Understanding ADHD in Low-Income Latino Children.

描述(由申请人提供)：大多数关于注意力缺陷/多动障碍(ADHD)的研究都是在居住在郊区的白人中产阶级男孩样本群中进行的。尽管拉丁裔将很快成为这个国家最大的少数民族群体，但与ADHD有关的研究很少。需要进行研究，以确定在文化上敏感、有效和在临床上有用的方法来诊断ADHD，并评估临床特征，如拉美裔儿童的损害水平和共病模式。为考虑到该国大多数拉美裔儿童独特的文化、历史和社会经济特征而专门制定的理论框架将极大地促进对患有多动症的拉美裔儿童的研究。该项目的研究目标是(1)确定在低收入城市环境下生活的拉丁裔和白人儿童样本中诊断ADHD所需的DSM-IV(美国精神病学协会，1994)的最佳症状数量；(2)确定ADHD评定量表IV上患有ADHD的拉丁裔和白人儿童的最佳截止分数；(3)确定生活在低收入城市环境中的拉丁裔和白人儿童在ADHD、混合型(ADHD/COM)共病模式上的不同；(4)探讨家族主义(一种文化价值观，涉及对核心家庭和大家庭成员的强烈认同和依恋)、文化适应与拉丁裔儿童的损害和共病程度之间的关系。为了测试AIMS(1)至(4)，将评估100名由教师转介的拉丁裔儿童和100名由教师转介的6至13岁的白人儿童，他们就读于以拉丁裔和白人学生为主的低收入地区的七所公立学校。我未来五年的目标是进行独立研究，调查拉丁裔儿童和患有ADHD的家庭出现的诊断和临床问题。为了让我精通这些领域，我和我的导师们制定了一项有四个具体目标的教育计划：1.精通了解应对ADHD的拉丁裔家庭的独特需求；2.在评估拉丁裔儿童的ADHD方面发展知识和实践技能；3.了解患有ADHD的拉丁裔儿童的共病障碍；4.更加熟练地进行研究设计和统计。此外，我将接受负责任的研究行为方面的培训。为了确保这项研究项目的所有方面都能满足拉美裔家庭的价值观和需求，我将组建一个利益相关者小组，由当地拉美裔社区的拉丁裔父母、专业人士和辅助专业人员组成。拟议的研究和教育计划的完成将使我能够成为一名熟练的独立研究员，并为目前未得到充分服务的ADHD儿童和家庭制定基于经验、具有文化敏感性的评估和干预程序。

DESCRIPTION (provided by applicant): Most research on attention-deficit/hyperactivity disorder (ADHD) has been conducted with sample groups of white, middle class boys living in suburban settings. Very few studies related to ADHD have been conducted with Latino children despite the fact that Latinos will soon be the largest ethnic minority group in this country. Research is needed to identify culturally sensitive, valid, and clinically useful methods for diagnosing ADHD and for assessing clinical characteristics such as impairment level and comorbidity patterns among Latino children. Theoretical frameworks specifically developed to take into account the unique cultural, historical, and socio-economic characteristics of most Latinos in this country would greatly facilitate research on Latino children with ADHD. The research aims of this project are (1) to determine the optimum number of symptoms from the DSM-IV (American Psychiatric Association, 1994) needed for the diagnosis of ADHD in a sample of Latino and White children living in low income urban settings; (2) to determine the optimal cut off scores for Latino and White children with ADHD on the ADHD Rating Scale IV; (3) to determine whether Latino and White children living in low-income urban settings differ in comorbidity patterns for ADHD, Combined Type (ADHD/COM); (4) to explore the relationship between familism (a cultural value that involves strong identification with and attachment to members of nuclear and extended families), acculturation and level of impairment and comorbidity among Latino children. To test Aims (1) through (4), 100 teacher-referred Latino children, and 100 teacher-referred White children between the ages of 6 and 13 attending seven public schools in a low income area with predominantly Latino and White student population will be assessed. My goal for the next five years is to conduct independent research to investigate diagnostic and clinical issues arising in Latino children and families coping with ADHD. In order for me to become proficient in these areas, my mentors and I have developed an educational plan with four specific aims: 1. To become proficient in understanding the unique needs of Latino families coping with ADHD; 2. To develop knowledge and practical skills in the assessment of ADHD among Latino children; 3. To become knowledgeable about comorbid disorders among Latino children with ADHD; 4. To become more proficient in research design and statistics. In addition, I will receive training in the responsible conduct of research. In order to insure that all aspects of this research project are responsive to the values and needs of Latino families, I will assemble a stakeholder group composed of Latino parents, professionals, and paraprofessionals from the local Latino community. The completion of the proposed research and educational plans will enable me to become a skilled independent researcher and to develop empirically based, culturally sensitive assessment and intervention procedures for what is currently an under-served segment of children and families coping with ADHD.