Attention Deficit Hyperactivity Disorder
Conditions
Keywords
adhd, adults, working memory, training, RCT
Brief summary
The purpose of this study is to evaluate whether computerised working memory training improves cognitive performance, ADHD symptoms, psychosocial functioning and quality of life in adults with ADHD, from psychiatric outpatient clinics (N=100) as well as from a high-security prison facility (N=50).
Detailed description
The primary aim is to evaluate whether 5 weeks of computerised working memory training improves working memory capacity. Secondary aims are to explore whether improvements in working memory capacity will be transferred to improvements in learning abilities and fluid intelligence. Also, far transfer effects on executive functioning, ADHD symptoms, psychosocial functioning and quality of life will be explored. Finally, it will also be assessed to what extent improvements gained from 5 weeks of working memory training will be maintained 3 and 6 months post-study, respectively.
Interventions
BEHAVIORALFlex working memory training
30-40 minutes of working memory training, 5 days a week for 5 weeks
Sponsors
Region Stockholm
Swedish Prison and Probation Services
The Söderströmska-Königska Foundation
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Confirmed ADHD according to DSM-IV criteria; ADHD combined type, ADHD inattentive type or ADHD UNS, primarily inattentive type. * Unmedicated for ADHD during the course of the trial, or being under stable ADHD medication for at least one month at baseline visit and without any planned changes in medication until post-study assessments have taken place.
Exclusion criteria
* Previous participation in computerised working memory training (completed training). * Any psychiatric disorder that in the judgment of the investigator, may interfere with study participation and/or study assessments, also including current substance abuse. * Participation in psychological treatment addressing ADHD during the course of the 5-week training period (psychoeducation is accepted). * Initiation of psychological treatment for coexistent disorders during the course of the study (treatment already ongoing at baseline visit is accepted if there are no planned changes during the 5-week training period).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in a composite measure of working memory capacity | Baseline and 7 weeks | The composite measure of working memory capacity comprises the sum score of: * Digit Span score (forwards/backwards) * Span Board score (forwards/backwards) * Arithmetics score * Spatial Working Memory score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Raven´s Standard Progressive Matrices score | Baseline, 7 and 31 weeks | Evaluating change in score of a short version of Raven´s Standard Progressive Matrices, as a measure of fluid intelligence. |
| Change in a composite measure of working memory capacity | Baseline and 31 weeks | The composite measure of working memory capacity will be assessed in a 6-month follow-up conducted at week 31 post-baseline, equivalent to week 24 post-intervention, to assess retention of any training-related improvements. |
| Change in Digit Span Forwards/Backwards score | Baseline, 7 and 31 weeks | Evaluating changes in both Digit Span forwards and backwards scores, as measures of simple verbal working memory capacity. |
| Change in Span Board Forwards/Backwards score | Baseline, 7 and 31 weeks | Evaluating changes in both Span Board forwards and backwards scores as measures of simple visuo-spatial working memory capacity. |
| Change in Arithmetics score | Baseline, 7 and 31 weeks | Evaluating change in Arithmetics score, as a measure of complex verbal working memory capacity as well as of mathematics ability. |
| Change in Spatial Working Memory score | Baseline, 7 and 31 weeks | Evaluating change in Spatial Working Memory score as a measure of complex visuo-spatial working memory capacity. |
| Change in Qbtest scores | Baseline, 7 and 31 weeks | Evaluating changes in Qbtest, a computerised CPT that in addition to measuring inattention and impulsivity also captures motor activity by an IR device during performance of the CPT. |
| Change in Sheehan Disability Scale (SDS) | Baseline, 7, 19, and 31 weeks | Evaluating changes in psychosocial functioning by the self-reported SDS conducted at baseline, post-intervention, at 3-month and 6-month follow-up. |
| Change in EuroQol- 5 Dimensions (EQ-5D) questionnaire | Baseline, 7, 19, and 31 weeks | Evaluating change in health-related quality of life by the self-reported generic QoL questionnaire EQ-5D, conducted at baseline, post-intervention, at 3-month and 6-month follow-up. |
| Change in Adult ADHD Quality of Life Measure (AAQoL) | Baseline, 7, 19, and 31 weeks | Evaluating change in health-related quality of life by the self-reported ADHD specific QoL measure AAQoL, conducted at baseline, post-intervention, at 3-month and 6-month follow-up. |
| Montgomery Åsberg Depression Rating Scale-Self report (MADRS-S) | Baseline and 7 weeks | Evaluating if depressive symptoms during the training period, as measured by the self-reported MADRS-S will influence adherence to and results of the working memory training. |
| Adverse events | Baseline and 7 weeks | All adverse events that occurred during the course of the 5-week intervention will be collected as part of the post-intervention assessments at week 7. |
| Change in Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | Baseline, 7, 19, and 31 weeks | Evaluating changes in ADHD symptoms by self-reported and informant-reported (significant other) versions of ASRS-v1.1, conducted at baseline, post-intervention, at 3-month and 6-month follow-up. |
Countries
Sweden
Outcome results
None listed