Journal of Abnormal Psychology Copyright 1989 by the American Psychological Association, Inc.

1989, Vol. 98, No. 3, 280-284 0021-843X/89/$00.75

Attention-Deficit Hyperactivity Disordered Boys' Evaluations of and
Attributions for Task Performance on Medication Versus Placebo
R i c h a r d Mi l i c h B a r b a r a G. L i c h t
University of Kent ucky Fl or i da St at e University
Debra A. Murphy and William E. Pelham
Western Psychi at ri c I nst i t ut e and Cl i ni c, Pi t t sburgh, Pennsyl vani a
The present study examined the effects of stimulant medication on the self-evaluations of and attri-
butions for task performance of 26 attention-deficit hyperactivity disordered boys. Each boy per-
formed a continuous performance task twice, once while on medication and once while on placebo.
Immediately following the completion of the task, the boys were asked a series of questions concern-
ing their self-evaluations of, and attributions for, their performance. Two findings of note were ob-
tained. First, medication, compared with placebo, increased the correspondence between the boys'
self-evaluations and their performance. Second, the boys did not use medication as a frequent expla-
nation for their performance, as others have predicted. In fact, the boys picked medication as an
explanation for their successes significantly less often than either effort or ability.
St i mul ant medi cat i on is t he most common i nt ervent i on for
at t ent i on-defi ci t hyperact i vi t y di sorder ( ADHD) , wi t h up t o
90% of chi l dren di agnosed wi t h t hi s di sor der receiving a medi -
cat i on t ri al at some poi nt i n t i me (Gadow, 1979). The wi de-
spr ead use of t hi s i nt ervent i on is underst andabl e, given evi-
dence t hat st i mul ant medi cat i on significantly i mproves bot h t he
cl assroom and social behavi or of ADHD chi l dr en (Pel ham,
1986). Al t hough t here is a general consensus concerni ng t he i m-
medi at e, positive i mpact of medi cat i on on t he behavi or of
ADHD chi l dren, several aut hors (e.g., Bugental, Whal en, &
Henker, 1977; Whal en & Henker, 1976) have expressed concern
t hat successful t r eat ment wi t h st i mul ant medi cat i on may have
a delayed, adverse effect on chi l dr en' s self-perceptions. It has
been argued t hat dr ug t r eat ment may l ead chi l dren t o at t r i but e
t hei r behavi or t o ext ernal factors (e.g., t he drug) and view t hei r
own efforts or abi l i t i es as pl ayi ng a relatively mi nor role. Thi s
bel i ef may l ead chi l dr en t o r espond passively, so t hat whi l e t ak-
i ng medi cat i on t hey may rel y on t he dr ug t o focus t hei r at t en-
t i on and efforts. When t he medi cat i on is di scont i nued, t hey may
feel like t hey ar e left wi t h no way t o cont rol t hei r own behavi or
(Rosen, O' Leary, & Conway, 1985).
Some case studies (e.g., Rosen et al., 1985) and i ndi r ect evi-
dence suggest t hat medi cat i on may have t hese negative effects.
Ami r khan (1982) f ound t hat t eachers and st udent s at t r i but ed
t he successes of hypot het i cal medi cat ed ADHD chi l dr en pr i -
mar i l y t o medi cat i on and t hose of hypot het i cal unmedi cat ed
ADHD chi l dren pr i mar i l y t o hi gh effort. Henker and Whal en
(1980) r epor t ed t hat when medi cat ed ADHD chi l dr en were
quest i oned about t hei r pr obl ems on a generallevel, t he chi l dren
i ndi cat ed t hat t hei r pr obl ems were physi ol ogi cal l y based and
t hat t he dr ug hel ped t hem cont r ol t hei r behavior. However, we
Correspondence concerning this article should be addressed to Rich-
ard Milich, Department of Psychology, University of Kentucky, Lexing-
ton, Kentucky 40506.
