CBT scores well vs neurofeedback for adult ADHD

New research from German investigators has shown that cognitive-behavioral therapy (CBT) achieved the same results as neurofeedback training in adult patients with attention-deficit hyperactivity disorder (ADHD). The findings were published in The Lancet Psychiatry.

Both modalities led to a similar decrease in symptoms in the comparative study, but CBT was shown to be more efficient, according to Michael Schönenberg, PhD, and his team at the University of Tübingen Department of Clinical Psychology and Psychotherapy.

Approximately 60% of children diagnosed with ADHD continue with the disorder into adulthood. Symptoms such as inability to concentrate on a single task for a length of time, impulsiveness, low stress tolerance, inner restlessness, and compulsion can complicate professional and private relationships.

Medication offers treatment for many of the symptoms, but similar non-pharmacologic successes have been reported.

Neurofeedback therapy is a controversial modality in which patients selectively learn to control their brain activity patterns to alleviate symptoms. Prior studies have shown this type of training to reduce ADHD symptoms, but the debate continues as to whether improvement was attributable to the training or a non-specific placebo effect.

In this study, psychologists at Tübingen worked with an international team of researchers to compare neurofeedback training, sham neurofeedback training, and CBT. In the sham neurofeedback group, the participants did not have their own brainwaves fed back to them. The CBT group involved specific strategies for planning actions, improving time management, stress mitigation techniques, and other similar topics.

During the course of 15 weeks, 118 adults with ADHD symptoms received either 30 neurofeedback sessions or 15 sham neurofeedback sessions followed by 15 actual neurofeedback sessions. The CBT group received a total of 12 group CBT sessions during 12 weeks.

Changes in the severity of symptoms were compared in objective tests of ability to concentrate, as well as in underlying brain wave patterns. Four measurement periods were used, ranging from before the start of intervention to six months after training had ended.

Results showed that neurofeedback was not superior to sham neurofeedback. The team said that both types of training showed good efficacy, but it could not be demonstrated that neurofeedback has a specific effect on brain waves.

Dr. Schönenberg said that CBT group therapy also led to a comparable reduction in symptoms.

"The method was considerably less involved as well,” he explained. “Among other things, it requires fewer sessions. And instead of training each individual, group work is possible. Plus there are no additional costs such as creating and maintaining technical equipment."

He reported that the results of the study showed that CBT approaches are effective and efficient in treating ADHD symptoms in adults.

“Before other methods for the therapy can be recommended, they must first demonstrate they are superior to standard CBT methods," he said.

To read more about this study, click here.