Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-Only, ADHD and conduct problems, and controls

Sarah A. Helseth, Daniel A. Waschbusch, Elizabeth M. Gnagy, Adia N. Onyango, Lisa Burrows-MacLean, Gregory A. Fabiano, Erika K. Coles, Anil Chacko, Brian T. Wymbs, Kathryn S. Walker, Frances A. Wymbs, Allison Garefino, Greta M. Massetti, Jessica Robb Mazzant, Martin T. Hoffman, James G. Waxmonsky, Kristin Nichols-Lopez, William E. Pelham

Research output: Contribution to journalArticle

Abstract

Objective: This study compared the unique and combined effects of evidence-based treatments for ADHD- stimulant medication and behavior modification-on children's rates of reinforcement for deviant peer behavior (RDPB). Method: Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions. Results: Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children's RDPB to levels similar to the control group. Conclusions: Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings.

Original languageEnglish (US)
Pages (from-to)280-292
Number of pages13
JournalJournal of Consulting and Clinical Psychology
Volume83
Issue number2
DOIs
StatePublished - Apr 1 2015

Fingerprint

Behavior Therapy
Pharmacology
Methylphenidate
Therapeutics
Reinforcement (Psychology)
Deviancy
Attention Deficit Hyperactivity Disorder
Peers
Therapy
Reinforcement
Placebos
Observation
Control Groups
Medication

Keywords

  • ADHD
  • deviancy training
  • peer interactions
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)

Cite this

Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-Only, ADHD and conduct problems, and controls. / Helseth, Sarah A.; Waschbusch, Daniel A.; Gnagy, Elizabeth M.; Onyango, Adia N.; Burrows-MacLean, Lisa; Fabiano, Gregory A.; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Wymbs, Frances A.; Garefino, Allison; Massetti, Greta M.; Mazzant, Jessica Robb; Hoffman, Martin T.; Waxmonsky, James G.; Nichols-Lopez, Kristin; Pelham, William E.

In: Journal of Consulting and Clinical Psychology, Vol. 83, No. 2, 01.04.2015, p. 280-292.

Research output: Contribution to journalArticle

Helseth, SA, Waschbusch, DA, Gnagy, EM, Onyango, AN, Burrows-MacLean, L, Fabiano, GA, Coles, EK, Chacko, A, Wymbs, BT, Walker, KS, Wymbs, FA, Garefino, A, Massetti, GM, Mazzant, JR, Hoffman, MT, Waxmonsky, JG, Nichols-Lopez, K & Pelham, WE 2015, 'Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-Only, ADHD and conduct problems, and controls', Journal of Consulting and Clinical Psychology, vol. 83, no. 2, pp. 280-292. https://doi.org/10.1037/a0038505
Helseth, Sarah A. ; Waschbusch, Daniel A. ; Gnagy, Elizabeth M. ; Onyango, Adia N. ; Burrows-MacLean, Lisa ; Fabiano, Gregory A. ; Coles, Erika K. ; Chacko, Anil ; Wymbs, Brian T. ; Walker, Kathryn S. ; Wymbs, Frances A. ; Garefino, Allison ; Massetti, Greta M. ; Mazzant, Jessica Robb ; Hoffman, Martin T. ; Waxmonsky, James G. ; Nichols-Lopez, Kristin ; Pelham, William E. / Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-Only, ADHD and conduct problems, and controls. In: Journal of Consulting and Clinical Psychology. 2015 ; Vol. 83, No. 2. pp. 280-292.
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AU - Burrows-MacLean, Lisa

AU - Fabiano, Gregory A.

AU - Coles, Erika K.

AU - Chacko, Anil

AU - Wymbs, Brian T.

AU - Walker, Kathryn S.

AU - Wymbs, Frances A.

AU - Garefino, Allison

AU - Massetti, Greta M.

AU - Mazzant, Jessica Robb

AU - Hoffman, Martin T.

AU - Waxmonsky, James G.

AU - Nichols-Lopez, Kristin

AU - Pelham, William E.

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N2 - Objective: This study compared the unique and combined effects of evidence-based treatments for ADHD- stimulant medication and behavior modification-on children's rates of reinforcement for deviant peer behavior (RDPB). Method: Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions. Results: Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children's RDPB to levels similar to the control group. Conclusions: Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings.

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