280
do not know how t hese chi l dr en perceive t hei r own behavi or i n
t he cont ext of per f or mi ng specific tasks. As Henker and Whal en
acknowl edged,
When we query them about behavior achievements and improve-
ments in a context suggesting neither hyperactivity nor medication,
they express the same volitional attributions as do most middle
class youngsters: "It depends on how hard you try" or "You can do
it if you really want to." (p. 155)
I t act ual l y is possi bl e t hat medi cat i on t r eat ment may have
some positive cogni t i ve- mot i vat i onal consequences. Specifi-
cally, Pel ham, Mi l i ch, and Wal ker (1986) exami ned t he effects
of st i mul ant medi cat i on on ADHD chi l dr en' s l earni ng o f non-
sense spelling words. Ha l f of t he chi l dr en had medi cat i on on
t he 1st day and pl acebo on t he 2nd, whi l e t he ot her hal f had t he
reverse order. The resul t s reveal ed a significant Dr ug Or der
i nt eract i on, such t hat when pl acebo pr eceded medi cat i on, pl a-
cebo per f or mance was significantly worse t han medi cat i on per-
formance; however, when medi cat i on pr eceded pl acebo, perfor-
mance in t he two condi t i ons was not significantly different. One
expl anat i on for t hi s finding is t hat chi l dren receiving medi ca-
t i on on t he first day had a significantly i ncr eased chance t hat
t hei r first exposur e t o t he t ask was successful. Thi s l ed t hem t o
appr oach t he t ask on t he second (i.e., pl acebo) day wi t h rel a-
tively hi gh expect anci es of success, whi ch l ed t o i ncr eased
effort, and t hus enhanced t hei r performance.
Because Pel ham et al. (1986) di d not assess chi l dr en' s expec-
tancies, we cannot say whet her t he medi cat i on- i nduced success
act ual l y di d enhance expectancies. I f we ar e t o underst and t he
cogni t i ve- mot i vat i onal consequences of medi cat i on, an i mpor -
t ant first st ep is t o det er mi ne whet her t he medi cat i on- i nduced
successes ar e per cept i bl e t o t he chi l dren. The present st udy was
desi gned t o addr ess t hi s and r el at ed issues.
At t ent i on-defi ci t hyperact i vi t y di sor der ed boys per f or med a
t ask once on medi cat i on and once on pl acebo. Following t he
t ask, t hey were asked about t hei r self-evaluations of and at t r i bu-
ADHD BOYS' SELF-EVALUATIONS 281
t i ons f or t hei r per f or mance. We hypot hes i zed t hat bot h t ask
pe r f or ma nc e and sel f - eval uat i ons o f pe r f or ma nc e woul d be bet -
t er under medi cat i on t ha n under pl acebo. Fur t he r mor e , be-
cause eval uat i ng one' s pe r f or ma nc e i nvol ves cogni t i ve j udg-
ment s , chi l dr en' s sel f - eval uat i ons s houl d be mo r e hi ghl y r el at ed
t o t hei r act ual pe r f or ma nc e under dr ug t ha n under pl acebo. Of
par t i cul ar i nt er est concer ni ng t he c hi l dr e n' s causal at t r i but i ons
was t he overal l degr ee t o whi c h t he boys bel i eved t ask out c ome s
wer e t he r esul t o f t hei r effort s r el at i ve t o medi cat i on.
Me t h o d
S u b j e c t s
Participants were 26 boys with behavior and learning problems who
had been referred to the 1987 Summer Treatment Program at Western
Psychiatric Institute and Clinic. On the basis of a structured parent in-
terview, all boys met the criteria for a Diagnostic and StatisticalManual
of Mental Disorders (DSM-m-R; American Psychiatric Association,
1987) diagnosis of ADHD. The boys averaged 11.0 positive symptoms
out of the total of ! 4. On the basis of the interview, 20 boys also obtained
a DSM-m-R diagnosis ofoppositional defiant disorder, and 8 boys, a diag-
nosis of conduct disorder. Teacher and parent ratings corroborated these
diagnoses. On the lnattention/Overactivity scale of the IOWA Conners
(Loney & Milich, 1982) the boys received an average rating of 1 i.2,
whereas on the abbreviated Conners teacher and parent rating scales
they averaged 18.9 and 19.8, respectively.t The boys ranged in age from
7.1 to 11.8 years, with a mean of 8.8 (SD = 1.3). They had a mean
Wechsler Intelligence Scale for Children-Revised (Wechsler, 1974) Full
Scale IQ of 104.3, ranging from 71 to 129.
Pr oc e dur e
The study consisted of a placebo-controlled, double-blind evaluation
of the effects of stimulant medication on the boys' evaluations of and
attributions for their performance on a continuous performance test
(CPT), a laboratory measure of sustained attention, impulsivity, or
both. Each boy performed the task once while on placebo and once
while on medication. Hal f of the boys received medication for the first
session and placebo for the second, whereas for the other boys the order
was reversed. Immediately following the task, boys were asked a series
of questions concerning their perceptions of their own performance.
