A novel group therapy for children with ADHD and severe mood dysregulation

J Atten Disord. 2013 Aug;17(6):527-41. doi: 10.1177/1087054711433423. Epub 2012 Feb 28.


Objective: No psychosocial treatments have been developed for children with ADHD and severe mood dysregulation (SMD) despite the significant prevalence and morbidity of this combination. Therefore, the authors developed a novel treatment program for children with ADHD and SMD.

Method: The novel therapy program integrates components of cognitive-behavioral therapies for affect regulation with a parent-training intervention for managing recurrent defiant behaviors. It consists of nine 105-min child and parent groups run in unison. A pilot trial was conducted with seven participants with ADHD and SMD ages 7 to 12 who were on a stable stimulant regimen.

Results: Six of the seven (86%) families completed the program. Participants showed large improvements in depressive symptoms, mood lability, and global functioning. Milder improvements in externalizing behaviors were observed.

Conclusion: Results suggest the feasibility and potential efficacy of the therapy program for children with ADHD and SMD and warrant a larger controlled trial.

Keywords: ADHD; cognitive-behavioral therapy; parent training; severe mood dysregulation.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Comorbidity
  • Female
  • Humans
  • Male
  • Mood Disorders / epidemiology
  • Mood Disorders / therapy*
  • Parents / education*
  • Patient Education as Topic / methods*
  • Pilot Projects
  • Psychotherapy, Group
  • Severity of Illness Index*
  • Treatment Outcome