The objective of this study was to investigate how adult patients with attention-deficit/hyperactivity disorder viewed the testing and use of stimulants in their children.
Methods:
Using a qualitative approach, we interviewed 32 outpatients from a special care unit of a university hospital.
Results:
Emerging themes centered around concerns about the right age to test children and opinions about stimulant treatment ranging from unreserved agreement to reluctance, as well as the need for a shared decision with the child.
Conclusions:
Our results suggest that better psychoeducational programs are needed, especially for adults with attention-deficit/hyperactivity disorder, in which long-term consequences of the disorder, areas of impairment, and possible treatment effects in their children are explained and concerns about unknown side effects and the right time to test and treat are addressed.
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References
1.
AbikoffH, HechtmanL, KleinRG, GallagherR, FleissK, EtcovitchJ, CousinsL, GreenfieldB, MartinD, PollackS: Social functioning in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. J Am Acad Child Adolesc Psychiatry, 43:820–829, 2004.
2.
AdlerLD, NierenbergAA: Review of medication adherence in children and adults with ADHD. Postgrad Med, 122:184–191, 2010.
3.
AshersonP, AkehurstR, KooijJJ, HussM, BeusterienK, SasaneR, GholizadehS, HodgkinsP: Under diagnosis of adult ADHD: Cultural influences and societal burden. J Atten Disord, 16:20S–38S, 2012.
4.
BabinskiDE, WaxmonskyJG, WaschbuschDA, HumphreyH, AlfonsoA, CrumKI, BernsteinM, SlavecJ, AugustusJN, PelhamWEJr.: A pilot study of stimulant medication for adults with attention-deficit/hyperactivity disorder (ADHD) who are parents of adolescents with ADHD: The acute effects of stimulant medication on observed parent-adolescent interactions. J Child Adolesc Psychopharmacol, 24:582–585, 2014.
5.
BarkleyRA: Adolescents with attention-deficit/hyperactivity disorder: An overview of empirically based treatments. J Psychiatr Pract, 10:39–56, 2004.
6.
BarkleyRA, CoxD: A review of driving risks and impairments associated with attention-deficit/hyperactivity disorder and the effects of stimulant medication on driving performance. J Saf Res, 38:113–128, 2007.
7.
BarkleyRA, FischerM, SmallishL, FletcherK: The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol, 111:279–289, 2002.
Bolea-AlamañacB, NuttDJ, AdamouM, AshersonP, BazireS, CoghillD, HealD, MullerU, NashJ, SantoshP, SayalK, Sonuga-BarkeE, YoungSJ; British Association for Psychopharmacology: Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: Update on recommendations from the British Association for Psychopharmacology. J Psychopharmacol, 28:179–203, 2014.
11.
BunfordN, EvansSW, BeckerSP, LangbergJM: Attention-deficit/hyperactivity disorder and social skills in youth: A moderated mediation model of emotion dysregulation and depression. J Abnorm Child Psychol, 43:283–296, 2015.
12.
BussingR, Koro-LjungbergM, NoguchiK, MasonD, MayersonG, GarvanCW: Willingness to use ADHD treatments: A mixed methods study of perceptions by adolescents, parents, health professionals and teachers. Soc Sci Med, 74:92–100, 2012a.
13.
BussingR, ZimaBT, MasonDM, MeyerJM, WhiteK, GarvanCW: ADHD knowledge, perceptions, and information sources: Perspectives from a community sample of adolescents and their parents. J Adolesc Health, 51:593–600, 2012b.
14.
BussingR, ZimaBT, MasonDM, PorterPC, GarvanCW: Receiving treatment for attention-deficit hyperactivity disorder: Do the perspectives of adolescents matter?. J Adolesc Health, 49:7–14, 2011.
15.
CanuWH, NewmanML, MorrowTL, PopeDL: Social appraisal of adult ADHD: Stigma and influences of the beholder's Big Five personality traits. J Atten Disord, 11:700–710, 2008.
16.
CharachA, YeungE, VolpeT, GoodaleT, DosreisS: Exploring stimulant treatment in ADHD: Narratives of young adolescents and their parents. BMC Psychiatry, 14:110, 2014.
17.
ColemanD, WalkerJS, LeeJ, FriesenBJ, SquirePN: Children's beliefs about causes of childhood depression and ADHD: A study of stigmatization. Psychiatr Serv, 60:950–957, 2009.
18.
CoyneI, AmoryA, KiernanG, GibsonF: Children's participation in shared decision-making: Children, adolescents, parents and healthcare professionals' perspectives and experiences. Eur J Oncol Nurs, 18:273–280, 2014.
19.
EbertD, KrauseJ, Roth-SackenheimC: ADHD in adulthood–guidelines based on expert consensus with DGPPN support. [In German]. Nervenarz, 74:939–945, 2003.
20.