Medication procedure. The boys received on each day, in opaque gela-
tin capsule form, either 0.3 mg/kg methylpbenidate or an identical-
looking placebo prepared by the research pharmacy. This dose ofmet h-
ylphenidate is the most common dosage in current use in research and
clinical settings when the purpose is to improve children' s performance
on cognitive tasks (Pelham, 1986). All of the children were participating
in clinical medication assessments in the summer treatment program,
and they had been receiving methylphenidate and placebo with order
randomized for several weeks prior to this study. The parents were in-
structed to tell their sons that they would be receiving different types of
medication, although the placebo trials were not to be mentioned. All
appropriate procedures had been followed to obtain consent (see Pel-
ham & Hoza, 1987). Medication was given at 8:00 a.m. and 11:30 a.m.,
and testing was always undertaken within 1-3 hr following capsule in-
gestion. Sessions were conducted in either the morning or afternoon
with the same boy participating at the same time for both sessions.
Experimental task. In order to investigate whether ADHD children
perceived their performances as better under medication than placebo,
it was necessary to employ a task that would show superior performance
under medication. A CPT task was chosen because it is considered the
standard laboratory measure of sustained attention (Douglas, 1983),
and it has consistently shown a dramatic medication effect (Pelham,
1986). The task was administered on Apple II microcomputers (Lind-
gren & Lyons, 1984). Letters of different colors flashed on the screen at
intervals of 900 ms. The boys were required to press the space bar each
time they saw an orange H followed by a blue T. The task lasted approxi-
mately 14 min, and consisted of 900 letters, 180 of which were targets.
Measures derived from the CPT were errors of omission--failing to
press the space bar when a target appeared--and errors of commis-
si on- pr essi ng the space bar in the absence of t he target.
Self-evaluation and attribution questionnaire. The questionnaire as-
sessed seven dimensions: (a) how well they thought they performed on
the task, (b) how easy they felt it was to pay attention, (c) how hard they
felt they tried, (d) how hard they thought the task was, (e) their affective
reaction to the task (e.g., how much they liked the task), (f) their expec-
tancies for future success on the task, and (g) how much they felt their
medication helped them on the task. The questions developed to assess
these dimensions were similar to those used in research on children' s
achievement-related beliefs (e.g., Diener & Dweck, 1980; Dweck,
Goetz, & Strauss, 1980). For example, the boys were asked to rate their
performance on a 10-point scale ranging from I did very well ( 1 ) to I did
very poorly (10). In order to increase the reliability of the assessments,
whenever possible, two separate questions were asked to assess each di-
mension. These two questions were averaged to yield a single score for
that dimension.
Because children' s causal attributions vary as a function of whether
they are explaining successes or failures (Bar-Tal & Darom, 1979), it
was necessary to determine whether the boys viewed their performance
as an overall good or bad job. The child was then asked six forced-choice
attribution questions to determine why he thought he did a good (or
bad)job. The attributionai choices for a good j ob were effort ("You tried
hard"), ability ("You' re good at this task"), task ("The task is easy for
kids your age"), and medication ("The pill you took today helped you").
Attributions were pitted against one another in random order, with all
possible pairwise comparisons being presented. Thus, the child could
pick each attribution between zero and three times. Licht, Kistner, Oz-
karagoz, Shapiro, and Clausen (1985) showed that this format could be
used reliably by children with learning problems. All questions were
read to the children by a trained research assistant to ensure that chil-
dren' s responses were not affected by any reading difficulties.
Re s u l t s
It was first necessar y t o de t e r mi ne whet her me di c a t i on sig-
ni f i cant l y i mpr ove d t he boys ' CP T pe r f or ma nc e c o mp a r e d wi t h
pl acebo. A 2 ( medi cat i on) 2 (order) anal ysi s o f var i ance
(ANOVA) f or er r or s o f omi s s i on pr oduc e d a si gni fi cant ma i n
effect f or medi cat i on, F( 1, 24) = 27. 9, p < . 001, but no signifi-
cant ma i n effect f or order, F( 1, 24) < l ; nor was t her e a signifi-
cant Medi cat i on Or de r i nt er act i on ( F < l ) . The me a ns o f t b e
omi ssi on er r or s f or t he me di c a t i on and pl acebo sessi ons wer e
16.3 ( SD = 14.7) and 27. 5 ( SD = 20. 7), respect i vel y. For t he
c ommi s s i on er r or s t her e was a si gni f i cant ma i n effect f or medi -
cat i on, F ( l , 24) = I 1. 7, p < . 002, but no si gni f i cant ma i n effect
f or or der ( F < 1); nor was t her e a si gni f i cant Medi cat i on Or -
der i nt er act i on ( F < 1). The me a n er r or s o f c ommi s s i on f or t he
me di c a t i on and pl acebo condi t i ons wer e 27. 2 ( SD = 46.1 ) and
65. 4 ( SD = 94. 4), respect i vel y.
