Running head: UNTREATED ADHD CAN INCREASE CRIMINAL BEHAVIOR 1 UNTREATED ADHD CAN INCREASE CRIMINAL BEHAVIOR 9 Untreated ADHD can increase Criminal Behavior Jailya Wooden Walden University April 4, 2020 Introduction The treatment of ADHD and the approaches to be employed are reliant on several factors including the age of the individuals suffering the disease, whether to be employed with other approaches and the comorbidities present. ADHD is a major issue in public health and can have negative effects on the families of the patient and society as a whole. As such, understanding the underlying factors of ADHD, its diagnosis and treatment approaches is crucial to how well the condition will be dealt with in the future. This paper looks into six research articles as part of the Capstone project and their studies of ADHD related subjects. Articles Synthesis According to Lücke et al., 2017, CBT or cognitive behavioral therapy is characterized as the standard type of psychotherapy administered in adults suffering ADHD. The article recognizes that biological factors including chronic negative feedback during childhood can play a role in the characterization of ADHD as a developmental disorder and these cannot be addressed substantially using CBT. The article looks into schema therapy which has recently become popular for use as a therapy approach when it comes to chronic psychiatric disorders due to its effectiveness. The therapy is centered on the targeting and identification of beliefs and dysfunctional patterns that are formed from experiences during childhood and encapsulated as early maladaptive schemas. The article also looks into studies that were used to demonstrate the increased prevalence of these schemas in ADHD suffering adults. As such, it analyzes the effectiveness and utilization of schema therapy and its potential in utilizing maladaptive schemas to treat ADHD. The effectiveness of the approach is bolstered when there are the influence and existence of secondary problems including impaired self-perception and poor coping mechanisms (Lücke et al., 2017). The article also cites the importance of conducting controlled randomized clinical studies to support the adoption of the approach and the analysis of its effectiveness in treating attention-deficit hyperactivity disorder, ADHD. According to Pan et al., 2019, the article looks into a study that compares CBT alone to its combination with medication in terms of cognitive and social functions, self-esteem, emotional symptoms and core symptoms in patients suffering ADHD. The study provides proof that CBT is an effective approach when it comes to treating ADHD regardless of whether it is employed with medication or not. There were, however, broader improvements when CBT was employed with medication in executive function but not in clinical symptoms, as compared to the use of CBT alone. This would, therefore, provide a scientific basis for the clinical selection of tr.

1. Running head: UNTREATED ADHD CAN INCREASE
CRIMINAL BEHAVIOR 1
UNTREATED ADHD CAN INCREASE CRIMINAL
BEHAVIOR 9
Untreated ADHD can increase Criminal Behavior
Jailya Wooden
Walden University
April 4, 2020
Introduction
The treatment of ADHD and the approaches to be employed are
reliant on several factors including the age of the individuals
suffering the disease, whether to be employed with other
approaches and the comorbidities present. ADHD is a major
issue in public health and can have negative effects on the
families of the patient and society as a whole. As such,
understanding the underlying factors of ADHD, its diagnosis
and treatment approaches is crucial to how well the condition

