MULTIMODAL TREATMENT STUDY OF CHILDREN WITH ADHD (MTA)

此竞争延续申请要求多年的资金 06至10的NIMH合作多模式治疗研究 儿童注意力缺陷多动障碍（MTA研究）。 在一项平行组设计中，576名严格诊断为 ADHD（6个地点各96名），年龄7-9岁，被随机分配到4个 治疗条件：（1）仅药物治疗;（2）仅心理社会治疗;（3） 综合（药物和心理社会）;或（4）评估和- 仅推荐。除后者外，所有人都接受了14个月的强化治疗， 在基线、3、9、14和24个月时对所有受试者进行评估。 因此，最初的MTA设计提供了短期（10个月后， 治疗）随访24个月，但资金和时间不足 阻碍了长期随访。这一延续请求， 与05年的配套竞争补充，将开始 通过以下方式对不同治疗效果进行长期随访 所有受试者至少持续到第5年（治疗后4年）。 目的1是对假设进行验证性检验 联合治疗策略明显更有效， 产生长期的治疗效果，并防止新的精神病 病理学比药物或心理社会治疗单独， 差异具有临床意义。目标2： 进行验证性测试的假设，系统，密集 治疗（所有3种活性MTA治疗）显著更多 有效（统计学和临床）产生长期治疗 比通常的治疗方法更能预防新的精神病理学 在社区里收到的。目标3：开展 系统治疗的假设的验证性检验 儿童早期的ADHD改变了随后的 药物使用和滥用，风险改变是临床上 显著继续目标4是进行探索性分析， 确定治疗前个体差异（严重程度， 合并症、父母功能、家族史）与 治疗效果的稳定性/变化模式。目标5是 进行探索性分析，以确定 治疗态度或归因的稳定/变化模式， 在治疗相关行为中， 治疗前或治疗后功能差异，治疗后 治疗满意度报告和先前存在的特征。

This Competing Continuation Application requests funding for Years 06 to 10 of the NIMH collaborative Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA Study). In a parallel-group design, 576 rigorously diagnosed children with ADHD (96 at each of 6 sites), age 7-9, are randomly assigned to four treatment conditions: (1) Medication-only; (2) Psychosocial-only; (3) Combined (medication & psychosocial); or (4) Assessment-and- Referral-only. All but the latter are treated intensively for 14 months, with assessments for all subjects at baseline, 3, 9, 14, and 24 months. The original MTA design thus provides short-term (10 months post- treatment) follow-up at 24 months, but insufficient funds and time prevented longer-term follow-up. This Continuation request, in concert with the companion Competing Supplement for Year 05, would begin the longer-term follow-up of differential treatment effects by following all subjects at least through their 5th year (4 yr post-treatment). Continuation Aim 1 is to conduct confirmatory tests of the hypothesis that a Combined Treatment strategy is significantly more effective in producing long-term therapeutic gains and preventing new psycho pathology than Medication or Psychosocial-treatment alone and that the difference is clinically meaningful. Continuation Aim 2 is to conduct confirmatory tests of the hypothesis that systematic, intensive treatments (all 3 active MTA treatments) are significantly more effective (statistically and clinically) in producing long-term therapeutic gains and preventing new psychopathology than treatments typically received in the community. Continuation Aim 3 is to conduct confirmatory tests of the hypothesis that systematic treatments for ADHD in early childhood alter the risk for subsequent patterns of substance use and abuse and that the risk alteration is clinically significant. Continuation Aim 4 is to conduct exploratory analyses to determine whether pre-treatment individual differences (severity, comorbidity, parent functioning, family history) are associated with patterns of stability/change in treatment effects. Continuation Aim 5 is to conduct exploratory analyses to determine the extent to which patterns of stability/change in therapeutic attitudes or attributions and in treatment-related behaviors vary as a function of randomly assigned treatment, pre- or post-treatment differences in functioning, post- treatment reports of satisfaction, and preexisting characteristics.