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Karen Cameron Wells

Associate Professor Emeritus in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
Box 3527MED Ctr, Durham, NC 27710
2608 Erwin Road Lakeview Pavi, Durham, NC 27705

Selected Publications


Adaptive Treatment for Youth With Substance Use and Depression: Early Depression Response and Short-term Outcomes.

Journal Article J Am Acad Child Adolesc Psychiatry · April 2022 OBJECTIVE: To investigate prevalence and predictors of early depression response (EDR) in adolescents with substance use and depression receiving cognitive-behavioral therapy (CBT) for substance use and to test the efficacy of supplemental CBT targeting de ... Full text Link to item Cite

Coping in the Aftermath of Youth's Suicidal Behaviors: A Comparison of Black Mothers and White Mothers

Journal Article Family Relations · February 1, 2021 Objective: To better understand Black mothers' and White mothers' qualitative reactions to their adolescents' hospitalizations due to suicide attempts. Background: Caregivers of youth with suicidal behaviors play a vital role in youth's subsequent treatmen ... Full text Cite

Feasibility of an Integrated Treatment Approach for Youth with Depression, Suicide Attempts, and Substance Use Problems.

Journal Article Evid Based Pract Child Adolesc Ment Health · 2021 Depression, suicidal behaviors and substance use problems frequently co-occur, and treatment for youth with these co-occurring problems is often fragmented and challenging. An integrated cognitive-behavioral treatment approach that builds upon a relapse pr ... Full text Link to item Cite

Mutations in sphingolipid metabolism genes are associated with ADHD.

Journal Article Transl Psychiatry · July 13, 2020 Attention deficit hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children, with genetic factors accounting for 75-80% of the phenotypic variance. Recent studies have suggested that ADHD patients might present with atypic ... Full text Link to item Cite

Testing Robustness of Child STEPs Effects with Children and Adolescents: A Randomized Controlled Effectiveness Trial.

Journal Article J Clin Child Adolesc Psychol · 2020 A critical task in psychotherapy research is identifying the conditions within which treatment benefits can be replicated and outside of which those benefits are reduced. We tested the robustness of beneficial effects found in two previous trials of the mo ... Full text Link to item Cite

How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning.

Journal Article J Atten Disord · July 2018 OBJECTIVE: Although substance use (SU) is elevated in ADHD and both are associated with disrupted emotional functioning, little is known about how emotions and SU interact in ADHD. We used a mixed qualitative-quantitative approach to explore this relations ... Full text Link to item Cite

Turning Points in the Lives of Youth of With/Without ADHD: Are They Linked to Changes in Substance Use?

Journal Article J Atten Disord · July 2018 OBJECTIVE: This study examines the behavior beliefs, social supports, and turning points in individuals with/without ADHD related to their substance use/abuse (SU/A) decisions. METHOD: The coded interviews from 60 participants with/without ADHD were compar ... Full text Link to item Cite

Follow-Up of Young Adults With ADHD in the MTA: Design and Methods for Qualitative Interviews.

Journal Article J Atten Disord · July 2018 OBJECTIVE: Qualitative interviews with 183 young adults (YA) in the follow-up of the Multimodal Treatment Study of Children With and Without ADHD (MTA) provide rich information on beliefs and expectations regarding ADHD, life's turning points, medication u ... Full text Link to item Cite

Late-Onset ADHD Reconsidered With Comprehensive Repeated Assessments Between Ages 10 and 25.

Journal Article Am J Psychiatry · February 1, 2018 OBJECTIVE: Adolescents and young adults without childhood attention deficit hyperactivity disorder (ADHD) often present to clinics seeking stimulant medication for late-onset ADHD symptoms. Recent birth-cohort studies support the notion of late-onset ADHD, ... Full text Link to item Cite

Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA).

Journal Article J Am Acad Child Adolesc Psychiatry · August 2017 OBJECTIVE: Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functi ... Full text Link to item Cite

Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.

Journal Article J Child Psychol Psychiatry · June 2017 OBJECTIVE: Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5-75%). This study documents how information source (parent vs. self-report), method (rating scale vs. interview), and symptom thresh ... Full text Link to item Cite

Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.

Journal Article J Child Psychol Psychiatry · June 2017 BACKGROUND: The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7-10 years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It ... Full text Link to item Cite

Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results.

Journal Article J Am Acad Child Adolesc Psychiatry · November 2016 OBJECTIVE: To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison ... Full text Link to item Cite

Childhood Factors Affecting Persistence and Desistence of Attention-Deficit/Hyperactivity Disorder Symptoms in Adulthood: Results From the MTA.

Journal Article J Am Acad Child Adolesc Psychiatry · November 2016 OBJECTIVE: To determine childhood factors that predict attention-deficit/hyperactivity disorder (ADHD) persistence and desistence in adulthood. METHOD: Regression analyses were used to determine associations between childhood factors and adult ADHD symptom ... Full text Link to item Cite

Parental aggression as a predictor of boys' hostile attribution across the transition to middle school.

Journal Article Int J Behav Dev · September 2016 Aggression among youth is public health problem that is often studied in the context of how youth interpret social information. Social cognitive factors, especially hostile attribution biases, have been identified as risk factors for the development of you ... Full text Link to item Cite

Counselor-Level Predictors of Sustained Use of an Indicated Preventive Intervention for Aggressive Children.

