Effectiveness of Psychoanalytic Psychotherapy and Behavioral Therapy Treatment in Children with Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder

Abstract

The study compares the effectiveness of long-term psychoanalytic psychotherapy without medication with behavioral therapy and/or medication treatment. Seventy-three children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) participated in a controlled trial. The primary outcome was symptom reduction 38 months after the pre-treatment assessment. Secondary outcomes were significantly lower scores for Conners Parent and Teacher Rating Scale, Child Behavior Checklist and Teacher Report Form scores. Both treatment groups demonstrated significant symptom reduction, with no significant differences in effectiveness between the two groups. Teacher ratings as well as parent ratings showed a significant decline over time on the ADHD index scores, on oppositional behavior and hyperactivity/impulsivity levels and on internalizing and externalizing problem scores. Both groups demonstrated similar main effects of time. There were no significant interactions between group and time. The findings of this study support psychoanalytic psychotherapy without medication as being as effective as behavioral treatment with methylphenidate in symptom reduction and problem reduction on ADHD/ODD related rating scales.

Notes

1. In order to assess whether the pre-treatment differences between the two groups affect the effectiveness, we first applied the propensity score method (Bartak et al., 2009). Thereby all biased pre-treatment variables that showed a p-value < .20 were reduced to a single propensity score using logistic regression with the dependent variable “group”. The propensity score was entered into the analysis of variance as a covariate. Calculations with and without propensity score yielded the same effectiveness. We decided to present the outcome data without the propensity score as a covariate because the sample is relatively small and because we wanted to give a full transparent picture of our data.

Additional information

Notes on contributors

Katrin Luise Laezer

Katrin Luise Laezer, PhD, is a clinical psychologist at the Sigmund-Freud-Institut and the University of Kassel. She works as a Post-Doc at the Center for Individual Development and Adaptive Learning in Frankfurt/Main. Along with other investigators, she conducted the controlled trial.