Internet-based Cognitive Behavioral Therapy for Adult Attention Deficit Hyperactivity Disorder
A Randomized Controlled Trial of Internet-based Cognitive Behavioral Therapy for Adult Attention Deficit Hyperactivity Disorder in Sweden
1 other identifier
interventional
200
1 country
1
Brief Summary
Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by lack of attention, hyperactivity, and impulsivity. It can have major impact on everyday life and result in negative consequences for one's personal, academic, and work situation. For individuals with symptoms of ADHD, increased levels of anxiety and depression are common, and an overall reduction of quality of life is often present. This study protocol describes a clinical trial of internet-based cognitive behavioral therapy (iCBT), using a randomized controlled study design, with the primary aim to increase quality of life, as well as to reduce symptoms of ADHD, anxiety, depression, and stress. A second aim is to investigate, by qualitative means, what aspects of treatment were perceived as helpful and hindering when it comes to completing iCBT. Two hundred participants with symptoms of ADHD will be included and randomized to two conditions (treatment and wait-list control). The treatment period is comprised of ten weeks, with two mandatory modules and ten modules from which the participants can choose freely. Self-report measures are completed by the participants at baseline and end of treatment, as well as at a six-month follow-up. The treatment is guided by therapists and consists of weekly correspondence with the participants. The study will utilize an intention to treat design, with ANOVAs and Reliable Change Index to evaluate treatment effects. The qualitative part of the project will be interview-based and employ thematic analysis. Lastly, a psychometric evaluation of a common instrument for determining ADHD-symptoms will also be made. The results will hopefully contribute to the evidence base for iCBT for individuals with symptoms of ADHD and help disseminate potentially effective interventions.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2023
Typical duration for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 21, 2022
CompletedStudy Start
First participant enrolled
January 25, 2023
CompletedFirst Posted
Study publicly available on registry
January 26, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
November 1, 2025
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2025
CompletedSeptember 2, 2025
August 1, 2025
2.8 years
December 21, 2022
August 25, 2025
Conditions
Outcome Measures
Primary Outcomes (4)
Adult Attention-deficit/hyperactivity disorder Quality-of-Life scale (AAQoL)
The AAQoL (Brod et al., 2015; Brod, Johnston, Able, \& Swindle, 2006) is a disease-specific quality of life measure for adults with ADHD. The instrument measures quality of life-consequences of ADHD in four domains using and consists of 29 items. The instrument has excellent internal consistency (Cronbach's α = .93 for the overall measure). One example of an item is "In the last two weeks, how hard has it been for you to remember important things?", scored on a five-point Likert-like scale from "Not at all/Never" (1) to "Extremely/Very Often" (5). The scale ranges from 0 to 145.
Change in quality of life from baseline to 10 week (i.e., post-treatment)
Adult Attention-deficit/hyperactivity disorder Quality-of-Life scale (AAQoL)
The AAQoL (Brod et al., 2015; Brod, Johnston, Able, \& Swindle, 2006) is a disease-specific quality of life measure for adults with ADHD. The instrument measures quality of life-consequences of ADHD in four domains using and consists of 29 items. The instrument has excellent internal consistency (Cronbach's α = .93 for the overall measure). One example of an item is "In the last two weeks, how hard has it been for you to remember important things?", scored on a five-point Likert-like scale from "Not at all/Never" (1) to "Extremely/Very Often" (5). The scale ranges from 0 to 145.
Change in quality of life from baseline six-month follow-up
Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1) Symptoms Checklist (ASRS)
The ASRS is an instrument that measures ADHD-symptoms (Kessler et al., 2005). The instrument consists of 18 items that correspond to the 18 symptom-criteria for ADHD found in the DSM-IV-TR (Association, 2000). Of these 18 questions, six have been identified as most predictive of ADHD-symptoms. The overall range of the entire measure is 0 to 72. However, there are separate items focusing on attention and hyperactivity.
Change in ADHD symptoms from baseline to 10 week (i.e., post-treatment)
Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1) Symptoms Checklist (ASRS)
The ASRS is an instrument that measures ADHD-symptoms (Kessler et al., 2005). The instrument consists of 18 items that correspond to the 18 symptom-criteria for ADHD found in the DSM-IV-TR (Association, 2000). Of these 18 questions, six have been identified as most predictive of ADHD-symptoms. The overall range of the entire measure is 0 to 72. However, there are separate items focusing on attention and hyperactivity.
Change in ADHD symptoms from baseline to six-month follow-up
Secondary Outcomes (7)
Generalized Anxiety Disorder - 7 Items (GAD-7)
Change in anxiety symptoms from baseline to 10 week (i.e., post-treatment)
Generalized Anxiety Disorder - 7 Items (GAD-7)
Change in anxiety symptoms from baseline to six-month follow-up
Patient Health Questionnaire - 9 Items (PHQ-9)
Change in depressive symptoms from baseline to 10 week (i.e., post-treatment)
Patient Health Questionnaire - 9 Items (PHQ-9)
Change in depressive symptoms from baseline to six-month follow-up
Perceived Stress scale (PSS)
Change in stress symptoms from baseline to 10 week (i.e., post-treatment)
- +2 more secondary outcomes
Study Arms (2)
Internet-based cognitive behavioral therapy
EXPERIMENTALWait-list control
NO INTERVENTIONInterventions
A ten-week treatment based on cognitive behavioral therapy for ADHD, including two mandatory modules and at least four self-selected modules (out of ten available modules). The treatment consists of reading material and exercises to be completed each week.
Eligibility Criteria
You may qualify if:
- Over 18 years old of age.
- Can read and write in Swedish.
- Have access to a computer, tablet, or smartphone with an Internet connection.
- Have previously been diagnosed with ADHD.
- Are studying at a university or college in Sweden or working at least 50% of a full time-employment.
You may not qualify if:
- Shows elevated symptoms of depression or risk of suicide, i.e., a total score on the Patient Health Questionnaire - 9 items (PHQ-9; Kroenke, K., Spitzer, R. L., \& Williams, J. B. (2001)), \> 15 points, or scores \> 2 points on question i) concerning suicidality.
- Has started or changed their medication for any psychiatric diagnosis in the last three months.
- Exhibits another form of psychiatric diagnosis that requires more specialized care, for example substance abuse syndrome, anorexia nervosa, bipolar disorder, psychotic symptoms, or schizophrenia, as assessed with the MINI (Sheehan et al., 1998).
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Karolinska Institutetlead
- Uppsala Universitycollaborator
Study Sites (1)
Uppsala University
Uppsala, 751 42, Sweden
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
David Forsström, PhD
Uppsala University
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
December 21, 2022
First Posted
January 26, 2023
Study Start
January 25, 2023
Primary Completion
November 1, 2025
Study Completion
December 31, 2025
Last Updated
September 2, 2025
Record last verified: 2025-08
Data Sharing
- IPD Sharing
- Will not share