Journal Article Prev Sci · November 2015 Despite widespread concern about the frequent failure of trained prevention staff to continue to use evidence-based programs following periods of intensive training, little research has addressed the characteristics and experiences of counselors that might ... Full text Link to item Cite

A school-based post-Katrina therapeutic intervention.

Journal Article Adm Policy Ment Health · May 2015 The current study presents the implementation of a set of school based interventions in a greater New Orleans school district one year following Hurricane Katrina. The interventions included adaptation and implementation of evidence based treatments in a c ... Full text Link to item Cite

Evaluation of underlying mechanisms in the link between childhood ADHD symptoms and risk for early initiation of substance use.

Journal Article Psychol Addict Behav · September 2014 Although there has been support for attention-deficit/hyperactivity disorder (ADHD) as a risk for early substance use, this link is not fully established or understood. Furthermore, the potential mechanisms explaining these associations are unclear. The cu ... Full text Link to item Cite

Bidirectional effects of parenting and youth substance use during the transition to middle and high school.

Journal Article Psychol Addict Behav · June 2014 The current study assessed bidirectional relationships between supportive parenting behaviors (i.e., involvement, positive parenting), parental control strategies (i.e., parental monitoring, effective discipline), and youth substance use in a sample of agg ... Full text Link to item Cite

Long-term outcomes for the Child STEPs randomized effectiveness trial: a comparison of modular and standard treatment designs with usual care.

Journal Article J Consult Clin Psychol · December 2013 OBJECTIVE: This article reports outcomes from the Child STEPs randomized effectiveness trial conducted over a 2-year period to gauge the longer term impact of protocol design on the effectiveness of evidence-based treatment procedures. METHOD: An ethnoraci ... Full text Link to item Cite

Three year follow-up of coping power intervention effects: evidence of neighborhood moderation?

Journal Article Prev Sci · August 2013 The Coping Power program is an indicated prevention program for at-risk aggressive preadolescent children, and has had demonstrated short-term effects on antisocial outcomes. This study provided a longer-term 3-year follow-up for a sample of 245 fourth gra ... Full text Link to item Cite

Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication.

Journal Article J Am Acad Child Adolesc Psychiatry · March 2013 OBJECTIVE: To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Defic ... Full text Link to item Cite

Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial.

Journal Article J Consult Clin Psychol · February 2013 OBJECTIVE: The study compared the efficacy of 2 behavioral interventions to ameliorate organization, time management, and planning (OTMP) difficulties in 3rd- to 5th-grade children with attention-deficit/hyperactivity disorder (ADHD). METHOD: In a dual-sit ... Full text Link to item Cite

Family-Based Cognitive-Behavioral Treatments for Suicidal Adolescents and Their Integration With Individual Treatment

Journal Article Cognitive and Behavioral Practice · May 1, 2012 A considerable research base underscores the importance of family functioning in the risk for and treatment of adolescent suicidal thoughts and behaviors. This paper reviews the extant empirical literature documenting associations between features of the f ... Full text Cite

Onset of alcohol or substance use disorders following treatment for adolescent depression.

Journal Article J Consult Clin Psychol · April 2012 OBJECTIVE: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). METHOD: Fo ... Full text Link to item Cite

The influence of neighborhood characteristics and parenting practices on academic problems and aggression outcomes among moderately to highly aggressive children

Journal Article Journal of Community Psychology · April 1, 2012 The current study utilized a longitudinal design to examine the effects of neighborhood and parenting on 120 at-risk children's academic and aggressive outcomes, concurrently and at two later timepoints during the transition to middle school. Random effect ... Full text Cite

Blood pressure and heart rate over 10 years in the multimodal treatment study of children with ADHD.

Journal Article Am J Psychiatry · February 2012 OBJECTIVE: It is unknown whether prolonged childhood exposure to stimulant medication for the treatment of attention deficit hyperactivity disorder (ADHD) increases the risk for developing abnormalities in blood pressure or heart rate. The authors examined ... Full text Link to item Cite

Recovery and recurrence following treatment for adolescent major depression.

Journal Article Arch Gen Psychiatry · March 2011 CONTEXT: Major depressive disorder in adolescents is common and impairing. Efficacious treatments have been developed, but little is known about longer-term outcomes, including recurrence. OBJECTIVES: To determine whether adolescents who responded to short ... Full text Link to item Cite

Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the Multimodal Treatment Study of Children With ADHD: developmental cascades and vicious cycles.

Journal Article Dev Psychopathol · November 2010 We examined the developmental processes involved in peer problems among children (M age = 10.41 years) previously diagnosed with attention-deficit/hyperactivity disorder (ADHD) at study entry (N = 536) and a comparison group (N = 284). Participants were fo ... Full text Open Access Link to item Cite

Time-dependent changes in positively biased self-perceptions of children with attention-deficit/hyperactivity disorder: a developmental psychopathology perspective.

Journal Article Dev Psychopathol · May 2010 This study examined changes in the degree of positive bias in self-perceptions of previously diagnosed 8- to 13-year-old children with attention-deficit/hyperactivity disorder (ADHD; n = 513) and comparison peers (n = 284) over a 6-year period. The dynamic ... Full text Link to item Cite

Ethnicity as a moderator of treatment effects on parent--child interaction for children with ADHD.

