TREATMENT OF PARENTING BEHAVIOR WITH A PSYCHOSTIMULANT - A CASE-STUDY OF AN ADULT WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER
TREATMENT OF PARENTING BEHAVIOR WITH A PSYCHOSTIMULANT - A CASE-STUDY OF AN ADULT WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER
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DOI：
10.1089/cap.1994.4.63
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发表时间：
1994-03-01
影响因子：
1.9
通讯作者：
PELHAM, W
中科院分区：
文献类型：
--
作者：
EVANS, SW;VALLANO, G;PELHAM, W
本案例研究描述了当父母也符合 ADHD 标准时，通过家长培训治疗患有 ADHD 症状的儿童时遇到的一些问题。母亲的注意力缺陷多动症症状降低了一致性，妨碍了监控，并阻止她保留准确的记录，从而影响了她的养育方式。她的多动症症状还对她与他人的关系、口语和书面语言的理解以及童年的社交和学术生活产生了负面影响。母亲报告说，儿子的行为问题严重且危险，导致他住院治疗。在发现母亲有多动症病史以及她无法从父母培训中受益后，治疗的重点从孩子的破坏性行为转向了母亲的功能失调行为。随后的门诊治疗重点是家长行为培训，以提高母亲管理孩子行为的能力。在对母亲进行精神刺激治疗（作为双盲、安慰剂对照门诊试验进行）后，她的养育行为得到改善，她报告说她儿子的行为也有所改善，尽管他从未接受过药物治疗。在缺乏对孩子行为的直接观察的情况下，推测母亲对接受兴奋剂治疗后孩子行为变化的报告是由于母亲行为的变化或母亲对儿子行为的看法和评价的变化，或两者兼而有之。如果父母和孩子都被诊断为多动症，临床医生可能会考虑替代治疗策略，即推迟对患有轻度多动症的孩子的药物治疗，直到父母进行药物试验后。
This case study describes some problems encountered in treating a child with ADHD symptoms through parent training when the parent also meets criteria for ADHD. The mother's ADHD symptoms affected her parenting by reducing consistency, impeding monitoring, and preventing her from keeping accurate records. Her ADHD symptoms also negatively affected her relationships with others, comprehension of spoken and written language, and her social and academic life in childhood. The mother reported that her son's behavior problems were severe and dangerous, and this resulted in his hospitalization. On discovering the mother's history of ADHD and her inability to benefit from parent training, the focus of treatment shifted from the child's disruptive behavior to the mother's dysfunctional behaviors. Subsequent outpatient treatment focused on behavioral parent training to improve the mother's ability to manage the child's behavior. Following psychostimulant treatment of the mother (conducted as a double-blind, placebo-controlled outpatient trial), her parenting behaviors improved and she reported improvements in her son's behavior, even though he had never been treated with medication. In the absence of direct observations of the child's behavior, it is speculated that the mother's reports of changes in the child's behavior after the mother's stimulant treatment were due to a change in the mother's behavior or to a change in the mother's perception and evaluation of her son's behavior, or both. In cases in which both a parent and child have an ADHD diagnosis, clinicians might consider the alternative treatment strategy of deferring medication treatment of a child with mild ADHD until after the parent's medication trial.