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Journal of Pediatric Psychology Advance Access originally published online on January 29, 2007
Journal of Pediatric Psychology 2007 32(6):664-675; doi:10.1093/jpepsy/jsl055
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Copyright © 2007 by the Ambulatory Pediatric Association, published by Elsevier Inc.

Moderators and Mediators of Treatment Outcome for Youth With ADHD: Understanding for Whom and How Interventions Work

Stephen P. Hinshaw, PhD

Department of Psychology, University of California, Berkeley, Calif.

All correspondence concerning this article should be addressed to Stephen Hinshaw, Department of Psychology, Tolman Hall #1650, University of California, Berkeley, CA 94720-1650. hinshaw{at}berkeley.edu.


  Abstract

Objective To present data on moderators and mediators of treatment response from the Multimodal Treatment Study of Children With ADHD (MTA). Methods Moderator variables (baseline factors that define subgroups with greater vs lesser intervention response) and mediator variables (factors occurring during treatment that explain how interventions "work") are described with specific application to the outcomes of the MTA Study. Results Key moderator variables (comorbid anxiety disorder, public assistance, severity of attention-deficit/hyperactivity disorder, parental depressive symptomatology, IQ) and mediator processes (negative/ineffective parental discipline) are reviewed. Conclusions Treatment research in the future should explicitly consider the exploration of moderator and mediator variables, which can greatly aid the explanatory power of clinical trials and specify the critical next steps for intervention research.

Key words: ADHD; mediator; moderator..

ADHD Special Issue, reprinted by permission from Ambulatory Pediatrics, Vol. 7, Number 2 (Supplement), Jan./Feb. 2007,

Received November 28, 2005; accepted April 1, 2006


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