If a patient were diagnosed with claustrophobia, then which area of their brain would show increased activity in an MRI study?

A study done recently showed that several management approaches, in addition to behavioral therapy interventions, may be necessary in preschool-aged children with moderate to severe attention-deficit/hyperactivity disorder (ADHD). That is, medication and some alternative therapies may be needed for preschool-aged children with ADHD who do not respond or do not follow behavior therapy. The researchers evaluated disruptive behavior in 74 children four to five years of age who were followed for 24 months. The children were randomized to either behavior therapy plus placebo or behavior therapy plus methylphenidate, and ADHD-related behaviors were compared. Parents reported ADHD symptoms observed at 6, 12, and 24 months. The researchers also noted several signs and symptoms of adverse effects that may have been due to the medication, such as insomnia, anorexia, irritability, and reduced growth and weight gain. The researchers found the children who received behavior therapy plus methylphenidate had significant reductions in ADHD symptoms at all time points compared to children who received behavior therapy plus placebo. 

Severity of ADHD was taken into account by presence of symptoms of marked impairment in social functioning. The researchers eliminated the possible role of delays in social development not specific to ADHD by analyzing children whose symptoms of social functioning impairment clearly resulted from inattention, hyperactivity, and impulsivity. Specifically, inattention was identified as the child wandering off task that was not due to lack of understanding or disobedience; hyperactivity was identified as excessive talking or fidgeting when not appropriate; and impulsivity was identified as hasty actions without forethought by the child and with significant potential to harm the child. Symptoms affecting the relationship and mental health of the child’s parents were also treated as reflective of severity of ADHD. For example, parents who experienced majorly reduced psychological well-being as a result of their child’s behavior reflected severe ADHD, and from the results, parents of children with severe ADHD who received behavior therapy plus methylphenidate reported a significant reduction in feeling unable to handle stress because of child’s behavior.

One of the researchers also found that use of some alternative therapies may be supported when combined with behavior therapy. In particular, there were decreases in hyperactive behaviors in children who were placed on additive-free diets. This finding may be of particular significance because eliminating artificial food additives may be done without risk of safety and avoids the potential adverse effects of medication.

Which conclusion is best supported by the findings in the study?

A study done recently showed that several management approaches, in addition to behavioral therapy interventions, may be necessary in preschool-aged children with moderate to severe attention-deficit/hyperactivity disorder (ADHD). That is, medication and some alternative therapies may be needed for preschool-aged children with ADHD who do not respond or do not follow behavior therapy. The researchers evaluated disruptive behavior in 74 children four to five years of age who were followed for 24 months. The children were randomized to either behavior therapy plus placebo or behavior therapy plus methylphenidate, and ADHD-related behaviors were compared. Parents reported ADHD symptoms observed at 6, 12, and 24 months. The researchers also noted several signs and symptoms of adverse effects that may have been due to the medication, such as insomnia, anorexia, irritability, and reduced growth and weight gain. The researchers found the children who received behavior therapy plus methylphenidate had significant reductions in ADHD symptoms at all time points compared to children who received behavior therapy plus placebo.

Severity of ADHD was taken into account by presence of symptoms of marked impairment in social functioning. The researchers eliminated the possible role of delays in social development not specific to ADHD by analyzing children whose symptoms of social functioning impairment clearly resulted from inattention, hyperactivity, and impulsivity. Specifically, inattention was identified as the child wandering off task that was not due to lack of understanding or disobedience; hyperactivity was identified as excessive talking or fidgeting when not appropriate; and impulsivity was identified as hasty actions without forethought by the child and with significant potential to harm the child. Symptoms affecting the relationship and mental health of the child’s parents were also treated as reflective of severity of ADHD. For example, parents who experienced majorly reduced psychological well-being as a result of their child’s behavior reflected severe ADHD, and from the results, parents of children with severe ADHD who received behavior therapy plus methylphenidate reported a significant reduction in feeling unable to handle stress because of child’s behavior.

One of the researchers also found that use of some alternative therapies may be supported when combined with behavior therapy. In particular, there were decreases in hyperactive behaviors in children who were placed on additive-free diets. This finding may be of particular significance because eliminating artificial food additives may be done without risk of safety and avoids the potential adverse effects of medication.

Which of the following is not a reasonable recommendation to provide for the management of moderate to severe ADHD?