Trial of Reminder Focused Positive Psychiatry in Comorbid Attention Deficit Hyperactive Disorder With Posttraumatic Stress Disorder

PTSD and ADHD are major public health problems. Many individuals with comorbid ADHD and PTSD continue to suffer despite treatment with FDA approved medications including antidepressants (sertraline and paroxetine), prazosin and/or the Institute of Medicine approved psychotherapy. Long-term outcomes with even the most intensive treatments, although significant, were modest, and reveal persistent morbidity and disability for many individuals with PTSD, especially in those with comorbid ADHD.19 While current treatments focused on treatment to reduce the associated suffering and disability of morbid ADHD and PTSD. These interventions are, however, not sufficient to promote human welfare, improve levels of positive psychosocial characteristics (PPCs), and resilience. Positive psychiatry (PP) focuses on promoting well-being, enhancing behavioral and mental wellness in both youth and adults20, however its impact on youth with comorbid PTSD and ADHD has not been studied. We hypothesize that PP intervention would significantly enhance vascular function, resilience, wellbeing, increase posttraumatic growth and reduce inflammation in morbid ADHD and PTSD. This randomized trial will the first to investigate the impact of psychiatric positive interventions, as opposed to intervention on ameliorating vulnerability, on adolescents with morbid ADHD and PTSD. Findings of this study can provide a better understanding of impact of PP on psychiatric and biomolecular characteristics of adolescent with PTSD and ADHD. If successful, this proposal will be available for large scale studies following which it could potentially be deployed in daily clinical practice.

RESEARCH METHOD:

In this randomized clinical trial, the three related and overlapping specific aims are directed to examine the feasibility of PP intervention, as well as its impact on positive psychological wellbeing, and neurovascular inflammation in adolescent subjects with comorbid ADHD and PTSD.

Synopsis. In this randomized clinical trial, 24 subjects with comorbid ADHD and PTSD, aged 12-18 years old, free of known medical and other major psychiatric disorders, will be recruited from the pool of eligible subjects at Los Angeles and Kern County Children Mental Health Centers (>1500 subjects) after obtaining informed consent from parents as well as subjects' assentment. Commonwealth and Oswell Kern County Mental Health Clinic will be used for subjects enrollment, randomization as well as study implementation from trauma disorder clinic. Kern Medical will be used for manuscript write up and analyses.

Parents and subjects will be informed of the risks associated with use of venipuncture and loss of confidentiality of collected information. Eligible subjects will be randomized to 1) PP group intervention, or 2) control condition group (12 in each group) for 6 week intervention and 6 week of follow up.