The Evidence Base for Psychosocial and Psychopharmacological Interventions for Children with
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Specific aims of project

The Evidence Base for Psychosocial and Psychopharmacological Interventions for Children with Attention-Deficit/Hyperactivity Disorder, Major Depressive Disorder, Disruptive Behavior Disorders, Anxiety Disorders,and Posttraumatic Stress DisorderBarbara J. Burns, Ph.D.Scott N. Compton, Ph.D.Helen L. Egger, M.D.Elizabeth M. Z. Farmer, Ph.D.Duke University Medical Center


Specific aims of project

Specific Aims of Project

I .To identify efficacious/effective interventions

for the treatment of childhood mental disorders

which could reduce the risk for substance use

problems in adolescence and later;

II.To identify mental health intervention studies

in which substance use outcomes could be

examined in adolescence and later.


Specific aims of project

Inclusion Criteria for Literature Search

  • Study on one of five childhood disorders or related symptom group

  • Utilized a controlled design

  • Targeted children in 6-12 age range

  • Published 1985-1999

    (except interventions studied earlier and not repeated later)

  • Focused on outpatient treatment


Search results

Search Results

Clinical ReferencesReferences Meeting

Condition Identified Inclusion Criteria

ADHD13231*

Depression 2819

Disruptive

Behavior 31430*

Disorders

Anxiety 7537

Disorders

Posttraumatic 58 5

Stress Disorder

*Studies with N < 30 were excluded


Specific aims of project

Descriptors in Matrices

Study design and description

Target population

Demographic characteristics

(Age, gender, race/ethnicity)

Outcomes

Comments


Types of interventions with positive findings by clinical condition

Types of Interventions with Positive Findings by Clinical Condition

  • PSYCHOSOCIAL

  • PSYCHOPHARMACOLOGICAL

  • ADJUNCTIVE

    (combined treatments)


Interventions with positive findings for attention deficit hyperactivity disorder

Interventions with Positive Findings forAttention-Deficit/Hyperactivity Disorder

PsychosocialPsychopharmacological Adjunctive

cognitive behaviormethylphenidate;slight evidence

therapy;desipramine;for psychosocial pindolol; in 2 of 8 studies

social skills training;buproprion; for combined

amphetamine sulfate treatment;

biofeedback

drugs superior to

psychosocial

treatment in

6 of 8 studies


Interventions with positive findings for depression

Interventions with Positive Findings forDepression

Psychosocial Psychopharmacological Adjunctive

cognitive behaviorfluoxetine none

therapy;

self-control training


Interventions with positive findings for disruptive behavior disorders

Interventions with Positive Findings forDisruptive Behavior Disorders

PsychosocialPsychopharmacological Adjunctive

parent training;lithium; none

multisystemic therapy;methylphenidate

case management;

anger-coping;

problem-solving skills

PATHS;

Project LIFT;

First Step;

Fast Track


Interventions with positive findings for anxiety disorders

Interventions with Positive Findings forAnxiety Disorders

PsychosocialPsychopharmacologicalAdjunctive

systematicsertraline none

desensitization;(for obsessive compulsive

modeling;disorder only)

reinforced practice;

cognitive behavior

therapy;

contingency

management;

cognitive self-control;

educational support


Interventions with positive findings for posttraumatic stress disorder

Interventions with Positive Findings forPosttraumatic Stress Disorder

PsychosocialPsychopharmacologicalAdjunctive

stressinoculation; none none

gradual exposure;

cognitive behavior therapy

(for parent and child)


Specific aims of project

Specific Aims of Project

I .to identify efficacious/effective interventions

for the treatment of childhood mental disorders

which could reduce the risk for substance use

problems in adolescence and later;

-- EFFICACY --


Specific aims of project

Response to Aim I. -- EFFICACY --

Efficacious interventions exist for all disorders examined

Strength of psychopharmacological evidence

varies by disorder

Availability of efficacious interventions in clinical practice

is unknown, but suspected to be low

Increasing efficacious interventions through training and

quality monitoring is warranted


Specific aims of project

Specific Aims of Project

II.to identify mental health intervention studies

in which substance use outcomes could be

examined in adolescence and later.

-- FOLLOW-UP STUDIES --


Specific aims of project

Response to Aim II.-- FOLLOW-UP STUDIES --

To select follow-up studies from existing studies,

decisions are needed relative to:

(1)the standard for evidence-based interventions

(2)current age of previously studied samples

(3)adequacy of the methods

(4)risk of samples (i.e., disorders, ethnic diversity)

for substance problems

Prospective studies needed with substance assessment

and follow-up incorporated to:

(1)replicate older efficacious treatments

(2)develop psychosocial treatments (especially for PTSD)

and medications (except ADHD)


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