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James G. Waxmonsky

TitleAssociate Professor
InstitutionCollege of Medicine
DepartmentPsychiatry
Address500 University Drive, Hershey, PA 17033
Phone7175318646
Fax7175316491

 Overview 
 overview
My research focuses on efforts to improve the long term outcomes of youth with ADHD as there is a paucity of data to support the long term benefits of ADHD treatments. For example, there has been a concern that patients may develop tolerance to CNS stimulants, thereby reducing long term response, yet there has been no formal examination of this process. Likewise, concerns exist that CNS stimulants may lead to meaningful growth suppression. I have led NIMH funded research assessing both of these questions as well as studying interventions aimed to prevent their occurrence. I have also begun to examine the management of insomnia in youth with ADHD and the contributing role of CNS stimulants. My primary means of improving longitudinal outcomes in this population has been the integration of specialized psychosocial interventions with pharmacological treatments to improve medication efficacy and tolerability. We have also developed psychosocial interventions suitable for primary care settings to improve treatment uptake and adherence for ADHD and other common mental health disorders.
Another common side effect concern surrounding ADHD medication is the capacity for these medications to induce adverse emotional responses. Children with preexisting affective lability are thought to be at increased risk for these types of reactions. My interest in this area led me to evaluate the effect of stimulant medication in children with Severe Mood Dysregulation (SMD), which has now been included in DSM 5 as Disruptive Mood Dysregulation Disorder (DMDD). I have published some of the first treatment studies for SMD which documented that youth with SMD and ADHD respond positively to stimulant medication and behavioral interventions; however, these children still remained more impaired than ADHD youth without mood impairments. I then developed a group therapy program that integrated aspects of traditional parent training programs with CBT techniques for pediatric mood disorders and found it to be effective for reducing irritability. Future work is focusing on identifying impaired neural circuits that drive the manifestation or irritability and aggression in children with a range of mental health diagnoses in order to inform treatment development. Targeted domains include impairments in facial affect recognition, reward processing, instrumental learning and physiological arousal.
During my work on all of these projects, I have come to recognize the impact of parental psychopathology on child treatment outcomes. For example, in my treatment study of youth with ADHD and SMD, we found that parental ADHD symptoms reduced the efficacy of the therapy program for improving their child’s mood. In another externally funded trial, we found that reducing parental ADHD symptoms improves parent-child interactions, especially during homework times, by helping parents to better modulate their levels of talkativeness to the task at hand. We are now beginning to examine other neurocognitive domains within parents to assess their influence on parent-child interactions and to inform the development of new treatments for disruptive behavioral disorders in children.


 Bibliographic 
 selected publications
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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  1. Meinzer MC, Pettit JW, Waxmonsky JG, Gnagy E, Molina BS, Pelham WE. Does Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) Predict Levels of Depressive Symptoms during Emerging Adulthood? J Abnorm Child Psychol. 2016 May; 44(4):787-97.
    View in: PubMed
  2. Waxmonsky JG. The ABCs of CNS stimulant misuse. J Clin Psychiatry. 2016 Mar; 77(3):e315-6.
    View in: PubMed
  3. Rosch KS, Fosco WD, Pelham WE, Waxmonsky JG, Bubnik MG, Hawk LW. Reinforcement and Stimulant Medication Ameliorate Deficient Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder. J Abnorm Child Psychol. 2016 Feb; 44(2):309-21.
    View in: PubMed
  4. Baweja R, Belin PJ, Humphrey HH, Babocsai L, Pariseau ME, Waschbusch DA, Hoffman MT, Akinnusi OO, Haak JL, Pelham WE, Waxmonsky JG. The Effectiveness and Tolerability of Central Nervous System Stimulants in School-Age Children with Attention-Deficit/Hyperactivity Disorder and Disruptive Mood Dysregulation Disorder Across Home and School. J Child Adolesc Psychopharmacol. 2016 Mar; 26(2):154-63.
