Anger control in response to verbal provocation: effects of stimulant medication for boys with ADHD

Although stimulant medication reduces hyperactive children's aggression in naturalistic settings, stimulant effects on anger control have not been demonstrated. We therefore assessed the role of methylphenidate in enhancing response to verbal provocation from familiar peers and from role-playing adults. Twenty-four boys with attention deficit-hyperactivity disorder (ADHD), aged 6-12, received small-group cognitive-behavioral intervention in anger management skills. During posttraining assessments, the children were randomly assigned to placebo versus .6 mg/kg of methylphenidate. In the peer provocations, methylphenidate enhanced self-control, decreased physical retaliation, and marginally increased the display of coping strategies. Medication and prompting were minimally beneficial in the delayed, adult-administered generalization assessments. Among the issues discussed are (a) differences between peer and adult provocation and (b) the roles of medication dosage and multimodality intervention for promoting socially competent behavior in children with ADHD.