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Does Attention‐Deficit/Hyperactivity Disorder Predominant Presentation Matter? Examining Functional and Symptom Changes After Cognitive Behavioural Therapy.

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Title: Does Attention‐Deficit/Hyperactivity Disorder Predominant Presentation Matter? Examining Functional and Symptom Changes After Cognitive Behavioural Therapy.
Authors: Crespín, Juan Jesús (AUTHOR), Corrales, Montse (AUTHOR), Richarte, Vanesa (AUTHOR), Parramon‐Puig, Gemma (AUTHOR), Querol, Paula (AUTHOR), Mestres, Ferran (AUTHOR), Ramos‐Sayalero, Carolina (AUTHOR), Boix, Maria (AUTHOR), Torrent, Carla (AUTHOR), Fadeuilhe, Christian (AUTHOR), Ramos‐Quiroga, Josep Antoni (AUTHOR), Amoretti, Silvia (AUTHOR)
Source: Clinical Psychology & Psychotherapy. Mar2026, Vol. 33 Issue 2, p1-16. 16p.
Subjects: Treatment of attention-deficit hyperactivity disorder, Emotion regulation, Repeated measures design, Statistical models, Attention-deficit hyperactivity disorder, Secondary analysis, Academic medical centers, T-test (Statistics), Data analysis, Research funding, Statistical sampling, Questionnaires, Functional status, Severity of illness index, Descriptive statistics, Maximum likelihood statistics, Impulsive personality, State-Trait Anxiety Inventory, Pre-tests & post-tests, One-way analysis of variance, Statistics, Cognitive therapy, Data analysis software, Psychological tests, Nonparametric statistics, Regression analysis, Symptoms
Geographic Terms: Spain
Abstract: Background: Cognitive behavioural therapy (CBT) is an effective intervention for adults with attention‐deficit/hyperactivity disorder (ADHD). While both brief (6‐session) and standard (12‐session) formats show efficacy, it remains unclear whether treatment response differs between distinct ADHD clinical presentations. Methods: This secondary analysis of a randomized trial included 80 adults with ADHD (57.5% male; mean age = 41.26 ± 9.32 years) allocated to brief or standard CBT. Clinical and functional outcomes were assessed at baseline, posttreatment, as well as 3‐ and 6‐month follow‐ups. Linear mixed‐effects models and the Reliable Change Index (RCI) evaluated interactions between time, treatment format and ADHD presentation (inattentive vs. combined). Results: CBT yielded significant improvements across all domains, with 94.5% of participants achieving reliable symptomatic improvement. A significant time × presentation interaction (p = 0.001, ηp2 = 0.135) revealed a steeper core symptom reduction in the combined group, which survived sensitivity analyses controlling for baseline severity. Regarding format, the brief version produced greater observer‐rated symptom improvement, whereas the standard format yielded greater long‐term functional gains (p = 0.009, ηp2 = 0.061). Improvements were sustained at the 6‐month follow‐up. No robust three‐way interactions emerged. Conclusions: CBT is highly effective and durable across ADHD presentations and formats. Although the combined presentation exhibited a more pronounced reduction in core symptoms, this differential trajectory represents a promising clinical trend requiring cautious interpretation. While brief formats efficiently address core symptoms, standard programs may better optimize long‐term functional recovery. Summary: CBT produces clinically significant and durable improvements in core ADHD symptoms, daily functioning and comorbid emotional distress in adults, with approximately 95% of participants achieving reliable symptomatic improvement.Adults with the combined presentation show a steeper trajectory of improvement in core symptoms following CBT, reflecting a genuine clinical response even when accounting for their greater baseline severityBoth brief (6‐session) and standard (12‐session) formats are broadly effective across clinical presentations; however, the standard format may offer additional long‐term benefits for functional recovery.Clinicians should consider ADHD presentations when tailoring treatment intensity, while recognizing that these subtype‐specific differential trajectories represent promising clinical trends that require replication. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background: Cognitive behavioural therapy (CBT) is an effective intervention for adults with attention‐deficit/hyperactivity disorder (ADHD). While both brief (6‐session) and standard (12‐session) formats show efficacy, it remains unclear whether treatment response differs between distinct ADHD clinical presentations. Methods: This secondary analysis of a randomized trial included 80 adults with ADHD (57.5% male; mean age = 41.26 ± 9.32 years) allocated to brief or standard CBT. Clinical and functional outcomes were assessed at baseline, posttreatment, as well as 3‐ and 6‐month follow‐ups. Linear mixed‐effects models and the Reliable Change Index (RCI) evaluated interactions between time, treatment format and ADHD presentation (inattentive vs. combined). Results: CBT yielded significant improvements across all domains, with 94.5% of participants achieving reliable symptomatic improvement. A significant time × presentation interaction (p = 0.001, ηp2 = 0.135) revealed a steeper core symptom reduction in the combined group, which survived sensitivity analyses controlling for baseline severity. Regarding format, the brief version produced greater observer‐rated symptom improvement, whereas the standard format yielded greater long‐term functional gains (p = 0.009, ηp2 = 0.061). Improvements were sustained at the 6‐month follow‐up. No robust three‐way interactions emerged. Conclusions: CBT is highly effective and durable across ADHD presentations and formats. Although the combined presentation exhibited a more pronounced reduction in core symptoms, this differential trajectory represents a promising clinical trend requiring cautious interpretation. While brief formats efficiently address core symptoms, standard programs may better optimize long‐term functional recovery. Summary: CBT produces clinically significant and durable improvements in core ADHD symptoms, daily functioning and comorbid emotional distress in adults, with approximately 95% of participants achieving reliable symptomatic improvement.Adults with the combined presentation show a steeper trajectory of improvement in core symptoms following CBT, reflecting a genuine clinical response even when accounting for their greater baseline severityBoth brief (6‐session) and standard (12‐session) formats are broadly effective across clinical presentations; however, the standard format may offer additional long‐term benefits for functional recovery.Clinicians should consider ADHD presentations when tailoring treatment intensity, while recognizing that these subtype‐specific differential trajectories represent promising clinical trends that require replication. [ABSTRACT FROM AUTHOR]
ISSN:10633995
DOI:10.1002/cpp.70271