Status:

TERMINATED

Neurophysiological Markers of Pediatric Irritability and Its Response to Intervention

Lead Sponsor:

Milton S. Hershey Medical Center

Conditions:

ADHD

Eligibility:

All Genders

5-12 years

Phase:

PHASE4

Brief Summary

There has been an increasing focus on the adverse impacts of irritability, defined as increased tendency towards anger. Irritability worsens peer relationships, family functioning, academic performanc...

Detailed Description

There has been an increasing focus on the adverse impacts of irritability, defined as increased tendency towards anger.In children, irritability manifests as a persistently negative mood and frequent ...

Eligibility Criteria

Inclusion

  • Ages 5-12: CNS stimulant medications are commonly used and well studies in this age range (Mixed amphetamine salt has been approved for children age 3 + and methylphenidate has been used in FDA funded studies on preschool children; American Pediatric Association guidelines are also recommend for the preschool children) and these are the age ranges where children are most likely to present for treatment of irritability.
  • 2\. Meets diagnostic criteria for any presentation type of ADHD. ADHD status will be assessed on the NIMH Computerized Diagnostic Interview Schedule for Children (C-DISC).54 The C-DISC will also be used to assess psychiatric comorbidity, with diagnoses confirmed by an MD/PhD prior to eligibility decisions. Symptom severity for ADHD, irritability and Oppositional Defiant Disorder (ODD) will be assessed using the Disruptive Behavior Disorders (DBD) Parent Rating Scale which is similar to the Vanderbilt, rating symptoms on a 0-3 likert.24 In accordance with previous studies of irritability in ADHD, the DBD irritability score (range 0-9) will be the primary outcome, with a moderate level of irritability (≥5) required for entry.12 DMDD status will be assessed using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL) but DMDD will not be required for entry as subthreshold levels of irritability produce significant impairment.7 3. Sex: male or female 4. Fluent in written and spoken English.

Exclusion

  • Age \<5 years of age or \>12 years of age.
  • Children with significant visual or hearing deficits or sensitivity to loud noises as test performance requires intact hearing and vision.
  • Children with a latex allergy as the sensors used in electrophysiology assessments have a latex component.
  • Serious neurological conditions that impacts cognition, such as an active seizure disorder
  • Current psychotropics other than FDA approved ADHD medications, as medication will be withheld on testing days. Unlike most other psychotropic medications, CNS stimulants can be withheld for brief periods and acutely restarted with no safety risks and lengthy titration process. Numerous ADHD studies have safely withdrawn these medications or substituted inert placebo for testing or clinical observation. Children taking an approved nonstimulant for ADHD plus a CNS Stimulant medication will be allowed to participate and will just have their CNS stimulant dose withheld on testing days.
  • Prominent traits of autism spectrum disorder (Social Communication Questionnaire Score \>15), marked developmental delay or psychiatric conditions requiring urgent treatment (mania, psychoses, suicidal ideation).
  • Parent or child not fluent in English

Key Trial Info

Start Date :

June 1 2018

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

June 30 2024

Estimated Enrollment :

11 Patients enrolled

Trial Details

Trial ID

NCT03279952

Start Date

June 1 2018

End Date

June 30 2024

Last Update

August 26 2025

Active Locations (1)

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Penn State Hershey

Hershey, Pennsylvania, United States, 17036