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This study investigated the efficacy of a mobile-based self-directed d-PMT for parents of children aged 4\u201311 years with attention-deficit\/hyperactivity disorder (ADHD) with or without oppositional defiant disorder (ODD), and without pharmacological and\/or behavioral therapy. Participants were randomized 1:1 to d-PMT (hiToco\n                    <jats:sup>\u00ae<\/jats:sup>\n                    ) plus treatment as usual (TAU) or TAU only for 16 weeks. The primary outcome was a reduction of parent-rated externalizing problem behavior including symptoms of ADHD and ODD. Secondary outcomes included parent-rated ADHD symptoms only, ODD symptoms only, and functional impairment of the child as well as parenting behavior and family strain. Sixty-five participants were randomized to the dPMT\u2009+\u2009TAU group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200934) or the TAU group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200931). All children had a clinical diagnosis of ADHD; clinically diagnosed ODD was reported in 9 children (26.5%) in the d-PMT\u2009+\u2009TAU group and 13 children (42%) in the TAU group. The mean\u2009\u00b1\u2009SD age of the children was 8.4\u2009\u00b1\u20091.7 years (69.2% boys). On average, participants used the program for 8\u00a0h in total. Regarding the primary outcome, significant treatment effects favoring the d-PMT\u2009+\u2009TAU group compared to the TAU group were observed at week 12 (W12) and W16 (Cohen\u2019s d at W12: 0.74; at W16: 0.48). Post-hoc analyses showed that 50% of the children in the d-PMT\u2009+\u2009TAU group compared to 30% in the TAU group were reliably recovered or improved. Significant treatment effects in favor of the d-PMT\u2009+\u2009TAU group were also observed for all secondary variables. Our findings suggest that a mobile-based self-directed d-PMT for parents may play an important role in the multimodal treatment of children with ADHD in future clinical routine practice.\n                  <\/jats:p>","DOI":"10.1007\/s00787-025-02799-2","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T06:07:08Z","timestamp":1751004428000},"page":"3973-3985","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of a mobile-based self-directed parent management training for parents of children with attention-deficit\/hyperactivity disorder with or without oppositional defiant disorder\u2013 a randomized controlled trial"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7929-0463","authenticated-orcid":false,"given":"M.","family":"D\u00f6pfner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"G\u00f6rtz-Dorten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"H\u00e4ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Handermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Sulprizio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5174-928X","authenticated-orcid":false,"given":"M.","family":"Hellmich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-4077","authenticated-orcid":false,"given":"D.","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ruhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Althen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Karus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4595-1144","authenticated-orcid":false,"given":"T.","family":"Banaschewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"issue":"8","key":"2799_CR1","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/j.jaac.2014.05.013","volume":"53","author":"D Daley","year":"2014","unstructured":"Daley D, van der Oord S, Ferrin M, Danckaerts M, Doepfner M, Cortese S et al (2014) Behavioral interventions in attention-deficit\/hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains. 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J Marriage Fam 77(2):388\u2013406. https:\/\/doi.org\/10.1111\/jomf.12163","journal-title":"J Marriage Fam"}],"container-title":["European Child &amp; Adolescent Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00787-025-02799-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00787-025-02799-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00787-025-02799-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T12:21:11Z","timestamp":1766751671000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00787-025-02799-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":41,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2799"],"URL":"https:\/\/doi.org\/10.1007\/s00787-025-02799-2","relation":{},"ISSN":["1018-8827","1435-165X"],"issn-type":[{"value":"1018-8827","type":"print"},{"value":"1435-165X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"assertion":[{"value":"30 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was carried out in accordance with DIN EN ISO 14155:2021-05 and the Declaration of Helsinki in its latest version. The study was approved by the ethics committee of the Medical Faculty of the University Heidelberg, Germany as leading ethics committee on July 7, 2022. The study was prospectively registered in the German Registry of Clinical Studies (DRKS00030086).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All parents\/legal guardians gave written informed consent. The children gave at least oral assent and were additionally offered the opportunity to add their names on the informed consent form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MD received consulting income and research support from Medice GmbH, Medigital GmbH, brainjo GmbH, and eyelevel GmbH. He received income as head, supervisor, and lecturer of the Centre of Child and Adolescent Cognitive Behaviour Therapy at the University Hospital Cologne and as consultant for Child Behaviour Therapy at the National Association of Statutory Health Insurance Physicians (Kassen\u00e4rztliche Bundesvereinigung). He also received royalties from treatment manuals, books and psychological tests published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, Wiley. AGD received consulting income and research support from Medice GmbH, Medigital GmbH, brainjo GmbH, and eyelevel GmbH. She received income as head, supervisor, and lecturer of the Centre of Child and Adolescent Cognitive Behaviour Therapy at the University Hospital Cologne. She also received royalties from treatment manuals, books and psychological tests published by Hogrefe, Huber, Kohlhammer, Springer. AH has received compensation for serving as consultant or speaker for Shire\u2013Takeda and Medice. FH has received compensation for serving as speaker for Medice. LS has received compensation for serving as speaker for Medice. MH received consulting income and research support from Medigital GmbH and eyelevel GmbH. He received income as scientist and lecturer of Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany and of the University Medical Center G\u00f6ttingen, Department of Medical Statistics, G\u00f6ttingen, Germany.HA, DV and MK are employees of Medigital GmbH. MR is an employee of MEDICE Arzneimittel P\u00fctter GmbH & Co. KG (parent company of Medigital GmbH). TB served in an advisory or consultancy role for AGB pharma, eyelevel GmbH, Infectopharm, Medice, Neurim Pharmaceuticals, Oberberg GmbH and Takeda. He received conference support or speaker\u2019s fee by Janssen-Cilag, Medice and Takeda. He received royalties from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}