CBT Without Medications for Adult ADHD: An Open Pilot Study of Five Patients

2011 ◽  
Vol 25 (4) ◽  
pp. 277-286 ◽  
Author(s):  
J. Russell Ramsay ◽  
Anthony L. Rostain
Keyword(s):  
Pilot Study ◽  
Adult Adhd ◽  
Behavioral Therapy ◽  
Small Sample Size ◽  
Preliminary Evidence ◽  
Primary Treatment ◽  
Small Sample ◽  
Future Research ◽  
Hyperactivity Disorder ◽  
Open Pilot

Medications are considered the primary treatment for symptoms of adult attention-deficit/hyperactivity disorder (ADHD), although medications alone may not produce sufficient functional improvements for many patients. Moreover, some adults with ADHD decline pharmacotherapy due to lack of response, side effects, medical contraindication, or personal choice. This article reports on the clinical outcomes of five adults with ADHD who completed cognitive behavioral therapy (CBT) without concurrent medication treatment. Nonparametric analysis of pretreatment and posttreatment clinical data indicated significant improvements on various measures of ADHD symptoms, overall functioning, depression, and anxiety. Although limited by the small sample size, the current pilot study provides preliminary evidence that CBT may be helpful for adults with ADHD who decline or are unable to take medications in cases in which their symptoms and impairments are relatively mild and uncomplicated. The limitations of this open pilot study and directions for future research also are discussed.

scholarly journals Managing Sleep in Adults with ADHD: From Science to Pragmatic Approaches

2021 ◽  
Vol 11 (10) ◽  
pp. 1361
Author(s):  
Craig B. H. Surman ◽  
Daniel M. Walsh
Keyword(s):  
Adult Adhd ◽  
Sleep Problems ◽  
Behavioral Therapy ◽  
Light Therapy ◽  
Preliminary Evidence ◽  
Future Research ◽  
Evidence Based ◽  
Research Directions ◽  
Evidence Based Treatments ◽  
Future Research Directions

Background: Sleep disorders and sleep problems commonly occur in adults with ADHD and add to functional impairment. Evidence-based treatments for sleep could improve function in the adult ADHD population. Methods: A literature review was conducted to present the clinical science informing treatment of sleep in adults with ADHD. Results: Six systematic prospective studies of sleep intervention in adults with ADHD were identified. Three of these, all including well-characterized ADHD patients, offered evidence for a significant effect of morning light therapy. Across the studies, preliminary evidence for melatonin, behavioral therapy, and weighted blankets were also found. Implication: Low-risk interventions such as light therapy may improve sleep in adults with ADHD, but many sleep interventions currently in use remain unstudied in the ADHD population. Considerations for evidence-informed practice and future research directions are discussed.

scholarly journals The Symbiotic Mutualism between Co-Creation and Entrepreneurship

2021 ◽  
Vol 13 (11) ◽  
pp. 6285
Author(s):  
Sandra Misiak-Kwit ◽  
Małgorzata Wiścicka-Fernando ◽  
Kelaniyage Shihan Dilruk Fernando
Keyword(s):  
Pilot Study ◽  
Small Sample Size ◽  
Strong Association ◽  
Sampling Technique ◽  
Small Sample ◽  
Entrepreneurial Intentions ◽  
Added Value ◽  
Primary Data ◽  
Exploratory Research ◽  
Symbiotic Mutualism

