Underrepresentation and moderation of parent education levels in ADHD psychosocial treatment trials: A meta-analysis

IF 12.2 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-08-13 DOI:10.1016/j.cpr.2025.102639

Samantha M. Margherio , Hannah Brockstein , Azadeh Bakhtiari , Steven W. Evans

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引用次数: 0

Abstract

Objective

We sought to ascertain the representativeness of psychosocial treatment trials for youth with ADHD in terms of parent education (PE) and race and to determine whether these study characteristics moderated treatment outcomes.

Method

High-quality randomized controlled trials (RCTs) of psychosocial treatments for children and adolescents with ADHD conducted in the U.S. and published between 2007 and 2025 were included in this study if they reported PE (% of parents with a college degree or higher) and race/ethnicity.

Results

A total of 46 studies were included, representing 5837 participants. Between 48 % and 52 % of parents had a college degree or higher, compared to 38 % in the U.S. population. Two-thirds of studies overrepresented highly educated parents. Samples were generally representative of diverse races and ethnicity, although this appeared driven by the 35 % of studies that oversampled racially minoritized youth whereas 26 % underrepresented racially minoritized youth. Subgroup meta-analyses indicated treatment was only superior to control conditions in reducing ADHD symptoms in samples with highly educated parents. For race, treatment was only associated with significant effects on hyperactivity/impulsivity symptoms among racially-representative samples who also had high PE.

Conclusion

These findings question the effectiveness of psychosocial interventions for youth with ADHD for families of diverse educational backgrounds. There is a dire need to recruit more diverse samples in terms of PE, and to develop interventions that are effective for families across all educational backgrounds.

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ADHD心理社会治疗试验中父母教育水平的不足和适度：一项荟萃分析

目的：我们试图从父母教育（PE）和种族方面确定青少年多动症心理社会治疗试验的代表性，并确定这些研究特征是否会调节治疗结果。方法2007年至2025年间在美国进行并发表的关于儿童和青少年多动症心理社会治疗的高质量随机对照试验（rct），如果他们报告了PE（具有大学或更高学历的父母的百分比）和种族/民族，则纳入本研究。结果共纳入46项研究，5837名受试者。48%到52%的父母拥有大学或更高学历，而在美国，这一比例为38%。三分之二的研究过度代表了受过高等教育的父母。样本通常具有不同种族和民族的代表性，尽管这似乎是由于35%的研究过度抽样了少数民族青年，而26%的研究未充分代表少数民族青年。亚组荟萃分析显示，在父母受过高等教育的样本中，治疗仅在减少ADHD症状方面优于对照组。就种族而言，治疗仅在具有高PE的具有种族代表性的样本中对多动/冲动症状有显著影响。结论这些发现质疑了不同教育背景家庭对青少年ADHD患者进行心理社会干预的有效性。迫切需要在体育方面招募更多不同的样本，并制定对所有教育背景的家庭有效的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.