2. will be dealt with in the future. This paper looks into six
research articles as part of the Capstone project and their
studies of ADHD related subjects.
Articles Synthesis
According to Lücke et al., 2017, CBT or cognitive behavioral
therapy is characterized as the standard type of psychotherapy
administered in adults suffering ADHD. The article recognizes
that biological factors including chronic negative feedback
during childhood can play a role in the characterization of
ADHD as a developmental disorder and these cannot be
addressed substantially using CBT. The article looks into
schema therapy which has recently become popular for use as a
therapy approach when it comes to chronic psychiatric disorders
due to its effectiveness. The therapy is centered on the targeting
and identification of beliefs and dysfunctional patterns that are
formed from experiences during childhood and encapsulated as
early maladaptive schemas. The article also looks into studies
that were used to demonstrate the increased prevalence of these
schemas in ADHD suffering adults. As such, it analyzes the
effectiveness and utilization of schema therapy and its potential
in utilizing maladaptive schemas to treat ADHD. The
effectiveness of the approach is bolstered when there are the
influence and existence of secondary problems including
impaired self-perception and poor coping mechanisms (Lücke et
al., 2017). The article also cites the importance of conducting
controlled randomized clinical studies to support the adoption
of the approach and the analysis of its effectiveness in treating
attention-deficit hyperactivity disorder, ADHD.
According to Pan et al., 2019, the article looks into a study that
compares CBT alone to its combination with medication in
terms of cognitive and social functions, self-esteem, emotional
symptoms and core symptoms in patients suffering ADHD. The
study provides proof that CBT is an effective approach when it
comes to treating ADHD regardless of whether it is employed
with medication or not. There were, however, broader
improvements when CBT was employed with medication in

3. executive function but not in clinical symptoms, as compared to
the use of CBT alone. This would, therefore, provide a
scientific basis for the clinical selection of treatment options
that would be based on the needs and characteristics of patients.
The study was the first to be conducted in China to look into the
efficacy of CBT with and without medication. The study showed
that it can be effective in adults suffering ADHD and there were
no overarching differences between the different groups when it
came to emotions and core symptoms. CBT alone was found to
be more effective for daily functions while its combination with
medication was more effective on emotional functions (Pan et
al., 2019). Moreover, the CBT treatment administered as part of
the study with and without medication showed results of
significant improvements in terms of functional and emotional
outcomes and ADHD symptoms in its baseline.
According to Stavrou, 2019, the study was purposed on
investigating the efficacy of the incorporation of mentalization
and psychodynamic psychotherapy as approaches for treating
ADHD and impairment in mentalization. It would also look into
the links between ADHD in children and mentalization capacity.
The study was based on the theory that there is a relationship
between mentalization capacity and ADHD and that for children
suffering mentalization capacity and ADHD, psychodynamic
psychotherapy can be effective. The study engaged children
who were previously diagnosed with mentalization impairment
and ADHD treatment using psychotherapy, and this was
combined with approaches that were focused on mentalization.
At the beginning and end of the treatment, the study employed
Rorschach’s tests. The results of the study indicated that there
was progress in terms of mentalization impairment and ADHD
in the children studied and that there was also a link or
relationship between ADHD and mentalization capacity
(Stavrou, 2019). This would have positive implications in the
treatment of ADHD with comorbidity with impairment in
mentalization.
According to Molina, 2016, the perception of children when it

4. comes to the behavior of their parents is crucial for their
adjustment. It can be very challenging to raise children with
ADHD and little is understood on how children suffering ADHD
perceive their parents’ style of raising children. The article
looked into a study that aimed to analyze how children with
ADHD perceived control and acceptance in child-parent
relationships. There was an analysis of how this perception
relates to externalizing behaviors, impulsivity or hyperactivity,
and inattention. The study analyzed children with ADHD and
those without ADHD attending psychotherapy, as well as those
with unknown status of ADHD and not attending psychotherapy.
The study included their parents. Analysis of variance indicated
that children suffering ADHD perceived increased levels of
pathological control in their maternal relationships as compared
to the other two groups. Those children with unknown status
and not attending psychotherapy showed higher extreme
autonomy than the other two groups. There were also findings
that the perception of extreme autonomy and pathological
control by parents could be used to predict externalizing
symptoms in ADHD suffering children. In children without
ADHD and attending psychotherapy, inattention could be
predicted using the perceptions of pathological control and
maternal acceptance. Moreover, perceived paternal acceptance
and perceived maternal pathological control could be used to
predict externalizing symptoms in children with ADHD and
attending psychotherapy (Molina, 2016). As such, the study
indicated the importance of considering the perceptions of
children when it comes to their relationships with their parents
on top of reports from their fathers on their behavior concerning
ADHD.
According to Wieber et al., 2018, ADHD is a huge problem in
public health and has numerous negative outcomes for the
individuals who are affected that can be burdening to society
and families. Even as non-pharmaceutical treatment options
and pharmacological treatment encapsulated in a multimodal
therapeutic approach is taken as the standard, the observation of

