Restricted accessResearch articleFirst published online 2020-2
Efficacy of Nonpharmacological Treatments on Comorbid Internalizing Symptoms of Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review
Background: Attention-deficit/hyperactivity disorder (ADHD) is highly comorbid in adulthood. This meta-analysis was aimed at ascertaining the efficacy of different psychotherapies in improving comorbid internalizing symptoms in adults with ADHD. Method: Twenty randomized controlled trials and 12 uncontrolled pretest–posttest studies were included and combined using the inverse variance method. Risk of bias and heterogeneity assessment and moderator analyses were performed. Results: Cognitive-behavioral therapy (CBT) improved quality of life (QoL), emotional dysregulation (ED), depression, and anxiety symptoms, particularly at follow-up, which was predicted by core symptoms reduction. A significant between-group effect was obtained only on QoL, ED, and self-esteem for dialectical behavior therapy (DBT), mindfulness-based therapies (MBTs), and neurofeedback, respectively. Conclusion: Results support CBT efficacy for treating comorbid internalizing symptoms. More research is needed to determine the effectiveness of DBT, MBT, and neurofeedback. The small number of studies evaluating some therapies and the high risk of bias observed might limit these results.
AdlerL. A.DirksB.DeasP.RaychaudhuriA.DauphinM.SaylorK.WeislerR. (2013). Self-reported quality of life in adults with attention-deficit/hyperactivity disorder and executive function impairment treated with lisdexamfetamine dimesylate: A randomized, double-blind, multicenter, placebo-controlled, parallel-group study. BMC Psychiatry, 13, Article 253. doi:10.1186/1471-244x-13-253
2.
Agnew-BlaisJ. C.PolanczykG. V.DaneseA.WertzJ.MoffittT. E.ArseneaultL. (2018). Young adult mental health and functional outcomes among individuals with remitted, persistent and late-onset ADHD. The British Journal of Psychiatry, 213, 526-534. doi:10.1192/bjp.2018.97
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
4.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
5.
AnkerE.BendiksenB.HeirT. (2018). Comorbid psychiatric disorders in a clinical sample of adults with ADHD, and associations with education, work and social characteristics: A cross-sectional study. BMJ Open, 8(3), e019700. doi:10.1136/bmjopen-2017-019700
6.
ArnsM.DrinkenburgW.Leon KenemansJ. (2012). The effects of QEEG-informed neurofeedback in ADHD: An open-label pilot study. Applied Psychophysiology Biofeedback, 37, 171-180. doi:10.1007/s10484-012-9191-4
7.
ArnsM.HeinrichH.StrehlU. (2014). Evaluation of neurofeedback in ADHD: The long and winding road. Biological Psychology, 95, 108-115. doi:10.1016/j.biopsycho.2013.11.013
8.
BachmannK.LamA. P.SörösP.KanatM.HoxhajE.MatthiesS.. . . PhilipsenA. (2018). Effects of mindfulness and psychoeducation on working memory in adult ADHD: A randomised, controlled fMRI study. Behaviour Research and Therapy, 106, 47-56. doi:10.1016/j.brat.2018.05.002
9.
BandelowB.MichaelisS. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17, 327-335. doi:10.1016/j.siny.2015.10.004
10.
BarkhamM.ConnellJ.MilesJ. N. V.EvansC.StilesW. B.MargisonF.Mellor-ClarkJ. (2006). Dose-effect relations and responsive regulation of treatment duration: The good enough level. Journal of Consulting and Clinical Psychology, 74, 160-167. doi:10.1037/0022-006X.74.1.160
11.
BarkleyR. A.BrownT. E. (2008). Unrecognized attention-deficit/hyperactivity disorder in adults presenting with other psychiatric disorders. CNS Spectrums, 13, 977-984.
12.
BarthB.MayerK.StrehlU.FallgatterA. J.EhlisA. C. (2017). EMG biofeedback training in adult attention-deficit/hyperactivity disorder: An active (control) training?Behavioural Brain Research, 329, 58-66. doi:10.1016/j.bbr.2017.04.021
13.
BaskinT. W.TierneyS. C.MinamiT.WampoldB. E. (2003). Establishing specificity in psychotherapy: A meta-analysis of structural equivalence of placebo controls. Journal of Consulting and Clinical Psychology, 71, 973-979. doi.:10.1037/0022-006X.71.6.973
14.
BegemannM. J. H.FlorisseE. J. R.van LutterveldR.KooymanM.SommerI. E. (2016). Efficacy of EEG neurofeedback in psychiatry: A comprehensive overview and meta-analysis. Translational Brain Rhythmicity, 1, 19-29. doi:10.15761/TBR.1000105
15.
BernardiS.FaraoneS. V.CorteseS.KerridgeB. T.PallantiS.WangS.BlancoC. (2012). The lifetime impact of attention deficit hyperactivity disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Psychological Medicine, 42, 875-887. doi:10.1017/S003329171100153X
16.
BertocciM. A.BebkoG.VersaceA.FournierJ. C.IyengarS.OlinoT.. . . PhillipsM. L. (2016). Predicting clinical outcome from reward circuitry function and white matter structure in behaviorally and emotionally dysregulated youth. Molecular Psychiatry, 21, 1194-1201. doi:10.1038/mp.2016.5
17.
BiedermanJ. (2004). Impact of comorbidity in adults with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 65(suppl 3), 3-7. doi:10.1038/ni.2065
18.
BiedermanJ.BallS. W.MonuteauxM. C.MickE.SpencerT. J.McCrearyM.FaraoneS. V. (2008). New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 426-434. doi:10.1097/CHI.0b013e31816429d3
19.
