My internship placement is at Cognitive Psychiatry of Chapel Hill, where I am currently leading a research study on the efficacy of brain training devices in treating the symptoms of adult ADHD, particularly its use in a clinical setting. While medication can be an effective treatment in treating ADHD, it is not uncommon that patients will seek a nonpharmacological treatment option if medication proves for whatever reason to be problematic or simply not preferred. Literature has shown that neurofeedback training ( the use of an EEG device coupled with a display of brain wave activity in the form of video games) can be helpful in treating symptoms of ADHD, particularly when added to preexisting treatment options such as medication and therapy. Sessions of neurofeedback training are currently being offered free to patients at CPCH too ascertain if it will be a viable treatment option for those diagnosed with ADHD and if it is a viable option as a whole for the practice to offer (for a charged price, of course).
We aimed to have about 20 participants in the study, and we were close to nearing that amount when patients steadily began to drop out. This, of course, is due to various reasons ranging from a patient noticing side effects of frustration and anger (we are doubtful as to the exact correlation of this) to patients being inconvenienced by taking time out of their already busy professional schedules to accommodate coming into the practice twice a week to participate in the training.
(On a side note, I think this something fascinating that I learned quite soon upon starting the study: ADHD patients are often high preforming and high achieving. Naïvely, I used to think that those with ADHD would struggle with coursework or professional work but most of the participants are quite successful businesspeople, doctors, lawyers, and students).
The irony is pretty rife in this situation. We picked the perfect population for high attrition rates. Literature on neurofeedback techniques are significantly centered on children’s studies, but children are a captive audience–their parents could force them into participating such that they would follow the study to its completion. With adults, it’s difficult. They have more going on in their lives, and, let’s not forget, they have ADHD so often times they might forget to come to an appointment let alone schedule an appointment. Frustration levels with these patients are also a determining factor in completing the study. Often times the software used as a part of the training malfunctions, and while it’s situational, it may put someone over the edge to not coming back for further sessions.
We haven’t yet collected all of the data. So far form continuous ADHD self-report scales collected during participants’ trainings, the results seem to be scattered–my supervisor and I agree that the results will most likely be inconclusive. However, what we learned through the process of this study perhaps can still be useful. For example, while each patient is reporting various levels of perceived effectiveness, it could be worthwhile to track which kinds of ADHD participants (inattentive vs. hyperactive/impulsive) reported that the neurofeedback training was most useful. The upshot of our study simply may simply be a suggestion for other psychiatric practices to carry out neurofeedback studies of their own to consolidate results in a real-world setting, and I don’t think that that’s necessarily a bad thing.