    View in: PubMed
  5. Waxmonsky JG, Waschbusch DA, Belin P, Li T, Babocsai L, Humphery H, Pariseau ME, Babinski DE, Hoffman MT, Haak JL, Mazzant JR, Fabiano GA, Pettit JW, Fallahazad N, Pelham WE. A Randomized Clinical Trial of an Integrative Group Therapy for Children With Severe Mood Dysregulation. J Am Acad Child Adolesc Psychiatry. 2016 Mar; 55(3):196-207.
    View in: PubMed
  6. Baweja R, Mattison RE, Waxmonsky JG. Impact of Attention-Deficit Hyperactivity Disorder on School Performance: What are the Effects of Medication? Paediatr Drugs. 2015 Dec; 17(6):459-77.
    View in: PubMed
  7. Mayes SD, Mathiowetz C, Kokotovich C, Waxmonsky J, Baweja R, Calhoun SL, Bixler EO. Stability of Disruptive Mood Dysregulation Disorder Symptoms (Irritable-Angry Mood and Temper Outbursts) Throughout Childhood and Adolescence in a General Population Sample. J Abnorm Child Psychol. 2015 Nov; 43(8):1543-9.
    View in: PubMed
  8. Bubnik MG, Hawk LW, Pelham WE, Waxmonsky JG, Rosch KS. Reinforcement enhances vigilance among children with ADHD: comparisons to typically developing children and to the effects of methylphenidate. J Abnorm Child Psychol. 2015 Jan; 43(1):149-61.
    View in: PubMed
  9. Helseth SA, Waschbusch DA, Gnagy EM, Onyango AN, Burrows-MacLean L, Fabiano GA, Coles EK, Chacko A, Wymbs BT, Walker KS, Wymbs FA, Garefino A, Massetti GM, Robb Mazzant J, Hoffman MT, Waxmonsky JG, Nichols-Lopez K, Pelham WE. Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls. J Consult Clin Psychol. 2015 Apr; 83(2):280-92.
    View in: PubMed
  10. Babinski DE, Waxmonsky JG, Waschbusch DA, Humphrey H, Alfonso A, Crum KI, Bernstein M, Slavec J, Augustus JN, Pelham WE. A pilot study of stimulant medication for adults with attention-deficit/hyperactivity disorder (ADHD) who are parents of adolescents with ADHD: the acute effects of stimulant medication on observed parent-adolescent interactions. J Child Adolesc Psychopharmacol. 2014 Dec; 24(10):582-5.
    View in: PubMed
  11. Babinski DE, Waxmonsky JG, Pelham WE. Treating parents with attention-deficit/hyperactivity disorder: the effects of behavioral parent training and acute stimulant medication treatment on parent-child interactions. J Abnorm Child Psychol. 2014 Oct; 42(7):1129-40.
    View in: PubMed
  12. Pelham WE, Burrows-MacLean L, Gnagy EM, Fabiano GA, Coles EK, Wymbs BT, Chacko A, Walker KS, Wymbs F, Garefino A, Hoffman MT, Waxmonsky JG, Waschbusch DA. A dose-ranging study of behavioral and pharmacological treatment in social settings for children with ADHD. J Abnorm Child Psychol. 2014 Aug; 42(6):1019-31.
    View in: PubMed
  13. Waxmonsky JG, Waschbusch DA, Babinski DE, Humphrey HH, Alfonso A, Crum KI, Bernstein M, Slavec J, Augustus JN, Pelham WE. Does pharmacological treatment of ADHD in adults enhance parenting performance? Results of a double-blind randomized trial. CNS Drugs. 2014 Jul; 28(7):665-77.
    View in: PubMed
  14. Sibley MH, Kuriyan AB, Evans SW, Waxmonsky JG, Smith BH. Pharmacological and psychosocial treatments for adolescents with ADHD: an updated systematic review of the literature. Clin Psychol Rev. 2014 Apr; 34(3):218-32.
    View in: PubMed
  15. Meinzer MC, Lewinsohn PM, Pettit JW, Seeley JR, Gau JM, Chronis-Tuscano A, Waxmonsky JG. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood. Depress Anxiety. 2013 Jun; 30(6):546-53.
