Risperidone Added to Parent Training and Stimulant Medication: Effects on Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Peer Aggression

摘要: Objective In this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication, and placebo (Basic therapy) versus stimulant, risperidone (Augmented by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant (ODD), conduct (CD) symptoms peer aggression, symptom-induced impairment, informant discrepancy. Method Children (6–12 years of age; N = 168) with severe physical ADHD, co-occurring ODD/CD received an open trial of parent training medication 3 weeks. Participants failing show optimal clinical response were randomly assigned Basic or Augmented therapy additional 6 weeks. Results Compared therapy, children receiving experienced greater reduction in parent-rated ODD severity ( p  = .002, Cohen's d = 0.27) aggression .02, 0.32) but not ADHD CD symptoms. Fewer (16%) than (40%) rated their parents as impaired by ODD at week 9/endpoint .008). Teacher ratings indicated in ADHD 0.61) CD symptoms aggression. Although both interventions associated marked symptom reduction, a relatively large percentage least 1 targeted 47%; 27%) teachers 48%; 38%). Conclusion was superior Basic therapy reducing symptoms, clinical improvement generally context specific, effect sizes ranged from small to moderate. Clinical registration information—Treatment Severe Childhood Aggression (The TOSCA Study); http://clinicaltrails.gov/; NCT00796302.