91Ó°ÊÓ

Some studies have indicated that neurofeedback may be an effective treatment for ADHD. Read excerpts from the research published in The Lancet Psychiatry and answer the questions that follow. (Source: Schönenberg et al., "Neurofeedback, sham neurofeedback, and cognitive-behavioral group therapy in adults with attention-deficit hyperactivity disorder: \(\mathrm{A}\) triple- blind, randomised, controlled trial, "The Lancet Psychiatry, vol. \(4[\) September 2017]: \(673-684\) ) Methods: We did a concurrent, triple-blind, randomised, controlled trial using adults with \(\mathrm{ADHD}\), aged 18 to 60 years. Participants were randomly assigned to three groups: a neurofeedback group which received 30 true neurofeedback sessions over 15 weeks, a sham neurofeedback group which received 15 sham (fake) followed by 15 true neurofeedback sessions over 15 weeks, or a meta-cognitive group therapy group which received 12 sessions over 12 weeks. The primary outcome was symptom score on the Conners" adult ADHD rating scale, assessed before treatment, at midtreatment (after 8 weeks), after treatment (after 16 weeks), and 6 months later. Results: Self-reported ADHD symptoms decreased substantially for all treatment groups between pretreatment and the end of 6 month follow-up, independent of treatment condition. There were no significant differences in outcomes between any of the groups. a. Identify the treatment variable and the response variable. b. Was this a controlled experiment or an observational study? c. Based on this study, would you agree that neurofeedback may be an effective treatment for ADHD? Why or why not?

Step by step solution

01

Identification of Variables

The treatment variable, also known as the independent variable, is the variable being manipulated in an experiment. In this case, it's the type of treatment given to each group (neurofeedback, sham neurofeedback, or meta-cognitive group therapy). The response variable, or dependent variable, is the outcome or result which changes depending on the treatment administered. Here, it is the symptom score on the Conners' adult ADHD rating scale.

02

Experiment Classification

This is a controlled experiment, not an observational study. The difference lies in the fact that in a controlled experiment, the researchers actively manipulate the independent variable and measure the effect on the dependent variable. In an observational study, researchers only monitor and do not manipulate. The text mentions a 'randomised, controlled trial', meaning that the subjects were randomly assigned to treatment groups and the treatments were controlled by the researchers.

03

Evaluation of Treatment Efficacy

Whether neurofeedback is an effective treatment for ADHD based on this study is debatable. All treatment groups saw a substantial decrease in ADHD symptoms, but there were no significant differences in outcomes between any of the groups. This suggests that while neurofeedback may be able to reduce ADHD symptoms, it may not be any more effective than sham neurofeedback or meta-cognitive group therapy.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Neurofeedback

Neurofeedback is an innovative technique used in various studies to treat Attention-Deficit/Hyperactivity Disorder (ADHD). This method involves training individuals to alter their brain activity by providing real-time feedback.
This feedback is typically presented through visual or audio cues, guiding the individual to modulate their neural patterns.

• Neurofeedback aims to enhance self-regulation and focus in individuals with ADHD.
• During a session, participants consciously observe the cues and learn to control their brainwave states.

Despite its potential, research like the one conducted by Schönenberg et al. illustrates that while neurofeedback can lead to symptom improvement, it might not outperform other interventions like sham neurofeedback or cognitive-behavioral therapy.

Controlled Experiment

A controlled experiment is a research method where the effect of an independent variable is tested on a dependent variable. Researchers use this model to establish cause-and-effect relationships.
In the study from *The Lancet Psychiatry*, the method was "triple-blind," meaning the participants, those administering the treatments, and those assessing the outcomes were unaware of which participants were receiving which treatments.

• The three groups were: neurofeedback, sham neurofeedback, and meta-cognitive group therapy.
• This approach ensured that external biases were minimized, providing more reliable results.

Controlled experiments are crucial in determining the effectiveness of treatments, as they control variables that could otherwise skew data.

Independent Variable

An independent variable is the one that researchers manipulate to observe its effect on dependent variables. In Schönenberg et al.'s study, the independent variable was the type of treatment given.
The treatments tested were:

• Neurofeedback sessions
• Sham (fake) neurofeedback sessions followed by real ones
• Meta-cognitive group therapy sessions

By adjusting these variables and observing the outcomes, researchers attempt to draw causal inferences about their effects on ADHD symptom severity.

Dependent Variable

The dependent variable is what researchers measure, focused on observing changes that occur due to variations in the independent variable. In this study, the dependent variable was the symptom score on the Conners' adult ADHD rating scale.

• This scale measures the severity of ADHD symptoms, such as inattentiveness and hyperactivity.
• Scores were recorded before the treatment, at midtreatment, after the treatment, and six months later.

Analyzing the dependent variable across different points in time helps researchers understand the longitudinal effect of treatments on the symptom severity.

Randomized Trial

A randomized trial ensures that each participant has an equal chance of being assigned to any of the treatment groups. It is an essential aspect of controlled experiments as it reduces selection bias.
In the ADHD treatment study, participants were randomized into the three treatment groups, establishing a foundation for fair comparison.

• This ensures that the groups are comparable at the start of the experiment.
• Randomization helps to distribute unknown confounding variables evenly between groups.

By using randomized trials, researchers aim for more credible and generalizable results, which is vital in clinical research for drawing reliable conclusions.