Multimodal treatment of ADHD in the MTA: An alternative outcome analysis

C. Keith Conners, Jeffrey N. Epstein, John S. March, Adrian Angold, Karen C. Wells, John Klaric, James M. Swanson, L. Eugene Arnold, Howard B. Abikoff, Glen R. Elliott, Laurence L. Greenhill, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, Helena C. Kraemer, Jeffrey H. Newcorn, William E. Pelham, Joanne B. Severe, Benedetto VitielloTimothy Wigal

Research output: Contribution to journalArticle

202 Scopus citations

Abstract

Objective: To conduct a post hoc investigation of the utility of a single composite measure of treatment outcome for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) at 14 months postbaseline. Background: Examination of multiple measures one at a time in the main MTA intent-to-treat outcome analyses failed to detect a statistically significant advantage of combined treatment (Comb) over medication management (MedMgt). A measure that increases power and precision using a single outcome score may be a useful alternative to multiple outcome measures. Method: Factor analysis of baseline scores yielded two "source factors" (parent and teacher) and one "instrument factor" (parent-child interactions). A composite score was created from the average of standardized parent and teacher measures. Results: The composite was internally consistent (α = .83), reliable (test-retest over 3 months = 0.86), and correlated 0.61 with clinician global judgments. In an intent-to-treat analysis, Comb was statistically significantly better than all other treatments, with effect sizes ranging from small (0.28) versus MedMgt, to moderately large (0.70) versus a community comparison group. Conclusions: A composite of ADHD variables may be an important tool in future treatment trials with ADHD and may avoid some of the statistical limitations of multiple measures.

Original languageEnglish (US)
Pages (from-to)159-167
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume40
Issue number2
DOIs
StatePublished - Jan 1 2001

Keywords

  • Attention-deficit/hyperactivity disorder
  • Clinical trial
  • Composite
  • NIMH collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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    Conners, C. K., Epstein, J. N., March, J. S., Angold, A., Wells, K. C., Klaric, J., Swanson, J. M., Arnold, L. E., Abikoff, H. B., Elliott, G. R., Greenhill, L. L., Hechtman, L., Hinshaw, S. P., Hoza, B., Jensen, P. S., Kraemer, H. C., Newcorn, J. H., Pelham, W. E., Severe, J. B., ... Wigal, T. (2001). Multimodal treatment of ADHD in the MTA: An alternative outcome analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 40(2), 159-167. https://doi.org/10.1097/00004583-200102000-00010