Journal Article J Atten Disord · May 2010 OBJECTIVE: To examine ethnic differences in observed parenting and child behavior and the moderating effects of ethnicity on the relationship between treatment and parent and child behavior. METHOD: Observations of 508 children with ADHD (ages 7-9) and the ... Full text Link to item Cite

Parent-reported homework problems in the MTA study: evidence for sustained improvement with behavioral treatment.

Journal Article J Clin Child Adolesc Psychol · 2010 Parent-report of child homework problems was examined as a treatment outcome variable in the MTA-Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine children ages 7.0 to 9.9 were randomly a ... Full text Link to item Cite

An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.

Journal Article J Clin Child Adolesc Psychol · November 2009 This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, ... Full text Link to item Cite

Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability.

Journal Article J Am Acad Child Adolesc Psychiatry · October 2009 OBJECTIVE: To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. METHOD: T ... Full text Link to item Cite

The Treatment for Adolescents With Depression Study (TADS): outcomes over 1 year of naturalistic follow-up.

Journal Article Am J Psychiatry · October 2009 OBJECTIVE: The Treatment for Adolescents With Depression Study (TADS) evaluates the effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), and their combination in adolescents with major depressive disorder. The authors report effectiveness outco ... Full text Link to item Cite

Depressive symptoms and clinical status during the Treatment of Adolescent Suicide Attempters (TASA) Study.

Journal Article J Am Acad Child Adolesc Psychiatry · October 2009 OBJECTIVE: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. METHOD: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depr ... Full text Link to item Cite

The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.

Journal Article J Am Acad Child Adolesc Psychiatry · October 2009 OBJECTIVE: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. METHOD: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were e ... Full text Link to item Cite

Implementation of a School-Based Prevention Program: Effects of Counselor and School Characteristics

Journal Article Professional Psychology: Research and Practice · October 1, 2009 The authors explore 2 broad categories of factors that could influence the intervention dissemination process: individual interventionist characteristics and school-level characteristics. Counselors from 32 schools received training in the Coping Power you ... Full text Cite

The influence of neighborhood disadvantage and perceived disapproval on early substance use initiation.

Journal Article Addict Behav · September 2009 The current study examined the role of neighborhood disadvantage, perceived caregiver disapproval, and perceived peer disapproval in early initiation of substance use in a sample of 126 aggressive 9th graders (66% male; 79% African American). Findings sugg ... Full text Link to item Cite

Dissemination of the Coping Power program: importance of intensity of counselor training.

Journal Article J Consult Clin Psychol · June 2009 This study examined an important but rarely investigated aspect of the dissemination process: the intensity of training provided to practitioners. Counselors in 57 schools were randomly assigned to 1 of 3 conditions: Coping Power-training plus feedback (CP ... Full text Link to item Cite

The effect of neighborhood disadvantage on proactive and reactive aggression

Journal Article Journal of Community Psychology · May 1, 2009 The current study examined the effect of neighborhood disadvantage on proactive and reactive aggression in a sample of 126 children (66% male) identified as aggressive. Sixth-grade proactive and reactive aggression was regressed on fifth-grade proactive an ... Full text Cite

Medication adherence in the MTA: saliva methylphenidate samples versus parent report and mediating effect of concomitant behavioral treatment.

Journal Article J Am Acad Child Adolesc Psychiatry · May 2009 OBJECTIVE: Although research supports the use of appropriately administered stimulant medication to treat children with ADHD, poor adherence and early termination undermine the efficacy of this treatment in real-world settings. Moreover, adherence measures ... Full text Link to item Cite

The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study.

Journal Article J Am Acad Child Adolesc Psychiatry · May 2009 OBJECTIVES: To determine any long-term effects, 6 and 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder ... Full text Link to item Cite

Inconsistent discipline as a mediator between maternal distress and aggression in boys

Journal Article Child and Family Behavior Therapy · January 1, 2009 The current study examines inconsistent discipline as a mediator in the association between maternal distress and child aggression and attention problems. Participants were 215 boys, ranging in age from 9 to 12 years, and their mothers. Mothers provided se ... Full text Cite

A clinical review of outcomes of the multimodal treatment study of children with attention-deficit/hyperactivity disorder (MTA).

Journal Article Curr Psychiatry Rep · October 2008 Over the past decade, the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder has provided a bewildering wealth of data (more than 70 peer-reviewed articles) addressing treatment-related questions for children with attentio ... Full text Link to item Cite

Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment study of Children With ADHD (MTA): part I: executive summary.

Journal Article J Atten Disord · July 2008 OBJECTIVE: To review the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published over the past decade as three sets of articles. METHOD: In a two-part article-Part I: Executive Summary (without distracting details) and Pa ... Full text Link to item Cite

Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment Study of children with ADHD (MTA): Part II: supporting details.

Journal Article J Atten Disord · July 2008 OBJECTIVE: To review and provide details about the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published during the past decade as three sets of articles. METHOD: In the second of a two part article, we provide addition ... Full text Link to item Cite

Developmental trajectories of proactive and reactive aggression from fifth to ninth grade.

