Analyzing the network of parent-rated ADHD symptoms before and 2 weeks after the onset of pharmaceutical treatment.

PROBLEM: Via a network analysis approach, following 2 weeks of the medication Ritalin, the present study investigated the quality of symptom interactions and the pattern of behavior changes to identify locations of functional weaknesses in the network interactions of symptomology.

METHODS

Ritalin® prescribed for 112 children (aged 4-14) with attention deficit hyperactivity disorder (ADHD) as diagnosed by five child and adolescent psychiatrists. Their parents completed Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV) before and after Ritalin® onset as the pre and post-test, respectively. Then, the network analysis approach was used to discover the pattern of changes in symptom interactions.

FINDINGS: The results indicated that in 2 weeks following its initiation, Ritalin significantly reduced restlessness and interactions between symptoms of impulsivity. "Inability to follow instructions" and "difficulty waiting their turn" symptoms were the most central symptoms of strength. Three symptoms, "Often has difficulty waiting their turn," "runs and climbs in situations where it is inappropriate" and "does not follow through on instructions," had the most expected influence. In the 14-day period of investigation, Ritalin® was effective in breaking some interactions and components of ADHD, but no significant mitigation of other components of the detected symptomatology network.

CONCLUSION

Follow-up investigations using network analysis can clarify the dynamics of the network changes after initiation of medications.