In this manuscript, the authors aim to explore firstly the association between entrepreneurial mindset and co-creation experience, secondly the association between co-creation experience and entrepreneurial intentions, and thirdly the association between entrepreneurial mindset and entrepreneurial intentions within the sustainability context. In this paper, the authors present the results of the pilot study. Primary data were collected from 500 university students from China, Georgia, Poland, Romania, and Sri Lanka by using a convenient sampling technique, and a literature review was the primary method of the concept development. The authors selected the above-mentioned countries to collect primary data by using a convenient sampling technique based on accessibility; they also visited all analysed countries in order to conduct the pilot survey personally. Descriptive statistics and the Spearman’s rank correlation coefficient were applied as primary statistical methods. The findings reveal that there is a very strong association between co-creation experience and entrepreneurial intentions, a very weak negative association between entrepreneurial mindset and co-creation experience, and, surprisingly, a weak association between entrepreneurial mindset and entrepreneurial intentions. The added value of the conducted pilot research involves filling in a gap regarding the relationship between experience and the subjective norm. In the presented pilot research, co-creation experience was compared with not only entrepreneurial mindset but with entrepreneurial intentions as well. An additional value of this exploratory research is compiling an international comparison. The main contribution of this pilot study is examining the symbiotic mutualism between co-creation and entrepreneurship. Among many platforms of associations, the following can be differentiated: creativity, innovativeness, openness, engagement, awareness, motivation, trust (level of social capital), and recognizing the significance of social and sustainable development objectives. Due to the small sample size, the results cannot be generalised. Results refer only to the respondents. However, the findings of the pilot study are the basis for further research studies on symbiotic mutualism between entrepreneurship and co-creation.

scholarly journals Blinding in electric current stimulation in subacute neglect patients with current densities of 0.8 A/m2: a cross-over pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Anna Gorsler ◽  
Ulrike Grittner ◽  
Nadine Külzow ◽  
Torsten Rackoll
Keyword(s):  
Pilot Study ◽  
Electric Fields ◽  
Standard Care ◽  
Small Sample Size ◽  
Small Sample ◽  
Related Factors ◽  
Attentional Deficits ◽  
Age Related ◽  
Current Densities ◽  
Improve Standard

Abstract Objective Neglect after stroke is a disabling disorder and its rehabilitation is a major challenge. Transcranial direct current stimulation (tDCS) seems to be a promising adjuvant technique to improve standard care neglect therapy. Since electric fields are influenced by age-related factors, higher current densities are probably needed for effective treatment in aged stroke patients. Validation of treatment efficacy requires sham-controlled experiments, but increased current densities might comprise blinding. Therefore, a pilot study was conducted to test sham adequacy when using current density of 0.8 A/m2. Whether especially neglect patients who mainly suffer from perceptual and attentional deficits are able to differentiate beyond chance active from sham tDCS was investigated in a randomized cross-over design (active/sham stimulation) in 12 early subacute patients with left-sided hemineglect. Stimulation (0.8 A/m2) was performed simultaneous to standard care neglect therapy. Results Odds ratio of correct guessing an atDCS condition compared to wrongly judge an atDCS condition as sham was 10.00 (95%CI 0.65–154.40, p = 0.099). However, given the small sample size and high OR, although likely somewhat overestimated, results require careful interpretation and blinding success in neglect studies with current densities of 0.8 A/m2 should be further confirmed.

scholarly journals The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

2021 ◽  
Vol 18 (5) ◽  
pp. 2379
Author(s):  
Seiyeong Park ◽  
Junhye Kwon ◽  
Chiyoung Ahn ◽  
Hae-Sung Cho ◽  
Hyo Youl Moon ◽  
...  
Keyword(s):  
University Students ◽  
Dopamine Receptor ◽  
Sport Participation ◽  
Small Sample Size ◽  
Behavioral Model ◽  
Small Sample ◽  
Male Students ◽  
Future Research ◽  
Dopamine Receptor D2 ◽  
The Impact

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

scholarly journals The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Random Effect ◽  
Small Sample ◽  
Future Research ◽  
Increased Risk

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

Perceptions and Understanding of Diabetes Mellitus Technology in Adults with Type 1 or Type 2 DM: A Pilot Survey from Pakistan

2021 ◽  
pp. 193229682110111
Author(s):  
Sarah Nadeem ◽  
Uswah Siddiqi ◽  
Russell Seth Martins ◽  
Kaleemullah Badini
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Diabetes Care ◽  
Online Survey ◽  
Small Sample Size ◽  
Developed Countries ◽  
Small Sample ◽  
Cost Of Care ◽  
Cross Sectional ◽  
Specific Patient

