DSM-IV ADHD IN AN ETHNICALLY DIVERSE COMMUNITY SAMPLE

拟议的项目将测试DSM-IV注意力缺陷/多动障碍的内部和外部有效性在一个种族多样化的人口，其中包括很大比例的非洲裔美国人和西班牙裔儿童。 父母和老师的ADHD评级将获得一个大的社区样本的儿童在丹佛大都会地区。 这项拟议的研究将首次估计非裔美国人和西班牙裔儿童中DSM-IV ADHD的患病率，以及DSM-IV ADHD三种诊断亚型中每一种的患病率。将测试ADHD患病率种族差异的几种相互竞争的解释，包括评估者偏见和对偏见的反应。 探索性和验证性因素分析将用于测试诊断的内部结构是否随种族而变化。 将评估人口统计学变量，如社会经济状况、居住地、环境压力源暴露和评估者种族，以检验这些变量是否能解释不同种族儿童的评级差异。 将进行功能障碍和共病精神病理学的测量，以测试来自不同种族的ADHD儿童是否在这些领域表现出差异。为了评估非裔美国儿童ADHD的病因，将对200名ADHD先证者和从整体非裔美国人样本中选择的200名比较先证者进行更广泛的评估。 将对父母ADHD进行评估，以测试ADHD在非裔美国人人群中是否具有显著的家族性，并将获得有关妊娠或分娩期间困难的数据，以测试围产期并发症是否与ADHD相关。 DNA样本将从所有先证者，他们的父母，以及与先证者年龄最接近的生物学兄弟姐妹中获得。 病例对照和同胞对比较，以及传递不平衡检验将用于在AA样本中进行几个理论上合理的候选基因与ADHD之间的遗传关联的第一次研究。

The proposed project will test the internal and external validity of DSM-IV attention- deficit/hyperactivity disorder in an ethnically diverse population that includes a large proportion of African American and Hispanic children. Parent and teacher ratings of ADHD will be obtained for a large community sample of children in the Denver metropolitan area. The proposed study will provide the first estimates of the prevalence of DSM-IV ADHD among African American and Hispanic children, as well as the prevalence of each of the three diagnostic subtypes of DSM-IV ADHD. Several competing explanations for ethnic differences in the prevalence of ADHD will be tested, including rater bias and response to prejudice. Exploratory and confirmatory factor analysis will be used to test if the internal structure of the diagnosis varies as a function of ethnicity. Demographic variables such as socioeconomics status, location of residence, exposure to environmental stressors, and rater ethnicity will be assessed to test if these variables account for differences in the ratings of children from different ethnic groups. Measures of functional impairment and comorbid psychopathology will be administered to test if children with ADHD from different ethnic groups exhibit differences in these domains. In order to assess the etiology of ADHD in African American children, more extensive assessments will be conducted with 200 probands with ADHD and 200 comparison probands selected from the overall African American sample. Parental ADHD will be assessed to test if ADHD is significantly familial in an African American population, and data will be obtained regarding difficulties during pregnancy or delivery to test if perinatal complications are associated with ADHD. DNA samples will be obtained from all probands, their parents, and the biological sibling closest in age to the proband. Case- control and sib-pair comparisons, and the transmission disequilibrium test will be used to conduct the first for genetic association between several theoretically plausible candidates genes and ADHD in an AA sample.