2026-09-21T17:35:31Zhttps://api.drum.lib.umd.edu/server/oai/requestoai:drum.lib.umd.edu:1903/189032017-06-13T10:41:05Zcom_1903_2226com_1903_1647com_1903_2col_1903_2757col_1903_3
Pumroy, Donald K.
Bradbard, Gail Susan
Digital Repository at the University of Maryland
University of Maryland (College Park, Md)
Department of Counseling, Higher Education, and Special Education
2016-11-17T00:49:58Z
2016-11-17T00:49:58Z
1973
https://doi.org/10.13016/M2WN7X
ILLiad #170280702
http://hdl.handle.net/1903/18903
It was the aim of the study: to compare the behavioral
and cognitive effects of pharmacological and behavioral
therapies in the short-term, clinical treatment of minimal
brain dysfunction; and, to compare the behavioral and cognitive
effects of stimulant (methylphenidate) and
antidepressant (imipramine) drugs in the short-term,
clinical treatment of minimal brain dysfunction.
Twenty-nine boys, ranging in age from 6 through 12 years,
with the diagnosis of minimal brain dysfunction with hyperactivity,
were randomly assigned to three treatment groups:
imipramine, methylphenidate, or behavior modification. The
total time of treatment for each child was 6 weeks.
For subjects within the imipramine and methylphenidate
groups, medication dosage was individually titrated by a
child psychiatrist. (Range: 75- 150 mg/daily of imipramine,
10- JO mg/daily of methylphenidate.)
Parents of subjects within the behavior modification
group individually met with an experimenter l hour per week.
Behavioral principles were discussed, problem behaviors
targeted, and behavioral programs devised for implementation
during the treatment period.
Subjects assigned to behavior modification were also
individually seen once weekly. The first part of a session
focused on behavioral control, following the method of
behavior rehearsal. Working from problem areas targeted by
parents, the subjects and experimenter discussed specific
encounters, and then reenacted these incidents, rehearsing
alternative, adaptive behaviors. The second part of a session
was devoted to cognitive control, with training in
self-directed verbal commands instituted. On tasks of trail
making, matching pictures, and embedded figures, subjects
verbally cued themselves to delay and to consider requirements
before attempting a solution, with reinforcement
contingent upon responses correct on initial trial.
For all groups, prior to and following treatment, behavioral
and cognitive measures were obtained: parents
completed a behavior rating scale, the Parent's Questionnaire;
teachers completed the School Report, assessing
behavior and academic achievement; and subjects were
administered a battery of psychological tests which included
the Wechsler Intelligence Scale for Children, Wide Range
Achievement Test, Porteus Maze Test, Bender Gestalt Test,
Developmental Test of Visual-Motor Integration, and Draw-APerson.
Analysis of the data from teachers' global ratings of
behavior indicated the superiority of pharmacological
treatment in comparison with behavioral treatment. Within
the cognitive area, based on teachers' global ratings of
academic achievement and the Porteus Maze Test, pharmacological
treatment was again shown superior. Isolating
specific group effects, contributing to the major portion
of the variance between pharmacological and behavioral
treatments was the superiority of methylphenidate to behavior
modification. Further research was felt necessary
concerning the therapeutic comparability or lack of
comparability of imipramine and behavior modification treatments.
Between imipramine and methylphenidate treatments, based
on teachers' ratings of hyperactivity and global ratings of
both behavior and academic achievement, differential effects,
in favor of methylphenidate, were suggested. Thus, the comparability
of imipramine and methylphenidate treatments in
terms of both behavioral and cognitive effects was felt to
be in question.
Results were discussed in terms of the bounds of the
design, procedure, and measurements. Qualifications were
noted concerning statistical power, Type I error, the
relative rather than absolute efficacy of the treatments,
and the validity of the measurements.
Application and research implications were presented.
The need for continued research into the application of
behavioral programs with MBD children, both independent of
and in conjunction with pharmacological treatment, was
stressed, with suggestions provided as to the clinic-based
and, to a limited extent, school-based implementation of
such programs.
en_US
Minimal Brain Dysfunction with Hyperactivity: a Comparison of the Behavioral and Cognitive Effects of Pharmacological and Behavioral Treatments
Other
Dissertation or Thesis
open.access