Faculty

Karen Wells

Associate Professor Emeritus in Psychiatry and Behavioral Sciences

Psychiatry, Child & Family Mental Health & Developmental Neuroscience
School of Medicine

2608 Erwin Road Lakeview Pavi, Durham, NC 27705

Box 3527MED Ctr, Durham, NC 27710

(919) 668-0082 karen.wells@duke.edu

I am the PI on an NIDA funded grant studying the incremental effectiveness of family therapy when applied in the context of an outpatient substance abuse treatment program for adolescent substance abusers. Subject/families are randomly assigned to one of two treatment conditions: Standard Outpatient Treatment or Standard Outpatient Treatment plus Family therapy. The family therapy intervention is based on a system/structural model of family functioning with specific focus on the content issues and family dynamics involved in substance abuse. Subject/families are assessed at baseline, immediate post intervention, and at a 6 month follow-up period. the study is of experimental significance because it addresses the question of whether changing family processes empirically identified as associated with substance abuse, results in changes in risk factors for substance abuse and actual substance use. The study is of public health significance because it addresses the added benefit of family therapy in substance abuse tretment program for adolescents. Although most thereticians call for family therapy for this population, fewer than 25% of treatment programs across the country include family therapy as a component of treatment.

I am also Co-PI on a NIDA funded study of the secondary prevention effects of cognitive behavioral intervention and behavioral parent training intervention on high risk aggressive boys. This is a school/community based secondary prevention program in which 4th and 5th grade boys, identified as at risk for later substance abuse by relatively high levels of aggressive/disruptive behavior in the school and home, are randomly assigned to receive cognitive behavior therapy alone, or the combination of cognitive behavioral therapy puls behavioral parent training, or a control condition of routine school based service. A normal (i.e., non-aggressive) control group is also being followed for comparison purposes. Subjects and their families are assessed at baseline and then reassessed at several follow-up intervals. We intended to follow these boys into middle school and high school to assess the impact of an early risk based prevention program on later substance use and abuse. the interventions consist of well researched single tretments for aggression, but their combinatory effects have not been well evaluated prior to this study.

I am Co-PI on a large NIMH funded, multi-site trial investigating multi-modality tretment for attention Deficit Hyperactivity Disorder (ADHD). This is a clinic-based intervention program for 7-9 year old, ADHD boys and girls. Subjects are randomly assigned to receive, Psychosocial Treatment Alone (consisting of Parent Training, A summer Treatment Program and Classroom Behavioral Intervention); Medication alone; their combination; or a community comparison group. The intervention occurs over a 13 month period and subjects are followed for two years. Hypotheses relate to both the short and long term effects of single versus multi-modality treatments for ADHD. Secondary hypotheses have to do with child's co-morbidity status (i.e., presence of secondary diagnoses such as Oppositional Defiant Disorder or Anxiety disorder) and its relationship to outcome. I developed and is responsible for the fidelity and integrity of the Parent Training Intervention for this large-scale, nationally visible project.

I am Co-PI on a NIDA funded grant of a study to develop treatment manuals for depressed, substance abusing adolescents. Dr. Curry is developing a manual for group treatment of the adolescents, and I am developing a coordinated manual for family treatment. The manuals will be based on cognitive-behavioral models of interpersonal and family functioning, and will be tested on a small N in this project. Once the manuals are developed, a proposal to test the efficacy of the combined model will be submitted to NIDA as a RO1 grant application.


Education & Training

Ph.D. 1978

University of Georgia, Athens

M.S. 0

University Health Service

Grants

Treatment for Teens with Alcohol Abuse and Depression

National Institutes of Health

Evaluating the Impact of Adolescent Suicide Attempts on Parents

National Institutes of Health

Duke MTA Study RFP: NIMH-08-DS-00008

National Institutes of Health

SOFTAD-Substance use outcomes following treatment adolescent depression

National Institutes of Health

PREMIER Mental Health Interventions Training Program

National Institutes of Health

Relapse Prevention for Suicidal Dually Diagnosed Youths

National Institutes of Health

Treatment of Adolescent Suicide Attempts (TASA)

National Institutes of Health

National Drug Abuse Treatment Clinical Trials Network

National Institutes of Health

Supplement to Multimodal Treatment Study of Children with ADHD

National Institutes of Health

Drug Abuse Treatment for Adolescents (DATA)

Substance Abuse and Mental Health Services Administration

Multimodal Treatment Study Of Children With Adhd(Mta)

