NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale.
NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale.
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NIMH 针对 ADHD 儿童的多中心多模式协作治疗研究：I. 背景和理由。
DOI：
10.1097/00004583-199508000-00008
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发表时间：
1995
影响因子：
13.3
通讯作者：
Swanson,JM
中科院分区：
文献类型：
--
作者：
Richters,JE;Arnold,LE;Jensen,PS;Abikoff,H;Conners,CK;Greenhill,LL;Hechtman,L;Hinshaw,SP;Pelham,WE;Swanson,JM
目的：美国国家精神卫生研究所最近启动了一项针对注意缺陷多动障碍(MTA)儿童的为期5年的多点多模式治疗研究，这是该研究所历史上第一个以儿童精神障碍为重点的重大临床试验。本文回顾了发起MTA的主要科学和临床基础。方法选择性地回顾文献，描述ADHD在儿童和青少年中的估计患病率，其核心临床特征，关于精神药理学和心理社会治疗效果的证据，以及导致MTA发展的相关研究问题和趋势。结果在几十年的治疗研究和临床实践中，对于以下多重问题的回答缺乏充分的基础：在什么情况下以及具有什么儿童特征(共病条件、性别、家族史、家庭环境、年龄、营养/代谢状况等)。哪些治疗或治疗组合(兴奋剂、行为治疗、家长培训、学校干预)对儿童功能的哪些领域(认知、学习、行为、神经生理、神经心理、同伴关系、家庭关系)有什么影响(改善、停滞、恶化)，持续多长时间(短期还是长期)，在多大程度上(影响大小，正常还是病理范围)，以及为什么(潜在变化)？结论这一多重问题中嵌套的重要科学、临床和公共卫生问题为MTA提供了动力和支架。J.Am阿卡德。青春期儿童。精神病学，1995，34，8：987-1000。
OBJECTIVEThe National Institute of Mental Health's recently initiated 5-year, multisite, multimodal treatment study of children with attention-deficit hyperactivity disorder (MTA) is the first major clinical trial in its history focused on a childhood mental disorder. This article reviews the major scientific and clinical bases for initiating the MTA.METHODA selective review of the literature is presented in the service of describing the estimated prevalence of ADHD among children and adolescents, its core clinical features, evidence concerning psychopharmacological and psychosocial treatment effects, and related research issues and trends leading to the development of the MTA.RESULTSDespite decades of treatment research and clinical practice, there is an insufficient basis for answering the following manifold question: under what circumstances and with what child characteristics (comorbid conditions, gender, family history, home environment, age, nutritional/metabolic status, etc.) do which treatments or combinations of treatment (stimulants, behavior therapy, parent training, school-based intervention) have what impacts (improvement, stasis, deterioration) on what domains of child functioning (cognitive, academic, behavioral, neurophysiological, neuropsychological, peer relations, family relations), for how long (short versus long term), to what extent (effect sizes, normal versus pathological range), and why (processes underlying change)?CONCLUSIONSThe important scientific, clinical, and public health issues nested within this manifold question provide both the impetus and scaffolding for the MTA. J. Am. Acad. Child Adolesc. Psychiatry, 1995, 34, 8:987–1000.