Evidence map›Paper›PMID 39400649›Full record

Trial reportResearch on child and adolescent psychopathology2025

High vs. Low Intensity Behavior Therapy Delivered to Adolescents with ADHD: Potential Adverse Long-Term Effects on Substance Use Outcomes.

Megan Kelley, Margaret H Sibley, Stefany J Coxe, Hana Basu, Samantha M Margherio, Steven W Evans, Frances L Wang

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Research on child and adolescent psychopathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Megan KelleyUniversity of Washington, Seattle, WA, USA.
Margaret H SibleyUniversity of Washington School of Medicine, Seattle Children's Research Institute, Seattle, WA, USA. margaret.sibley@seattlechildrens.org.
Stefany J CoxeCedars Sinai Medical Center, Los Angeles, CA, USA.
Hana BasuUniversity of Washington, Seattle, WA, USA.
Samantha M MargherioVirginia Polytechnic Institute and State University, Blacksburg, VA, USA.
Steven W EvansOhio University, Athens, OH, USA.
Frances L WangUniversity of Pittsburgh, Pittsburgh, PA, USA.

Funding

National Center for Special Education Research, Institute of Education Sciences R324A120169
6 · The paper itself

Abstract

Individuals with ADHD are at risk for substance use initiation in adolescence and escalation to problematic use in adulthood. Little is known about the impact of psychosocial ADHD treatment on substance use. Based on existing theory, both therapeutic (i.e., through reducing symptoms and impairments) and iatrogenic effects (i.e., through improved social functioning) of psychosocial treatment for ADHD on adolescent substance use initiation are plausible. A primarily ethnic/racial minority sample (~ 95% Latinx or Black) of rising ninth grade students with ADHD (n = 106) were randomly assigned to receive high intensity (i.e., Summer Treatment Program-Adolescent, parent training, and school consultation) or lower intensity (parent training, organization skills training, and school consultation) intervention the summer before entering high school. Participants were followed four-years post-baseline and substance use was documented. Analyses tested treatment effects on substance use initiation (alcohol and/or marijuana) and mediators of main effects. After controlling for covariates, participants assigned to HI (37.5%) were significantly more likely than LI (18.6%) to initiate substance use by end of high school, indicating an iatrogenic effect of HI treatment. No significant mediators were detected. Post-hoc exploration of moderators suggested that youth with elevated Posttraumatic Stress Disorder (PTSD) symptoms may have experienced a benefit of HI treatment on substance use whereas youth without elevated PTSD symptoms experienced iatrogenic effects. Large, well-powered, samples should examine moderated mediational models to better understand who is most risk for iatrogenic effects of ADHD psychosocial treatment and why. Clinicians delivering psychosocial treatment to adolescents with ADHD should monitor for potential iatrogenic effects.

Indexed as

Attention Deficit Disorder with HyperactivityBehavior TherapySubstance-Related DisordersAdolescentAdolescent BehaviorFemaleHumansMaleTreatment OutcomeADHDAdolescencePsychosocial treatmentSubstance use

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.