5. MPH or methylphenidate treatment is important. This is due to
its likely correspondence to the reduced utilization of other
options for treatments. The article looks into a study geared
towards the analysis of the perceived challenges and the
practice of pediatricians when it comes to treatment and
diagnosis of ADHD. The study utilized an online survey
analyzing perceived challenges, personal attitudes, and therapy
and diagnostic procedures that were sent to an organization of
pediatricians. The professionals reported that selecting a
therapy was done based on the exchanges with children and
parents and the children suffering ADHD. The pediatricians set
up three meetings, two of which the child suffering ADHD
attends. They report and include information from numerous
sources before diagnosing. The challenges mentioned included
limited resources, frequent comorbidities, and the subjective
characteristics of diagnosis (Wieber et al., 2018). The most
frequent treatment approach was pharmacological therapy, then
psychotherapy and lastly, occupational therapy. In terms of case
management, the challenges included unfavorable public
attitudes regarding medication and decreased availability of
psychotherapy and youth and child psychiatry. The study found
out that pediatricians make considerations of multimodal
approaches to treating ADHD and indicate a high involvement
of the children and their families in the selection of the therapy
to be employed. There were also indications of the potential of
improving the cooperation with other specialists including
social workers and teachers in school (Wieber et al., 2018).
There was also the potential for increased availability of ADHD
information and psychotherapy.
According to Scholle et al., 2020, the article looked into a study
that was aimed at the identification of the characteristics that
could be utilized to predict the use of psychotherapy and/or
medication after the commencing diagnosis of ADHD. The use
of medication was associated with the male gender and
diagnoses with comorbid conduct and developmental disorder,
comorbid depression and hyperactivity. The use of

6. psychotherapy alone was associated with emotional and conduct
disorders, somatoform, comorbid neurotic and the male gender.
Receiving both treatments, on the other hand, was associated
with emotional and conduct disorders, somatoform, and neurotic
and comorbid depressions. The study indicated that in the
instances of equal access to both options for treatment, those
with externalizing symptoms, for instance, were increasingly
prone to receive psychotherapy and or medication than an
average child diagnosed with the condition. Additionally,
patients with psychiatric comorbidities representing
externalizing symptoms such as conduct disorders and
internalizing symptoms such as anxiety and depression were
increasingly likely to receive medication and psychotherapy.
The reduced chances of receiving additional psychotherapy
when it comes to mental retardation were identified and were
taken as a reflection that there is slowly increasing empirical
confirmation of the effectiveness of psychotherapy (Scholle et
al., 2020). Other explanations included the likelihood of a lower
percentage of psychotherapists who deal with the population of
low IQ children.
Summary
The effectiveness of the schema therapy treatment approach for
ADHD is bolstered when there are the influence and existence
of secondary problems including impaired self-perception and
poor coping mechanisms. CBT alone was found to be more
effective for daily functions while its combination with
medication was more effective on emotional functions.
Perceived paternal acceptance and perceived maternal
pathological control could be used to predict externalizing
symptoms in children with ADHD and attending psychotherapy.
Experts indicated that selecting a therapy was done based on the
exchange between children and parents and the children
suffering from ADHD. Moreover, patients with psychiatric
comorbidities representing externalizing symptoms and
internalizing symptoms were increasingly likely to receive
medication and psychotherapy. This paper looks into six

7. research articles as part of the Capstone project and their
studies of ADHD related subjects.
References
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New psychotherapeutic approaches in adult ADHD:
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8. Stavrou, P. D. (2019). Outcomes of Psychodynamic
Psychotherapy with Incorporated Mentalization-Focused
Approaches for Children with ADHD and Mentalization
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