Socioeconomic Status as a Moderator of ADHD Treatment Outcomes

Ricardo Rieppi, Laurence L. Greenhill, Rebecca E. Ford, Shirley Chuang, Min Wu, Mark Davies, Howard B. Abikoff, L. Eugene Arnold, C. Keith Conners, Glen R. Elliott, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, Helena C. Kraemer, John S. March, Jeffrey H. Newcorn, William E. Pelham, Joanne B. Severe, James M. SwansonBenedetto Vitiello, Karen C. Wells, Timothy Wigal

Research output: Contribution to journalArticle

86 Scopus citations

Abstract

Objective: To explore whether socioeconomic status (SES) variables moderate treatment response of attention-deficit/hyperactivity disorder (ADHD) to medication management (MedMgt), behavioral treatment (Beh), combined intervention (Comb), and routine community care (CC). Method: The MTA Cooperative Group's intent-to-treat (ITT) analyses were repeated, covarying for composite Hollingshead SES, education, occupation, income, and marital status. Results: Individual SES variables were more informative than the composite Hollingshead Index. Treatment response of children from less educated households paralleled ITT outcomes: no significant difference was found between Comb and MedMgt (both better than Beh and CC) for core ADHD symptoms. However, children from more educated families showed superior reduction of ADHD symptoms with Comb. For oppositional-aggressive symptoms, children from blue-collar, lower SES households benefited most from Comb, whereas those from white-collar, higher SES homes generally showed no differential treatment response. Household income and marital status failed to influence outcomes. Controlling for treatment attendance attenuated the moderating effects of the SES variables only for MedMgt. Conclusions: Investigators are encouraged to use independent SES variables for maximal explanation of SES effects. Clinicians should prioritize target symptoms and consider the mediating role of treatment adherence when determining an ADHD patient's optimal intervention plan.

Original languageEnglish (US)
Pages (from-to)269-277
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume41
Issue number3
DOIs
StatePublished - Mar 2002

Keywords

  • Attention-deficit/hyperactivity disorder
  • Clinical trial
  • Moderator
  • Socioeconomic status

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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    Rieppi, R., Greenhill, L. L., Ford, R. E., Chuang, S., Wu, M., Davies, M., Abikoff, H. B., Arnold, L. E., Conners, C. K., Elliott, G. R., Hechtman, L., Hinshaw, S. P., Hoza, B., Jensen, P. S., Kraemer, H. C., March, J. S., Newcorn, J. H., Pelham, W. E., Severe, J. B., ... Wigal, T. (2002). Socioeconomic Status as a Moderator of ADHD Treatment Outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 41(3), 269-277. https://doi.org/10.1097/00004583-200203000-00006