Methods of Psychological Intervention or Therapy

¶ … amphetamines for the treatment of Attention Deficit Disorder. The writer explores the study, the method used, the results and other pertinent data. There were fours sources used to complete this paper.

Attention Deficit Disorder, commonly referred to as ADHD affects a significant percentage of the population. "Attention deficit hyperactivity disorder (ADHD) is characterized by significant deficits in attention, impulse control, and activity level and affects 3% to 5% of the school-age population (Handen, 1999)." Regardless of the number of people who have it, the symptoms are strikingly similar and can have a negative impact on the life of the ADHD patient. Social, business and other problems often erupt in the person who has ADHD, that can include being overly talkative, domineering, impulsive, immature and aggressive. All of these traits combine to make the person difficult to be around or do business with in many cases (Merrell, 2001). "Children in schools can be disruptive while adults can impede the smooth operation of a business. There is also evidence that children with ADHD have difficulty adapting their behavior to accommodate the requirements of a shifting social climate (Landau & Milich, 1988; Saunders & Chambers, 1996; Whalen & Henker, 1998). This adaptation difficulty often leads to their use of a domineering and aggressive interaction style when a more cooperative style is required (Whalen & Henker, 1998). This particular deficit seems to lead to many of the social difficulties mentioned earlier (Merrell, 2001)."

In recent years there has been a focus placed on locating the most effective treatment for those who have ADHD. Media has zeroed in on the debates surrounding the use of amphetamines as a treatment option for the disorder. The debate has centered on giving amphetamines to children with the disorder. The lines are firmly drawn in the sand with those who advocate their use on one side, and those who believe they are ineffective or to dangerous to use on the other. Treatment of ADHD often centers on the use of some type of medication. Whether or not amphetamines are effective and safe is a topic that is easily heated because the bulk of patients with ADHD are children. Recent studies have concluded that the use of Amphetamines in patients with ADHD is an effective treatment for the symptoms of the disorder.

The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants (Kidd, 2000)."

Regardless of the cause it is commonly believed that the use of amphetamines for treatment is an effect avenue.

One study about the use of amphetamines used a double blind placebo controlled method of determining the effectiveness of using them for treatment of ADHD.

The study was conducted to test the efficacy of the medication in both extended release and immediate release doses of dextroamphetamine sulfate.. The study used 35 children who had definitive diagnoses of Attention Deficit Hyperactivity Disorder (Sharp et al., 2001).

The study used Adderall and a placebo to test the true effects and impact of the amphetamine on the symptoms and control of ADHD.

Stimulants are the drugs of choice for the pharmacological treatment of attention deficit hyperactivity disorder (ADHD), and the most frequently prescribed agent remains methylphenidate (MPH), with a positive response rate exceeding 70% (Spencer et al., 1996). Several controlled crossover studies suggest that nearly all children with combined-type ADHD who are nonresponders to MPH respond favorably to dextroamphetamine sulfate and vice versa (Arnold, 1996; Arnold et al., 1978; Elia et al., 1991; Sharp et al., 1999). In the past few years, a mixture of 75% dextroamphetamine and 25% levoamphetamine (Popper, 1994) has been aggressively marketed under the trade name Adderall[R], attaining an estimated 29% of market share in 2000 (Goodman and Nachman, 2000) (Sharp et al., 2001)."

This study used 21 males and 14 females who had a mean age of 9.1 years. Each of the children involved in the study had a history of severe ADHD symptoms including impulsivity, inattention and hyperactivity. Out of the 35 study participants ten of them were also diagnosed with Oppositional Defiant Disorder and six had a learning disorder.

The children were located at local schools and excluded if they had an IQ less than 80 or if they had a chronic tic disorder such as Tourette's syndrome (Sharp et al., 2001).

Children participated in a research school 5 days per week consisting of formal academic instruction from 9 A.M. To 12:30 P.M. And therapeutic recreation (sports, art therapy, structured social skills sessions) from 1 P.M. To 3 P.M. Behavior management techniques were used extensively within the program, although parent training was not provided (Sharp et al., 2001)."

There was a three-week observation period in which the students were medication free and testing was done to make sure there were no underlying physical issues that could interfere with the study results.

Double-blind medications were administered for 8 weeks, followed by 2 weeks of open treatment optimization (Sharp et al., 2001). Each child received 2 weeks each of Adderall, immediate-release dextroamphetamine, dextroamphetamine Spansules, and placebo in random order (Sharp et al., 2001). Active drugs were given in two doses, one per week. The overall mean low dose was 7.8 mg (range 5 -- 25 mg, 0.24 mg/kg) and the mean high dose was 12.8 mg (range 10 -- 30 mg, 0.39 mg/kg). The dose order was randomized across subjects, but the same order, either increasing (n = 18) or decreasing (n = 17), was used for a given subject (Sharp et al., 2001)."

The results indicated that there is a strong evidence of success in the use of amphetamines in the treatment of symptoms of ADHD.

There was a significant effect of medication on the Conners Teacher Hyperactivity factor score ([F.sub.3,32] = 15.70, p [less than].001), obtained in the classroom between 9 A.M. And 12:30 P.M. Contrast analysis revealed that immediate-release dextroamphetamine, which did not differ significantly from Adderall, decreased teacher-rated hyperactivity significantly more than dextroamphetamine Spansules (p =.025). Higher doses were significantly more effective than lower doses for all three medications ([F.sub.1,34] = 5.38, p =.03) (Sharp et al., 2001)."

In Timed academic tasks were performed each weekday at 11 A.M. Stimulants significantly increased the number of math problems attempted and number of problems done correctly ([F.sub.3,32] = 6.25,p =.002 and [F.sub.3,32] = 5.58, p =.003, respectively). Immediate-release dextroamphetamine and dextroamphetamine Spansules both significantly increased the number of problems attempted relative to placebo (p =.01 and p =.003, respectively). Improvements on Adderall did not reach significance; drug-drug differences were not statistically significant (Sharp et al., 2001)."