BiedermanJ.PettyC. R.ClarkeA.LomedicoA.FaraoneS. V. (2011). Predictors of persistent ADHD: An 11-year follow-up study. Journal of Psychiatric Research, 45, 150-155. doi:10.1016/j.jpsychires.2010.06.009
20.
BigmanY. E.MaussI. B.GrossJ. J.TamirM. (2016). Yes I can: Expected success promotes actual success in emotion regulation. Cognition and Emotion, 30, 1380-1387. doi:10.1080/02699931.2015.1067188
21.
Bihlar MuldB.JokinenJ.BölteS.HirvikoskiT. (2016). Skills training groups for men with ADHD in compulsory care due to substance use disorder: A feasibility study. ADHD Attention Deficit and Hyperactivity Disorders, 8, 159-172. doi:10.1007/s12402-016-0195-4
22.
BlanckP.PerlethS.HeidenreichT.KrögerP.DitzenB.BentsH.ManderJ. (2018). Effects of mindfulness exercises as stand-alone intervention on symptoms of anxiety and depression: Systematic review and meta-analysis. Behaviour Research and Therapy, 102, 25-35. doi:10.1016/j.brat.2017.12.002
23.
BleidornW.RubenC. A.JaapJ. A. D.RentfrowP. J.GebauerJ. E.PotterJ.GoslingS. D. (2016). Age and gender differences in self-esteem—A cross-cultural window. Journal of Personality and Social Psychology, 111, 396-410. doi:10.1037/pspp0000078
24.
BorensteinM.HedgesL. V.HigginsJ. P. T.RothsteinH. R. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1, 97-111. doi:10.1002/jrsm.12
25.
BramhamJ.MurphyD. G. M.XenitidisK.AshersonP.HopkinG.YoungS. (2012). Adults with attention deficit hyperactivity disorder: An investigation of age-related differences in behavioural symptoms, neuropsychological function and co-morbidity. Psychological Medicine, 42, 2225-2234. doi:10.1017/S0033291712000219
26.
BramhamJ.YoungS.BickerdikeA.SpainD.McCartanD.XenitidisK. (2009). Evaluation of group cognitive behavioral therapy for adults with ADHD. Journal of Attention Disorders, 12, 434-441. doi:10.1177/1087054708314596
27.
BronT. I.BijlengaD.VerduijnJ.PenninxB. W. J. H.BeekmanA. T. F.KooijJ. J. S. (2016). Prevalence of ADHD symptoms across clinical stages of major depressive disorder. Journal of Affective Disorders, 197, 29-35. doi:10.1016/j.jad.2016.02.053
28.
BrownT. E.FloodE.SaroccoP.AtkinsN.KhachatryanA. (2017). Persisting psychosocial impairments in adults being treated with medication for attention deficit/hyperactivity disorder. Psychopharmacology Bulletin, 47(4), 8-17.
29.
BuenoV. F.KozasaE. H.AparecidaM.AlvesT. M.LouzãM. R.PompéiaS. (2015). Mindfulness meditation improves mood, quality of life, and attention in adults with attention deficit hyperactivity disorder. BioMed Research International, 2015, 1-14.
30.
CadmanT.FindonJ.EklundH.HaywardH.HowleyD.CheungC.. . . AshersonP. (2016). Six-year follow-up study of combined type ADHD from childhood to young adulthood: Predictors of functional impairment and comorbid symptoms. European Psychiatry, 35, 47-54. doi:10.1016/j.eurpsy.2015.08.007
31.
CairncrossM.MillerC. J. (2016). The effectiveness of mindfulness-based therapies for ADHD: A meta-analytic review. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054715625301
32.
CarpenterJ. K.AndrewsL. A.WitcraftS. M.PowersM. B.SmitsJ. A. J.HofmannS. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35, 502-514. doi:10.1002/da.22728
33.
ChenT. J.JiC. Y.WangS. S.LichtensteinP.LarssonH.ChangZ. (2016). Genetic and environmental influences on the relationship between ADHD symptoms and internalizing problems: A Chinese twin study. American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics, 171, 931-937. doi:10.1002/ajmg.b.32411
34.
CherkasovaM. V.FrenchL. R.SyerC. A.CousinsL.GalinaH.Ahmadi-KashaniY.HechtmanL. (2016). Efficacy of cognitive behavioral therapy with and without medication for adults with ADHD: A randomized clinical trial. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054716671197
35.
ChoiS. W.ChiS. E.ChungS. Y.KimJ. W.AhnC. Y.KimH. T. (2010). Is alpha wave neurofeedback effective with randomized clinical trials in depression? A pilot study. Neuropsychobiology, 63, 43-51. doi:10.1159/000322290
36.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
37.
ColeP.WeibelS.NicastroR.HaslerR.DayerA.AubryJ. M.. . . PerroudN. (2016). CBT/DBT skills training for adults with attention deficit hyperactivity disorder (ADHD). Psychiatria Danubina, 28, 103-107.
38.
CookJ.KnightE.HumeI.QureshiA. (2014). The self-esteem of adults diagnosed with attention-deficit/hyperactivity disorder (ADHD): A systematic review of the literature. ADHD Attention Deficit and Hyperactivity Disorders, 6, 249-268. doi:10.1007/s12402-014-0133-2
39.
CorbisieroS.MörstedtB.BittoH.StieglitzR. D. (2017). Emotional dysregulation in adults with attention-deficit/hyperactivity disorder—validity, predictability, severity, and comorbidity. Journal of Clinical Psychology, 73, 99-112. doi:10.1002/jclp.22317
40.
