Treatment Response & Psychophysiology in Preschool ADHD

治疗反应

• 批准号: 6866834
• 负责人: CAROLYN H WEBSTER-STRATTON
• 金额: $ 43.02万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-11 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6866834
• 关键词: aggression; attention deficit disorder; behavior modification; behavior prediction; behavior therapy; behavioral /social science research tag; biomarker; child behavior disorders; clinical research; comorbidity; conduct disorder; electrocardiography; galvanic skin response; human subject; human therapy evaluation; interview; longitudinal human study; mental disorder prevention; oppositional defiant disorder; parents; patient oriented research; preschool child (1-5); psychological tests; psychophysiology; questionnaires; teacher

DESCRIPTION (provided by applicant): Preschool symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) mark significant risk for the development of early-onset conduct disorder (CD). In turn, early-onset CD exacts enormous costs on society in terms of delinquency, school drop out, substance abuse, and interpersonal violence. Because CD interventions become increasingly less effective with older children, preventing the disorder may require that we target at-risk preschoolers with ADHD, before conduct problems emerge. Yet very little research has addressed ADHD among preschoolers, with no studies examining CD outcomes. Although psychostimulants are effective in reducing core ADHD symptoms, they do not appear to prevent the progression of ADHD and ODD to CD. Given this, and given that psychosocial interventions represent the only well established CD treatment, it is critical to evaluate such interventions for preschoolers with ADHD, and to examine CD outcomes. It is also critical that we examine the biological substrates of impulsivity and emotion regulation in preschoolers with ADHD, as it remains unclear whether markers that differentiate between older children with ADHD and CD also discriminate between ADHD preschoolers who do and do not develop later CD, or if these markers diverge later in development. Furthermore, it is unknown whether such markers predict treatment response or are affected by successful intervention. In the proposed study, a multimodal intervention of established efficacy for treating conduct problems will be delivered to 4- to 6-year-old children with ADHD or ADHD + ODD. Aims of the study are to (a) evaluate the effectiveness of the intervention for interrupting the ongoing progression of ADHD/ODD to CD; (b) assess pretreatment biological markers of impulsivity and emotion regulation and determine if such markers predict treatment response; (c) examine biological and psychosocial mediators of treatment outcome at 2-year follow-up; (d) examine familial mediators of children's behavioral and physiological regulation at follow-up. The study will be the first to (a) test whether a well established intervention for ODD and CD is effective in preventing CD in high-risk preschoolers, (b) assess pretreatment biological markers of outcome, (c) examine interactions between biological and environmental risk for developing CD, and (d) examine potential differences in CD outcomes for ADHD preschoolers with and without comorbid oppositionality.

描述（由申请人提供）：学龄前儿童注意力缺陷/多动障碍 (ADHD) 和对立违抗障碍 (ODD) 的症状标志着发生早发性品行障碍 (CD) 的重大风险。反过来，早发性CD在犯罪、辍学、药物滥用和人际暴力方面给社会造成了巨大的损失。由于 CD 干预措施对于年龄较大的儿童越来越不有效，因此预防这种疾病可能需要我们在行为问题出现之前针对患有 ADHD 的高危学龄前儿童。然而，很少有研究涉及学龄前儿童的多动症，也没有研究检查 CD 的结果。尽管精神兴奋剂可以有效减轻 ADHD 的核心症状，但它们似乎并不能阻止 ADHD 和 ODD 发展为 CD。鉴于此，并且鉴于心理社会干预是唯一成熟的 CD 治疗方法，因此评估对患有 ADHD 的学龄前儿童的此类干预措施并检查 CD 的结果至关重要。同样重要的是，我们检查患有 ADHD 的学龄前儿童冲动和情绪调节的生物学基础，因为目前尚不清楚区分患有 ADHD 和 CD 的年龄较大儿童的标记是否也能区分后来发展和不发展 CD 的 ADHD 学龄前儿童，或者如果这些标记在发育后期出现分歧。此外，尚不清楚这些标志物是否可以预测治疗反应或是否受到成功干预的影响。在拟议的研究中，将为 4 至 6 岁患有 ADHD 或 ADHD + ODD 的儿童提供治疗品行问题的有效多模式干预措施。该研究的目的是 (a) 评估干预措施对于阻止 ADHD/ODD 持续进展为 CD 的有效性； (b) 评估治疗前冲动和情绪调节的生物标志物，并确定这些标志物是否可以预测治疗反应； (c) 在两年的随访中检查治疗结果的生物和心理社会调节因素； (d) 在随访中检查儿童行为和生理调节的家庭调节因素。该研究将首次（a）测试针对ODD和CD的完善干预措施是否能有效预防高危学龄前儿童的CD，（b）评估治疗前结果的生物标志物，（c）检查生物和环境之间的相互作用发展 CD 的风险，以及 (d) 检查有或没有共病对立的 ADHD 学龄前儿童 CD 结果的潜在差异。