Treatment Response & Psychophysiology in Preschool ADHD

治疗反应

• 批准号: 7093027
• 负责人: CAROLYN H WEBSTER-STRATTON
• 金额: $ 42.05万
• 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/7093027
• 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）：注意力缺陷/多动症障碍（ADHD）和对立反抗障碍（ODD）的学前教育症状标志着早期发作行为障碍（CD）发展的重大风险。反过来，就犯罪，辍学，滥用毒品和人际暴力而言，早期发作的CD在社会上的巨大成本。由于CD干预措施对年龄较大的儿童的有效性越来越降低，因此在出现问题问题之前，可以防止这种疾病靶向具有多动症的高风险学龄前儿童。然而，很少有研究对学龄前儿童的多动症进行了研究，没有研究CD结果的研究。尽管精神刺激剂可有效减少核心多动症症状，但它们似乎并不能阻止多动症的发展和奇怪的CD。鉴于此，并且鉴于心理社会干预措施代表了唯一建立的CD治疗，因此评估患有多动症的学龄前儿童并检查CD结果至关重要。同样至关重要的是，我们必须检查ADHD学龄前儿童的冲动性和情绪调节的生物学基质，因为尚不清楚是否尚不清楚与ADHD和CD之间区分的标记是否会区分患有ADHD的学龄前儿童，而ADHD学龄前儿童也会在后来的CD中不发展，或者这些标记是否在后来的开发中差异。此外，尚不清楚这种标志物是预测治疗反应还是受到成功干预的影响。在拟议的研究中，治疗行为问题的已建立功效的多模式干预将交付给4至6岁的ADHD或ADHD + ODD。该研究的目的是（a）评估干预措施中断ADHD/ODD到CD的持续进展的有效性； （b）评估冲动性和情绪调节的预处理生物学标志物，并确定此类标志物是否预测治疗反应； （c）在2年随访中检查治疗结果的生物学和社会心理介体； （d）在随访时检查儿童行为和生理调节的家族介体。该研究将是（a）测试奇数和CD的良好干预措施是否有效预防高危学龄前儿童的CD，（b）评估预后预处理的生物学标志物，（c）检查生物学和环境发展CD的风险之间的相互作用，以及（d）在ADHD Preschools aDHD Preschools and Composect and comerbiondity and CD的潜在差异。