Compensatory Executive Functioning Skills Training in Adolescents with ADHD

多动症青少年的补偿性执行功能技能培训

• 批准号: 8060607
• 负责人: Steven A Safren
• 金额: $ 30.67万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-10 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8060607
• 关键词: Acute; Adaptive Behaviors; Adherence; Adolescence; Adolescent; Adult; Aftercare; Anxiety; Area; Attention; Attention deficit hyperactivity disorder; Awareness; Behavior; Behavioral; Behavioral Medicine; Behavioral Symptoms; Biological; Cellular Phone; Child; Child Behavior Checklist; Childhood; Cognitive; Cognitive Therapy; Combined Modality Therapy; Computers; Coping Skills; Country; Cues; Data; Development; Developmental Process; Diagnosis; Disease; Distress; Education; Educational process of instructing; Educational workshop; Effectiveness; Emotions; Environment; Feasibility Studies; Feedback; Funding; Future; Goals; Head; Hyperactive behavior; Impairment; Impulsivity; Individual; Informal Social Control; Internet; Intervention; Investigation; Knowledge; Lead; Learning; Life; Low Prevalence; Manuals; Measures; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Methodology; Modeling; Motivation; National Institute of Mental Health; Neurobiology; Outcome; Outcome Assessment; Outcome Study; Parents; Participant; Patient Self-Report; Patients; Pattern; Performance; Pharmaceutical Preparations; Pharmacotherapy; Phase; Pilot Projects; Population; Prevalence; Problem Solving; Process; Psychological reinforcement; Psychopharmacology; Published Comment; Publishing; Randomized; Randomized Controlled Trials; Reading; Recommendation; Records; Relaxation; Reporting; Research; Residual state; Secondary to; Series; Services; Severities; Short-Term Memory; Social Accountability; Source; Speech Development; Spouses; Staging; Stimulus; Structure; Symptoms; Teenagers; Testing; Thinking; Time; Training; Treatment outcome; Waiting Lists; Work; Writing; base; behavioral impairment; blind; clinical effect; clinically significant; coping; design; executive function; experience; follow-up; functional disability; improved; inattention; information gathering; innovation; meetings; neuropsychiatry; neuropsychological; novel; prevent; primary outcome; programs; psychosocial; rehearsal; sex; skills; skills training; sound; teacher; theories; therapy development; treatment response; trial comparing

DESCRIPTION (provided by applicant): This is the third submission of an R34 to conduct a formative randomized controlled trial of CBT for ADHD in adolescents who are treated by medications and still have significant residual symptoms. ADHD in adolescence is a prevalent, distressing, and interfering condition. Although medications are efficacious in treating ADHD in adolescents, typically significant residual symptoms remain after psychopharmacotherapy. Unlike other mental health problems with a similar prevalence (e.g. anxiety and depression), there is a lack of psychosocial treatments for adolescents with ADHD. The proposed project is to complete stages 2 and 3 of intervention development as outlined by NIMH PA 06-248, adapting our cognitive behavioral therapy for residual ADHD in adults to the adolescent population. Intervention. The intervention is based on existing conceptual models of ADHD, our work with adults, and an open phase pilot with adolescents. In our previous work, we have demonstrated that our manualized CBT for residual ADHD in adults was more effective than continued medications alone. The treatment is now being compared to relaxation with educational support in the context of a full scale randomized controlled trial in adults (MH069812). The CBT involves four core modules and one optional module. The core modules in the adult intervention are 1) psycho education and organizing/planning; 2) coping with distractibility, 3) adaptive thinking, and 4) involvement of a significant other (in the adult study, one's partner or spouse). The optional module is on utilizing the previously learned skills for coping with procrastination. For adolescents, we have adapted this approach to include check-in time with parents, innovative material that caters to adolescents (i.e. internet / cell phones), a focus on schoolwork and chores, and a decreased focus on cognitive restructuring. Design. Forty adolescents with ADHD who are stabilized on medications but still show clinically significant residual symptoms will be block randomized by sex and ADHD severity to either CBT or a wait-list control. Self-report, parent-report, teacher report, and independent assessor (who will be blind to treatment condition) data will be used as outcomes. Environment/feasibility. The PI team, as part of the CBT and Behavioral Medicine Programs at MGH, has extensive experience conducting CBT outcome studies. Collaborating with the pediatric psychopharmacology unit at MGH, we have access to potential participants through one of the largest pediatric psychopharmacology services in the country. This unit sees hundreds of adolescents with ADHD per year, all of whom is treated with medications and would be eligible for the planned trial.

描述（由申请人提供）：这是R34的第三次提交，以在接受药物治疗并仍然具有显着残留症状的青少年中对ADHD进行形成性随机对照试验。青春期的多动症是一种普遍，令人沮丧和干扰的条件。尽管药物有效地治疗青少年的ADHD，但心理药治疗后通常仍然存在重要的残留症状。与其他类似患病率的心理健康问题（例如焦虑和抑郁症）不同，患有多动症的青少年缺乏社会心理治疗。拟议的项目是完成NIMH PA 06-248概述的干预开发的第2和3阶段，以适应我们对成年人残留ADHD的认知行为疗法对青少年人群。干涉。干预措施基于ADHD的现有概念模型，我们与成年人的工作以及与青少年的开放阶段飞行员。在我们以前的工作中，我们证明了成人剩余多动症的手动CBT比仅持续的药物更有效。现在，在成人的全尺度随机对照试验的背景下，将治疗与放松和教育支持进行比较（MH069812）。 CBT涉及四个核心模块和一个可选模块。成人干预的核心模块是1）心理教育和组织/计划； 2）应对分散性，3）自适应思维和4）参与重要的其他人（在成人研究中，伴侣或配偶）。可选的模块是利用以前学习的技能来应对拖延。对于青少年来说，我们已经对这种方法进行了调整，包括与父母的入住时间，适应青少年的创新材料（即互联网 /手机），专注于学校工作和杂务，以及对认知重组的关注下降。设计。有40名ADHD稳定在药物上但仍显示出临床上显着的残留症状的青少年将被性别和ADHD严重程度随机封闭，以使CBT或等待名单控制。自我报告，家长报告，教师报告和独立评估师（将视而不见治疗条件）数据将被用作结果。环境/可行性。作为MGH的CBT和行为医学计划的一部分，PI团队在进行CBT成果研究方面拥有丰富的经验。与MGH的儿科心理药理学部门合作，我们可以通过该国最大的儿科心理药理学之一与潜在的参与者联系。该单元看到每年有数百名ADHD的青少年，所有这些青少年都接受了药物治疗，并且有资格参加计划的试验。