Tabl e 1 pr esent s t he resul t s o f t he cor r el at ed t t est s c ompa r i ng
t he boys ' sel f - eval uat i ons on me di c a t i on versus pl acebo. I n re-
The scores on the Conners parent and teacher rating scales were
most likely attenuated somewhat because several of the boys were on
medication at the time when the ratings were completed.
282 MILICH, LICHT, MURPHY, AND PELHAM
Tabl e 1
Cor r e l at e d t - Te s t s Be t we e n Dr u g a n d Pl ac e bo Condi t i ons
Drug Placebo
Variable M SD M SD r ~ t
Self-evaluations
How well they thought they did 9.60 2.5 9.54 2.4 .83 0.21
How easy they felt it was to pay
attention 8.38 2.7 8.23 2.8 .53 0.30
How hard they felt they tried 9.83 2.3 9.50 2.4 .83 1.19
How hard they thought the task
was 5.15 3.9 4.07 3.7 .74 2.02
How much they liked the task 8.25 2.8 7.92 3.2 .91 1.22
How well they thought they
would do in the future 9.71 2.4 9.73 2.2 .96 0.14
How much they thought the
pill helped 6.30 3.9 5.57 4.2 .70 I. 17
Attributions for success
Effort 2.58 0.8 2.29 1.0 .41 1.43
Task 1.04 0.8 1.54 0.8 .29 2.50
Ability 1.58 0.7 1.58 0.7 .39 0.00
Medication 0.79 1.0 0.58 1.0 .65 1.23
a Correlation between the drug and placebo data.
sponse t o t he quest i on of whet her t hey di d a good or bad j ob,
onl y 2 of t he 26 boys i ndi cat ed on ei t her day t hat t hey di d a bad
j ob. These two boys were dr opped from t he anal yses i nvol vi ng
at t ri but i ons. As is evi dent i n Tabl e 1, none of t he compar i sons
was significant. Two of t he anal yses were margi nal l y significant
( p < . 1), al t hough i n a count er i nt ui t i ve di rect i on. The boys were
mor e likely t o at t r i but e t hei r percei ved good per f or mance t o t he
ease of t he t ask when t hey were on pl acebo t han when t hey were
on medi cat i on, and t hey r epor t ed t hat t he t ask was har der on
medi cat i on t han on pl acebo.
A different pi ct ur e emerged when we exami ned t he rel at i ons
between t he boys' per f or mance and t hei r self-evaluations
wi t hi n t he dr ug and pl acebo condi t i ons. Wi t hi n each condi t i on,
correl at i ons were cal cul at ed between per f or mance (i.e., er r or
score) and self-evaluations. I n or der t o decrease t he number of
analyses, t he two er r or scores were st andar di zed and t hen aver-
aged t o pr oduce one score summar i zi ng overall per f or mance.
The correl at i ons for t he two er r or scores for t he medi cat i on and
pl acebo condi t i ons were .44 ( p < .05) and .32 ( p < .06), respec-
tively. 2 As is evi dent in Tabl e 2, different pat t er ns of rel at i ons
emerged for dr ug and pl acebo condi t i ons. Four of t he seven cor-
rel at i ons for t he dr ug condi t i on were significant. The bet t er t he
per f or mance on t he t ask (i.e., t he fewer errors), t he mor e likely
boys were t o r epor t t hat t hey di d well, t hat i t was easy t o pay
at t ent i on, t hat t hey t r i ed har d, and t hat t hey woul d do well
agai n i f t hey r epeat ed t he task. I n cont rast , none o f t he cor r e-
l at i ons was significant for t he pl acebo condi t i on. I n a t est of t he
difference bet ween dependent correl at i ons, t wo of t he cor r e-
l at i ons for t he medi cat i on days were significantly great er t han
compar abl e correl at i ons for pl acebo days: for "easy t o pay at -
t ent i on, " t(23) = 2.2, p < .05; for "t r yi ng har d, " t(23) = 3.6, p <
.01. Thus, medi cat i on i ncr eased t he correspondence between
t he boys' per f or mance and t hei r self-evaluations.
