Moderators and mediators of treatment outcome for youth with ADHD: understanding for whom and how interventions work

J Pediatr Psychol. 2007 Jul;32(6):664-75. doi: 10.1093/jpepsy/jsl055. Epub 2007 Jan 29.

Abstract

Objective: To present data on moderators and mediators of treatment response from the Multimodal Treatment Study of Children With ADHD (MTA).

Methods: Moderator variables (baseline factors that define subgroups with greater vs lesser intervention response) and mediator variables (factors occurring during treatment that explain how interventions "work") are described with specific application to the outcomes of the MTA Study.

Results: Key moderator variables (comorbid anxiety disorder, public assistance, severity of attention-deficit/hyperactivity disorder, parental depressive symptomatology, IQ) and mediator processes (negative/ineffective parental discipline) are reviewed.

Conclusions: Treatment research in the future should explicitly consider the exploration of moderator and mediator variables, which can greatly aid the explanatory power of clinical trials and specify the critical next steps for intervention research.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Child
  • Clinical Trials as Topic
  • Comorbidity
  • Epidemiologic Factors
  • Epidemiologic Measurements
  • Humans
  • Research Design*
  • Risk Factors
  • Treatment Outcome