Many adults with attention deficit hyperactivity disorder (ADHD) experience difficulties with inattention, planning, impulsivity and emotion regulation that impacts work and social life negatively also after treatment with medication. There are various psychological treatments aiming to improve these symptoms, but it is not known if they work or not.
The goal of this clinical trial is to evaluate group cognitive behavioural therapy (CBT) for adults with attention deficit hyperactivity disorder (ADHD) in comparison to an active control group consisting of a discussion and activity group. Previous research suggests that group CBT works about equally well as other structured group activities. The main questions the researchers aim to answer are if group CBT work better than activity groups to:
* Improve symptoms of ADHD * Improve general mental health and life quality * Improve every-day functioning The researchers also want to learn if group CBT or activity groups work better for some people with ADHD depending on individual characteristics such as * Type of symptoms, age, gender or co-occurring psychiatric diagnoses
The comparison is a manualised structured activity group given at the same number of sessions and same group size. All participants will visit our clinics at 14 occasions. They will:
* Fill in questionnaires before and after the group intervention, and online after 6, 12 and 24 months * Do an interview with an independent trained clinician about their daily functioning and difficulties related to ADHD symptoms before and after the group intervention, and after 6, 12 and 24 months
Fulfilling criteria for ADHD
Motivation and practical possibility to participate in the treatment.
Ongoing psychosis
Ongoing suicidality/severe self-injury
Intellectual disability
Insufficient Swedish language skills.
Parallel
Group CBT based on DBT-skills training
BehavioralThe Swedish version manual of Hesslinger's DBT-based skills training for adults with ADHD. The program includes psychoeducation, skills training and mindfulness exercises and aims to improve ADHD symptoms, especially disorganised and dysfunctional behaviour, emotion dysregulation and impulse control. The skills training group will meet at the clinic weekly for 14 weeks for 2 hours including a break in the middle. The groups are led by two clinicians.
Activity group
BehavioralThe Activity group is a structured manualised group intervention designed for this as well as prior and planned future studies of psychosocial treatments for adults with ADHD and/or autism. The program includes group discussions, peer-sharing and social every-day life activities. The Activity groups will meet at the clinic weekly for 14 weeks for 2 hours including a break in the middle. The groups are led by two trainers.
Change in Adult ADHD Self-Report Scale (ASRS)
ASRS is a self-reported symptom questionnaire for adults with ADHD. It has 18 questions about how often the participant experiences a certain symptom, with five response choices ranging from 0 (never) to 4 (very often) points.
Change in Clinical Global Impressions-Severity (CGI-S)
CGI-S is a 7-point scale where the clinician rate the severity of the patients illness at the time of assessment.
Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM)
CORE-OM is a self-rating questionnaire covering general psychiatric symptoms, well-being and functioning. It has 34 questions about how often the participant experiences a certain symptom, with five response choices ranging from 0 (not at all) to 4 (most or all of the time) points.
Brunnsviken Brief Quality of Life Inventory (BBQ)
BBQ is a validated brief version of the self-rating Quality of Life Scale, with higher sensitivity to change. It consists of 12 statements and the participant indicates how much they agree with each statement in five response choices ranging from 0 (do not agree at all) to 4 (agree completely).
Difficulties in Emotion Regulation Scale, brief version (DERS-16)
DERS-16 is a validated brief version of the original 36 item self-assessment measuring clinically relevant difficulties in emotional regulation. DERS-16 consists of 16 questions about how often a statement applies to the participant, with five response choices ranging from 1-5 where 1 is almost never (0-10% of the time) and 5 is almost always (91-100%).
Treatment Credibility questionnaire (TCS)
Swedish version of the TCS for assessment of treatment fidelity and expectation in both participants with ADHD and clinicians administering the CBT and activity groups.
Negative Effects Questionnaire (NEQ)
A self-report measure for assessment of adverse events associated with psychological treatment. The 20 item version will be used, and participants rate a statement ranging from 0-4 where 0 is not at alls and 4 is extremely.
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