Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-16T16:56:25.364Z Has data issue: false hasContentIssue false

Effects of neurofeedback on the dysregulation profile in children with ADHD: SCP NF meets SDQ-DP – a retrospective analysis

Published online by Cambridge University Press:  24 January 2019

Hartmut Heinrich*
Affiliation:
Department of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany kbo-Heckscher-Klinikum, Munich, Germany Research Institute Brainclinics, Nijmegen, The Netherlands (Research Fellow)
Holger Gevensleben
Affiliation:
Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
Andreas Becker
Affiliation:
Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
Aribert Rothenberger
Affiliation:
Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
*
Author for correspondence: Hartmut Heinrich, E-mail: hartmut.heinrich@uk-erlangen.de

Abstract

Background

As children with attention-deficit/hyperactivity disorder (ADHD) usually show psychopathological signs beyond their core symptoms (e.g. elevated scores of the dysregulation profile (DP) in 30–40%), treatments with a broader approach to self-regulation skills may be supportive. Neurofeedback (NF) may reflect such an option. Aim of the present analysis was to compare the effects of slow cortical potential (SCP) NF and θ/β NF on the DP using data from a previous trial.

Methods

Thirty children with ADHD (aged 8–12 years) and a DP score in the Strengths and Difficulties Questionnaire (SDQ-DP) ⩾ 3 were included. NF treatment consisted of one block of SCP NF and one block of θ/β NF (18 units per block) allowing an intraindividual comparison. Effects of the NF protocols were also contrasted to a control group (n = 18) that completed an attention skills training (between-group analysis).

Results

Regarding the SDQ-DP, SCP NF was superior to θ/β NF and the control condition. Effects of SCP NF and θ/β NF on ADHD symptom severity were not significantly different. The SDQ-DP score did not correlate with EEG-related measures previously found to be predictors for SCP NF on ADHD symptoms.