CowleyB.HolmströmÉ.JuurmaaK.KovarskisL.KrauseC. M. (2016). Computer enabled neuroplasticity treatment: A clinical trial of a novel design for neurofeedback therapy in adult ADHD. Frontiers in Human Neuroscience, 10, 1-13. doi:10.3389/fnhum.2016.00205
41.
CuijpersP.CristeaI. A.KaryotakiE.ReijndersM.HuibersM. J. H. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15, 245-258. doi:10.1002/wps.20346
42.
CuijpersP.de WitL.KleiboerA.KaryotakiE.EbertD. D. (2018). Problem-solving therapy for adult depression: An updated meta-analysis. European Psychiatry, 48, 27-37. doi:10.1016/j.eurpsy.2017.11.006
43.
CuijpersP.LiJ.HofmannS. G.AnderssonG. (2010). Self-reported versus clinician-rated symptoms of depression as outcome measures in psychotherapy research on depression: A meta-analysis. Clinical Psychology Review, 30, 768-778. doi:10.1016/j.cpr.2010.06.001
44.
CunillR.CastellsX.TobiasA.CapellàD. (2016). Efficacy, safety and variability in pharmacotherapy for adults with attention deficit hyperactivity disorder: A meta-analysis and meta-regression in over 9000 patients. Psychopharmacology, 233, 187-197. doi:10.1007/s00213-015-4099-3
45.
DanO.RazS. (2015). The relationships among ADHD, self-esteem, and test anxiety in young adults. Journal of Attention Disorders, 19, 231-239. doi:10.1177/1087054712454571
46.
den BergB. R. H.MarcoenA. (2004). High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Development, 75, 1085-1097.
47.
DiMauroJ.DominguesJ.FernandezG.TolinD. F. (2013). Long-term effectiveness of CBT for anxiety disorders in an adult outpatient clinic sample: A follow-up study. Behaviour Research and Therapy, 51, 82-86. doi:10.1016/j.brat.2012.10.003
48.
DittnerA. J.HodsollJ.RimesK. A.RussellA. J.ChalderT. (2018). Cognitive–behavioural therapy for adult attention-deficit hyperactivity disorder: A proof of concept randomised controlled trial. Acta Psychiatrica Scandinavica, 137, 125-137. doi:10.1111/acps.12836
49.
DonkerT.GriffithsK. M.CuijpersP.ChristensenH. (2009). Psychoeducation for depression, anxiety and psychological distress: A meta-analysis. BMC Medicine, 7, Article 79. doi:10.1186/1741-7015-7-79
50.
DuvalS.TweedieR. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56, 455-463. doi:10.1111/j.0006-341X.2000.00455.x
51.
EdvinssonD.LindströmE.BingeforsK.LewanderT.EkseliusL. (2013). Gender differences of axis I and II comorbidity in subjects diagnosed with attention-deficit hyperactivity disorder as adults. Acta Neuropsychiatrica, 25, 165-174. doi:10.1111/j.1601-5215.2012.00682.x
52.
EggerM.SmithG. D.SchneiderM.MinderC. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315, 629-634. doi:10.1136/bmj.315.7109.629
53.
EkersD.WebsterL.Van StratenA.CuijpersP.RichardsD.GilbodyS. (2014). Behavioural activation for depression; An update of meta-analysis of effectiveness and sub group analysis. PLoS ONE, 9(6), e100100. doi:10.1371/journal.pone.0100100
54.
EmilssonB.GudjonssonG.SigurdssonJ. F.BaldurssonG.EinarssonE.OlafsdottirH.YoungS. (2011). Cognitive behaviour therapy in medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. BMC Psychiatry, 11(1), Article 116. doi:10.1186/1471-244X-11-116
55.
EpsteinT.PatsopoulosN. A.WeiserM. (2014). Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 9(9), Cd005041. doi:10.1002/14651858.CD005041.pub2
56.
FayyadJ.SampsonN. A.HwangI.AdamowskiT.Aguilar-GaxiolaS.Al-HamzawiA.. . . ZaslavskyA. M. (2016). The descriptive epidemiology of DSM-IV Adult ADHD in the world health organization world mental health surveys. ADHD Attention Deficit and Hyperactivity Disorders, 9, 47-65. doi:10.1007/s12402-016-0208-3
57.
FlemingA. P.McMahonR. J.MoranL. R.PetersonA. P.DreessenA. (2015). Pilot randomized controlled trial of dialectical behavior therapy group skills training for ADHD among college students. Journal of Attention Disorders, 19, 260-271. doi:10.1177/1087054714535951
58.
GarciaC. R.BauC. H. D.SilvaK. L.Callegari-JacquesS. M.SalgadoC. A. I.FischerA. G.. . . GrevetE. H. (2012). The burdened life of adults with ADHD: Impairment beyond comorbidity. European Psychiatry, 27, 309-313. doi:10.1016/j.eurpsy.2010.08.002
59.
GoldenW. L. (2012). Cognitive hypnotherapy for anxiety disorders. American Journal of Clinical Hypnosis, 54, 263-274. doi:10.1080/00029157.2011.650333
60.
GroganK.BramhamJ. (2016). Demographic, developmental and psychosocial predictors of the development of anxiety in adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 8, 35-44. doi:10.1007/s12402-015-0183-0
61.
GuY.XuG.ZhuY. (2017). A randomized controlled trial of mindfulness-based cognitive therapy for college students with ADHD. Journal of Attention Disorders, 22, 388-399. doi:10.1177/1087054716686183
62.
GudjonssonG. H.SigurdssonJ. F.EyjolfsdottirG. A.SmariJ.YoungS. (2009). The relationship between satisfaction with life, ADHD symptoms, and associated problems among university students. Journal of Attention Disorders, 12, 507-515. doi:10.1177/1087054708323018
63.