EscobarR, SoutulloCA, HervasA, GastaminzaX, PolaviejaP, GilaberteI: Worse quality of life for children with newly diagnosed attention-deficit/hyperactivity disorder, compared with asthmatic and healthy children. Pediatrics, 116:e364–e369, 2005.
21.
FayyadJ, De GraafR, KesslerR, AlonsoJ, AngermeyerM, DemyttenaereK, De GirolamoG, HaroJM, KaramEG, LaraC, LepineJP, OrmelJ, Posada-VillaJ, ZaslavskyAM, JinR: Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry, 190:402–409, 2007.
22.
FiorilloA, LucianoM, Del VecchioV, SampognaG, Obradors-TarragoC, MajM, ConsortiumR: Priorities for mental health research in Europe: A survey among national stakeholders' associations within the ROAMER project. World Psychiatry, 12:165–170, 2013.
23.
GinsbergY, QuinteroJ, AnandE, CasillasM, UpadhyayaHP: Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: A review of the literature. Prim Care Companion CNS Disord, 16: pii: PCC.13r01600, 2014.
24.
GjervanB, HjemdalO, NordahlHM: Functional impairment mediates the relationship between adult ADHD inattentiveness and occupational outcome. J Atten Disord, 20:510–518, 2016.
25.
GrahamJ, BanaschewskiT, BuitelaarJ, CoghillD, DanckaertsM, DittmannRW, DopfnerM, HamiltonR, HollisC, HoltmannM, Hulpke-WetteM, LecendreuxM, RosenthalE, RothenbergerA, SantoshP, SergeantJ, SimonoffE, Sonuga-BarkeE, WongIC, ZuddasA, SteinhausenHC, TaylorE; European Guidelines Group: European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry, 20:17–37, 2011.
26.
HalmøyA, FasmerOB, GillbergC, HaavikJ: Occupational outcome in adult ADHD: Impact of symptom profile, comorbid psychiatric problems, and treatment: A cross-sectional study of 414 clinically diagnosed adult ADHD patients. J Atten Disord, 13:175–187, 2009.
27.
HansenDL, HansenEH: Caught in a balancing act: Parents' dilemmas regarding their ADHD child's treatment with stimulant medication. Qual Health Res, 16:1267–1285, 2006.
28.
HarpinV, MazzoneL, RaynaudJP, KahleJ, HodgkinsP: Long-term outcomes of ADHD: A systematic review of self-esteem and social function. J Atten Disord, 20:295–305, 2016.
29.
HarpinVA: The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child, 90:i2–i7, 2005.
30.
HarveyE, DanforthJ, McKeeTE, UlaszekW, FriedmanJ: Parenting of children with attention-defecit/hyperactivity disorder (ADHD): The role of parental ADHD symptomatology. J Atten Disord, 7:31–42, 2003.
31.
HechtmanL, AbikoffH, KleinRG, WeissG, RespitzC, KouriJ, BlumC, GreenfieldB, EtcovitchJ, FleissK, PollackS: Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. J Am Acad Child Adolesc Psychiatry, 43:812–819, 2004.
32.
HillJC, SchoenerEP: Age-dependent decline of attention deficit hyperactivity disorder. Am J Psychiatry, 153:1143–1146, 1996.
33.
HozaB: Peer functioning in children with ADHD. J Pediatr Psychol, 32:655–663, 2007.
34.
HumphreysKL, GalanCA, TottenhamN, LeeSS: Impaired social decision-making mediates the association between ADHD and social problems. J Abnorm Child Psychol, 44:1023–1032, 2016.
35.
JohnstonC, MashEJ, MillerN, NinowskiJE: Parenting in adults with attention-deficit/hyperactivity disorder (ADHD). Clin Psychol Rev, 32:215–228, 2012.
36.
KesslerRC, AdlerLA, BarkleyR, BiedermanJ, ConnersCK, FaraoneSV, GreenhillLL, JaegerS, SecnikK, SpencerT, UstunTB, ZaslavskyAM: Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: Results from the national comorbidity survey replication. Biol Psychiatry, 57:1442–1451, 2005.
37.
KooijSJ, BejerotS, BlackwellA, CaciH, Casas-BrugueM, CarpentierPJ, EdvinssonD, FayyadJ, FoekenK, FitzgeraldM, GaillacV, GinsbergY, HenryC, KrauseJ, LensingMB, ManorI, NiederhoferH, Nunes-FilipeC, OhlmeierMD, OswaldP, PallantiS, PehlivanidisA, Ramos-QuirogaJA, RastamM, Ryffel-RawakD, StesS, AshersonP: European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry, 10:67, 2010.
38.
KrainAL, KendallPC, PowerTJ: The role of treatment acceptability in the initiation of treatment for ADHD. J Atten Disord, 9:425–434, 2005.
39.
LawGU, SinclairS, FraserN: Children's attitudes and behavioural intentions towards a peer with symptoms of ADHD: Does the addition of a diagnostic label make a difference?. J Child Health Care, 11:98–111, 2007.
40.
