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02-10-2020 | Original Article | Uitgave 1/2021

Cognitive Therapy and Research 1/2021

Psychotherapy, Atomoxetine or Both? Preliminary Evidence from a Comparative Study of Three Types of Treatment for Attention-Deficit/Hyperactivity Disorder in Children

Cognitive Therapy and Research > Uitgave 1/2021
Daniel David, Anca Dobrean, Costina Ruxandra Păsărelu, Felicia Iftene, Viorel Lupu, Elena Predescu, Manfred Döpfner
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10608-020-10157-6) contains supplementary material, which is available to authorized users.
Daniel David and Anca Dobrean with the same principal contribution.
Clinical trial registration information: ISRCTN92640175.

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The current study aimed to investigate using a superiority framework the efficacy of a combined treatment (cognitive-behavioral therapy based on behavioral components derived from classical behavioral therapy modifications and cognitive components mainly derived from rational emotive behavior therapy, plus an attention training component in a virtual environment (CBT/REBT + ATX, N = 20) as compared to psychotherapy alone (CBT/REBT, delivered over 16 weeks, N = 18—reference treatment) and non-stimulant medication alone (atomoxetine; ATX, N = 21—reference treatment) for children with Attention-Deficit/Hyperactivity Disorder (ADHD).


A three-arm pilot randomized controlled trial was conducted. Fifty-nine children (Mage = 8.46, SD = 1.57) were randomly allocated to one of the 3 conditions.


Our preliminary findings indicated a significant difference between the CBT/REBT + ATX and ATX group at post-treatment for the total ADHD symptoms rated by parent, d = 1.30, 95% CI [0.63, 1.98], p = 0.010.


The combined treatment seems to be superior to the medication alone on parent ratings on ADHD symptoms, however, on clinical ratings on ADHD diagnosis and functioning there are no significant group differences between treatments. Future larger trials with follow-up assessments are needed to test the stability of the effects over time.

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