HeparkS.JanssenL.de VriesA.SchoenbergP. L. A.DondersR.KanC. C.SpeckensA. E. M. (2015). The efficacy of adapted MBCT on core symptoms and executive functioning in adults with ADHD: A preliminary randomized controlled trial. Journal of Attention Disorders, 23, 351-362. doi:10.1177/1087054715613587
64.
HesslingerB.Tebartz Van ElstL.NybergE.DykierekP.RichterH.BernerM.EbertD. (2002). Psychotherapy of attention deficit hyperactivity disorder in adults. European Archives of Psychiatry and Clinical Neuroscience, 252, 177-184. doi:10.1007/s00406-002-0379-0
65.
HigginsJ. P. T.AltmanD. G.GotzscheP. C.JuniP.MoherD.OxmanA. D.. . . SterneJ. A. C. (2011). The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343, d5928-d5928. doi:10.1136/bmj.d5928
66.
HigginsJ. P. T.GreenS. (2011). Cochrane handbook for systematic reviews of interventions. Hoboken, NJ: John Wiley.
67.
HigginsJ. P. T.ThompsonS. G.DeeksJ. J.AltmanD. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557-560. doi:10.1136/bmj.327.7414.557
68.
HirschO.ChavanonM. L.RiechmannE.ChristiansenH. (2018). Emotional dysregulation is a primary symptom in adult attention-deficit/hyperactivity disorder (ADHD). Journal of Affective Disorders, 232, 41-47. doi:10.1016/j.jad.2018.02.007
69.
HirvikoskiT.WaalerE.AlfredssonJ.PihlgrenC.HolmströmA.JohnsonA.. . . NordströmA. L. (2011). Reduced ADHD symptoms in adults with ADHD after structured skills training group: Results from a randomized controlled trial. Behaviour Research and Therapy, 49, 175-185. doi:10.1016/j.brat.2011.01.001
70.
HirvikoskiT.WaalerE.LindströmT.BölteS.JokinenJ. (2015). Cognitive behavior therapy-based psychoeducational groups for adults with ADHD and their significant others (PEGASUS): An open clinical feasibility trial. ADHD Attention Deficit and Hyperactivity Disorders, 7, 89-99. doi:10.1007/s12402-014-0141-2
71.
HölzelB. K.LazarS. W.GardT.Schuman-OlivierZ.VagoD. R.OttU. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6, 537-559. doi:10.1177/1745691611419671
HoxhajE.SadoharaC.BorelP.D’AmelioR.SobanskiE.MüllerH.. . . PhilipsenA. (2018). Mindfulness vs psychoeducation in adult ADHD: A randomized controlled trial. European Archives of Psychiatry and Clinical Neuroscience, 268, 321-335. doi:10.1007/s00406-018-0868-4
74.
HuangF.TangY.ZhaoM.WangY.PanM.WangY.QianQ. (2019). Cognitive-behavioral therapy for adult ADHD: A randomized clinical trial in China. Journal of Attention Disorders, 23(9), 1035-1046. doi:10.1177/1087054717725874
75.
HunterJ. E.SchmidtF. L. (2004). Technical questions in meta-analysis of d values. In HunterJ. E.SchmidtF. L. (Eds.), Methods of meta-analysis: Correcting error and bias in research findings (2nd ed., pp. 335-390). Thousand Oaks, CA: SAGE.
76.
JanssenL.de VriesA. M.HeparkS.SpeckensA. E. M. (2017). The feasibility, effectiveness, and process of change of mindfulness-based cognitive therapy for adults with ADHD: A mixed-method pilot study. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054717727350
77.
JanssenL.KanC. C.CarpentierP. J.SizooB.HeparkS.SchellekensM. P. J.. . . SpeckensA. E. M. (2018). Mindfulness-based cognitive therapy v. treatment as usual in adults with ADHD: A multicentre, single-blind, randomised controlled trial. Psychological Medicine, 49, 55-65. doi:10.1017/S0033291718000776
78.
JensenC. M.AmdisenB. L.JørgensenK. J.ArnfredS. M. H. (2016). Cognitive behavioural therapy for ADHD in adults: Systematic review and meta-analyses. ADHD Attention Deficit and Hyperactivity Disorders, 8, 3-11. doi:10.1007/s12402-016-0188-3
79.
KaiserD. A. (1997). Efficacy of neurofeedback on adults with attentional deficit and related disorders. EEG Spectrum, 1997, 1-6.
80.
KarlssonP.BergmarkA. (2015). Compared with what? An analysis of control-group types in Cochrane and Campbell reviews of psychosocial treatment efficacy with substance use disorders. Addiction, 110, 420-428. doi:10.1111/add.12799
81.
KatzmanM. A.BilkeyT. S.ChokkaP. R.FalluA.KlassenL. J. (2017). Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry, 17(1), Article 302. doi:10.1186/s12888-017-1463-3
82.
KesslerR. C.AdlerL.BarkleyR.BiedermanJ.ConnersC. K.DemlerO.. . . ZaslavskyA. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the national comorbidity survey replication. American Journal of Psychiatry, 163, 716-723. doi:10.1176/appi.ajp.163.4.716
83.
KnouseL. E.TellerJ.BrooksM. A. (2017). Meta-analysis of cognitive behavioral treatments for adult ADHD. Journal of Consulting and Clinical Psychology, 85, 737-750. doi:10.1037/ccp0000216
84.
