Web-Based Stress Management for Working Adults With Attention-Deficit/Hyperactivity Disorder (ADHD): Single-Arm, Open Pilot Trial
Bibliographic record
Abstract
Background: National and international guidelines advocate for a multimodal approach to treating adult attention-deficit/hyperactivity disorder (ADHD), combining pharmacotherapy with psychological interventions. While recent reviews support cognitive behavioral therapy (CBT) as a viable treatment for ADHD in adults, evidence remains limited. Another challenge is the availability of psychological interventions, with stimulants remaining the primary treatment choice for adults with ADHD. One promising approach to increasing access to psychological interventions is the dissemination of internet-delivered CBT. Objective: This study evaluated the feasibility, acceptability, and effects of a guided web-based stress management program specifically designed for working adults with ADHD. The intervention aimed to enhance quality of life by addressing stress, exhaustion, anxiety, and depression, commonly experienced by this population. Methods: Thirty-six participants took part in a single-arm open trial, with assessments before, during, and after the intervention. The intervention consisted of 12 modules based on CBT principles, focusing on executive functioning, stress management, and emotion regulation, with clinician support on demand. Primary and secondary outcomes included quality of life (Adult ADHD Quality of Life Scale [AAQoL]), perceived stress (Perceived Stress Scale [PSS-10]), exhaustion (Karolinska Exhaustion Disorder Scale [KEDS]), anxiety (Generalized Anxiety Disorder 7-item Scale [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), and ADHD symptoms (the World Health Organization Adult ADHD Self-Report Scale [ASRS]). Results: Results indicated a statistically and clinically significant improvement in quality of life (Cohen d=0.84), and a reduction in ADHD symptoms (d=0.98), as well as statistically significant reductions in perceived stress (d=0.83), exhaustion (d=1.12), anxiety (d=1.70), and depression (d=1.25). Improvements were sustained at a 12-week follow-up. A clinically significant improvement in quality of life was observed in 36% (13/36) of participants. Participants reported high satisfaction with the program and the guidance. Adherence was high, with an overall assessment response rate of 84%, a mean of 78% of modules opened, and no explicit dropouts. Twelve of the 36 participants reported negative effects. Qualitative content analysis of participants' written feedback revealed positive experiences and suggestions for improvement. Conclusions: This study suggests promise for web-delivered interventions tailored to the needs of adults with ADHD, pending further research and development in controlled studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".