    View in: PubMed
  16. Sibley MH, Waxmonsky JG, Robb JA, Pelham WE. Implications of changes for the field: ADHD. J Learn Disabil. 2013 Jan-Feb; 46(1):34-42.
    View in: PubMed
  17. Nahum-Shani I, Qian M, Almirall D, Pelham WE, Gnagy B, Fabiano GA, Waxmonsky JG, Yu J, Murphy SA. Experimental design and primary data analysis methods for comparing adaptive interventions. Psychol Methods. 2012 Dec; 17(4):457-77.
    View in: PubMed
  18. Nahum-Shani I, Qian M, Almirall D, Pelham WE, Gnagy B, Fabiano GA, Waxmonsky JG, Yu J, Murphy SA. Q-learning: a data analysis method for constructing adaptive interventions. Psychol Methods. 2012 Dec; 17(4):478-94.
    View in: PubMed
  19. Strand MT, Hawk LW, Bubnik M, Shiels K, Pelham WE, Waxmonsky JG. Improving working memory in children with attention-deficit/hyperactivity disorder: the separate and combined effects of incentives and stimulant medication. J Abnorm Child Psychol. 2012 Oct; 40(7):1193-207.
    View in: PubMed
  20. Sibley MH, Pelham WE, Molina BS, Gnagy EM, Waxmonsky JG, Waschbusch DA, Derefinko KJ, Wymbs BT, Garefino AC, Babinski DE, Kuriyan AB. When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol. 2012 Dec; 80(6):1052-61.
    View in: PubMed
  21. Waxmonsky JG, Wymbs FA, Pariseau ME, Belin PJ, Waschbusch DA, Babocsai L, Fabiano GA, Akinnusi OO, Haak JL, Pelham WE. A novel group therapy for children with ADHD and severe mood dysregulation. J Atten Disord. 2013 Aug; 17(6):527-41.
    View in: PubMed
  22. Graziano PA, Bagner DM, Waxmonsky JG, Reid A, McNamara JP, Geffken GR. Co-occurring weight problems among children with attention deficit/hyperactivity disorder: the role of executive functioning. Int J Obes (Lond). 2012 Apr; 36(4):567-72.
    View in: PubMed
  23. Waxmonsky JG, Waschbusch DA, Glatt SJ, Faraone SV. Prediction of placebo response in 2 clinical trials of lisdexamfetamine dimesylate for the treatment of ADHD. J Clin Psychiatry. 2011 Oct; 72(10):1366-75.
    View in: PubMed
  24. Waxmonsky JG, Waschbusch DA, Akinnusi O, Pelham WE. A comparison of atomoxetine administered as once versus twice daily dosing on the school and home functioning of children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2011 Feb; 21(1):21-32.
    View in: PubMed
  25. Waschbusch DA, Cunningham CE, Pelham WE, Rimas HL, Greiner AR, Gnagy EM, Waxmonsky J, Fabiano GA, Robb JA, Burrows-Maclean L, Scime M, Hoffman MT. A discrete choice conjoint experiment to evaluate parent preferences for treatment of young, medication naive children with ADHD. J Clin Child Adolesc Psychol. 2011; 40(4):546-61.
    View in: PubMed
  26. Waxmonsky JG, Waschbusch DA, Pelham WE, Draganac-Cardona L, Rotella B, Ryan L. Effects of atomoxetine with and without behavior therapy on the school and home functioning of children with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2010 Nov; 71(11):1535-51.
    View in: PubMed
  27. Pelham WE, Waxmonsky JG, Schentag J, Ballow CH, Panahon CJ, Gnagy EM, Hoffman MT, Burrows-MacLean L, Meichenbaum DL, Forehand GL, Fabiano GA, Tresco KE, Lopez-Williams A, Coles EK, González MA. Efficacy of a methylphenidate transdermal system versus t.i.d. methylphenidate in a laboratory setting. J Atten Disord. 2011 Jan; 15(1):28-35.
    View in: PubMed
  28. Ashare RL, Hawk LW, Shiels K, Rhodes JD, Pelham WE, Waxmonsky JG. Methylphenidate enhances prepulse inhibition during processing of task-relevant stimuli in attention-deficit/hyperactivity disorder. Psychophysiology. 2010 Sep; 47(5):838-45.
