Does Attention-Deficit/Hyperactivity Disorder Predominant Presentation Matter? Examining Functional and Symptom...

Area of Science:

• Psychiatry and Behavioral Science
• Clinical Psychology

Background:

• Cognitive behavioural therapy (CBT) is a proven intervention for adult attention-deficit/hyperactivity disorder (ADHD).
• Previous research indicates efficacy for both brief (6-session) and standard (12-session) CBT formats.
• The differential impact of these formats on distinct ADHD presentations remains under investigation.

Purpose of the Study:

• To investigate whether treatment response to CBT in adults with ADHD differs based on distinct clinical presentations (inattentive vs. combined).
• To compare the efficacy of brief versus standard CBT formats concerning symptom reduction and functional outcomes.
• To assess the durability of treatment gains over a 6-month follow-up period.

Main Methods:

• A secondary analysis of a randomized trial involving 80 adults diagnosed with ADHD.
• Participants were allocated to either brief (6-session) or standard (12-session) CBT.
• Linear mixed-effects models and Reliable Change Index (RCI) were used to analyze clinical and functional outcomes at baseline, posttreatment, and 3- and 6-month follow-ups, examining interactions between time, treatment format, and ADHD presentation.

Main Results:

• Cognitive behavioural therapy (CBT) demonstrated significant improvements across all assessed domains, with 94.5% of participants achieving reliable symptomatic improvement.
• A significant interaction between time and ADHD presentation indicated a steeper reduction in core ADHD symptoms for the combined presentation group (p=0.001).
• The brief CBT format showed greater observer-rated symptom improvement, whereas the standard format resulted in greater long-term functional gains (p=0.009), with improvements sustained at 6 months.

Conclusions:

• Cognitive behavioural therapy (CBT) is a highly effective and durable treatment for adults with ADHD, irrespective of presentation or format.
• While the combined ADHD presentation showed a more pronounced reduction in core symptoms with CBT, the standard format may be more beneficial for long-term functional recovery.
• Brief CBT formats efficiently target core symptoms, whereas standard formats may offer enhanced long-term functional benefits, warranting further clinical consideration.