Journal Article J Clin Child Adolesc Psychol · April 2008 This study examined the developmental trajectories of proactive and reactive aggression from 5th to 9th grade in a sample of 126 children (66% male) screened to be in the top 31% on a measure of aggression. Prospective relations between proactive and react ... Full text Link to item Cite

The relation between childhood proactive and reactive aggression and substance use initiation.

Journal Article J Abnorm Child Psychol · February 2008 The current study examined whether proactive and reactive aggression were associated with the risk for initiation of substance use from fourth to ninth grade in a sample of 126 aggressive children (66% male). In addition, the study examined whether these f ... Full text Link to item Cite

The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes.

Journal Article Arch Gen Psychiatry · October 2007 CONTEXT: The Treatment for Adolescents With Depression Study evaluates the effectiveness of fluoxetine hydrochloride therapy, cognitive behavior therapy (CBT), and their combination in adolescents with major depressive disorder. OBJECTIVE: To report effect ... Full text Link to item Cite

Pathways from proactive and reactive aggression to substance use.

Journal Article Psychol Addict Behav · September 2007 Childhood aggression is a known risk factor for adolescent substance use; however, aggression is a complex construct, and developmental researchers have identified a variety of subdimensions that may be germane to substance use. Very little research has ex ... Full text Link to item Cite

Effects of stimulant medication on growth rates across 3 years in the MTA follow-up.

Journal Article J Am Acad Child Adolesc Psychiatry · August 2007 OBJECTIVE: To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD. METHOD: Naturalistic subgroups were established based on patterns of treatment with stim ... Full text Link to item Cite

Secondary evaluations of MTA 36-month outcomes: propensity score and growth mixture model analyses.

Journal Article J Am Acad Child Adolesc Psychiatry · August 2007 OBJECTIVE: To evaluate two hypotheses: that self-selection bias contributed to lack of medication advantage at the 36-month assessment of the Multimodal Treatment Study of Children With ADHD (MTA) and that overall improvement over time obscured treatment e ... Full text Link to item Cite

3-year follow-up of the NIMH MTA study.

Journal Article J Am Acad Child Adolesc Psychiatry · August 2007 OBJECTIVE: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 m ... Full text Link to item Cite

Delinquent behavior and emerging substance use in the MTA at 36 months: prevalence, course, and treatment effects.

Journal Article J Am Acad Child Adolesc Psychiatry · August 2007 OBJECTIVE: To compare delinquent behavior and early substance use between the children in the Multimodal Treatment Study of Children With ADHD (MTA; N = 487) and those in a local normative comparison group (n = 272) at 24 and 36 months postrandomization an ... Full text Link to item Cite

Child and parent predictors of perceptions of parent--child relationship quality.

Journal Article J Atten Disord · July 2007 OBJECTIVE/METHOD: Predictors of perceptions of parent-child relationship quality were examined for 175 children with ADHD, 119 comparison children, and parents of these children, drawn from the follow-up phase of the Multimodal Treatment Study of Children ... Full text Link to item Cite

Parent training in the treatment of ADHD

Chapter · January 1, 2007 Attention deficit hyperactivity disorder (ADHD) is a chronic and impairing disorder of childhood, adolescence, and adulthood and is characterized by primary symptoms of inattention, impulsivity, and overactivity (1). In addition, ADHD is usually associated ... Full text Cite

Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS).

Journal Article J Am Acad Child Adolesc Psychiatry · December 2006 OBJECTIVE: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. METHOD: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of ... Full text Link to item Cite

Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS).

Journal Article J Am Acad Child Adolesc Psychiatry · December 2006 OBJECTIVE: To identify predictors and moderators of response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive-behavioral therapy (CBT), both fluoxetine and CBT, or clinical management with pill placebo in ... Full text Link to item Cite

Treatment-related changes in objectively measured parenting behaviors in the multimodal treatment study of children with attention-deficit/hyperactivity disorder.

Journal Article J Consult Clin Psychol · August 2006 The present study examined treatment outcomes for objectively measured parenting behavior in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine ethnically and socioeconomically diverse ... Full text Link to item Cite

Assessing medication effects in the MTA study using neuropsychological outcomes.

Journal Article J Child Psychol Psychiatry · May 2006 BACKGROUND: While studies have increasingly investigated deficits in reaction time (RT) and RT variability in children with attention deficit/hyperactivity disorder (ADHD), few studies have examined the effects of stimulant medication on these important ne ... Full text Link to item Cite

The mutual influence of parenting and boys' externalizing behavior problems

Journal Article Journal of Applied Developmental Psychology · March 1, 2006 The current study examined the mutual influence of parenting and boys' externalizing behavior from 4th to 8th grade, how these relationships change as children develop, and the stability of parenting and child behavior in a sample of 122 boys. Child behavi ... Full text Cite

Self-perceived social acceptance and peer social standing in children with aggressive-disruptive Behaviors

Journal Article Social Development · February 1, 2006 Examining children's perceptions of their social acceptance in conjunction with others' ratings of their peer social standing can enhance our understanding of the heterogeneity in children exhibiting disruptive behavior problems. Using a sample of 213 yout ... Full text Cite

Does multimodal treatment of ADHD decrease other diagnoses?

