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Objectives: Guidelines recommend parent management training in the multi-modal treatment of attention deficit hyperactivity disorder (ADHD). The availability of such interventions in Japan is limited. This study evaluated the effects of Well Parent Japan, a hybrid intervention including a group Japanese language adaptation of the New Forest Parenting Programme for ADHD (NFPP) augmented with strategies to improve parent's psychological wellbeing and enhance confidence in their ability to implement change. Methods: Mothers of children aged 6–12 years displaying marked symptoms of ADHD were randomly assigned to the intervention (n = 28) or a waitlist control condition (n = 24). Measures were completed at baseline and again 14 weeks later. Parenting stress was the primary outcome. Other outcomes included maternal depression, parenting self-efficacy, reported and observed parenting behaviour, and maternal ratings of child ADHD, oppositional defiant disorder (ODD) symptoms, and internalizing problems. Results: Analysis of covariance (ANCOVA) compared the groups post intervention. Intervention mothers reported significantly less parenting stress, higher parenting self-esteem and use of more effective parenting strategies compared with controls, including a reduction in observed negative parenting, post intervention. These mothers also reported lower levels of child aggression and internalizing problems post intervention together with a trend (p < 0.05) toward reduced symptoms of inattention. Conclusions: Well Parent Japan is an effective psychosocial intervention for parents of children with ADHD in Japan. The group format and the session content is well tolerated. This is the first randomized control trial (RCT) of a psychosocial intervention targeting ADHD in Japan. Highlights: Well Parent Japan reduced mothers' parenting stress and increased their efficacy. Program completion also resulted in improvements in observed and reported parenting practices. Mothers reported reduced ADHD symptoms, aggression, and internalizing problems. Well Parent Japan offers an effective psychosocial intervention for ADHD in Japan. [ABSTRACT FROM AUTHOR]

Research on motivational processes in attention deficit/hyperactivity disorder (ADHD) focuses on reward. Studies with punishment are limited and findings mixed. This study evaluated the effects of punishment on response allocation in Japanese children with and without ADHD. Thirty-four children meeting DSM-IV criteria for ADHD and 59 typically developing control-group children completed an operant task in which they choose between playing two simultaneously available games. Reward was arranged symmetrically across the games under concurrent variable interval schedules. Asymmetric punishment schedules were superimposed with responses on one game punished four times as often as responses on the other. Children with ADHD showed greater behavioral sensitivity to punishment than controls. They allocated significantly more responses to the less frequently punished alternative and were more likely to play this game on consecutive trials and responded more slowly to the more punished game. Control group children allocated their responses evenly across games. Punishment exerted greater control over the behavior of Japanese children with ADHD than controls, similar to findings with children from Western countries, suggesting this is a common characteristic of the disorder. The behavior of typically developing Japanese children, while demonstrating awareness of punishment, was not controlled by the frequency of its occurrence.

Background: Most research on motivational processes in attention deficit hyperactivity disorder (ADHD) has been undertaken in Western Europe and North America. The extent to which these findings apply to other cultural groups is unclear. The current study evaluated the behavioral sensitivity of Japanese children with and without ADHD to changing reward availability. Forty-one school-aged children, 19 diagnosed with DSM-IV ADHD, completed a signal-detection task in which correct discriminations between two stimuli were associated with different reinforcement frequencies. The response alternative associated with the higher rate of reinforcement switched twice during the task without warning., Findings: Both groups of children developed an initial bias toward the more frequently reinforced response alternative. When the reward contingencies switched the response allocation (bias) of the control group children followed suit. The response bias scores of the children with ADHD did not, suggesting impaired tracking of reward availability over time., Conclusions: Japanese children with ADHD adjust their behavioral responses to changing reinforcer availability less than their typically developing peers. This is not explained by poor attention to task or a lack of sensitivity to reward. The current results are consistent with altered sensitivity to changing reward contingencies identified in non-Japanese samples of children with ADHD. Irrespective of their country of origin, children with ADHD will likely benefit from behavioral expectations and reinforcement contingencies being made explicit together with high rates of reinforcement for appropriate behaviors.