Multimodal Treatment Study of ADHD

Jensen, P.S., Hinshaw, S.P., Swanson, J.M., et al. Findings from the NIMH Multimodal Treatment study of ADHD (MTA) implications and applications for primary care providers. J. Dev. Behav. Pediatr. 22, 60-73, 2001. 

Over the last several years, NIMH has funded a cohort of dedicated stimulant/ADHD advocates to conduct an expensive, nationwide, longterm study under naturalistic conditions in the community to prove the effectiveness of stimulants in treating so-called ADHD (Jensen et ah, 2001). The list of authors includes Peter Jensen, Stephen Hinshaw, James Swanson, Larry Greenhill, and even Keith Conners. It was as if the aging Stimulant Club had gone on government relief to produce the NIMH Multimodal Treatment Study of ADHD (MTA), whose results continue to be published. 

MTA Cooperative Group. (2004). National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up Changes in effectiveness and growth after the end of treatment. Pediatrics 113, 762-769. 

The influential Multimodal Treatment Study of ADHD (MTA study) demonstrated... 

Despite the overwhelming evidence for short-term effectiveness, only recently have studies begun to address long-term benefits of stimulant treatments. Prospective randomized controlled trials with durations of 12 to 24 months and doses up to 60 mg/day of MPH have been conducted to address this issue. The largest of these studies, the National Institute of Mental Health (NIMH)-sponsored Multimodal Treatment Study of Attention-Deficit Hyperactivity Disorder (MTA Study), showed that stimulants (either by themselves or in combination with behavioral treatments) lead to stable, long-term improvements in ADHD symptoms as long as the medication is taken (MTA Cooperative Group, 1999). 

MTA Cooperative Group (1999a) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 56 1073-1086. 

B., Severe, J., Wells, K.C., and Pelham, WE. (2000) Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA). J Abnorm Child Psychol 28 527-541. 

Box 7.6 The MTA Study (Multimodal Treatment Study of Children with ADHD)... 

MTA Co-operative Group. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder. The Multimodal Treatment Study of children with ADHD. Arch Gen Psychiatry 1999 56 1088-%... 

The Multimodal Treatment of ADHD (MTA) Study, a large, multisite study of ADHD treatment (MTA Cooperative Group, 1999), highlights the importance of this therapeutic alliance. When outcome was measured only in terms of the child s inattention, stimulant medication alone did as well as medication plus psychosocial treatment. However, the combination of medication and psychotherapy had the best outcome in parent satisfaction and in reducing disruptive behaviors (Hinshaw et ah, 2000), which are important factors in longer-term compliance with treatment and outcome. 

Hechtman L, Abikoff H. Multimodal treatment plus stimulants vs stimulant treatment in ADHD children results from a two year comparative treatment study. 42nd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, New Orleans, 1995. 

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