Journal Article Clinical Neuroscience Research · December 1, 2005 Comorbid conditions in children with attention deficit hyperactivity disorder (ADHD) are frequent and can affect treatment response and life course. From the multimodal treatment study of ADHD (MTA), we examined the persistence or development of conditions ... Full text Cite

ADHD and manic symptoms: Diagnostic and treatment implications

Journal Article Clinical Neuroscience Research · December 1, 2005 Introduction: Reports document children with attention deficit hyperactivity disorder (ADHD) and irritability, aggression or mood lability. Whether these additional symptoms represent severe ADHD, juvenile bipolar disorder, or other comorbidities is often ... Full text Cite

Refining the diagnoses of inattention and overactivity syndromes: A reanalysis of the Multimodal Treatment study of attention deficit hyperactivity disorder (ADHD) based on ICD-10 criteria for hyperkinetic disorder

Journal Article Clinical Neuroscience Research · December 1, 2005 There are large differences between nations in the diagnosis and management of children with marked impulsiveness and inattention. The differences extend to the names and definitions of disorder and the extent to which medication should be used. This paper ... Full text Cite

Gestational and postnatal tobacco smoke exposure as predictor of ADHD, comorbid ODD/CD, and treatment response in the MTA

Journal Article Clinical Neuroscience Research · December 1, 2005 Objective: To examine relationships among early smoke exposure (ESE), attention-deficit/hyperactivity disorder (ADHD), oppositional-defiant or conduct disorder (ODD/CD), and whether ESE affects symptom severity, comorbidity, and later treatment response. S ... Full text Cite

Cost-effectiveness of ADHD treatments: findings from the multimodal treatment study of children with ADHD.

Journal Article Am J Psychiatry · September 2005 OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is a costly public health problem. To the authors' knowledge, this is the first study on the cost-effectiveness of the major forms of ADHD treatments used in NIMH's Multimodal Treatment Study of Ch ... Full text Link to item Cite

Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder.

Journal Article J Clin Child Adolesc Psychol · March 2005 Peer-assessed outcomes were examined at the end of treatment (14 months after study entry) for 285 children (226 boys, 59 girls) with attention deficit hyperactivity disorder (ADHD) who were rated by their classmates (2,232 classmates total) using peer soc ... Full text Link to item Cite

The influence of maternal stress and distress on disruptive behavior problems in boys.

Journal Article J Am Acad Child Adolesc Psychiatry · March 2005 OBJECTIVE: The current study examined how self-reported maternal stress and distress are associated with child disruptive behaviors. METHOD: Mother and teacher ratings of child disruptive behavior problems (attention problems, aggression, and delinquency) ... Full text Link to item Cite

The Treatment for Adolescents With Depression Study (TADS): demographic and clinical characteristics.

Journal Article J Am Acad Child Adolesc Psychiatry · January 2005 OBJECTIVE: The Treatment for Adolescents With Depression Study is a multicenter, randomized clinical trial sponsored by the NIMH. This study is designed to evaluate the short- and long-term effectiveness of four treatments for adolescents with major depres ... Full text Link to item Cite

Striving for effectiveness in the treatment of adolescent depression: Cognitive behavior therapy for multisite community intervention

Journal Article Cognitive and Behavioral Practice · January 1, 2005 The Treatment for Adolescents With Depression Study (TADS) was designed to compare the relative and combined effectiveness of cognitive, behavior therapy (CBT) and fluoxetine, each of which had demonstrated efficacy in carefully controlled single-site stud ... Full text Cite

Parent involvement in CBT treatment of adolescent depression: Experiences in the Treatment for Adolescents with Depression Study (TADS)

Journal Article Cognitive and Behavioral Practice · January 1, 2005 The Treatment for Adolescents With Depression Study (TADS) evaluated the short- and long-term effectiveness of cognitive behavior therapy (CBT) alone, fluoxetine alone, and their combination, relative to pill placebo, and the 12-week treatment effects were ... Full text Cite

The services for children and adolescents-parent interview: development and performance characteristics.

Journal Article J Am Acad Child Adolesc Psychiatry · November 2004 OBJECTIVE: To date, no instrument has been developed that captures children's services use across primary care, specialty mental health, and other settings, including setting, treatment type, provider discipline, and length and intensity of specific interv ... Full text Link to item Cite

Negative emotions and alcohol use initiation in high-risk boys: the moderating effect of good inhibitory control.

Journal Article J Abnorm Child Psychol · October 2004 Studies on the relation between negative affect and later alcohol use have provided mixed results. Because definitions of negative affect often include diverse emotions, researchers have begun to dismantle this higher-order construct in an attempt to expla ... Full text Link to item Cite

AACAP 2002 research forum: placebo and alternatives to placebo in randomized controlled trials in pediatric psychopharmacology.

Journal Article J Am Acad Child Adolesc Psychiatry · August 2004 OBJECTIVE: The use of placebo in the pediatric age group has come under increasing scrutiny. At the 2002 Annual Meeting of the American Academy of Child and Adolescent Psychiatry, the Academy's Workgroup on Research conducted a research forum. The purpose ... Full text Link to item Cite

The coping power program for preadolescent aggressive boys and their parents: outcome effects at the 1-year follow-up.