LaCountP. A.HartungC. M.SheltonC. R.ClappJ. D.ClappT. K. W. (2015). Preliminary evaluation of a combined group and individual treatment for college students with attention-deficit/hyperactivity disorder. Cognitive and Behavioral Practice, 22, 152-160. doi:10.1016/j.cbpra.2014.07.004
85.
LenziF.CorteseS.HarrisJ.MasiG. (2018). Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 84, 359-367. doi:10.1016/j.neubiorev.2017.08.010
86.
LeppingP.WhittingtonR.SambhiR. S.LaneS.PooleR.LeuchtS.. . . WaheedW. (2017). Clinical relevance of findings in trials of CBT for depression. European Psychiatry, 45, 207-211. doi:10.1016/j.eurpsy.2017.07.003
87.
LiberatiA.AltmanD. G.TetzlaffJ.MulrowC.GotzscheP. C.IoannidisJ. P. A.. . . MoherD. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ, 339, b2700-b2700. doi:10.1136/bmj.b2700
88.
LinehanM. M. (1993). Cognitive-behavioral treatment of border-line personality disorder. New York, NY: The Guilford Press.
89.
LocherC.GaabJ.BleaseC. (2018). When a placebo is not a placebo: Problems and solutions to the gold standard in psychotherapy research. Frontiers in Psychology, 9, Article 2317. doi:10.3389/fpsyg.2018.02317
90.
LopezP. L.TorrenteF. M.CiapponiA.LischinskyA. G.Cetkovich-BakmasM.RojasJ. I.. . . ManesF. F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults (Review). Cochrane Database of Systematic Reviews. Advance online publication. doi:10.1002/14651858.CD010840.pub2
91.
López-PinarC.Martínez-SanchísS.Carbonell-VayáE.Fenollar-CortésJ.Sánchez-MecaJ. (2018). Long-term efficacy of psychosocial treatments for adults with attention-deficit/hyperactivity disorder: A meta-analytic review. Frontiers in Psychology, 9, 1-16. doi:10.3389/fpsyg.2018.00638
92.
MarwoodL.WiseT.PerkinsA. M.CleareA. J. (2018). Meta-analyses of the neural mechanisms and predictors of response to psychotherapy in depression and anxiety. Neuroscience & Biobehavioral Reviews, 95, 61-72. doi:10.1016/j.neubiorev.2018.09.022
93.
MayerK.BlumeF.WyckoffS. N.BrokmeierL. L.StrehlU. (2016). Neurofeedback of slow cortical potentials as a treatment for adults with attention-deficit/hyperactivity disorder. Clinical Neurophysiology, 127, 1374-1386. doi:10.1016/j.clinph.2015.11.013
94.
MayerK.WyckoffS. N.SchulzU.StrehlU. (2012). Neurofeedback for adult attention-deficit/hyperactivity disorder: Investigation of slow cortical potential neurofeedback—Preliminary results. Journal of Neurotherapy, 16, 37-45. doi:10.1080/10874208.2012.650113
95.
McIntyreR. S.KennedyS. H.SoczynskaJ. K.NguyenH. T. T.BilkeyT. S.WoldeyohannesH. O.. . . MuzinaD. J. (2010). Attention-deficit/hyperactivity disorder in adults with bipolar disorder or major depressive disorder. The Primary Care Companion to the Journal of Clinical Psychiatry, 12, 1-15. doi:10.4088/PCC.09m00861gry
96.
MennellaR.PatronE.PalombaD. (2017). Frontal alpha asymmetry neurofeedback for the reduction of negative affect and anxiety. Behaviour Research and Therapy, 92, 32-40. doi:10.1016/j.brat.2017.02.002
97.
MercierC.PéladeauN.TempierR. (1998). Age, gender and quality of life. Community Mental Health Journal, 34, 487-500. doi:10.1023/A:1018790429573
98.
MichielsenM.ComijsH. C.SemeijnE. J.BeekmanA. T. F.DeegD. J. H.Sandra KooijJ. J. (2013). The comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: A longitudinal study. Journal of Affective Disorders, 148, 220-227. doi:10.1016/j.jad.2012.11.063
99.
MitchellJ. T.McIntyreE. M.EnglishJ. S.DennisM. F.BeckhamJ. C.KollinsS. H. (2013). A pilot trial of mindfulness meditation training for ADHD in adulthood: Impact on core symptoms, executive functioning, and emotion dysregulation. Journal of Attention Disorders, 21, 1105-1120. doi:10.1177/1087054713513328
100.
MitchellJ. T.RobertsonC. D.AnastopolousA. D.Nelson-GrayR. O.KollinsS. H. (2012). Emotion dysregulation and emotional impulsivity among adults with attention-deficit/hyperactivity disorder: Results of a preliminary study. Journal of Psychopathology and Behavioral Assessment, 34, 510-519. doi:10.1007/s10862-012-9297-2
101.
MoëllB.KollbergL.NasriB.LindeforsN.KaldoV. (2015). Living smart—A randomized controlled trial of a guided online course teaching adults with ADHD or sub-clinical ADHD to use smartphones to structure their everyday life. Internet Interventions, 2, 24-31. doi:10.1016/j.invent.2014.11.004
102.
MorgensternsE.AlfredssonJ.HirvikoskiT. (2016). Structured skills training for adults with ADHD in an outpatient psychiatric context: An open feasibility trial. ADHD Attention Deficit and Hyperactivity Disorders, 8, 101-111. doi:10.1007/s12402-015-0182-1
103.
MorrisS. B. (2000). Distribution of the standardized mean change effect size for meta-analysis on repeated measures. British Journal of Mathematical and Statistical Psychology, 53, 17-29. doi:10.1348/000711000159150
104.
MorrisS. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational Research Methods, 11, 364-386. doi:10.1177/1094428106291059
105.
