Study: DBT Plus tDCS May Best Improve ADHD Symptoms in Adults
DBT (dialectical behavioral therapy) combined with tDCS (transcranial direct current stimulation) improved ADHD symptoms, such as hyperactivity and inattention, in adults participating in a new study of treatment options.
September 22, 2022
Treatment that combines dialectical behavioral therapy (DBT) with transcranial direct current stimulation (tDCS) may deliver the greatest improvement in cognitive and emotional symptoms of ADHD in adults, according to a new study published in the Journal of Attention Disorders. Researchers investigated the effects of tDCS and DBT alone and together, and found that the combined multimodal treatment worked best at managing ADHD symptoms.1
“Optimization of the clinical effects of DBT combined with tDCS represents a potential avenue to focus on brain plasticity and enhance the therapeutic effects,” researchers said.
tDCS is a non-invasive brain modulation method where weak electrical currents pass through two electrodes placed over the scalp.2 DBT is a cognitive behavioral therapy that was initially used to treat chronic suicidal behaviors and borderline personality disorder (BPD).3
Study participants included 80 adults with ADHD (63 females, 17 males) aged 18-45. They were randomly sorted into control, DBT-only, tDCS-only, and combined groups.
The tDCS-only and combined groups received ten 20-minute sessions of anodal (excites neuron activity) and cathodal (inhibits or reduces neuronal activity) stimulation over 30 days. The DBT-only and combined groups received ten individual DBT therapy sessions once weekly, for 1 to 1.5 hours.
The study found that DBT and tDCS used in isolation improved selective attention and response inhibition, sustained attention, and emotion regulation in adults with ADHD. However, the DBT-only group did not reflect increased attention on the ADHD self-report scale (ASRS), while the tDCS-only group did. The tDCS-only group did not report improvements in hyperactivity on the ASRS, while the DBT-only group did.1
Researchers concluded that the most promising results occurred using tDCS concurrently with DBT. “Our findings showed that merely applying tDCS or DBT alone might not improve cognitive and behavioral functioning. tDCS, thus, might act as a ‘restoration’ tool to benefit from DBT intervention,” they said.
The lack of research surrounding the effectiveness of integrated interventions and the increased interest in non-medication interventions for ADHD treatment served as impetuses for the study. “Even though the effects of tDCS and cognitive training have been investigated separately, the effects of integration of these interventions are only beginning to be explored,” researchers said.
Limitations of the study included the lack of a sham tDCS group and blinded assessments. “Clearly, further comparisons with sham-controlled groups and blinded assessment are required for the robust demonstration of the efficacy of any protocol with tDCS,” researchers said.
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1 Basiri, N., and Hadianfard, H. (2022) Adult ADHD Treatment Based on Combination of Dialectical Behavior Therapy (DBT) and Transcranial Direct Current Stimulation (tDCS) as Measured by Subjective and Objective Scales.Journal of Attention Disorders. https://doi.org/10.1177/10870547221118527
2Thair H., Holloway A.L., Newport R., and Smith A.D. (2017) Transcranial Direct Current Stimulation (tDCS): A Beginner’s Guide for Design and Implementation. Front. Neurosci. 11:641. https://doi.org/10.3389/fnins.2017.00641
3Fullen T., Jones S. L., Emerson L. M., Adamou M. (2020). Psychological treatments in adult ADHD: A systematic review. Journal of Psychopathology & Behavioral Assessment. 42(3), 500–518.https://link.springer.com/article/10.1007/s10862-020-09794-8