I n t er ms of t he boys' at t r i but i ons for t hei r per f or mance, onl y
one resul t appr oached significance. On medi cat i on, t he bet t er
t he boys di d on t he CPT, t he mor e likely t hey were t o at t r i but e
t hei r success t o t hei r abi l i t y ( p = .07).
The next set of analyses concer ned t he relative i mpor t ance of
t he four at t r i but i onal factors for expl ai ni ng t he boys' successes.
For bot h medi cat i on and pl acebo days, t he r ank order, from
most t o l east oft en chosen, was effort, ability, t ask, and medi ca-
t i on. For t he medi cat i on condi t i on, al l possi bl e pai r ed compar i -
sons (i.e., cor r el at ed t tests) were significant, except for t he com-
par i son of t ask wi t h medi cat i on. For t he pl acebo condi t i on, al l
possi bl e pai r ed compar i sons were significant, except for t he
compar i son of abi l i t y wi t h task. Thus, regardl ess of medi cat i on
condi t i on, effort was seen by t he boys as t he pr i mar y det er mi -
nant of t hei r successes, whereas medi cat i on was viewed as bei ng
rel at i vel y uni mpor t ant .
Because chi l dr en' s at t r i but i ons var y as a funct i on of age
(Kistner, Osborne, & LeVerrier, 1988), i t was possi bl e t hat ol der
chi l dr en mi ght view t he i mpor t ance of medi cat i on differently
t han younger chi l dren. To assess this, we cor r el at ed t he chi l -
dr en' s ages wi t h t hei r at t r i but i ons on medi cat i on and on pl a-
cebo. The onl y not abl e cor r el at i ons were i n t he medi cat i on con-
di t i on. Ther e was a significant t endency for ol der boys t o at t r i b-
ut e t hei r successes t o medi cat i on less oft en t han younger boys,
r(22) = - . 3 5 , p < .05, and t here was a t r end for ol der boys t o
at t r i but e t hei r successes t o abi l i t y mor e oft en t han younger
boys, r(22) = .31, p < .06. No cor r el at i ons were significant for
t he pl acebo condi t i on, al t hough t here was a t r end for t he ol der
boys t o make fewer at t r i but i ons t o t he pill, r(22) = - . 28, p <
.09. These resul t s ar e consi st ent wi t h Henker and Whal en' s
(1980) r epor t t hat ol der ADHD chi l dr en were less likely t han
2 As a further check on averaging the two error scores, the relation
between performance and the self-evaluation measures was examined
separately for both the omission and commission scores. All conclu-
sions remained the same. Copies of the results for the two error scores
separately are available from Richard Milich.
ADHD BOYS' SELF-EVALUATIONS 283
Table 2
Correlations Between Task Errors and Self-Evaluations
for Drug and Placebo Conditions
Variable Drug Placebo
Self-evaluations
How well they thought they did -.34* -. 25
How easy they felt it was to pay attention a -.48** - . 10
How hard they felt they tried a -.47* - . 18
How hard they thought the task was .23 .09
How much they liked the task -. 29 -. 32
How well they thought they would do in the
future -.35* -. 28
How much they thought the pill helped .02 .05
Attributions for success
Effort .24 .01
Task -. 04 .09
Ability -. 30 .05
Medication .05 - . 12
Note. A negative correlation means that the better the performance, the
higher the score was on that dimension.
a Correlation for drug data was significantly greater than corresponding
value for placebo data.
*p < .05. **p < .01.
younger ones t o view medication as a pr i mar y solution t o their
probl em.
Di s c us s i on
Cont r ar y t o expectations, no significant differences were ob-
tained when compari ng ADHD boys' mean self-evaluation and
attribution responses under medication and placebo condi-
tions, even t hough the children performed significantly better
on medication t han placebo. However, differential patterns of
correlations were obt ai ned within the two conditions. For medi-
cation, several significant correlations were obt ai ned between
children' s performance and their self-evaluations. The better
the boys' performance on t he task, the more likely t hey were t o
report t hat t hey did well, t hat they tried hard, t hat it was easy
t o pay attention, and t hat t hey would do well again i f t hey re-
peated the task. No significant correlations between perfor-
mance and self-evaluations were obt ai ned for the placebo con-
dition.
These findings suggest t hat one of the effects of medication,
compar ed with placebo, is t o increase the correspondence be-
tween performance and self-evaluations. There are several plau-
sible and not necessarily incompatible explanations for this ob-
servation. First, medication may have led t o better attending
behavior so t hat the boys were more aware of how well t hey
were doing on the CPT. Second, the medication may have led t o
mor e reflective responding by the boys, so t hat t hey responded
more carefully when presented with self-evaluation questions.