LebowitzMS: Stigmatization of ADHD: A developmental review. J Atten Disord, 20:199–205, 2016.
41.
LeeSS, HumphreysKL, FloryK, LiuR, GlassK: Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: A meta-analytic review. Clin Psychol Rev, 31:328–341, 2011.
42.
MartinJK, PescosolidoBA, OlafsdottirS, McLeodJD: The construction of fear: Americans' preferences for social distance from children and adolescents with mental health problems. J Health Soc Behav, 48:50–67, 2007.
43.
MatzaLS, ParamoreC, PrasadM: A review of the economic burden of ADHD. Cost Eff Resour Alloc, 3:1, 2005.
44.
MayringP: Combination and integration of qualitative and quantitative analysis. Forum Qual Soc Res ISSN: 1438–5627, 2001.
45.
MirandaA, TárragaR, FernándezMI, ColomerC, PastorG: Parenting Stress in families of children with autism spectrum disorder and ADHD. Except Child, 82:81–95, 2015.
46.
MoriyamaTS, PolanczykGV, TerziFS, FariaKM, RohdeLA: Psychopharmacology and psychotherapy for the treatment of adults with ADHD-a systematic review of available meta-analyses. CNS Spectr, 18:296–306, 2013.
47.
National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: Diagnosis and management. 2008. Available at https://www.nice.org.uk/guidance/cg722008. Accessed September1, 2016.
48.
SchachterHM, KingJ, LangfordS, MoherD: How efficacious and safe is short-acting methylphenidate for the treatment of attention-deficit disorder in children and adolescents? A meta-analysis. Can Med Assoc J, 165:1475–1488, 2001.
49.
SeixasM, WeissM, MüllerU: Systematic review of national and international guidelines on attention-deficit hyperactivity disorder. J Psychopharmacol, 26:753–765, 2012.
50.
Sonuga-BarkeEJ, DaleyD, ThompsonM: Does maternal ADHD reduce the effectiveness of parent training for preschool children's ADHD?. J Am Acad Child Adolesc Psychiatry, 41:696–702, 2002.
StrohJ, FrankenbergerW, Cornell-SwansonLV, WoodC, PahlS: The use of stimulant medication and behavioral interventions for the treatment of attention deficit hyperactivity disorder: A survey of parents' knowledge, attitudes, and experiences. J Child Fam Stud, 17:385–401, 2007.
53.
StrohJ, FrankenbergerW, WoodC, PahlS: The use of stimulant medication and behavioral interventions for the treatment of attention deficit hyperactivity disorder: A survey of parents' knowledge, attitudes, and experiences. J Child Fam Stud, 17:385–401, 2008.
54.
Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management, WolraichM, BrownL, BrownRT, DuPaulG, EarlsM, FeldmanHM, GaniatsTG, KaplanekB, MeyerB, PerrinJ, PierceK, ReiffM, SteinMT, VisserS.ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128:1007–1022, 2011.
55.
SungV, HiscockH, SciberrasE, EfronD: Sleep problems in children with attention-deficit/hyperactivity disorder: Prevalence and the effect on the child and family. Arch Pediatr Adolesc Med, 162:336–342, 2008.
56.
ThiruchelvamD, CharachA, SchacharRJ: Moderators and mediators of long-term adherence to stimulant treatment in children with ADHD. J Am Acad Child Adolesc Psychiatry, 40:922–928, 2001.
57.
TongA, SainsburyP, CraigJ: Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care, 19:349–357, 2007.
58.
Van der OordS, PrinsPJ, OosterlaanJ, EmmelkampPM: Efficacy of methylphenidate, psychosocial treatments and their combination in school-aged children with ADHD: A meta-analysis. Clin Psychol Rev, 28:783–800, 2008.
59.
WalkerJS, ColemanD, LeeJ, SquirePN, FriesenBJ: Children's stigmatization of childhood depression and ADHD: Magnitude and demographic variation in a national sample. J Am Acad Child Adolesc Psychiatry, 47:912–920, 2008.
60.
WienerJ, BiondicD, GrimbosT, HerbertM: Parenting stress of parents of adolescents with attention-deficit hyperactivity disorder. J Abnorm Child Psychol, 44:561–574, 2016.
61.
WilensTE, FaraoneSV, BiedermanJ, GunawardeneS: Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics, 111:179–185, 2003.
62.
WilsonCJ, BushnellJA, CaputiP: Early access and help seeking: Practice implications and new initiatives. Early Interv Psychiatry, 5Suppl 1:34–39, 2011.
63.
WolraichML, WibbelsmanCJ, BrownTE, EvansSW, GotliebEM, KnightJR, RossEC, ShubinerHH, WenderEH, WilensT: Attention-deficit/hyperactivity disorder among adolescents: A review of the diagnosis, treatment, and clinical implications. Pediatrics, 115:1734–1746, 2005.
64.
World Health Organization. The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines: Geneva: World Health Organization, 1992.