Introduction: Diabetes mellitus technology (DMT) is increasingly used for routine management in developed countries, yet its uptake in developing countries is not as consistent. Multiple factors may influence this, including country specific patient perception regarding DMT. We conducted a pilot study in Pakistan to understand this important question which has not been studied yet. Methods: A cross-sectional pilot study was conducted in Pakistan. An anonymous survey exploring perceptions of diabetes technology was circulated on social media platforms, collecting responses over 2 weeks. Target population included adults (≥18 years) living in Pakistan, with DM1 or 2. Results: A total of 40 responses were received. The majority (36/40) reported using conventional glucometers. Nine used continuous glucose monitoring (CGM). Thirty-two of 40 patients believed DMT improved diabetes care, 22 felt it helped decreased risk of Diabetes-related complications. 15/40 stated that DMT results in increased cost of care. Sixteen reported their diabetes care teams had never discussed wearable DMT options whereas 11 disliked them because they did not want a device on their self. Conclusion: In our pilot study we have identified broad themes of opportunity and challenges to DMT use in Pakistan. Patients’ perceptions regarding DMT were generally positive but significant barriers to its acceptance included high cost, lack of discussion between doctor and patient about available technology and personal hesitation. Limitations of our study include sampling bias (online survey) and small sample size, but this data can help inform larger studies, to look at this important topic in greater detail.

scholarly journals Sexual Orientation Provisions in Canadian Collective Agreements

2004 ◽  
Vol 58 (4) ◽  
pp. 644-666 ◽  
Author(s):  
Travor Brown
Keyword(s):  
Sexual Orientation ◽  
Public Sector ◽  
Small Sample Size ◽  
Small Sample ◽  
Future Research ◽  
Empirical Testing ◽  
Collective Agreements ◽  
The Past ◽  
Workplace Needs ◽  
Public Sector Bargaining

Abstract The past decade has been marked by increased awareness concerning employment discrimination against gays and lesbians. Yet, to the author’s knowledge, there has been limited research regarding the response of Canadian labour organizations to the workplace needs of gay and lesbian members. Limitations of these previous studies include small sample size, lack of theoretical framework, and the absence of empirical testing of hypotheses. The present study builds on these works through the use of Craig’s model, the inclusion of multi-disciplinary research, and the empirical testing of data collected from more than 240 Canadian collective agreements. Key findings include that larger, public sector bargaining units with equality clauses in their collective agreements were most likely also to contain clauses that prohibited discrimination based on sexual orientation. The paper concludes with suggestions for future research.

What women want: the effect of health agency advertising on patient-doctor communication

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cynthia Morton ◽  
Sabrina Habib ◽  
Jon Morris
Keyword(s):  
Sexual Health ◽  
Small Sample Size ◽  
Health Agency ◽  
Small Sample ◽  
Communication Strategy ◽  
Future Research ◽  
Health Communications ◽  
Content Type ◽  
Women’S Sexual Health ◽  
Doctor Communication

Purpose The purpose of this study is to investigate the relationship between women’s sexual health agency and their intent to initiate communications with their doctors. The research questions examined the effect sexual health agency has on patient-doctor communication, women’s emotional responses to health advertisements encouraging patient communication with their doctors, attitude toward the message and behavioral intentions after exposure to the advertising message. Design/methodology/approach An experimental design was implemented via an online questionnaire instrument to test the differences between younger-aged women (25 to 45 years) and mature-aged women (46 to 70 years). It was observed that 188 women who reported their status as single and sexually active in the past 12 months were exposed to a health advertisement that encouraged patient-doctor communication. Analyses were conducted to compare between-group measures on sexual health agency, emotional response and attitude toward the ad and behavioral intention. Findings No statistical difference existed between younger and older women. In general, women expect their doctor to lead conversations about sexual health but are positively reinforced by health messages that encourage their assertiveness as patients. Research limitations/implications The small sample size also may have limited the study’s potential to evaluate differences between age segments. Future research should explore this further. Practical implications The study provides evidence that sexual health advertising can reinforce women’s intent to initiate conversations with doctors regardless of age. Social implications Health communications can bolster women’s sexual health agency and improve patient-initiated conversations with doctors. Originality/value The study is the first to explore advertising messaging’s potential for applying health agency as a communication strategy for encouraging sexual health communications between women and their doctors.