Finally, consistent with a concept raised by Douglas (1983),
when taking medication, the boys may have been more invested
in the task so t hat they were more concerned with having their
responses t o the self-evaluation questions accurately reflect
their performance. The nat ure of the present study did not al-
low for a det ermi nat i on of which, i f any, of these mechani sms
was operative. It is possible t hat several of these factors were
operating simultaneously t o produce the increased correspon-
dence between performance and self-evaluation on medication.
Whatever the explanation, the present results suggest that,
while on medication, ADHD children may be better able and/
or more motivated t o moni t or their own behavior and thereby
better det ermi ne the appropriateness of their responses and task
strategies.
We di d not obt ai n the Dr ug Medication interaction Pel-
ham et al. (1986) report ed (i.e., t hat placebo performance was
better when the placebo day followed t han when it preceded
the medication day). One interpretation of their interaction was
t hat medication-induced successes led t hem t o appr oach the
task on the 2rid day with relatively high expectancies of success.
I n light of the present finding t hat self-evaluations were not
higher under medication t han under placebo, it is plausible t hat
the Pel ham et al. findings were due t o other factors. However, it
is also plausible t hat Pelham et al.'s findings were due t o en-
hanced expectations from the medication-induced success, but
t hat procedural differences prevented subjects in the present
study from having higher self-evaluations under medication.
Specifically, Pelham et al. gave accuracy feedback t o the sub-
jects after each response (i.e., after each at t empt at spelling a
word). I n the present study, no performance feedback was
given, and the nat ure o f the CPT task was such t hat it may have
been especially difficult t o ascertain how well one was doing.
Perhaps subjects in the present study would have shown higher
self-evaluations and future expectations under medication t han
under placebo i f t hey had been given some performance feed-
back duri ng the session or i f a different task had been used t hat
more readily allowed t hem t o ascertain how they were per-
forming.
Cont r ar y t o much speculation in the field, no evidence was
found t o support the not i on t hat medication produces predom-
inantly external, medication-related explanations for perfor-
mance. I f anything, the results were i n the opposite direction.
For bot h the medication and placebo conditions, medication
was chosen less often t han each of the other three attributions
for the boys' good performances. I n addition, on medication
there was a trend for a relation between performance and ability
attributions, such t hat the better the boys did, the more likely
they were t o attribute this good performance t o their ability.
The present study was conduct ed as part of an intensive day-
t reat ment pr ogr am for ADHD children involving randomized,
double-blind, placebo-controlled medication trials. As such,
the children were unaware of the fact t hat they were receiving
placebo trials intermittently. However, it is possible t hat some
of the children suspected such differences in the capsules they
took. It is also conceivable t hat these suspicions caused the chil-
dren t o decrease the degree t o which t hey attributed their suc-
cess t o medication. However, it is not clear how such knowledge
of the placebo trial could have produced the differential pat-
terns of correlations seen in Table 2.
The present study represents a first step i n exami ni ng the
effects of stimulant medication on the cognitive-motivational
functioning of ADHD children. On the basis of the present re-
sults, some future studies seem appropriate. First, the present
study compar ed medication and placebo conditions, but a no-
medication condition was not used. Thus, this study exami ned
284 MILICH, LICHT, MURPHY, AND PELHAM
t he di r ect effect of medi cat i on on per f or mance and self-evalua-
tions. Because t he boys bel i eved t hat t hey were on medi cat i on
dur i ng bot h sessions, t he pr esent resul t s di d not addr ess
whet her t here ar e self-evaluation differences associ at ed wi t h
knowi ng whet her one is receiving medi cat i on.
I n summary, t he pr esent st udy is one of t he first t o exami ne
syst emat i cal l y t he effects of medi cat i on t r eat ment on cogni t i ve-
mot i vat i onal factors among ADHD boys. Much of what has
been wri t t en t o dat e has rel i ed on case studies and specul at i on
r at her t han syst emat i c investigation. The pr esent resul t s ar e
generally i nconsi st ent wi t h what is r out i nel y bel i eved about
medi cat i on' s effects and suggest t hat furt her syst emat i c i nvest i -
gat i ons are needed. The cur r ent st udy f ound no evidence for
negative cogni t i ve- mot i vat i onal consequences of medi cat i on
t r eat ment , and i n fact suggested t he possi bi l i t y of cer t ai n posi -
tive effects.
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Received May 26, 1988
Revision received Sept ember 8, 1988
Accept ed Januar y 4, 1989