Date of Award

5-2010

Degree Name

Doctor of Philosophy

Department

Psychology

Abstract

Idiosyncratic effects of Vyvanse™ (lisdexamfetamine dimesylate) and placebo were evaluated in a double-blind alternating treatments experimental design in this 4-week study. Direct, objective measures were combined with traditional behavior ratings to provide data sets to assess whether or not the prescribed stimulant medication showed detectable therapeutic effects for a child whose positive response to medication was not obvious via traditional subjective methods. Effects of medication on core ADHD symptoms, academic performance, and sleep in four children ages 10-12 with attention deficit/ hyperactivity disorder. Potential side effects were also measured. Daily measures included parent rating scales, side effects checklist, sleep journal and sleep questionnaires. Weekly data collection of objective measures included a computerized a continuous performance task, 1-minute reading and math tests, and youth self-report instruments. Brief daily school interval data and teacher ratings were collected for one child who was enrolled during the school year. A local pediatrician followed standard clinical practice to provide dose titration and clinical supervision.

All children were referred for clarification of effects or dose titration of Vyvanse. Data sets provided copious and sometimes conflicting information between parent ratings and objective measures. The ability to conceptualize medication effects from both parent responses and direct measures enabled the physician to alter the child's course of treatment. Attention and motion data from the M-MAT offered information not otherwise available, allowed a behind-the-scene look at effects of less-obvious processes (e.g. processing speed, patterns of attendant responses, subtle hyperactivity), a process that supports clinical experience and judgment. Daily monitoring of side effects and weekly visits with a physician provided for closer monitoring for potential adverse events. Data plotted over time (parent ratings) or condition (objective measures) painted a different clinical picture for each child. Responses common to all participants included minimal side effects and no discernable effects on sleep. Medication effects were fairly straightforward for two participants, while a more enigmatic picture presented for the final two children.

Access Setting

Dissertation-Open Access

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