TY  - JOUR
AU  - Nordby, Emilie S
AU  - Guribye, Frode
AU  - Schønning, Viktor
AU  - Andersen, Sander Lindholm
AU  - Kuntsi, Jonna
AU  - Lundervold, Astri J
PY  - 2024
DA  - 2024/1/17
TI  - A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study
JO  - JMIR Form Res
SP  - e53931
VL  - 8
KW  - ADHD
KW  - adult
KW  - adults
KW  - app
KW  - applications
KW  - apps
KW  - attention deficit
KW  - blended intervention
KW  - blended
KW  - develop
KW  - development
KW  - digital
KW  - emotion regulation
KW  - emotion
KW  - emotional
KW  - emotions
KW  - feasibility
KW  - group session
KW  - group sessions
KW  - hybrid
KW  - hyperactivity
KW  - inattention
KW  - mental health
KW  - neurodevelopmental
KW  - psychotherapy
KW  - satisfaction
KW  - skill
KW  - training
AB  - Background: Many adults with attention-deficit/hyperactivity disorder (ADHD) experience difficulties related to emotion regulation. Such difficulties are known to substantially impact quality of life and overall functioning. Yet, there is a lack of treatment interventions specifically designed to address these challenges. Objective: This study aimed to describe the development and assess the feasibility, along with the initial clinical outcomes, of a novel blended intervention for adults with ADHD. The blended intervention combines both face-to-face and digital components and is specifically designed to address emotion dysregulation in ADHD. Methods: This intervention was an 8-week blended intervention combining weekly face-to-face group sessions with a supplementary digital companion app. The intervention is based on elements from dialectic behavioral therapy skills training and positive psychology. To evaluate its feasibility, we performed a 10-week feasibility study with an uncontrolled pre-post study design, including 16 adults with ADHD and co-occurring emotion dysregulation. The feasibility measures encompassed adherence, satisfaction, and perceived credibility of the intervention. Clinical outcomes were evaluated by self-reported symptoms of emotion dysregulation, inattention, hyperactivity-impulsivity, executive function, depression, anxiety, and a measure of quality of life. Paired sample 2-tailed t tests were used to analyze clinical outcomes with a Bonferroni-corrected significance level. Results: Both treatment credibility and treatment satisfaction were rated favorably by the majority of the participants. In particular, the participants emphasized meeting others with ADHD as beneficial. In terms of adherence, 3 participants withdrew before initiating the intervention, while another 4 participants did not complete the intervention. On average, the participants who enrolled in the intervention attended 6.2 of the 8 group sessions and completed 6.7 of the 8 skills training modules in the companion app. In terms of clinical outcomes, there was a reduction in symptoms of emotion dysregulation from before to after the intervention (d=2.0). Significant improvements were also observed in measures of inattention (d=1.1) and hyperactivity-impulsivity (d=0.9). However, no significant improvements were found in the domains of depression, anxiety, quality of life, and executive functioning. Conclusions: The results are encouraging, both in terms of feasibility and the preliminary clinical results on emotion dysregulation. The blended format, combining digital and face-to-face elements, may also seem to offer some advantages: the group-based format was valued as it facilitated peer interaction, while a rather high completion of modules in the companion app highlights its potential to enhance skills training between the group sessions. Future randomized controlled trials are called for to further evaluate the clinical effectiveness of the intervention. Trial Registration: ClinicalTrials.gov NCT05644028; https://clinicaltrials.gov/study/NCT05644028 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e53931
UR  - https://doi.org/10.2196/53931
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38231536
DO  - 10.2196/53931
ID  - info:doi/10.2196/53931
ER  -