Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.
Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.
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DOI：
10.1080/15374416.2015.1102069
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Stein MA
中科院分区：
文献类型：
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作者：
Chronis-Tuscano A;Wang CH;Strickland J;Almirall D;Stein MA
由于遗传和环境因素，患有成人注意力缺陷/多动障碍（ADHD）母亲的幼儿有患ADHD的风险。此外，父母多动症与父母的不适应和儿童行为治疗反应差有关。因此，可能需要一种由行为父母训练（BPT）和母亲兴奋剂药物（MSM）组成的联合方法来有效地治疗家庭中的ADHD。然而，最初向所有家庭提供BPT+MSM联合治疗可能是不必要的负担，因为并非所有家庭都可能需要联合治疗。本研究的目的是研究如何对这些多重家庭进行组合、顺序和个性化治疗，以使父母和孩子都受益，从而影响儿童ADHD和破坏性行为症状的进程。本文介绍了我们正在进行的顺序多重评估随机试验（SMART）的基本原理、设计和初步经验（基于N = 26名参与者），该试验旨在回答有关研究方案和干预措施的可行性和可接受性的问题。本文还描述了基于SMART试点中所学到的知识，随后的全面SMART可能会如何变化，并说明了全面SMART如何用于告知临床决策，以了解如何对父母患有ADHD的复杂儿童和家庭进行组合，顺序和个性化治疗。
Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome since not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. This paper presents our rationale for, design of, and preliminary experiences (based on N = 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This manuscript also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot, and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD.