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Structured skills training for adults with ADHD in an outpatient psychiatric context: an open feasibility trial

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ADHD Attention Deficit and Hyperactivity Disorders

Abstract

The aim of the current study was to evaluate the feasibility, acceptability, and effectiveness of Dialectical Behavioral Therapy-based skills training groups for adults with ADHD in an outpatient psychiatric context. Furthermore, the purpose was to analyze the impact of clinical characteristics on the effect and attrition. Ninety-eight adults (out of 102) with ADHD were allocated to the treatment. Self-rating scales were administered as baseline before the first session (T1), post-treatment (T2), and at 3-month follow-up (T3). Approximately 80 % (74 individuals) attended at least two-thirds of the sessions. Treatment satisfaction was good. ADHD symptoms and ADHD-related functional impairment in every-day life were reduced. Well-being, ability to be mindful, acceptance of emotions and quality of life were increased. The results were stable at 3-month follow-up. None of the predictors, i.e., age, comorbidity, ADHD medication status, IQ-level, treatment credibility, or functional impairment at the beginning of treatment, significantly predicted treatment outcome (change in ADHD symptoms from T1 to T2). Likewise, none of the predictors, i.e., irritability/aggression, comorbidity, and functional impairment, were significantly associated with attrition. Due to the difficulties in predicting treatment outcome, as well as attrition, based on clinical characteristics, broad inclusion criteria should be applied.

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Acknowledgments

We are indebted to all participants. We would also like to thank all psychologists who were group leaders: Ulrika Backlund, Cecilia Pihlgren, Johan Åhlén, Johan Albinsson, Alexandra Boalt, Johan Pahnke, Kristina Österman, Jessica Brannmark Willekens, Lina Sagerlov Gunnarsson, Anna Eriksson, Matilda Larsson, and Louise Frödell.

Role of the Funding sources

Financial support was provided through the Regional Agreement on Medical Training and Clinical Research (ALF) between the Stockholm County Council and Karolinska Institutet, as well as the foundation Psykiatrifonden.

Authors contributions

EM and TH designed the database and EM performed the data entry. All authors contributed to the design of the statistical analyses. TH performed the statistical analysis. EM and TH drew the figures. EM wrote the first draft. All authors read and commented on the manuscript.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, Pediatric Neuropsychiatry Unit, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, CAP Research Center, Gävlegatan 22, 113 30, Stockholm, Sweden

    E. Morgensterns & T. Hirvikoski

  2. PRIMA Neuropsychiatry, Stockholm, Sweden

    J. Alfredsson

  3. Habilitation and Health, Stockholm County Council, Stockholm, Sweden

    T. Hirvikoski

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  1. E. Morgensterns
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  2. J. Alfredsson
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  3. T. Hirvikoski
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Correspondence to T. Hirvikoski.

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Conflict of interest

Two of the authors are also authors of the Swedish version of the treatment manual.

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Morgensterns, E., Alfredsson, J. & Hirvikoski, T. Structured skills training for adults with ADHD in an outpatient psychiatric context: an open feasibility trial. ADHD Atten Def Hyp Disord 8, 101–111 (2016). https://doi.org/10.1007/s12402-015-0182-1

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