Integrated Tx for Depressed Mothers of ADHD Children

针对多动症儿童抑郁母亲的综合治疗

• 批准号: 7034264
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 20.11万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-15 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7034264
• 关键词: attention deficit disorder; behavior test; behavioral /social science research tag; child rearing; clinical depression; clinical research; clinical trials; cognitive behavior therapy; human subject; human therapy evaluation; maternal behavior; mother child interaction; outcomes research; patient care planning; patient oriented research; personal log /diary; self concept; stress management; training

DESCRIPTION (provided by applicant): Parents of children with attention-deficit/hyperactivity disorder (ADHD) experience a great deal of parenting stress and are far more likely than parents of non-disordered children to experience psychopathology themselves. It has been theorized that such parental problems may negatively impact parenting, which then exacerbates child behavior problems, creating a reciprocal pattern of negative parent-child interactions within the families of children with ADHD. There are also important implications of parental psychopathology on child treatment. Given that both behavioral and pharmacological treatments for childhood ADHD rely on parents (particularly mothers) to obtain and consistently administer treatment, it is no surprise that parental psychopathology (particularly maternal depression) predicts poorer child treatment response. Yet, existing ADHD treatments largely fail to directly address parental problems. The objective of the proposed project is to develop and evaluate a novel, integrated approach to behavioral parent training for mothers of children with ADHD with elevated depressive symptoms in order to facilitate successful outcomes following treatment. In Phase 1, we will complete the development and refinement of a manualized treatment, integrating the two empirically validated treatments: cognitive-behavioral depression intervention (specifically, the Coping with Depression Course) and behavioral parent training for ADHD. In Phase 2, 88 mothers with children with ADHD and elevated depressive symptoms will be recruited and randomly assigned to either: 1) standard behavioral parent training or 2) integrated parent intervention (IPI-A). Outcome measures include maternal self-reports of depressed mood (primary), parenting stress, self-esteem, expectations and attributions for child behavior, parenting sense of competence, self-reported and observed parenting behavior and parental reports of child behavior and associated family impairment. Based on the outcome of this preliminary trial the IPI-A protocol will be further refined and prepared for larger-scale clinical trials.

描述（由申请人提供）：患有注意力缺陷/多动障碍（ADHD）的儿童的父母承受着巨大的养育压力，并且比非障碍儿童的父母更有可能经历精神病理学。据推测，此类父母问题可能会对养育子女产生负面影响，从而加剧儿童的行为问题，在患有多动症的儿童的家庭中形成负面亲子互动的相互模式。父母精神病理学对儿童治疗也有重要影响。鉴于儿童多动症的行为和药物治疗都依赖于父母（特别是母亲）获得并持续进行治疗，因此父母的精神病理学（特别是母亲抑郁症）预测儿童治疗反应较差也就不足为奇了。然而，现有的多动症治疗很大程度上无法直接解决父母的问题。该项目的目标是开发和评估一种新颖的、综合的方法，对患有抑郁症状的多动症儿童的母亲进行行为父母培训，以促进治疗后取得成功的结果。在第一阶段，我们将完成手动治疗的开发和完善，整合两种经过经验验证的治疗方法：认知行为抑郁干预（特别是应对抑郁课程）和针对多动症的行为家长培训。在第二阶段，将招募 88 名患有多动症和抑郁症状加重的孩子的母亲，并随机分配到：1）标准行为家长培训或 2）综合家长干预（IPI-A）。结果测量包括母亲自我报告的抑郁情绪（主要）、养育压力、自尊、对儿童行为的期望和归因、养育能力感、自我报告和观察到的养育行为以及父母对儿童行为和相关家庭障碍的报告。根据初步试验的结果，IPI-A方案将进一步完善，并为更大规模的临床试验做好准备。