MörtbergE. (2014). Working alliance in individual and group cognitive therapy for social anxiety disorder. Psychiatry Research, 220, 716-718. doi:10.1016/j.psychres.2014.07.004
106.
MotterJ. N.PimontelM. A.RindskopfD.DevanandD. P.DoraiswamyP. M.SneedJ. R. (2016). Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis. Journal of Affective Disorders, 189, 184-191. doi:10.1016/j.jad.2015.09.022
107.
MoukhtarianT. R.CooperR. E.VassosE.MoranP.AshersonP. (2017). Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis. European Psychiatry, 44, 198-207. doi:10.1016/j.eurpsy.2017.05.021
108.
MüllerD.GrevetE. H.PanzenhagenA. C.CupertinoR. B.da SilvaB. S.KappelD. B.. . . BauC. H. D. (2017). Evidence of sexual dimorphism of HTR1B gene on major adult ADHD comorbidities. Journal of Psychiatric Research, 95, 269-275. doi:10.1016/j.jpsychires.2017.09.011
109.
National Institute for Health and Care Excellence. (2008). Attention deficit hyperactivity disorder: The NICE guidelines on diagnosis and management of ADHD in children, young people and adults [CG72]. London, England: Author.
110.
NeacsiuA. D.EberleJ. W.KramerR.WiesmannT.LinehanM. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40-51. doi:10.1016/j.brat.2014.05.005
111.
NewarkP. E.ElsässerM.StieglitzR. D. (2016). Self-esteem, self-efficacy, and resources in adults with ADHD. Journal of Attention Disorders, 20, 279-290. doi:10.1177/1087054712459561
112.
PetterssonR.SöderströmS.Edlund-SöderströmK.NilssonK. W. (2014). Internet-based cognitive behavioral therapy for adults with ADHD in outpatient psychiatric care: A randomized trial. Journal of Attention Disorders, 21, 508-521. doi:10.1177/1087054714539998
113.
PetticrewM.RobertsH. (2005). Systematic reviews in the social sciences: A practical guide. Oxford, UK: Blackwell Publishing.
114.
PhilipsenA.JansT.GrafE.MatthiesS.BorelP.CollaM.. . . Tebartz van ElstL. (2015). Effects of group psychotherapy, individual counseling, methylphenidate, and placebo in the treatment of adult attention-deficit/hyperactivity disorder: A randomized clinical trial. JAMA Psychiatry, 72, 1199-1210. doi:10.1001/jamapsychiatry.2015.2146
115.
PhilipsenA.RichterH.PetersJ.AlmB.SobanskiE.CollaM.. . . HesslingerB. (2007). Structured group psychotherapy in adults with attention deficit hyperactivity disorder. The Journal of Nervous and Mental Disease, 195, 1013-1019. doi:10.1097/NMD.0b013e31815c088b
116.
Piñeiro-DieguezB.Balanzá-MartínezV.García-GarcíaP.Soler-LópezB.DomingoM. A.LabarraJ. D. A.. . . RamosJ. M. Z. (2016). Psychiatric comorbidity at the time of diagnosis in adults with ADHD: The CAT study. Journal of Attention Disorders, 20, 1066-1075. doi:10.1177/1087054713518240
117.
PozzaA.DèttoreD. (2017). Drop-out and efficacy of group versus individual cognitive behavioural therapy: What works best for obsessive-compulsive disorder? A systematic review and meta-analysis of direct comparisons. Psychiatry Research, 258, 24-36. doi:10.1016/j.psychres.2017.09.056
118.
PradaP.NicastroR.ZimmermannJ.HaslerR.AubryJ. M.PerroudN. (2015). Addition of methylphenidate to intensive dialectical behaviour therapy for patients suffering from comorbid borderline personality disorder and ADHD: A naturalistic study. ADHD Attention Deficit and Hyperactivity Disorders, 7, 199-209. doi:10.1007/s12402-015-0165-2
119.
QuinteroJ.MoralesI.VeraR.ZuluagaP.FernándezA. (2017). The impact of adult ADHD in the quality of life profile. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054717733046
120.
RabipourS.RazA. (2012). Training the brain: Fact and fad in cognitive and behavioral remediation. Brain and Cognition, 79, 159-179. doi:10.1016/j.bandc.2012.02.006
121.
RetzW.StieglitzR. D.CorbisieroS.Retz-JungingerP.RöslerM. (2012). Emotional dysregulation in adult ADHD: What is the empirical evidence?Expert Review of Neurotherapeutics, 12, 1241-1251. doi:10.1586/ern.12.109
122.
RosenthalR. (1979). The file drawer problem and tolerance for null results. Psychological Bulletin, 86, 638-641. doi:10.1037/0033-2909.86.3.638
123.
RosenthalR. (1991). Meta-analytic procedures for social research (ed. rev.). Newbury Park, CA: SAGE.
124.
RydellM.TaylorM. J.LarssonH. (2017). Genetic and environmental contributions to the association between ADHD and affective problems in early childhood—A Swedish population-based twin study. American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics, 174, 538-546. doi:10.1002/ajmg.b.32536
125.
SafrenS. A.OttoM. W.SprichS.WinettC. L.WilensT. E.BiedermanJ. (2005). Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behaviour Research and Therapy, 43, 831-842. doi:10.1016/j.brat.2004.07.001
126.
SafrenS. A.SprichS.ChulvickS.OttoM. W. (2004). Psychosocial treatments for adults with attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America, 27, 349-360.doi:10.1016/S0193-953X(03)00089-3
127.
