Department of Human Development and Family Studies.
Department of Psychology.
J Consult Clin Psychol. 2021 Jan;89(1):21-33. doi: 10.1037/ccp0000553.
College students with attention deficit/hyperactivity disorder (ADHD) are at increased risk for numerous educational and psychosocial difficulties. This study reports findings from a large, multisite randomized controlled trial examining the efficacy of a treatment for this population, known as ACCESS-Accessing Campus Connections and Empowering Student Success.
ACCESS is a cognitive-behavioral therapy program delivered via group treatment and individual mentoring across two semesters. A total of 250 students (18-30 years of age, 66% female, 6.8% Latino, 66.3% Caucasian) with rigorously defined ADHD and comorbidity status were recruited from two public universities and randomly assigned to receive ACCESS immediately or on a 1-year delayed basis. Treatment response was assessed on three occasions, addressing primary (i.e., ADHD, executive functioning, depression, anxiety) and secondary (i.e., clinical change mechanisms, service utilization) outcomes.
Latent growth curve modeling (LGCM) revealed significantly greater improvements among immediate ACCESS participants in terms of ADHD symptoms, executive functioning, clinical change mechanisms, and use of disability accommodations, representing medium to large effects (Cohen's d, .39-1.21). Across these same outcomes, clinical significance analyses using reliable change indices (RCI; Jacobson & Truax, 1992) revealed significantly higher percentages of ACCESS participants showing improvement. Although treatment-induced improvements in depression and anxiety were not evident from LGCM, RCI analyses indicated that immediate ACCESS participants were less likely to report a worsening in depression/anxiety symptoms.
Findings from this RCT provide strong evidence in support of the efficacy and feasibility of ACCESS as a treatment for young adults with ADHD attending college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
患有注意缺陷多动障碍（ADHD）的大学生面临着许多教育和心理社会困难的风险增加。本研究报告了一项大型多地点随机对照试验的结果，该试验研究了一种针对该人群的治疗方法的疗效，称为 ACCESS-访问校园联系和增强学生成功。
ACCESS 是一种认知行为疗法，通过小组治疗和个体指导在两个学期内进行。共有 250 名（18-30 岁，66%为女性，6.8%为拉丁裔，66.3%为白种人）严格定义的 ADHD 和合并症患者从两所公立大学招募，并随机分配接受 ACCESS 立即或延迟 1 年的治疗。在三个时间点评估治疗反应，解决主要（即 ADHD、执行功能、抑郁、焦虑）和次要（即临床变化机制、服务利用）结果。
潜在增长曲线模型（LGCM）显示，立即接受 ACCESS 治疗的参与者在 ADHD 症状、执行功能、临床变化机制和使用残疾津贴方面有显著改善，代表中到大效应（Cohen's d，.39-1.21）。在这些相同的结果中，使用可靠变化指数（RCI；Jacobson & Truax，1992）的临床显著性分析显示，ACCESS 参与者有显著更高比例的改善。虽然 LGCM 没有显示出治疗引起的抑郁和焦虑的改善，但 RCI 分析表明，立即接受 ACCESS 治疗的参与者报告抑郁/焦虑症状恶化的可能性较小。
这项 RCT 的结果提供了强有力的证据，支持 ACCESS 作为治疗大学生 ADHD 的有效性和可行性。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