Improvement of facial affect recognition in children and adolescents with attention-deficit/hyperactivity disorder under methylphenidate

2013 ◽  
Vol 26 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Sophie Beyer von Morgenstern ◽  
Ingrid Becker ◽  
Judith Sinzig
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Small Sample Size ◽  
Facial Affect ◽  
Small Sample ◽  
Aetiological Factor ◽  
Affect Recognition ◽  
Facial Affect Recognition ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant

Introduction and HypothesisSome authors draw a connection between the dopaminergic pathways and emotional perception. The present study is based on that association and addresses the question whether methylphenidate and the resulting amelioration of the disturbed dopamine metabolism lead to an improvement of the facial affect recognition abilities in children with attention-deficit/hyperactivity disorder (ADHD).MethodsA computer test was conducted on 21 participants, aged 7–14 years and with a diagnosis of ADHD – some with comorbid oppositional defiant disorder – conducted the FEFA (Frankfurt Test and Training of Facial Affect), a computer test to examine their facial affect recognition abilities. It consists of two subtests, one with faces and one with eye pairs. All participants were tested in a double-blind cross-over study, once under placebo and once under methylphenidate.Results and DiscussionThe collected data showed that methylphenidate leads to amelioration of facial affect recognition abilities, but not on a significant level. Reasons for missing significance may be the small sample size or the fact that there exists some overlapping in cerebral connections and metabolic pathways of the site of action of methylphenidate and the affected dopaminergic areas in ADHD. However, consistent with the endophenotype concept, certain gene locations of the dopaminergic metabolism as both an aetiological factor for ADHD and the deficient facial affect recognition abilities with these individuals were considered. Consulting current literature they were found to be not concordant. Therefore, we conclude that the lacking significance of the methylphenidate affect on facial affect recognition is based on this fact.

Cultivating creative workplaces through mindfulness

2019 ◽  
Vol 32 (1) ◽  
pp. 15-31 ◽  
Author(s):  
Ellen Keithline Byrne ◽  
Tojo Thatchenkery
Keyword(s):  
Treatment Group ◽  
Comparison Group ◽  
Small Sample Size ◽  
Experimental Studies ◽  
Small Sample ◽  
Mindfulness Training ◽  
Laboratory Research ◽  
Future Research ◽  
Sample Population ◽  
Content Type

Purpose The purpose of this paper is to examine how mindfulness training impacts creativity with individuals in a workgroup and propose a methodology for future research. Design/methodology/approach The methodology developed drew on existing laboratory-based research and applied those designs in a real-world application. The sample participants were from a mid-sized real estate firm that included ten realtors and support staff, six in the treatment group and four in the comparison group. The study took place over 16 weeks where pre-test and post-test mindfulness and creativity assessments were administered. A five-week mindfulness training was conducted with the treatment group and following the post-tests with the comparison group. Findings Results indicated that the mindfulness training positively impacted creativity in the moment and over time. There was evidence that the mindfulness training positively impacted an individual’s level of attention and awareness in daily activities which is likely to influence creative outcomes in organizational settings. Research limitations/implications This study shows that it is possible to design experimental studies in work settings and contribute to the empirical research about mindfulness despite the widely held perception about scarcity of time and lack of access to do such research. The findings also build on existing literature and address some of the gaps in current research. The most notable limitation relates to the small sample size. Practical implications The finding affirms that even a short but consistent practice of mindfulness in organizations can lead to a measurable increase in creativity. Originality/value This empirical study adds value to existing literature by expanding laboratory-based methodology to a practical application. One of the unique aspects of this research relates to the sample population. This research was conducted with an intact workgroup and translates the insights gained from laboratory research to a potential benefit for an organization by applying a version of this methodology to enhance its workgroup creativity.

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