a Department of Psychology, Queens College , City University of New York.
J Clin Child Adolesc Psychol. 2013;42(6):769-83. doi: 10.1080/15374416.2013.787622. Epub 2013 May 13.
The current review applied the evidence-based treatment criteria espoused by the Society for Clinical Child and Adolescent Psychology (Silverman & Hinshaw, 2008 ) to specifically evaluate the short-term and longer term efficacy of Cogmed Working Memory Training (CWMT) as a treatment for youth with Attention-Deficit/Hyperactivity Disorder (ADHD). Utilizing a systematic literature search, 7 studies that employed the school-age version of CWMT were identified for this review. The data reviewed herein suggest mixed findings regarding the benefit of CWMT for youth with ADHD. Two randomized controlled studies have demonstrated that CWMT led to improvements in neuropsychological outcomes and parent-rated ADHD symptoms relative to wait-list control and placebo treatment conditions. Another study demonstrated effects of CWMT relative to a placebo condition on an analog observation of behavior during an academic task, although this study did not find an effect of CWMT on parent-rated ADHD. Finally, an additional study utilizing an active comparison control condition did not find incremental benefits of CWMT on parent- or teacher-rated ADHD. Critical issues in interpreting existing studies include lack of alignment between demonstrated outcomes and the hypothesized model of therapeutic benefit of CWMT, issues with equivalence of control conditions, and individual differences that may moderate treatment response. Collectively, the strengths and limitations of the studies reviewed suggest that CWMT is best defined as a Possibly Efficacious Treatment for youth with ADHD. We suggest future directions for research and conclude with clinical implications of our findings for the treatment of youth with ADHD.
本综述应用了临床儿童和青少年心理学协会(Silverman & Hinshaw, 2008)所倡导的循证治疗标准,专门评估认知加工速度训练(Cogmed Working Memory Training,CWMT)作为治疗注意力缺陷多动障碍(ADHD)青少年的短期和长期疗效。通过系统文献检索,确定了 7 项采用 CWMT 学龄版的研究纳入本综述。本文所回顾的数据表明,CWMT 对 ADHD 青少年的益处存在混合结果。两项随机对照研究表明,CWMT 导致神经心理学结果和父母评定的 ADHD 症状改善,与等待名单对照和安慰剂治疗条件相比。另一项研究表明,CWMT 相对于安慰剂条件对学术任务期间行为的模拟观察有影响,尽管该研究未发现 CWMT 对父母评定的 ADHD 有影响。最后,一项利用积极对照条件的额外研究未发现 CWMT 在父母或教师评定的 ADHD 方面有额外的益处。解释现有研究的关键问题包括表现出的结果与 CWMT 的治疗效益假设模型之间缺乏一致性、对照条件的等效性问题,以及可能调节治疗反应的个体差异。总的来说,所审查研究的优缺点表明,CWMT 最好被定义为 ADHD 青少年的可能有效治疗方法。我们提出了未来的研究方向,并根据我们的研究结果对治疗 ADHD 青少年的临床意义进行了总结。