A PROSPECTIVE STUDY OF THE DEVELOPMENT OF ADHD AND ODD

ADHD 和 ODD 发展的前瞻性研究

基本信息

批准号：
6616181
负责人：
ELIZABETH A HARVEY
金额：
$ 29.98万
依托单位：
UNIVERSITY OF MASSACHUSETTS AMHERST
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-07-15 至 2005-06-30
项目状态：
已结题

项目摘要

This proposal focuses on the early development of attention- deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD). Although these disorders are typically diagnosed in elementary school age children, associated symptoms are thought to appear frequently by the preschool years. By the time ADHD children are diagnosed and treated, the comorbid problems and interaction patterns that may have caused them are likely firmly entrenched and resistant to treatment. Early interventions that target children at risk for developing ADHD could have the potential to prevent the development of comorbid problems among ADHD children and may limit the symptom severity and degree of impairment among children with ADHD. Early identification of these children is critical to early intervention. Therefore, the proposed project seeks to identify factors that predict the development of pure ADHD and comorbid ADHD/ODD among preschool children with externalizing problems. This prospective study will follow 180 three-year-old children with externalizing problems and 70 non-problem comparison children. Diagnostic and family assessments will be conducted yearly from age three to age six. The following specific aims will be addressed: a) to determine the extent to which preschoolers with externalizing problem are later diagnosed with ADHD, b) to evaluate the utility of early hyperactivity/impulsivity in predicting later ADHD diagnoses, c) to examine whether the chronicity and biological markers of early hyperactive/impulsive symptoms and neuropsychological functioning predict later ADHD and whether they predict ADHD beyond early hyperactivity/impulsivity, d) to evaluate the utility of early hostility/defiance in predicting later ODD among ADHD children, e) to examine whether parental discipline, family stress (including parent psychopathology, marital discord, negative life events, SES, and single parenthood), and family history of antisocial behavior predict later ODD among ADHD children and whether they predict ODD beyond what would be predicted from early hostility/impulsivity, f) to examine whether parental discipline mediates the effects of family stress on the development of ODD among ADHD children, g) to evaluate whether family stress interacts with early hyperactivity/impulsivity and hostility/defiance in predicting parental discipline and later ODD, and h) To examine whether early hostility/defiance and hyperactivity/impulsivity interact with parenting in predicting later ODD.

该提案重点关注注意力缺陷/多动障碍 (ADHD) 和共病对立违抗障碍 (ODD) 的早期发展。尽管这些疾病通常是在小学年龄的儿童中诊断出来的，但相关症状被认为在学龄前儿童中经常出现。当多动症儿童得到诊断和治疗时，可能导致他们的共病问题和互动模式可能已经根深蒂固并且对治疗产生抵抗力。针对有患 ADHD 风险的儿童的早期干预措施可能有可能预防 ADHD 儿童合并症问题的发展，并可能限制 ADHD 儿童的症状严重程度和损伤程度。早期识别这些儿童对于早期干预至关重要。因此，拟议的项目旨在确定预测具有外化问题的学龄前儿童纯 ADHD 和共病 ADHD/ODD 发展的因素。这项前瞻性研究将跟踪 180 名有外化问题的三岁儿童和 70 名没有问题的对照儿童。从三岁到六岁，每年都会进行一次诊断和家庭评估。将解决以下具体目标：a）确定有外化问题的学龄前儿童后来被诊断为 ADHD 的程度，b）评估早期多动/冲动在预测以后 ADHD 诊断中的效用，c）检查是否长期存在早期多动/冲动症状和神经心理功能的生物标志物可以预测以后的 ADHD，以及它们是否可以预测早期多动/冲动之外的 ADHD，d) 评估早期敌意/反抗的效用预测 ADHD 儿童后来的 ODD，e) 检查父母管教、家庭压力（包括父母精神病理学、婚姻不和、负面生活事件、SES 和单亲家庭）和反社会行为家族史是否可以预测 ADHD 儿童后来的 ODD，以及是否他们预测的 ODD 超出了早期敌意/冲动的预测范围，f) 检查父母管教是否介导家庭压力对 ADHD 儿童 ODD 发展的影响，g) 评估家庭压力是否与 ADHD 儿童相互作用。早期的多动/冲动和敌意/反抗在预测父母管教和后来的 ODD 中，以及 h) 检查早期的敌意/反抗和多动/冲动是否与养育方式相互作用以预测后来的 ODD。