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DOI: 10.1055/s-0028-1112130
© Georg Thieme Verlag KG Stuttgart · New York
Self Concept, Action Control and ADHD Symptoms under Methylphenidate Treatment in Adults with ADHD
Publication History
received 24.07.2008
revised 20.10.2008
accepted 29.10.2008
Publication Date:
18 May 2009 (online)
Abstract
Introduction: Self-efficacy of adults with ADHD might be changed unfavourably under methylphenidate treatment. Therefore, we sought to investigate the initial situation and changes under this medication, regarding features related to self-efficacy (self concept, locus of control and action control).
Methods: 3 self-rating scales (FSKN, IPC, and HAKEMP-90/ACS-90) were applied to 24 adults with ADHD combined type, before and after 5 months of methylphenidate treatment.
Results: No negative changes with respect to ADHD symptoms or any questionnaire were found under medication. In fact, both ADHD symptom domains, 5 out of 10 self concept subscale scores, and all 3 action control subscale scores changed favourably. Regression analysis revealed that only facets of self concept, but not of locus of control or of action control, predicted the patients’ response to stimulant medication (i.e., a reduction of ADHD symptoms).
Discussion: Positive changes of self-concept and action control features under methylphenidate treatment in this study may encourage therapists to treat adults with ADHD with stimulants, thus not being at risk to decrease their patients’ self-efficacy. In combined pharmacological/psychotherapeutic approaches, self-concept scales could be used to predict treatment outcome, and in order to monitor interactions between ADHD symptom reduction and self concept.
References
-
1
American Psychiatric Association
.
Diagnostic and statistical manual of mental disorders, 4th edn . Washington, DC: APA 1994 - 2 Carlson C-L, Pelham W-E, Milich R. et al . ADHD boys’ performance and attributions following success and failure: drug effects and individual differences. Cognit Ther Res. 1993; 17 269-287
-
3 Deusinger I-M.
Die Frankfurter Selbstkonzeptskalen (FSKN). Handanweisung (German) . Göttingen: Hogrefe 1986 - 4 Dulcan M-K, Benson R-S. AACAP Official Action. Summary of the practice parameters for the assessment and treatment of children, adolescents, and adults with ADHD. J Am Acad Child Adolesc Psychiatry. 1997; 36 1311-1317
- 5 Ebert D, Krause J, Roth-Sackenheim C. ADHD in adulthood – guidelines based on expert consensus with DGPPN support (German). Nervenarzt. 2003; 74 939-946
- 6 Gonzales L-O, Sellers E-W. The effect of a stress-management program on self concept, locus of control, and the acquisition of coping skills in school-age children diagnosed with attention deficit hyperactivity disorder. J Child Adolesc Psychiatr Nurs. 2002; 15 5-15
- 7 Hoza B, Pelham W-E, Dobbs J. et al . Do boys with attention-deficit/hyperactivity disorder have positive illusory self-concepts?. J Abnorm Psychol. 2002; 111 268-278
-
8 Krampen G.
IPC-Fragebogen zu Kontrollüberzeugungen (“Locus of Control”). Deutsche Bearbeitung der IPC-Scales von Hanna Levenson. Handanweisung (German) . Göttingen: Hogrefe 1981 -
9 Kuhl J. A theory of action and state orientations. In Kuhl J, Beckmann J, eds.
Volition and personality: action versus state orientation . Göttingen: Hogrefe 1994: 9-46 -
10 Kuhl J. Action and state orientation: psychometric properties of the action control scales (ACS-90). In Kuhl J, Beckmann J, eds.
Volition and personality: action versus state orientation . Göttingen: Hogrefe 1994: 47-59 - 11 Linn R-T, Hodge G-K. Locus of control in childhood hyperactivity. J Consult Clin Psychol. 1982; 50 592-593
- 12 Milich R, Carlson C-L, Pelham W-E. et al . Effects of methylphenidate on the persistence of ADHD following failure experiences. J Abnorm Child Psychol. 1991; 19 519-536
- 13 MTA Cooperative Group . A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 1999; 56 1073-1086
- 14 Nutt D-J, Fone K, Asherson P. et al . Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2007; 21 10-41
- 15 Omizo M-M, Michael W-B. Biofeedback-induced relaxation training and impulsivity, attention to task, and locus of control among hyperactive boys. J Learn Disabil. 1982; 15 414-416
- 16 Pelham W-E, Hoza B, Kipp H-L. et al . Effects of methylphenidate and expectancy on ADHD children's performance, self evaluations, persistence, and attributions on a cognitive task. Exp Clin Psychopharmacol. 1997; 5 1-11
- 17 Pelham W-E, Murphy D-A, Vanatta K. et al . Methylphenidate and attributions in boys with attention deficit hyperactivity disorder. J Consult Clin Psychol. 1992; 60 282-292
- 18 Pelham W-E, Waschbusch D-A, Hoza B. et al . Effects of methylphenidate and expectancy on performance, self-evaluations, persistence, and attributions on a social task in boys with ADHD. Exp Clin Psychopharmacol. 2001; 9 425-437
- 19 Remschmidt H. Global ADHD Working Group . Global consensus on ADHD/HKD. Eur Child Adolesc Psychiatry. 2005; 14 127-137
- 20 Rösler M, Retz W, Retz-Junginger P. et al . Tools for the diagnosis of attention-deficit/hyperactivity disorder in adults. Self-rating behavior questionnaire and diagnostic checklist (German). Nervenarzt. 2004; 75 888-895
- 21 Rotter J-B. The role of the psychological situation in determining the direction of human behaviour. Nebraska symposium on motivation. 1955; 3 245-268
- 22 Safren S-A, Otto M-W, Sprich S. et al . Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther. 2005; 43 831-842
- 23 Skutle A. The relationship among self-efficacy expectancies, severity of alcohol abuse, and psychological benefits from drinking. Addict Behav. 1999; 24 87-98
- 24 Stevenson C-S, Whitmont S, Bornholt L. et al . A cognitive remediation programme for adults with attention deficit hyperactivity disorder. Aust N Z J Psychiatry. 2002; 36 610-616
- 25 Ward M-F, Wender P-H, Reimherr F-W. The Wender Utah rating scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993; 150 885-890
-
26 Wender P-H.
Attention-deficit hyperactivity disorder in adults . New York: Oxford University Press, New York 1995 - 27 Wender P-H. Pharmacotherapy of attention-deficit/hyperactivity disorder in adults. J Clin Psychiatry. 1998; 59 ((Suppl. 7)) 76-79
Correspondence
Dr. M.-A. Edel
Department of Psychiatry
Ruhr University
LWL Hospital Bochum
Alexandrinenstr. 1
44791 Bochum
Germany
Phone: +49/234/5077 222
Fax: +49/234/5077 102
Email: marc-andreas.edel@rub.de