Attention-Deficit/Hyperactivity Disorder (ADHD) Temperament Profiles Predict Treatment Response to Combined Medication and Behavioral Intervention
Year: 2026
Type: preprint
Abstract: Attention-deficit/hyperactivity disorder (ADHD) is characterized by heterogeneity with respect to both clinical presentation (i.e., symptoms, associated behaviors, comorbid diagnoses) and treatment response. Temperament-based profiles – irritable, mild, and surgent – may help to explain this heterogeneity. Although stimulant medications, such as osmotic-release oral system (OROS) methylphenidate, and behavioral therapy are considered first-line interventions, a significant proportion of youth with ADHD demonstrate suboptimal treatment response. The present study examined whether treatment-based improvement across symptom domains of inattentive, hyperactivity/impulsive, oppositional defiant (ODD), and mood symptoms differs as a function of ADHD temperament profile. The broader study included 155 youth (75 with ADHD; 80 neurotypical controls), aged 6-12 years. ADHD youth completed an 8-week double-masked, placebo-controlled, cross-over trial of OROS methylphenidate during a behavioral intervention, the Summer Treatment Program (STP). Symptoms were assessed using the parent-rated Pittsburgh Modified Conners (P-MC) at baseline and at intervention weeks 5 and 8 (i.e., prior to and after the cross-over). Temperament profiles were derived via latent-profile analysis of the parent-rated Temperament in Middle Childhood Questionnaire (TMCQ). The irritable profile demonstrated the greatest reduction in ODD and mood symptoms across the 8-week intervention. Findings support the clinical utility of temperament-based approaches in capturing heterogeneity in ADHD. KEY WORDS: Attention-deficit/hyperactivity disorder (ADHD), Temperament, Treatment response, Stimulant medication, Behavioral therapy
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7208806409