National Institutes of Health

Substance Abuse Prevention For Aggressive Preadolescents

National Institutes of Health

Secondary Prevention Of Substance Use In High Risk Boys

National Institutes of Health

Multimodal Treatment Studt Of Children With Adhd

National Institutes of Health

Secondary Intervention Of Substance Use In High Risk Boys

National Institutes of Health

Secondary Prevention Of Subtance Abuse In High Risk Boys

National Institutes of Health

Treatment For Depressed, Substance Abusing Adolescents

National Institutes of Health

Treatment For Depressed, Substnace Abusing Adolescents

National Institutes of Health

Multi-Modal Treatment Of Adhd

National Institutes of Health

Multimodel Treatment Study Of Children With Adhd

National Institutes of Health

Adolescent Drug Abuse: Controlled Trial Of Family Therapy

National Institutes of Health

Adolescent Drug Abuse: A Controlled Trial Of Family Therap

National Institutes of Health
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Publications

Testing Robustness of Child STEPs Effects with Children and Adolescents: A Randomized Controlled Effectiveness Trial.

PMID 31517543
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How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning.

PMID 28166690
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Turning Points in the Lives of Youth of With/Without ADHD: Are They Linked to Changes in Substance Use?

PMID 28423975
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Follow-Up of Young Adults With ADHD in the MTA: Design and Methods for Qualitative Interviews.

PMID 28617075
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Late-Onset ADHD Reconsidered With Comprehensive Repeated Assessments Between Ages 10 and 25.

PMID 29050505
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Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA).

PMID 28735698
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Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.

PMID 27642116
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Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.

PMID 28295312
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Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results.

PMID 27806862
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Childhood Factors Affecting Persistence and Desistence of Attention-Deficit/Hyperactivity Disorder Symptoms in Adulthood: Results From the MTA.

PMID 27806861
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Parental aggression as a predictor of boys' hostile attribution across the transition to middle school.

PMID 27647945
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Counselor-Level Predictors of Sustained Use of an Indicated Preventive Intervention for Aggressive Children.

PMID 25307416
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A school-based post-Katrina therapeutic intervention.

PMID 25047869
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Evaluation of underlying mechanisms in the link between childhood ADHD symptoms and risk for early initiation of substance use.

PMID 25222174
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Bidirectional effects of parenting and youth substance use during the transition to middle and high school.

PMID 24955670
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Erratum: Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in The Multimodal Treatment Study of Children With ADHD: Developmental cascades and vicious cycles (Development and Psychopathology (2010) DOI: 10.1017/S0954579410000465)

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Long-term outcomes for the Child STEPs randomized effectiveness trial: a comparison of modular and standard treatment designs with usual care.

PMID 23978169
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Three year follow-up of coping power intervention effects: evidence of neighborhood moderation?

PMID 23065350
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Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication.

PMID 23452682
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Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial.

PMID 22889336
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Family-Based Cognitive-Behavioral Treatments for Suicidal Adolescents and Their Integration With Individual Treatment

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The influence of neighborhood characteristics and parenting practices on academic problems and aggression outcomes among moderately to highly aggressive children

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Onset of alcohol or substance use disorders following treatment for adolescent depression.

PMID 22250853
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Blood pressure and heart rate over 10 years in the multimodal treatment study of children with ADHD.

PMID 21890793
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Recovery and recurrence following treatment for adolescent major depression.

PMID 21041606
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Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the Multimodal Treatment Study of Children With ADHD: developmental cascades and vicious cycles.

PMID 20883582
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Time-dependent changes in positively biased self-perceptions of children with attention-deficit/hyperactivity disorder: a developmental psychopathology perspective.

PMID 20423548
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Ethnicity as a moderator of treatment effects on parent--child interaction for children with ADHD.

PMID 19531810
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Parent-reported homework problems in the MTA study: evidence for sustained improvement with behavioral treatment.

PMID 20390813
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An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.

PMID 20183665
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Implementation of a School-Based Prevention Program: Effects of Counselor and School Characteristics

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Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability.

PMID 19730273
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The Treatment for Adolescents With Depression Study (TADS): outcomes over 1 year of naturalistic follow-up.

PMID 19723787
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Depressive symptoms and clinical status during the Treatment of Adolescent Suicide Attempters (TASA) Study.

PMID 20854770
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The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.

PMID 19730274
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The influence of neighborhood disadvantage and perceived disapproval on early substance use initiation.

PMID 19473772
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Dissemination of the Coping Power program: importance of intensity of counselor training.