Conclusions

SCP NF may reflect a more general approach to improve cognitive, emotional and behavioral self-regulation skills. If confirmed in a larger sample, the SDQ-DP score could be used as an indication criterion and contribute to the individualization of NF in ADHD. Overall, the differential effect provides further evidence for the specificity of NF effects.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aggensteiner, PM, Brandeis, D, Millenet, S, Hohmann, S, Ruckes, C, Beuth, S, Albrecht, B, Schmitt, G, Schermuly, S, Wörz, S, Gevensleben, H, Freitag, CM, Banaschewski, T, Rothenberger, A, Strehl, U and Holtmann, M (2019) Slow cortical potentials neurofeedback in children with ADHD: comorbidity, self-regulation and clinical outcomes 6 months after treatment in a multicenter randomized controlled trial. European Child & Adolescent Psychiatry. doi: 10.1007/s00787-018-01271-8.CrossRefGoogle Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th Edn (DSM-IV). American Psychiatric Press: Washington, DC.Google Scholar
Arns, M, Feddema, I and Kenemans, JL (2014a) Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency. Frontiers Human Neuroscience 8, 1019.CrossRefGoogle Scholar
Arns, M, Heinrich, H and Strehl, U (2014b) Evaluation of neurofeedback in ADHD: the long and winding road. Biological Psychology 95, 108115.CrossRefGoogle Scholar
Ayer, L, Greaves-Lord, K, Althoff, RR, Hudziak, JJ, Dieleman, GC, Verhulst, FC and van der Ende, J (2013) Blunted HPA axis response to stress is related to a persistent dysregulation profile in youth. Biological Psychology 93, 343351.CrossRefGoogle ScholarPubMed
Benjamin, DJ, Berger, JO, Johannesson, M, Nosek, BA, Wagenmakers, EJ, Berk, R, Bollen, KA, Brembs, B, Brown, L, Camerer, C, Cesarini, D, Chambers, CD, Clyde, M, Cook, TD, De Boeck, P, Dienes, Z, Dreber, A, Easwaran, K, Efferson, C, Fehr, E, Fidler, F, Field, AP, Forster, M, George, EI, Gonzalez, R, Goodman, S, Green, E, Green, DP, Greenwald, AG, Hadfield, JD, Hedges, LV, Held, L, Ho, TH, Hoijtink, H, Hruschka, DJ, Imai, K, Imbens, G, Ioannidis, JPA, Jeon, M, Jones, JH, Kirchler, M, Laibson, D, List, J, Little, R, Lupia, A, Machery, E, Maxwell, SE, McCarthy, M, Moore, DA, Morgan, SL, Munafó, M, Nakagawa, S, Nyhan, B, Parker, TH, Pericchi, L, Perugini, M, Rouder, J, Rousseau, J, Savalei, V, Schönbrodt, FD, Sellke, T, Sinclair, B, Tingley, D, Van Zandt, T, Vazire, S, Watts, DJ, Winship, C, Wolpert, RL, Xie, Y, Young, C, Zinman, J and Johnson, VE (2018) Redefine statistical significance. Nature Human Behaviour 2, 610.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, CR, Day, H, Goldin, RL, Spencer, T, Faraone, SV, Surman, CB and Wozniak, J (2012) Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder. Journal of Developmental & Behavioral Pediatrics 33, 236243.CrossRefGoogle ScholarPubMed
De Caluwé, E, Decuyper, M and De Clercq, B (2013) The child behavior checklist dysregulation profile predicts adolescent DSM-5 pathological personality traits 4 years later. European Child & Adolescent Psychiatry 22, 401411.CrossRefGoogle ScholarPubMed
Deutz, MH, Geeraerts, SB, van Baar, AL, Deković, M and Prinzie, P (2016) The dysregulation profile in middle childhood and adolescence across reporters: factor structure, measurement invariance, and links with self-harm and suicidal ideation. European Child & Adolescent Psychiatry 25, 431442.CrossRefGoogle ScholarPubMed
Döpfner, M and Lehmkuhl, G (2000) DISYPS-KJ – Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter. Hans Huber: Bern.Google Scholar
Döpfner, M, Berner, W, Flechtner, H, Lehmkuhl, G and Steinhausen, HC (1999) Psychopathologisches Befund-System für Kinder und Jugendliche (CASCAP-D). Hogrefe: Göttingen.Google Scholar
Gevensleben, H, Holl, B, Albrecht, B, Vogel, C, Schlamp, D, Kratz, O, Studer, P, Rothenberger, A, Moll, GH and Heinrich, H (2009 a) Is neurofeedback an efficacious treatment for ADHD? A randomized controlled clinical trial. Journal of Child Psychology and Psychiatry 50, 780789.CrossRefGoogle Scholar
Gevensleben, H, Holl, B, Albrecht, B, Schlamp, D, Kratz, O, Studer, P, Wangler, S, Rothenberger, A, Moll, GH and Heinrich, H (2009 b) Distinct EEG effects related to neurofeedback training in children with ADHD: a randomized controlled trial. International Journal of Psychophysiology 74, 149157.CrossRefGoogle ScholarPubMed
Gevensleben, H, Holl, B, Albrecht, B, Schlamp, D, Kratz, O, Studer, P, Rothenberger, A, Moll, GH and Heinrich, H (2010) Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial. European Child & Adolescent Psychiatry 19, 715724.CrossRefGoogle ScholarPubMed
Gevensleben, H, Kleemeyer, M, Rothenberger, LG, Studer, P, Flaig-Röhr, A, Moll, GH, Rothenberger, A and Heinrich, H (2014) Neurofeedback in ADHD: further pieces of the puzzle. Brain Topography 27, 2032.CrossRefGoogle ScholarPubMed
