ADHD ADOLESCENTS--FAMILY CONFLICTS AND THEIR TREATMENT

我们之前的研究（MH#51583）发现，人际关系的严重程度 家庭内部的冲突对大多数人造成了严重的问题， ADHD青少年的家庭，尤其是患有共病的ADHD青少年 对立违抗性障碍（ODD）。我们最初的拨款也检查了 三种基于家庭的治疗方法对这些冲突的有效性。 在组水平上，所有处理均产生相同且显著的 减少冲突，彼此之间只有微小的差异。在 然而，在个体水平上，高达80%的家庭没有表现出临床症状。 治疗引起的显著或可靠的变化。很明显， ADHD/ODD青少年家庭的心理治疗需要 增强会上确定了几个因素， 努力这些措施是：10包括父亲与青少年的治疗; 2)增加治疗次数; 3）结合有前途的 治疗方法; 4）评估父亲所扮演的单独角色 在家庭冲突中。因此，我们建议将我们的补助金延长3年 对父母与青少年的冲突及其处理进行额外的研究， 注意力缺陷多动障碍/古怪的青少年。这项研究将涉及90名患有ADHD和ODD的青少年 随机分配到解决问题的沟通训练（PSCT） 单独或PSCT结合父母行为管理训练（BMT）。 所有受试者将接受18次治疗，但将重新评估 治疗中途，以评价治疗效果， 治疗剂量（9 vs 18次）。父亲参与治疗 要大力、系统地鼓励。因此，这些疗法将 通过解决所有上述因素（剂量， 治疗组合，父亲参与）。评定量表，治疗师 评分，以及对母亲和父亲的直接观察 相互作用将用于评估治疗过程和结果 方面的影响.治疗结果的潜在预测因素将再次 考察

Our previous grant (MH#51583) found that serious degrees of interpersonal conflict within families posed significant problems for the majority of families of ADHD teens, and markedly more so in ADHD teens with co-morbid oppositional - defiant disorder (ODD). Our initial grant also examined the effectiveness of three family-based treatments for these conflicts. At the group level, all treatments produced equal and significant reductions in conflicts with only minor differences among them. At the individual level, however, up to 80% of the families showed no clinical significant or reliable changes due to treatment. Clearly, the potency of psychosocial treatments for families of ADHD/ODD teens requires enhancement. Several factors were identified that could focus such efforts. These are: 10 including fathers in therapy with the adolescent; 2) increasing the number of therapy sessions; 3) combining promising therapy approaches; and 4) evaluating the separate role played by fathers in family conflicts. We therefore propose a 3 year renewal of our grant to conduct an additional study of parent-teen conflict and its treatment in ADHD/ODD teens. The study will involve 90 teens with ADHD and ODD randomly assigned to either problem-solving communication training (PSCT) alone or to PSCT combined with parent behavior management training (BMT). All subjects will receive 18 sessions of therapy but will be re-evaluated half-way through therapy to evaluate treatment effects as a function of dose of treatment (9 vs 18 sessions). Father involvement in therapy will be strongly and systematically encouraged. The therapies, therefore, will be enhanced by addressing all of the above noted factors (dosage, treatment combination, father involvement). Rating scales, therapist ratings, and direct observations of mother-teen and father-teen interactions will be used to assess treatment process and outcome effects. Potential predictors of treatment outcome will again be examined.