Developing Treatment for Older Adolescents with ADHD

为患有多动症的老年青少年开发治疗方法

• 批准号: 7211653
• 负责人: Steven W. Evans
• 金额: $ 19.68万
• 依托单位: JAMES MADISON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7211653
• 关键词: adolescence (12-20); attention deficit disorder; behavioral /social science research tag; clinical research; handbook; health education; hospital community relations; human subject; human therapy evaluation; patient oriented research; psychotherapy; social behavior disorders; social psychology; therapy compliance; therapy design /development; training

DESCRIPTION (provided by applicant): This application is for a "From Intervention Development to Services: Exploratory Research Grants (R34)" in response to PAR-03-078. The proposal is a Stage I development project to develop and conduct a preliminary evaluation of a set of psychosocial interventions for high school aged adolescents with ADHD. The rationale for this project follows from evidence documenting the presence of significant impairment in this population, a decline in the use of medication treatment during these years, and a lack of any reported psychosocial interventions. A treatment manual, training materials, fidelity procedures, assessment instruments, and related materials will be prepared using input from a community development team and experience gained providing these treatment services. Results from pilot studies will provide estimates of effect sizes to inform the planning of future studies, provide data on feasibility and acceptability, and generate hypotheses about moderators and mediators of treatment. The procedures include both clinician and paraprofessional delivered services targeting social impairment and academic problems in the school, community, and family contexts. Some of the interventions are modifications of techniques that have been developed and evaluated for middle school aged adolescents with ADHD. Paraprofessional coaches provide a large portion of the services focusing primarily on the generalization of behaviors to their natural settings. Treatment delivery has been designed to be responsive to the unique developmental issues associated with older adolescents. Like other psychosocial treatments for individuals with chronic disorders, providing medication education to encourage appropriate evaluations and adherence to prescribed medication is an important component of this treatment. During year 01, 10 subjects will be recruited to receive the treatment. The experience and data gained from this will guide the refinement of procedures prior to a pilot clinical trial in years 02 and 03 (n=36). In addition to group differences (treatment vs. community care) analyses will examine rates of attrition, mean number of sessions completed, mean treatment satisfaction ratings, and the proportion of subjects who achieve at least a 0.5 or 1.0 effect size improvement on outcome measures. Exploratory analyses of hypotheses related to potential moderators (gender, comorbid conditions, etc.) and mediators (medication usage, attendance, adherence, etc.) will be completed to inform future work.

描述（由申请人提供）：本申请针对 PAR-03-078 的“从干预开发到服务：探索性研究补助金 (R34)”。该提案是一个第一阶段的开发项目，旨在为患有多动症的高中青少年制定一套心理社会干预措施并进行初步评估。该项目的基本原理是根据记录该人群存在显着损伤、这些年来药物治疗使用率下降以及缺乏任何报告的心理社会干预措施的证据得出的。将利用社区发展团队的意见以及提供这些治疗服务所获得的经验来准备治疗手册、培训材料、保真度程序、评估工具和相关材料。试点研究的结果将提供效应大小的估计，为未来研究的规划提供信息，提供可行性和可接受性的数据，并生成有关治疗的调节因素和调节因素的假设。这些程序包括临床医生和辅助专业人员提供的服务，针对学校、社区和家庭环境中的社会障碍和学业问题。其中一些干预措施是对针对患有多动症的中学生开发和评估的技术进行的修改。辅助专业教练提供大部分服务，主要侧重于将行为推广到自然环境中。治疗的提供旨在应对与老年青少年相关的独特发育问题。与针对慢性病患者的其他心理社会治疗一样，提供药物教育以鼓励适当的评估和遵守处方药物是这种治疗的重要组成部分。第一年，将招募 10 名受试者接受治疗。从中获得的经验和数据将指导 02 年和 03 年试点临床试验（n=36）之前的程序完善。除了群体差异（治疗与社区护理）之外，分析还将检查自然减员率、完成的平均疗程数、平均治疗满意度评分以及在结果指标上实现至少 0.5 或 1.0 效果大小改善的受试者比例。将完成与潜在调节因素（性别、合并症等）和调节因素（药物使用、出勤、依从性等）相关的假设的探索性分析，以便为未来的工作提供信息。