The impact of acupuncture on self-perceived stress and ADHD core symptomatology in an adult, atomoxetine-taking ADHD participant: insights from an in-depth single case study

Background: Attention Deficit Hyperactivity Disorder (ADHD) includes inattention, hyperactivity, and impulsivity as core symptoms and is associated with increased self-perceived stress. Primary Study Objective: This article evaluates the impact of acupuncture (provided in addition to regular pharmacological treatment with Atomoxetine) on self-perceived stress and ADHD core symptomatology, compared to atomoxetine (ATX) alone. Methods/Design: In-depth single case study, involving a mixed methods approach with questionnaires and interviews was used. The participant completed two rating scales. Additionally, semi-structured interviews were held. Qualitative data were subjected to content analysis and both sets of data were triangulated. Setting: Data collection/intervention (treatments) took place at an Acupuncture clinic in Hamburg, Germany, EU. Participant(s): One adult, atomoxetine-taking ADHD participant. Intervention: Acupuncture according to Chinese medicine-diagnosis twice/week, over the course of eight weeks, following a pre-defined but flexible point protocol. Primary Outcome Measures: 1) The Current Symptom Scale (CSS) and the Perceived Stress Scale (PSS). 2) Semi-structured interviews. Results: Acupuncture treatments in addition to regular ATX intake positively affected the participant’s ADHD symptoms (PSS - 31%, total score of the CSS - 47%). There was a considerable decrease in subgroup scores (attention deficit - 39%; functionality impairment - 55%; hyperactivity/impulsivity - 53%; impulsivity - 30%). Post-interventional interviews showed perceived increased self-control, (self-) awareness and centeredness. Combined treatment was perceived as more beneficial than pharmaceutical treatment alone. Conclusion: Acupuncture treatment appears to have a positive impact on both self-perception of stress and ADHD core symptomatology. Findings were partially congruent with the reviewed research literature but due to limitations/risks of bias (ROBs) associated with the design, no concrete conclusions regarding a potential method-related specificity can be drawn. Further research with larger samples and a more robust design is recommended.