Gruzelier, JH, Holmes, P, Hirst, L, Bulpin, K, Rahman, S, van Run, C and Leach, J (2014) Replication of elite music performance enhancement following alpha/theta neurofeedback and application to novice performance and improvisation with SMR benefits. Biological Psychology 95, 96107.CrossRefGoogle ScholarPubMed
Holtmann, M, Becker, A, Banaschewski, T, Rothenberger, A and Roessner, V (2011) Psychometric validity of the strengths and difficulties questionnaire-dysregulation profile. Psychopathology 44, 5359.CrossRefGoogle ScholarPubMed
Jordan, P, Rescorla, LA, Althoff, RR and Achenbach, TM (2016) International comparisons of the youth self-report dysregulation profile: latent class analyses in 34 societies. Journal of the American Academy of Child and Adolescent Psychiatry 55, 10461053.CrossRefGoogle ScholarPubMed
Konicar, L, Veit, R, Eisenbarth, H, Barth, B, Tonin, P, Strehl, U and Birbaumer, N (2015) Brain self-regulation in criminal psychopaths. Scientific Reports 5, 9426.CrossRefGoogle ScholarPubMed
Kunze, B, Wang, B, Isensee, C, Schlack, R, Ravens-Sieberer, U, Klasen, F, Rothenberger, A, Becker, A and BELLA-study group (2018) Gender associated developmental trajectories of SDQ-dysregulation profile and its predictors in children. Psychological Medicine 48, 404415.CrossRefGoogle ScholarPubMed
Meisel, V, Servera, M, Garcia-Banda, G, Cardo, E and Moreno, I (2013) Neurofeedback and standard pharmacological intervention in ADHD: a randomized controlled trial with six-month follow-up. Biological Psychology 94, 1221.CrossRefGoogle ScholarPubMed
Pigott, HE, Cannon, R and Trullinger, M (2018) The fallacy of sham-controlled neurofeedback trials: a reply to thibault and colleagues (2018) Journal of Attention Disorders. doi:10.1177/1087054718790802Google Scholar
Ravens-Sieberer, U, Kurth, BM, Wittchen, HU, Rothenberger, A and Schulte-Markwort, M (eds) (2008) Mental health in children and adolescents – results of the BELLA study in Germany. European Child & Adolescent Psychiatry 17(Suppl. 1).Google ScholarPubMed
Ravens-Sieberer, U, Klasen, F and Rothenberger, A (2015) Mental health in minors – epidemiology in the longterm. European Child & Adolescent Psychiatry 24, 603727.Google Scholar
Rothenberger, A, Coghill, D, Döpfner, M, Falissard, B and Steinhausen, HC (eds) (2006) ADORE (Attention-Deficit/Hyperactivity Disorder Observational Research in Europe) baseline data of a large-scale longitudinal study. European Child & Adolescent Psychiatry 15(Suppl 1).Google Scholar
Sharp, C and Tackett, JL (2014) Handbook of Borderline Personality Disorder in Children and Adolescents. Springer: New York.CrossRefGoogle Scholar
Strehl, U, Aggensteiner, P, Wachtlin, D, Brandeis, D, Albrecht, B, Arana, M, Bach, C, Banaschewski, T, Bogen, T, Flaig-Röhr, A, Freitag, CM, Fuchsenberger, Y, Gest, S, Gevensleben, H, Herde, L, Hohmann, S, Legenbauer, T, Marx, AM, Millenet, S, Pniewski, B, Rothenberger, A, Ruckes, C, Wörz, S and Holtmann, M (2017) Neurofeedback of slow cortical potentials in children with attention-deficit/hyperactivity disorder: a multicenter randomized trial controlling for unspecific effects. Frontiers Human Neuroscience 11, 135.CrossRefGoogle ScholarPubMed
Tewes, U, Rossmann, P and Schallberger, U (2000) Hamburg-Wechsler-Intelligenztest für Kinder III (HAWIK-III). Hogrefe: Göttingen.Google Scholar
Thibault, RT, Veissière, S, Olson, JA and Raz, A (2018) Treating ADHD with suggestion: neurofeedback and placebo therapeutics. Journal of Attention Disorders 22, 707711.CrossRefGoogle ScholarPubMed
Van Doren, J, Heinrich, H, Bezold, M, Reuter, N, Kratz, O, Horndasch, S, Berking, M, Ros, T, Gevensleben, H, Moll, GH and Studer, P (2017) Theta/beta neurofeedback in children with ADHD: feasibility of a short-term setting and plasticity effects. International Journal of Psychophysiology 112, 8088.CrossRefGoogle ScholarPubMed
Van Doren, J, Arns, M, Heinrich, H, Vollebregt, MA, Strehl, U and Loo, SK (2018) Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child & Adolescent Psychiatry. doi: 10.1007/s00787-018-1121-4.Google ScholarPubMed
Wang, B, Brueni, LG, Isensee, C, Meyer, T, Bock, N, Ravens-Sieberer, U, Klasen, F, Schlack, R, Becker, A, Rothenberger, A and BELLA study group (2018) Predictive value of dysregulation profile trajectories in childhood for symptoms of ADHD, anxiety and depression in late adolescence. European Child & Adolescent Psychiatry 27, 767774.CrossRefGoogle ScholarPubMed
Wangler, S, Gevensleben, H, Albrecht, B, Studer, P, Rothenberger, A, Moll, GH and Heinrich, H (2011) Neurofeedback in children with ADHD: specific event-related potential findings of a randomized controlled trial. Clinical Neurophysiology 122, 942950.CrossRefGoogle ScholarPubMed
Woerner, W, Becker, A and Rothenberger, A (2004) Normative data and scale properties of the German parent SDQ. European Child & Adolescent Psychiatry 13(Suppl. 2), 1116.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Heinrich et al. supplementary material

Table S1

Download Heinrich et al. supplementary material(PDF)
PDF 92.4 KB