According to Allison Dovi, School Psychology Ph.D. candidate:

My eight-minute, TED-style talk stemmed from my dissertation research and emphasizes how framing second-generation antipsychotic medication as a “mood stabilizer” may influence parents' acceptability of this off-label prescription in treating pediatric ADHD. My research seeks to determine whether prescribers’ intentional or unintentional framing of an off-label psychotropic (Risperdal) as an antipsychotic, mood stabilizer, or a psychiatric drug influences caregivers’ acceptability of the drug to treat a child with attention-deficit/hyperactivity disorder (ADHD).  

Exploring the influence of framing, which refers to changes made to presented information that elicits a change in thinking, is important in treatment communication since caregivers’ acceptability of their child’s treatment often predicts its initiation and adherence.  However, since the majority of the population is not well-versed in child psychopharmacology, many caregivers seeking psychotropic intervention for their ADHD child may be confused by clinicians’ use of framing.  For example, if a prescriber states that Risperdal is a mood stabilizer, which is not formally recognized by the FDA, rather than its true classification (second-generation antipsychotic [SGA]), the prescriber may have unknowingly or knowingly used framing techniques to induce a higher rate of acceptability of the drug. 

My research focuses on whether framing affects caregivers’ acceptability of an SGA, Risperdal, since SGAs are increasingly prescribed off-label (i.e., not FDA-approved) to treat ADHD and aggressive behaviors.  A recent study, Crystal et al. (2009), indicated that non-comorbid ADHD diagnoses accounted for 29.1% of Medicaid and 18.9% of privately insured youth receiving SGA prescriptions.  Based on the significant side effect profile associated with this drug classification and limited empirical data supporting the efficacy and effectiveness of this practice, the off-label prescription of SGAs to treat non-comorbid pediatric ADHD is concerning.

If this study finds that framing does influence caregivers’ acceptability of the presented drug, it may be deemed unethical for prescribers to continue using inaccurate language since it affects caregivers’ decision-making.  If sufficiently replicated, this study’s findings may provide empirical support for legislators to generate policies or laws potentially requiring prescribers to use accurate language, such as SGA’s true drug classification rather than mood stabilizer or another non-FDA recognized term. 

It may be important to provide caregivers with accurate information to enable them to ask additional questions, discuss alternative treatments, establish a concrete medication management system, and allow them to make more informed decisions regarding their child’s treatment.