Whalen 1990.

Study characteristics
Methods	2‐day cross‐over trial with 2 interventions MPH 0.3 mg/kg Placeb In a connected trial 25 children were randomised to the same interventions. The outcome of this trial included the social judgement processes during the different drug conditions. Outcomes from the trial included in this review were reported in this connected trial.
Participants	Number of participants screened: unknown Number of participants included: 24 Number of participants followed up: 24 (22 boys, 2 girls) Number of withdrawals: 0 ADHD diagnosis: trial 1 DSM‐III‐R Age: trial one mean 9 years 8 months (range 6.4‐13.2 years) IQ: no mental disability MPH‐naive: 0% Ethnicity: white (92%), African American (4%), Hispanic (4%) Country: USA Setting: outpatient clinic (Summer Treatment Program) Comorbidity: not stated Comedication: not stated Other sociodemographics: all were from middle‐ or low middle‐income backgrounds Inclusion criteria Primary diagnosis of ADDH Taking MPH on a regular basis before the programme Conners' ADHD Stigma Questionnaire: ratings from parents > 15 Exclusion criteria No information
Interventions	Participants were randomly assigned to 1 of the possible drug condition orders of 0.3 mg/kg MPH or placebo. Mean MPH dosage: 8.75 mg Administration schedule: twice/d, morning and lunchtime Duration of each medication condition: 1 day Washout before trial initiation: unknown Medication‐free period between interventions: medication and placebo were given on 2 consecutive days Titration period: none Treatment compliance: good (2 staff dispensed the medication for ingestion)
Outcomes	General behaviour Evaluations of Social Behaviors in Medicated and Unmedicated Peers (Negative detections): rated by healthy controls (children)
Notes	Sample calculation: no Ethics approval: no information Key conclusions of trial authors In both studies, double‐blind ratings done by naive and staff observers demonstrated nearly identical medication effects, that is, placebo‐related increases in behaviour problems and MPH‐related increases in dysphoria Ratings of medication effects proved remarkably resilient, showing an invulnerability to biasing influences introduced by general knowledge about research design, diagnostic status or treatment effects; or by specific knowledge about and experience with participating children Exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: yes; only participants taking maintenance dosage of MPH or well titrated Any withdrawals due to AEs: no Funding source: not stated Email correspondence with trial authors: January 2014. No supplemental information has been received
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information
Allocation concealment (selection bias)	Unclear risk	No information
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Both active medication and placebo were placed in opaque gelatin capsules. 2 staff, blinded to medication status, dispensed medication
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Assessments were made by independent healthy controls through video tapes
Incomplete outcome data (attrition bias) All outcomes	Low risk	No dropouts Selection bias (e.g. titration after randomisation → exclusion): no
Selective reporting (reporting bias)	Low risk	No indication of selective reporting