SalomoneS.FlemingG. R.ShanahanJ. M.CastorinaM.BramhamJ.O’ConnellR. G.RobertsonI. H. (2015). The effects of a Self-Alert Training (SAT) program in adults with ADHD. Frontiers in Human Neuroscience, 9, Article 45. doi:10.3389/fnhum.2015.00045
128.
SchoenbergP. L. A.HeparkS.KanC. C.BarendregtH. P.BuitelaarJ. K.SpeckensA. E. M. (2014). Effects of mindfulness-based cognitive therapy on neurophysiological correlates of performance monitoring in adult attention-deficit/hyperactivity disorder. Clinical Neurophysiology, 125, 1407-1416. doi:10.1016/j.clinph.2013.11.031
129.
SchönenbergM.WiedemannE.SchneidtA.ScheeffJ.LogemannA.KeuneP. M.HautzingerM. (2017). Neurofeedback, sham neurofeedback, and cognitive-behavioural group therapy in adults with attention-deficit hyperactivity disorder: A triple-blind, randomised, controlled trial. The Lancet Psychiatry, 4, 673-684. doi:10.1016/S2215-0366(17)30291-2
130.
SegalZ.WilliamsJ.TeasdaleJ. (2002). Mindfulness-based cognitive therapy for depression: A new approach to relapse prevention. New York, NY: The Guilford Press.
131.
SegenreichD.PaezM. S.RegallaM. A.FortesD.FaraoneS. V.SergeantJ.MattosP. (2015). Multilevel analysis of ADHD, anxiety and depression symptoms aggregation in families. European Child & Adolescent Psychiatry, 24, 525-536. doi:10.1007/s00787-014-0604-1
132.
ShawP.StringarisA.NiggJ.LeibenluftE. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171, 276-293. doi:10.1176/appi.ajp.2013.13070966
133.
SimonV.CzoborP.BalintS.MeszarosA.BitterI. (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: Meta-analysis. The British Journal of Psychiatry, 194, 204-211. doi:10.1192/bjp.bp.107.048827
134.
SimonV.CzoborP.BitterI. (2013). Is ADHD severity in adults associated with the lifetime prevalence of comorbid depressive episodes and anxiety disorders?European Psychiatry, 28, 308-314. doi:10.1016/j.eurpsy.2012.05.002
135.
SolantoM. V.MarksD. J.MitchellK. J.WassersteinJ.KofmanM. D. (2008). Development of a new psychosocial treatment for adult ADHD. Journal of Attention Disorders, 11, 728-736. doi:10.1177/1087054707305100
136.
SolantoM. V.MarksD. J.WassersteinJ.AbikoffH.AlvirJ. M. J.KofmanM. D. (2010). Effects of Meta-Cognitive Therapy (MCT) for adult ADHD. American Journal of Psychiatry, 167, 958-968. doi:10.1176/appi.ajp.2009.09081123
137.
SolbergB. S.HalmøyA.EngelandA.IglandJ.HaavikJ.KlungsøyrK. (2018). Gender differences in psychiatric comorbidity: A population-based study of 40,000 adults with attention deficit hyperactivity disorder. Acta Psychiatrica Scandinavica, 137, 176-186. doi:10.1111/acps.12845
138.
SternA.MalikE.PollakY.BonneO.MaeirA. (2016). The efficacy of computerized cognitive training in adults with ADHD: A randomized controlled trial. Journal of Attention Disorders, 20, 991-1003. doi:10.1177/1087054714529815
139.
StevensonC. S.WhitmontS.BornholtL.LiveseyD.StevensonR. J. (2002). A cognitive remediation programme for adults with attention deficit hyperactivity disorder. Australian & New Zealand Journal of Psychiatry, 36, 610-616. doi:10.1046/j.1440-1614.2002.01052.x
140.
TeasdaleJ. D.SegalZ.WilliamsM. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help?Behaviour Research and Therapy, 33, 25-39. doi:10.1016/0005-7967(94)E0011-7
141.
ThompsonL.ThompsonM. (1998). Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Applied Psychophysiology Biofeedback, 23, 243-263. doi:10.1023/A:1022213731956
142.
ValentineS. E.BankoffS. M.PoulinR. M.ReidlerE. B.PantaloneD. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71, 1-20. doi:10.1002/jclp.22114
143.
Van der OordS.BoyerB. E.Van dyckL.MackayK. J.De MeyerH.BaeyensD. (2018). A randomized controlled study of a cognitive behavioral planning intervention for college students with ADHD: An effectiveness study in student counseling services in Flanders. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054718787033
144.
VidalR.ValeroS.NogueiraM.PalomarG.CorralesM.RicharteV.. . . Ramos-QuirogaJ. A. (2014). Emotional lability: The discriminative value in the diagnosis of attention deficit/hyperactivity disorder in adults. Comprehensive Psychiatry, 55, 1712-1719. doi:10.1016/j.comppsych.2014.07.001
145.
Vidal-EstradaR.BoschR.NogueiraM.Gómez-BarrosN.ValeroS.PalomarG.. . . Ramos-QuirogaJ. A. (2013). Psychoeducation for adults with attention deficit hyperactivity disorder vs. cognitive behavioral group therapy: A randomized controlled pilot study. The Journal of Nervous and Mental Disease, 201, 894-900. doi:10.1097/NMD.0b013e3182a5c2c5
146.
Vidal-EstradaR.CastellsJ.RicharteV.PalomarG.GarciaM.NicolauR.. . . Ramos-QuirogaJ. A. (2015). Group therapy for adolescents with attention-deficit/hyperactivity disorder: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 275-282. doi:10.1016/j.jaac.2014.12.016
147.