Journal Article J Consult Clin Psychol · August 2004 This study evaluates the effects of the Coping Power Program with at-risk preadolescent boys at the time of transition from elementary school to middle school. Aggressive boys were randomly assigned to receive only the Coping Power child component, the ful ... Full text Link to item Cite

Classroom environment influences on aggression, peer relations, and academic focus

Journal Article Journal of School Psychology · March 1, 2004 Peers serve as reinforcers and models of behavior, and consequently classrooms containing high numbers of students with poor academic skills or behavior problems are likely to promote these behaviors in individual students. This study examined how variatio ... Full text Cite

Nine months of multicomponent behavioral treatment for ADHD and effectiveness of MTA fading procedures.

Journal Article J Abnorm Child Psychol · February 2004 We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) w ... Full text Link to item Cite

Childhood behavioral and emotional disorders.

Journal Article J Marital Fam Ther · October 2003 We reviewed the literature on family treatment for childhood behavioral and emotional disorders and found an increase in the number of studies since 1995; however there was significant variation by disorder and therapy model. There is substantially more re ... Full text Link to item Cite

Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD.

Journal Article J Consult Clin Psychol · August 2003 From the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder--a randomized clinical trial of 579 children ages 7-9 years receiving 14 months of medication management, behavioral treatment, combination, or community care--th ... Full text Link to item Cite

Cognitive-behavioral intervention for depressed, substance-abusing adolescents: development and pilot testing.

Journal Article J Am Acad Child Adolesc Psychiatry · June 2003 OBJECTIVES: To develop a cognitive-behavioral treatment for depressed, substance-abusing adolescents, determine its feasibility, and test its association with symptomatic improvement. METHOD: Based on the efficacy of cognitive-behavioral interventions for ... Full text Link to item Cite

Which treatment for whom for ADHD? Moderators of treatment response in the MTA.

Journal Article J Consult Clin Psychol · June 2003 Using receiver operating characteristics, the authors examined outcome predictors (variables associated with outcome regardless of treatment) and moderators (variables identifying subgroups with differential treatment effectiveness) in the Multimodal Treat ... Full text Link to item Cite

Treatment for Adolescents With Depression Study (TADS): rationale, design, and methods.

Journal Article J Am Acad Child Adolesc Psychiatry · May 2003 OBJECTIVES: A rapidly growing empirical literature on the treatment of major depressive disorder (MDD) in youth supports the efficacy of short-term treatment with depression-specific cognitive-behavioral therapy or medication management with a selective se ... Full text Link to item Cite

Effectiveness of the Coping Power program and of classroom intervention with aggressive children: Outcomes at a 1-year follow-up

Journal Article Behavior Therapy · January 1, 2003 This study examines key substance use, delinquency, and school-based aggressive behavior outcomes at a 1-year follow-up for a cognitive-behavioral intervention delivered to aggressive children and their parents at the time of these children's transition to ... Full text Cite

The Coping Power program at the middle-school transition: universal and indicated prevention effects.

Journal Article Psychol Addict Behav · December 2002 This study evaluates the effects of an indicated preventive intervention and a universal preventive intervention. Children were identified as being at risk on the basis of 4th-grade teachers' ratings of children's aggressive and disruptive behaviors, and i ... Full text Link to item Cite

Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA.

Journal Article J Abnorm Child Psychol · August 2002 In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of ... Full text Link to item Cite

Observed classroom behavior of children with ADHD: relationship to gender and comorbidity.

Journal Article J Abnorm Child Psychol · August 2002 Examined hypothesized gender and comorbidity differences in the observed classroom behavior of children with attention deficit hyperactivity disorder (ADHD). The behavior of 403 boys and 99 girls with ADHD, ages 7-10, was compared (a) to observed, sex-spec ... Full text Link to item Cite

Emergency/Adjunct services and attrition prevention for randomized clinical trials in children: the MTA manual-based solution.

Journal Article J Am Acad Child Adolesc Psychiatry · May 2002 Treatment studies in child and adolescent psychiatry are increasingly characterized by long-term, multisite, randomized clinical trials (RCTs). During the course of these RCTs it is common for clinical exigencies to emerge that require rapid, direct interv ... Full text Link to item Cite

Socioeconomic status as a moderator of ADHD treatment outcomes.

Journal Article J Am Acad Child Adolesc Psychiatry · March 2002 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 commu ... Full text Link to item Cite

Contextual social-cognitive mediators and child outcome: a test of the theoretical model in the Coping Power program.

Journal Article Dev Psychopathol · 2002 This study tests the contextual social-cognitive model, which has served as the basis for the Coping Power program, an indicated preventive intervention with at-risk preadolescent boys at the time of transition from elementary to middle school. The context ... Full text Link to item Cite

Comprehensive versus matched psychosocial treatment in the MTA study: conceptual and empirical issues.

Journal Article J Clin Child Psychol · March 2001 Addressed some factual inaccuracies and presented alternative positions on key issues raised in the article by Greene and Ablon (this issue) on the question, "What does the Multimodal Treatment Study (MTA) tell us about effective psychosocial treatment for ... Full text Link to item Cite

Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2001 OBJECTIVE: To conduct a post hoc investigation of the utility of a single composite measure of treatment outcome for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) at 14 months po ... Full text Link to item Cite

ADHD comorbidity findings from the MTA study: comparing comorbid subgroups.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2001 OBJECTIVES: Previous research has been inconclusive whether attention-deficit/hyperactivity disorder (ADHD), when comorbid with disruptive disorders (oppositional defiant disorder [ODD] or conduct disorder [CD]), with the internalizing disorders (anxiety a ... Full text Link to item Cite

Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2001 OBJECTIVES: To develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hypera ... Full text Link to item Cite

Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2001 OBJECTIVE: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial id ... Full text Link to item Cite

Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers.

