{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:03:31Z","timestamp":1785240211396,"version":"3.55.0"},"reference-count":83,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children and adolescents with Attention\u2010Deficit\/Hyperactivity Disorder (ADHD) often show increased emotional dysregulation (ED) and internalizing emotional problems (iEP). However, the predictive and moderating role of these emotional difficulties in the treatment of ADHD\u2014particularly regarding pharmacological (methylphenidate, MPH) and non\u2010pharmacological approaches (neurofeedback at home, NF@home)\u2014remains understudied. This study aims to evaluate the effectiveness of MPH and NF@home in reducing iEP\/ED in children with ADHD and to assess the predictive role of iEP\/ED and neuropsychological executive function (EF) measures in treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The per\u2010protocol sample included 146 children (7\u201313\u2009years) diagnosed with ADHD (inattentive or combined type). iEP was measured with the Strengths and Difficulties Questionnaire (SDQ), ED via a dysregulation profile, and EF using the BRIEF and Continuous Performance Test (CPT). ADHD symptoms were assessed using the ADHD Rating Scale IV. Participants were randomized to either the MPH group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959) or the NF group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200987), which included NF\n                      <jats:sub>SMR<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200972) and NF\n                      <jats:sub>TBR<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), based on individual Theta\/Beta\u2010Ratio (TBR). Mixed\u2010model analyses considered symptom severity at baseline, age, gender, IQ, and study center as covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All intervention groups showed significant changes in iEP, but with different effects regarding parent (NF\n                      <jats:sub>SMR<\/jats:sub>\n                      :\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.396, 95% CI [\u22120.574, \u22120.217]; NF\n                      <jats:sub>TBR<\/jats:sub>\n                      :\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.367, 95% CI [\u22120.747, 0.013]; MPH:\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.409, 95% CI [\u22120.603, \u22120.215]) and teacher ratings (NF\n                      <jats:sub>SMR<\/jats:sub>\n                      :\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.211, 95% CI [\u22120.405, \u22120.017]; NF\n                      <jats:sub>TBR<\/jats:sub>\n                      :\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.639, 95% CI [\u22121.06, \u22120.222]; MPH:\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.142, 95% CI [\u22120.340, 0.056]). There was no between\u2010intervention effect, supported by non\u2010inferiority analyses. For ED, we also found significant effects for all interventions; however, significantly more pronounced effects were obtained for MPH. Moreover, both prediction models indicated a limited predictive value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest non\u2010inferiority of NF versus MPH treating iEP within an ADHD sample. However, due to limited predictive value, no clear clinical guidance can yet be drawn regarding personalized treatment recommendations. Further studies are needed to confirm and extend these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.70205","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:36:36Z","timestamp":1785238596000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emotional problems and dysregulation in children\/youth with\n                    <scp>ADHD<\/scp>\n                    : predictive and moderating effects in a randomized controlled trial of methylphenidate and neurofeedback"],"prefix":"10.1111","author":[{"given":"Amelie","family":"Bohner","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim\/Heidelberg University  Mannheim Germany"},{"name":"German Center for Mental Health (DZPG), Mannheim \u2010 Heidelberg \u2010 Ulm, partner site Mannheim  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Heidelberg \u2010 Ulm, partner site Mannheim  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Bousquet","sequence":"additional","affiliation":[{"name":"Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier\u2010Saint Eloi Hospital University of Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurore","family":"Bussalb","sequence":"additional","affiliation":[{"name":"RDS SAS  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Delhaye","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry, Erasme Academic Hospital Universit\u00e9 Libre de Bruxelles  Bruxelles Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Delorme","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry Department and Child Brain Institute, Robert Debr\u00e9 Hospital 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Mannheim \u2010 Heidelberg \u2010 Ulm, partner site Mannheim  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-8030","authenticated-orcid":false,"given":"Louis","family":"Mayaud","sequence":"additional","affiliation":[{"name":"RDS SAS  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5322-7140","authenticated-orcid":false,"given":"Konstantin","family":"Mechler","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim\/Heidelberg University  Mannheim Germany"},{"name":"German Center for Mental Health (DZPG), Mannheim \u2010 Heidelberg \u2010 Ulm, partner site Mannheim  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Menache","sequence":"additional","affiliation":[{"name":"Clinique des 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