A Neuroaffirmative, Self-Determination Theory–Based Psychosocial Intervention for Adults With Attention-Deficit/Hyperactivity Disorder: Randomized Feasibility Study
Notice bibliographique
Résumé
BACKGROUND: Neurodevelopmental disorders are complex and heterogeneous, creating challenges for treatment design. Multiple syndromes are associated with executive function (EF) deficits; however, theories of attention-deficit/hyperactivity disorder (ADHD) centralize a singular perspective of outcomes arising from EF impairments in adults. Deficit-based etiologies state ADHD-related EF impairments interfere with agentic self-development, perspectives that may inadvertently contribute to social stigma and influence neurotype dysphoria in ADHD identity construction. Challenges to this perspective highlight heterogeneity, context variability, the absence of a single EF deficit of origin, correlational neuroimaging data, and limited investigation into altered brain activity in ADHD research. Recommendations for psychosocial interventions primarily support cognitive behavioral therapy, which centers on a deficit-based etiology of ADHD and prioritizes symptom reduction and cognitive control of self-regulation as treatment outcomes-skills that require additional cognitive effort and may involve avoidance of emotional experiences to minimize negative affect. Transdiagnostic approaches are recommended to gain new insights into mental health challenges. Self-Determination Theory (SDT) presents a transdiagnostic approach that offers alternative outcomes by prioritizing basic psychological need satisfaction, which supports strong identity formation, motivation, and self-regulation. OBJECTIVE: This study examines the feasibility and effects of an SDT-based quality-of-life therapeutic intervention for adults with ADHD. METHODS: We aimed to recruit 30 participants aged 18 years or older with a confirmed diagnosis of ADHD and access to an internet connection. Participants were recruited from the Adult ADHD Clinic at the South West Yorkshire Partnership National Health Service Foundation Trust and allocated through 4-block randomization by a nonblinded researcher to either an 11-session therapeutic coaching intervention (n=11) or a control waitlist (n=9) condition. Feasibility was evaluated by pretreatment and posttreatment measurements of health-related quality of life (QoL), psychological distress, ADHD symptoms, ADHD-related QoL, self-reflection and insight, autonomous functioning, and individual outcome measures of impairment. Participants also responded to a qualitative feedback interview question on intervention value. RESULTS: Adherence was high for both intervention completion (10/11, 91.6%) and control condition completion (9/11, 81.8%). Results showed clinically significant improvement on measures of psychological distress, specifically in the subscales of problems (z=0.0; P=.01), nonrisk (z=2.0; P=.01), functions (z=5.0; P=.02), and well-being (z=6.0; P=.03), as well as ADHD symptoms (z=3.0; P≤.01), particularly inattention (z=3.0; P≤.01), outcomes not specifically targeted by the intervention. Additional clinically significant findings of improvement in QoL, specifically in outlook subscale (z=21; P=.67), reduction of distress in problems identified in the individual outcome measure and the need for self-reflection subscale of self-reflection for the control group (z=1.0; P=.05) indicate potential positive effectiveness despite the impact of COVID-19. Positive qualitative feedback on usefulness and transferability of the intervention was provided by 90% (20/23) of participants. CONCLUSIONS: This study suggests that a randomized controlled trial of an SDT-based psychosocial intervention with nondeficit-based outcomes for adults with ADHD is feasible and recommended. TRIAL REGISTRATION: ClinicalTrials.gov NCT04832737; https://clinicaltrials.gov/study/NCT04832737.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».