Journal Article J Dev Behav Pediatr · February 2001 In 1992, the National Institute of Mental Health and 6 teams of investigators began a multisite clinical trial, the Multimodal Treatment of Attention-Deficit Hyperactivity Disorder (MTA) study. Five hundred seventy-nine children were randomly assigned to e ... Full text Link to item Cite

Symptom profiles in children with ADHD: effects of comorbidity and gender.

Journal Article J Am Acad Child Adolesc Psychiatry · February 2001 OBJECTIVE: To examine ratings and objective measures of attention-deficit/hyperactivity disorder (ADHD) symptoms to assess whether ADHD children with and without comorbid conditions have equally high levels of core symptoms and whether symptom profiles dif ... Full text Link to item Cite

Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA).

Journal Article J Abnorm Child Psychol · December 2000 Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of ... Full text Link to item Cite

Psychosocial treatment strategies in the MTA study: rationale, methods, and critical issues in design and implementation.

Journal Article J Abnorm Child Psychol · December 2000 The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial eve ... Full text Link to item Cite

Family processes and treatment outcome in the MTA: negative/ineffective parenting practices in relation to multimodal treatment.

Journal Article J Abnorm Child Psychol · December 2000 To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on t ... Full text Link to item Cite

Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study.

Journal Article J Abnorm Child Psychol · December 2000 Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7-9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, ... Full text Link to item Cite

The Multidimensional Anxiety Scale for Children (MASC): Confirmatory factor analysis in a pediatric ADHD sample

Journal Article Journal of Attention Disorders · January 1, 1999 While considerable attention has been paid to discriminating attention-deficit/hyperactivity and anxiety disorders, there are as yet no published confirmatory factor analytic studies of any self-report anxiety scale in ADHD youth. The Multidimensional Anxi ... Full text Cite

A new self-report scale for assessment of adolescent psychopathology: factor structure, reliability, validity, and diagnostic sensitivity.

Journal Article J Abnorm Child Psychol · December 1997 This paper describes four studies on self-reported problems in 2,243 adolescent males and females, 12 to 17 years of age. In Study 1, principal-axis factoring of 102 items covering 11 problem domains revealed six factors comprising 49.5% of the variance. S ... Full text Link to item Cite

National Institute of Mental Health Collaborative Multimodal Treatment Study of Children with ADHD (the MTA). Design challenges and choices.

Journal Article Arch Gen Psychiatry · September 1997 The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first child multisite cooperative agreement treatment study of children conducted by the National Institute of Mental Health, Roc ... Full text Link to item Cite

The moderating effects of children's fear and activity level on relations between parenting practices and childhood symptomatology.

Journal Article J Abnorm Child Psychol · June 1997 Parenting practices have been previously linked to childhood symptomatology. However, little consideration has been given to the potential effect of individual differences within the child on this relation. The current study assessed the moderating effects ... Full text Link to item Cite

NIMH collaborative multimodal treatment study of children with ADHD (MTA): Design, methodology, and protocol evolution

Journal Article Journal of Attention Disorders · January 1, 1997 The steering committee of the collaborative six-site Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (the MTA) had to develop a common protocol consistent with public health goals and with scientific and clinical state ... Full text Cite

Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial

Journal Article Journal of Attention Disorders · January 1, 1997 As the largest randomized clinical trial conducted by the National Institute of Mental Health, the Multimodal Treatment Study of Children with ADHD (MTA) will yield data on a diverse sample of 576 7.0- to 9.9-year-old children with attention-deficit hypera ... Full text Cite

The death of discipline: Is the requiem premature?

Journal Article Aggression and Violent Behavior · January 1, 1997 There is a current trend among one sector of the professional mental- health community against the use of confrontive discipline with children and toward a positive-only approach to child behavior management. The current paper addresses this position by pr ... Full text Cite

Attention-deficit/hyperactivity disorder: Part II. Treatment strategies

Journal Article Journal of Practical Psychiatry and Behavioral Health · December 1, 1996 In the second half of this two-part article, the authors review the current state of knowledge about the treatment of attention-deficit/hyperactivity disorder (ADHD) across the lifespan. They first discuss general principles of pharmacotherapy for ADHD and ... Cite

Medication treatment strategies in the MTA Study: relevance to clinicians and researchers.

