findings.
Conclusions:
- ADHD boys exhibit a self-enhancing attributional bias, attributing success to internal factors and failure to external ones.
- This bias influences how they perceive the efficacy of ADHD medication.
- Further research should explore interventions to modify these attributional patterns for improved treatment adherence and outcomes.