PMID 19485582
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The effect of neighborhood disadvantage on proactive and reactive aggression

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Medication adherence in the MTA: saliva methylphenidate samples versus parent report and mediating effect of concomitant behavioral treatment.

PMID 19307987
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The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study.

PMID 19318991
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Inconsistent discipline as a mediator between maternal distress and aggression in boys

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A clinical review of outcomes of the multimodal treatment study of children with attention-deficit/hyperactivity disorder (MTA).

PMID 18803917
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Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment study of Children With ADHD (MTA): part I: executive summary.

PMID 18573923
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Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment Study of children with ADHD (MTA): Part II: supporting details.

PMID 18573924
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Developmental trajectories of proactive and reactive aggression from fifth to ninth grade.

PMID 18470777
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The relation between childhood proactive and reactive aggression and substance use initiation.

PMID 17823863
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Treatment of Adhd in Children and Adolescents

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The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes.

PMID 17909125
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Pathways from proactive and reactive aggression to substance use.

PMID 17874886
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Effects of stimulant medication on growth rates across 3 years in the MTA follow-up.

PMID 17667480
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Secondary evaluations of MTA 36-month outcomes: propensity score and growth mixture model analyses.

PMID 17667479
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3-year follow-up of the NIMH MTA study.

PMID 17667478
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Delinquent behavior and emerging substance use in the MTA at 36 months: prevalence, course, and treatment effects.

PMID 17667481
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Child and parent predictors of perceptions of parent--child relationship quality.

PMID 17606771
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Parent training in the treatment of ADHD

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Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS).

PMID 17135987
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Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS).

PMID 17135988
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Treatment-related changes in objectively measured parenting behaviors in the multimodal treatment study of children with attention-deficit/hyperactivity disorder.

PMID 16881772
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Assessing medication effects in the MTA study using neuropsychological outcomes.

PMID 16671928
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The mutual influence of parenting and boys' externalizing behavior problems

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Self-perceived social acceptance and peer social standing in children with aggressive-disruptive Behaviors

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Does multimodal treatment of ADHD decrease other diagnoses?

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ADHD and manic symptoms: Diagnostic and treatment implications

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Refining the diagnoses of inattention and overactivity syndromes: A reanalysis of the Multimodal Treatment study of attention deficit hyperactivity disorder (ADHD) based on ICD-10 criteria for hyperkinetic disorder

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Gestational and postnatal tobacco smoke exposure as predictor of ADHD, comorbid ODD/CD, and treatment response in the MTA

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Cost-effectiveness of ADHD treatments: findings from the multimodal treatment study of children with ADHD.

PMID 16135621
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Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder.

PMID 15677282
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The influence of maternal stress and distress on disruptive behavior problems in boys.

PMID 15725971
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Striving for effectiveness in the treatment of adolescent depression: Cognitive behavior therapy for multisite community intervention

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Parent involvement in CBT treatment of adolescent depression: Experiences in the Treatment for Adolescents with Depression Study (TADS)

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The Treatment for Adolescents With Depression Study (TADS): demographic and clinical characteristics.

PMID 15608541
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The services for children and adolescents-parent interview: development and performance characteristics.

PMID 15502592
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Negative emotions and alcohol use initiation in high-risk boys: the moderating effect of good inhibitory control.

PMID 15500030
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AACAP 2002 research forum: placebo and alternatives to placebo in randomized controlled trials in pediatric psychopharmacology.

PMID 15266201
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The coping power program for preadolescent aggressive boys and their parents: outcome effects at the 1-year follow-up.

PMID 15301641
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Classroom environment influences on aggression, peer relations, and academic focus

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Nine months of multicomponent behavioral treatment for ADHD and effectiveness of MTA fading procedures.

PMID 14998110
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Childhood behavioral and emotional disorders.

PMID 14593693
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Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD.

PMID 12924677
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Cognitive-behavioral intervention for depressed, substance-abusing adolescents: development and pilot testing.

PMID 12921473
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Which treatment for whom for ADHD? Moderators of treatment response in the MTA.

PMID 12795577
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Treatment for Adolescents With Depression Study (TADS): rationale, design, and methods.

PMID 12707557
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Effectiveness of the Coping Power program and of classroom intervention with aggressive children: Outcomes at a 1-year follow-up

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Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA.

PMID 12108764
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Observed classroom behavior of children with ADHD: relationship to gender and comorbidity.

PMID 12109488
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Emergency/Adjunct services and attrition prevention for randomized clinical trials in children: the MTA manual-based solution.

PMID 12014781
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Socioeconomic status as a moderator of ADHD treatment outcomes.