    View in: PubMed
  29. Shiels K, Hawk LW, Reynolds B, Mazzullo RJ, Rhodes JD, Pelham WE, Waxmonsky JG, Gangloff BP. Effects of methylphenidate on discounting of delayed rewards in attention deficit/hyperactivity disorder. Exp Clin Psychopharmacol. 2009 Oct; 17(5):291-301.
    View in: PubMed
  30. Wozniak J, Mick E, Waxmonsky J, Kotarski M, Hantsoo L, Biederman J. Comparison of open-label, 8-week trials of olanzapine monotherapy and topiramate augmentation of olanzapine for the treatment of pediatric bipolar disorder. J Child Adolesc Psychopharmacol. 2009 Oct; 19(5):539-45.
    View in: PubMed
  31. Spencer SV, Hawk LW, Richards JB, Shiels K, Pelham WE, Waxmonsky JG. Stimulant treatment reduces lapses in attention among children with ADHD: the effects of methylphenidate on intra-individual response time distributions. J Abnorm Child Psychol. 2009 Aug; 37(6):805-16.
    View in: PubMed
  32. Waschbusch DA, Pelham WE, Waxmonsky J, Johnston C. Are there placebo effects in the medication treatment of children with attention-deficit hyperactivity disorder? J Dev Behav Pediatr. 2009 Apr; 30(2):158-68.
    View in: PubMed
  33. Leddy JJ, Waxmonsky JG, Salis RJ, Paluch RA, Gnagy EM, Mahaney P, Erbe R, Pelham WE, Epstein LH. Dopamine-related genotypes and the dose-response effect of methylphenidate on eating in attention-deficit/hyperactivity disorder youths. J Child Adolesc Psychopharmacol. 2009 Apr; 19(2):127-36.
    View in: PubMed
  34. Waxmonsky J, Pelham WE, Gnagy E, Cummings MR, O'Connor B, Majumdar A, Verley J, Hoffman MT, Massetti GA, Burrows-MacLean L, Fabiano GA, Waschbusch DA, Chacko A, Arnold FW, Walker KS, Garefino AC, Robb JA. The efficacy and tolerability of methylphenidate and behavior modification in children with attention-deficit/hyperactivity disorder and severe mood dysregulation. J Child Adolesc Psychopharmacol. 2008 Dec; 18(6):573-88.
    View in: PubMed
  35. Waxmonsky J, Wood BL, Stern T, Ballow M, Lillis K, Cramer-Benjamin D, Mador J, Miller BD. Association of depressive symptoms and disease activity in children with asthma: methodological and clinical implications. J Am Acad Child Adolesc Psychiatry. 2006 Aug; 45(8):945-54.
    View in: PubMed
  36. Wilens TE, Waxmonsky J, Scott M, Swezey A, Kwon A, Spencer TJ, Biederman J. An open trial of adjunctive donepezil in attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2005 Dec; 15(6):947-55.
    View in: PubMed
  37. Waxmonsky JG, Wilens TE. Pharmacotherapy of adolescent substance use disorders: a review of the literature. J Child Adolesc Psychopharmacol. 2005 Oct; 15(5):810-25.
    View in: PubMed
  38. Waxmonsky JG. Nonstimulant therapies for attention-deficit hyperactivity disorder (ADHD) in children and adults. Essent Psychopharmacol. 2005; 6(5):262-76.
    View in: PubMed
  39. Waxmonsky J. Assessment and treatment of attention deficit hyperactivity disorder in children with comorbid psychiatric illness. Curr Opin Pediatr. 2003 Oct; 15(5):476-82.
    View in: PubMed
  40. Pelham WE, Aronoff HR, Midlam JK, Shapiro CJ, Gnagy EM, Chronis AM, Onyango AN, Forehand G, Nguyen A, Waxmonsky J. A comparison of ritalin and adderall: efficacy and time-course in children with attention-deficit/hyperactivity disorder. Pediatrics. 1999 Apr; 103(4):e43.
    View in: PubMed
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