FAMILY GENETIC STUDY OF GIRLS WITH ADHD

患有多动症的女孩的家族遗传学研究

• 批准号: 2415995
• 负责人: JOSEPH BIEDERMAN
• 金额: $ 42.99万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-05-01 至 1998-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2415995
• 关键词: academic achievement; adolescence (12-20); aggression; alcoholism /alcohol abuse; antisocial personality; anxiety disorders; attention deficit disorder; child (0-11); child behavior disorders; disease /disorder proneness /risk; drug abuse; family genetics; family structure /dynamics; female; gender difference; human subject; interview; longitudinal human study; major depression; medical complication; pregnancy; psychological tests; sign /symptom; social psychology

The mental health concerns of children and the identification of risk factors responsible for childhood psychopathology are a high research priority for the NIMH as reflected in the NIMH "National Plan for Research on Child and Adolescent Mental Disorders." A parallel concern of the research community is that psychiatric health issues are understudied in females, especially for disorders that are more prevalent among males. This is true for Attention Deficit Hyperactivity Disorder (ADHD). Because family disruption and severe behavioral disturbances are observed less frequently among ADHD girls in comparison to ADHD boys, they are less likely than boys to come to the attention of health care providers and are rarely enrolled in research protocols. When they are, their numbers are often insufficient to make meaningful inferences. The under-identification and under-treatment of ADHD girls may have substantial mental health and educational implications. Thus, research is needed to develop a better understanding of ADHD in girls. In our pilot study of girls with DSM-III Attention Deficit Disorder (ADD) we demonstrated the feasibility of studying this disorder in females. We now propose to extend this research to a family genetic study of DSM-III-R ADHD in girls. This will complement our studies of boys with DSM-III-R ADHD. We already have shown that, among boys, ADHD is familial and that the familial correlates of psychiatric comorbidity shed light on the etiologic relationships between ADHD and conduct, anxiety and major depressive disorders. We have completed the ascertainment of boys with ADHD and a contrast group of 120 normal control boys of similar age, social class, and ethnic background. We collected cognitive, social functioning and psychiatric diagnostic data as well as measures of environmental adversity from these probands, the 454 parents and siblings of ADHD probands and the 368 parents and siblings of normal controls. We are currently following these boys and their siblings over a five year period to assess family-genetic, psychosocial and cognitive predictors of outcome in ADHD. The overall goal of the proposed research is to determine if our findings among ADHD boys will generalize to a sample of ADHD girls. We also seek t determine if there are gender differences in the family- genetic correlates of ADHD and if the disorder is expressed differently in boys and girls. To achieve our goals we will, in the five years proposed for this study, ascertain and assess 140 girl probands with ADHD, and 120 girl controls. Although more work is needed to comprehensively understand ADHD in boys, we believe that now is the right time to pursue a study of ADHD girls. Our preliminary studies of ADD girls demonstrate the feasibility of finding girl patients and provide data on which to base our initial hypotheses. Our work with boys provides additional directions and hypotheses. By initiating a family study of ADHD girls, we intend to lay the groundwork for a long-term longitudinal study of the girls and their families. This, in conjunction with our longitudinal family study of ADHD boys, should provide the field with valuable data about ADHD in the years to come.

儿童的心理健康问题和风险识别 造成儿童精神病理学的因素是一项高度研究 NIMH 的优先事项反映在 NIMH“国家计划”中 儿童和青少年精神障碍的研究。” 一个平行的关注 研究界认为精神健康问题是 对女性的研究不足，特别是对于更常见的疾病 多见于男性。 这对于注意力缺陷来说是正确的 多动症（ADHD）。 由于家庭破裂和严重 多动症女孩中行为障碍的发生率较低 与多动症男孩相比，他们比男孩更不可能 引起医疗保健提供者的注意并且很少参加 研究协议。 当他们出现时，他们的人数通常是 不足以做出有意义的推论。 身份识别不足 多动症女孩治疗不足可能会带来严重的心理健康问题 和教育意义。 因此，需要研究开发一种 更好地了解女孩的多动症。 在我们对患有 DSM-III 注意力缺陷障碍的女孩进行的试点研究中 （ADD）我们证明了研究这种疾病的可行性 女性。 我们现在建议将这项研究扩展到家族遗传 DSM-III-R 女孩 ADHD 的研究。 这将补充我们的研究 患有 DSM-III-R ADHD 的男孩。 我们已经表明，在男孩中，多动症 是家族性的，并且家族性与精神科共病相关 阐明多动症和行为之间的病因关系， 焦虑症和重度抑郁症。 我们已经完成了 确定患有 ADHD 的男孩和 120 名正常的对照组 控制年龄、社会阶层和种族背景相似的男孩。 我们 收集认知、社会功能和精神诊断数据 以及这些先证者对环境逆境的测量， 454 名 ADHD 先证者的父母和兄弟姐妹以及 368 名父母和兄弟姐妹 正常对照的兄弟姐妹。 我们目前正在追踪这些男孩 他们的兄弟姐妹在五年内评估家族遗传， ADHD 结果的心理社会和认知预测因素。 拟议研究的总体目标是确定我们的 多动症男孩的研究结果将推广到多动症女孩的样本。 我们还试图确定家庭中是否存在性别差异—— ADHD 的遗传相关性以及该疾病是否有不同的表达 在男孩和女孩中。 为了实现我们的目标，我们将在五年内 本研究建议确定并评估 140 名女孩先证者 注意力缺陷多动症和120女孩对照。 尽管要全面了解 ADHD 还需要做更多的工作 孩子们，我们相信现在是研究多动症的最佳时机 女孩们。 我们对 ADD 女孩的初步研究表明 寻找女孩患者并提供依据的数据的可行性 我们最初的假设。 我们与男孩的合作提供了额外的 方向和假设。 通过发起一项针对多动症女孩的家庭研究， 我们打算为长期纵向研究奠定基础 女孩们和她们的家人。 这一点，结合我们的 ADHD 男孩的纵向家庭研究，应该为该领域提供 未来几年有关多动症的宝贵数据。