ATTENTIONAL DEFICIT CHILDREN: A DIMENSIONAL ANALYSIS

这项研究将描绘人格的某些维度方面 (冲动、焦虑倾向和感觉寻求)和实验室 200例异种、临床和临床患者的神经系统敏感性测定 学校转介的注意力缺陷障碍(ADD)科目(结构化 访谈诊断)和50名对照。行为和生理 在增减和信号期间采取措施 检测程序。主要目标是构建一棵决策树 这将在以下意义上提高ADD受试者的DSM-III诊断能力 使其在随访时更能预测临床结果。 我们和其他人过去的研究表明，增加-减少 个体对递增的音调作出反应的过程 强度，区分多动型ADD儿童和对照组 治疗用药量的预测。我们将尝试复制和 使用信号检测技术扩展这些结果 优于为研究神经紧张而增加程序 系统敏感度和注意过程。俄罗斯调查人员将 以敏感为力量。这是他们作为受试者的评估 能够检测强度较低的刺激和/或承受较强的刺激 刺激物。我们将这一定义扩展到包括四个相对假设的 独立维度：对低强度和高强度的色调和 对奖惩敏感。这四项实验室措施将 与人格的维度方面相关，包括 冲动、攻击性、焦虑性和寻求感觉。 主题将以以下几种方式分组：(A)根据 DSM-III诊断；(B)基于DSM-III和人格特征； (C)根据DSM-III诊断和敏感性指数；和(D)关于 DSM-III的基础、个性和敏感性测量。我们 假设(B)、(C)和(D)将更能预测临床 结果比(A)。我们还预计(B)将与 实验室测量的灵敏度比(A)更高，但预计(B)和(C)将是 结果的独立预测因素，并与 结果。我们期望(D)是对结果的最好预测， 尤其是对于接受哌醋甲酯治疗的儿童。

This study will map certain dimensional aspects of personality (impulsivity, anxiety-proneness, and sensation seeking) and laboratory measures of nervous system sensitivity in 200 heterogeneous, clinically and school referred attention deficit disordered (ADD) subjects (structured interview diagnosis) and 50 controls. Behavioral and physiological measures will be obtained during augmentation-reduction and signal detection procedures. The primary goal is to construct a decision tree that will enhance the DSM-III diagnosis of ADD subjects in the sense of making it more predictive of clinical outcome at follow-up. Past research of ours and others indicates that an augmentation-reduction procedure, in which the individual responds to tones of increasing intensity, differentiates hyperactive ADD children from controls and is predictive of therapeutic drug dose. We will attempt to replicate and extend these results using signal detection techniques which would appear to be superior to augmenting procedures for purposes of studying nervous system sensitivity and attentional processes. Russian investigators refer to sensitivity as strength. This is assessed by them as a subject's ability to detect stimuli low in intensity and/or to withstand strong stimuli. We extend this definition to include four hypothesized relatively independent dimensions: sensitivity to tones low and high in intensity and sensitivity to reward and punishment. These four laboratory measures will be correlated with dimensional aspects of personality, including impulsivity, aggressivity, anxiety-proneness, and sensation seeking. Subjects will be grouped post hoc in several ways: (a) on the basis of DSM-III diagnosis; (b) on the basis of DSM-III and personality attributes; (c) on the basis of DSM-III diagnoses and sensitivity indices; and (d) on the basis of DSM-III, personality, and sensitivity measures. We hypothesize that (b), (c) and (d) will be more predictive of clinical outcome than (a). We also expect (b) to correlate more closely with the laboratory measures of sensitivity than (a), but expect (b) and (c) to be independent predictors of outcome and to correlate about equally with outcome. And we expect (d) to be the best predictor of outcome, particularly for children receiving methylphenidate.