VirtaM.HiltunenS.MattssonM.KallioS. (2015). The impact of hypnotic suggestions on reaction times in continuous performance test in adults with ADHD and healthy controls. PLoS ONE, 10(5), e0126497. doi:10.1371/journal.pone.0126497
148.
VirtaM.SalakariA.AntilaM.ChydeniusE.PartinenM.KaskiM.. . . IivanainenM. (2010a). Hypnotherapy for adults with attention deficit hyperactivity disorder: A randomized controlled study. Contemporary Hypnosis, 27, 5-18.
149.
VirtaM.SalakariA.AntilaM.ChydeniusE.PartinenM.KaskiM.. . . IivanainenM. (2010b). Short cognitive behavioral therapy and cognitive training for adults with ADHD—A randomized controlled pilot study. Neuropsychiatric Disease and Treatment, 6, 443-453. doi:10.3200/ENVT.50.5.12-25
150.
VitolaE. S.BauC. H. D. D.SalumG. A.HortaB. L.QuevedoL.BarrosF. C.. . . GrevetE. H. (2017). Exploring DSM-5 ADHD criteria beyond young adulthood: Phenomenology, psychometric properties and prevalence in a large three-decade birth cohort. Psychological Medicine, 47, 744-754. doi:10.1017/S0033291716002853
151.
WampoldB. E.FrostN. D.YulishN. E. (2016). Placebo effects in psychotherapy: A flawed concept and a contorted history. Psychology of Consciousness: Theory, Research, and Practice, 3, 108-120. doi:10.1037/cns0000045
152.
WangX.CaoQ.WangJ.WuZ.WangP.SunL.. . . WangY. (2016). The effects of cognitive-behavioral therapy on intrinsic functional brain networks in adults with attention-deficit/hyperactivity disorder. Behaviour Research and Therapy, 76, 32-39. doi:10.1016/j.brat.2015.11.003
153.
WebbC. A.BeardC.KertzS. J.HsuK. J.BjörgvinssonT. (2016). Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement. Behaviour Research and Therapy, 81, 12-20. doi:10.1016/j.brat.2016.03.006
154.
WeissM.HechtmanL. (2006). A randomized double-blind trial of paroxetine and/or dextroamphetamine and problem-focused therapy for attention-deficit/hyperactivity disorder in adults. Journal of Clinical Psychiatry, 67, 611-619. doi:10.4088/JCP.v67n0412
155.
WeissM.MurrayC.WasdellM.GreenfieldB.GilesL.HechtmanL. (2012). A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC Psychiatry, 12(1), Article 30. doi:10.1186/1471-244X-12-30
156.
WhiteH. A.ShahP. (2006). Training attention-switching ability in adults with ADHD. Journal of Attention Disorders, 10, 44-53. doi:10.1177/1087054705286063
157.
WigginsD.SinghK.GetzH. G.HutchinsD. E. (1999). Effects of brief group intervention for adults with attention deficit/hyperactivity disorder. Journal of Mental Health Counseling, 21, 82-92.
158.
WilensT. E.NierembergA. A.RostainA. L.SpencerT. J. (2008). Adult attention-deficit hyperactivity disorder and the role of depression. CNS Spectrums, 13(5), 2-17.
159.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva, Switzerland: Author.
160.
WymbsB. T.MolinaB. S. G. (2015). Integrative couples group treatment for emerging adults with ADHD symptoms. Cognitive and Behavioral Practice, 22, 161-171. doi:10.1016/j.cbpra.2014.06.008
161.
YoshimasuK.BarbaresiW. J.ColliganR. C.VoigtR. G.KillianJ. M.WeaverA. L.KatusicS. K. (2018). Adults with persistent ADHD: Gender and psychiatric comorbidities—A population-based longitudinal study. Journal of Attention Disorders, 22, 535-546. doi:10.1177/1087054716676342
162.
YoungS.BramhamJ.GrayK.RoseE.YoungS.GrayK.RoseE. (2008). The experience of receiving a diagnosis and treatment of ADHD in adulthood: A qualitative study of clinically referred patients using interpretative phenomenological analysis. Journal of Attention Disorders, 11, 493-503. doi:10.1177/1087054707305172
163.
YoungS.KhondokerM.EmilssonB.SigurdssonJ. F.Philipp-WiegmannF.BaldurssonG.. . . GudjonssonG. (2015). Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: A randomized controlled trial using multi-level analysis. Psychological Medicine, 45, 2793-2804. doi:10.1017/S0033291715000756
164.
YoungS.RossR. R. (2007). R&R2 for ADHD youths and adults: A prosocial competence training program. Ottawa, Ontario, Canada: Cognitive Centre of Canada.
165.
YoungZ.MoghaddamN.TickleA. (2016). The efficacy of cognitive behavioral therapy for adults with ADHD: A systematic review and meta-analysis of randomized controlled trials. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054716664413
166.
ZilverstandA.SorgerB.Slaats-WillemseD.KanC. C.GoebelR.BuitelaarJ. K. (2017). fMRI neurofeedback training for increasing anterior cingulate cortex activation in adult attention deficit hyperactivity disorder: An exploratory randomized, single-blinded study. PLoS ONE, 12(1), e0170795. doi:10.1371/journal.pone.0170795
167.
ZwartL. M.KallemeynL. M. (2001). Peer-based coaching for college students with ADHD and learning disabilities. Journal of Postsecondary Education and Disability, 15, 1-15.
168.
ZylowskaL.AckermanD. L.YangM. H.FutrellJ. L.HortonN. L.HaleT. S.SmalleyS. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD: A feasibility study. Journal of Attention Disorders, 11, 737-746. doi:10.1177/1087054707308502
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