PMID 11886021
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The coping power program at the middle-school transition: Universal and indicated prevention effects

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Contextual social-cognitive mediators and child outcome: a test of the theoretical model in the Coping Power program.

PMID 12549711
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Comprehensive versus matched psychosocial treatment in the MTA study: conceptual and empirical issues.

PMID 11294072
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Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.

PMID 11211364
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ADHD comorbidity findings from the MTA study: comparing comorbid subgroups.

PMID 11211363
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Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment.

PMID 11211365
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Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial.

PMID 11211366
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Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers.

PMID 11265923
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Symptom profiles in children with ADHD: effects of comorbidity and gender.

PMID 11214601
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Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA).

PMID 11104315
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Psychosocial treatment strategies in the MTA study: rationale, methods, and critical issues in design and implementation.

PMID 11104313
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Family processes and treatment outcome in the MTA: negative/ineffective parenting practices in relation to multimodal treatment.

PMID 11104317
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Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study.

PMID 11104316
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The Multidimensional Anxiety Scale for Children (MASC): Confirmatory factor analysis in a pediatric ADHD sample

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A new self-report scale for assessment of adolescent psychopathology: factor structure, reliability, validity, and diagnostic sensitivity.

PMID 9468109
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National Institute of Mental Health Collaborative Multimodal Treatment Study of Children with ADHD (the MTA). Design challenges and choices.

PMID 9294378
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The moderating effects of children's fear and activity level on relations between parenting practices and childhood symptomatology.

PMID 9212377
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NIMH collaborative multimodal treatment study of children with ADHD (MTA): Design, methodology, and protocol evolution

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Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial

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The death of discipline: Is the requiem premature?

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Attention-deficit/hyperactivity disorder: Part II. Treatment strategies

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Medication treatment strategies in the MTA Study: relevance to clinicians and researchers.

PMID 8885584
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Social learning and systems family therapy for childhood oppositional disorder: comparative treatment outcome.

PMID 3370964
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Use of the abikoff classroom observation coding system on a children's inpatient psychiatric unit

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Childhood and adolescent obesity: progress in behavioral assessment and treatment.

PMID 3875086
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A social learning approach, vol. 3: Coercive family process

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A comparison of staff training procedures. Behavioral applications in the child psychiatric inpatient setting.

PMID 6477388
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The effects of nocturnally administered stimulant medication on EEG sleep and behavior in hyperactive children.

PMID 6875127
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Behavioral family therapy with conduct disorders in children

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Maternal perception of maladjustment in clinic-referred children: An extension of earlier research

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Side effects of parent counseling on marital satisfaction

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Teaching parents to modify child behavior problems: an examination of some follow-up data.

PMID 7288537
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Use of single-subject methodology in clinical decision-making with a hyperactive child on the psychiatric inpatient unit

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Factors in the referral of children for behavioral treatment: a comparison of mothers of clinic-referred deviant, clinic-referred non-deviant and non-clinic children.

PMID 7295255
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Crisis treatment of a preadolescent who accidentally killed his twin.

PMID 7191212
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An examination of differences between nonclinic and behavior-problem clinic-referred children and their mothers.

PMID 7410715
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Effect of a reliability observer on the frequency of positive parent behavior recorded during naturalistic parent-child interactions

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The use of a self-control package to enhance temporal generality of a parent training program

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An examination of the social validity of a parent training program

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Social skills training in unipolar nonpsychotic depression.

PMID 484734
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Parent behavioral training: an analysis of the relationship among multiple outcome measures.

PMID 489846
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An examination of predictors of maternal perceptions of maladjustment in clinic-referred children.

PMID 500956
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Parent Behavioral Training to Modify Child Noncompliance: Treatment Generalization Across Time and from Home to School

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Behavioral treatment of obsessive-compulsive neurosis.

PMID 426749
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Situation generality of overcorrective functional movement training.

PMID 740817
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Predictors of child noncompliant behavior in the home.

PMID 627653
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Effects of cue-controlled relaxation on psychomotor seizures: an experimental analysis.

PMID 352332
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Effects of a verbal warning and overcorrection on stereotyped and appropriate behaviors.

PMID 604380
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Teachers and parents: Where have all the "good" contingency managers gone?

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Dry-bed training and retention control training: A comparison

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Effects of a procedure derived from the overcorrection principle on manipulated and nonmanipulated behaviors.

PMID 599110
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Changes in functional bladder capacity and bed-wetting during and after retention control training: a case study

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The effects of social punishment on noncompliance: a comparison with timeout and positive practice.

PMID 1002633
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