Journal Article J Am Acad Child Adolesc Psychiatry · October 1996 OBJECTIVE: Clinicians have difficulty applying drug research findings to clinical practice, because research protocols use methods different from those used in daily office practice settings. METHOD: To design a medication protocol for a multisite clinical ... Full text Link to item Cite

Use of the abikoff classroom observation coding system on a children's inpatient psychiatric unit

Journal Article Journal of Psychopathology and Behavioral Assessment · March 1, 1986 The Abikoff systematic observation coding system (Abikoff, Gittelman-Klein, & Klein, 1977) has received considerable attention in the literature for assessing disruptive and off-task classroom behavior. However, its use has been restricted to regular class ... Full text Cite

A social learning approach, vol. 3: Coercive family process

Journal Article Behavior Therapy · January 1, 1984 Full text Cite

Behavioral family therapy with conduct disorders in children

Journal Article Behavior Therapy · January 1, 1983 Child behavior therapy has developed primarily within a parent consultation framework (i.e., parent training), especially with "conduct disorder" problems in children. Recent critiques within the field of behavior therapy as well as an increasing amount of ... Full text Cite

Maternal perception of maladjustment in clinic-referred children: An extension of earlier research

Journal Article Journal of Behavioral Assessment · June 1, 1982 The purpose of the present study was to extend earlier research examining predictors of maternal perceptions of maladjustment in clinic-referred children. Forty-five mothers and their clinic-referred children served as subjects. Maternal perceptions of chi ... Full text Cite

Side effects of parent counseling on marital satisfaction

Journal Article Journal of Counseling Psychology · January 1, 1982 In a study with 27 mothers and their clinic-referred children, mothers were divided into 3 groups based on their pretreatment level of marital satisfaction (Locke Marital Adjustment Test). Child compliance and deviant behavior as measured by independent ob ... Full text Cite

Use of single-subject methodology in clinical decision-making with a hyperactive child on the psychiatric inpatient unit

Journal Article Behavioral Assessment · June 1, 1981 The efficacy of various types of stimulant medications as well as behavioral interventions for treatment of hyperactive children has been well established. The present study illustrates the use of single-subject methodology in deciding which treatment or c ... Cite

Crisis treatment of a preadolescent who accidentally killed his twin.

Journal Article Am J Psychother · July 1980 Justification and effectiveness of a multimodal approach to treating a preadolescent who accidentally killed his twin is presented and recommended as a model for treatment of similarly disturbed children. The interaction of dynamically oriented therapy, ph ... Full text Link to item Cite

Effect of a reliability observer on the frequency of positive parent behavior recorded during naturalistic parent-child interactions

Journal Article Journal of Behavioral Assessment · March 1, 1980 The purpose of the present study was to examine the effect of the presence of a reliability observer on the number of positive parent behaviors recorded by a primary observer during naturalistic parent-child interactions. Thirty parents and their young cli ... Full text Cite

The use of a self-control package to enhance temporal generality of a parent training program

Journal Article Behaviour Research and Therapy · January 1, 1980 The purpose of the present study was to examine the effectiveness of a self-control package in enhancing temporal generality of a parent training program. Sixteen mothers and their clinic-referred noncompliant children were assigned to either a parent trai ... Full text Cite

An examination of the social validity of a parent training program

Journal Article Behavior Therapy · January 1, 1980 This study examined the social validity of a parent training program. Subjects were 15 clinic-referred children and their mothers and 15 nonclinic mother-child pairs. Home observations were conducted pre- and posttreatment and at a 2-month follow-up for th ... Full text Cite

Parent behavioral training: an analysis of the relationship among multiple outcome measures.

Journal Article J Abnorm Child Psychol · September 1979 The purpose of the present study was to examine the relationship among three types of outcome measures that have been employed to evaluate parent behavioral trainining: observational data collected by independent observers, parent-collected data, and paren ... Full text Link to item Cite

Predictors of child noncompliant behavior in the home.

Journal Article J Consult Clin Psychol · February 1978 Full text Link to item Cite

Effects of a verbal warning and overcorrection on stereotyped and appropriate behaviors.

Journal Article J Abnorm Child Psychol · December 1977 In Experiment I, the effects of a verbal warning, such as is used in Overcorrection, delivered contingently on the stereotyped mouthing behavior of two autistic/retarded children were examined. A multiple baseline design across subjects was used. The resul ... Full text Link to item Cite

Effects of a procedure derived from the overcorrection principle on manipulated and nonmanipulated behaviors.

Journal Article J Appl Behav Anal · 1977 Positive practice overcorrection has been shown to be effective in reducing stereotypic self-stimulatory behaviors displayed by retarded and autistic individuals. In addition, the procedure also may increase the occurrence of appropriate behavior through i ... Full text Link to item Cite

Dry-bed training and retention control training: A comparison

Journal Article Behavior Therapy · January 1, 1977 This study examined the efficacy of Dry-Bed Training (DBT) in the treatment of nocturnal enuresis and provided a direct comparison with Retention Control Training (RCT). Changes in bladder capacity as well as wets per night were recorded. The results revea ... Full text Cite

Changes in functional bladder capacity and bed-wetting during and after retention control training: a case study

Journal Article Behavior Therapy · January 1, 1975 Changes in functional bladder capacity and frequency of bed-wetting were recorded during retention control training with a 42 month old girl. Bladder capacity increased and remained above baseline levels. Bed-wetting decreased and did not occur during the ... Full text Cite

The effects of social punishment on noncompliance: a comparison with timeout and positive practice.

Journal Article J Appl Behav Anal The effects of social punishment, positive practice, and timeout on the noncompliant behavior of four mentally retarded children were assessed in a multitreatment withdrawal design. When programmed, the experimental procedure occurred contigent on non-comp ... Full text Link to item Cite