Standard versus Culturally-Modified ADHD Treatment

摘要 注意力缺陷多动障碍（ADHD）是最常见的精神健康问题之一。 儿童疾病，影响约5%的青年（阿帕，2013）。长期的、发展的 ADHD的发展轨迹表明，这些儿童继续经历使人衰弱的症状， 严重的学术，社会和家庭困难进入成年期（Biederman等人，2012年）。考虑到 与ADHD相关的功能障碍对个人和社会，当务之急是有效的， ADHD的治疗应该提供给尽可能多的受影响的年轻人。鉴于惊人的精神 美国一些快速增长的少数民族群体（如拉丁美洲人）的健康差距， 特别重要的是，要确保为这些身体状况不佳的儿童提供有效的治疗， 在治疗结果研究中，检查父母对ADHD或其他 外化障碍（弗洛雷斯和TCOPR，2010;米兰达等人，2005年;美国人口普查局，2008年）。因此， 与R21的目标相一致，目前的试点研究旨在弥补我们在知识上的现有差距 通过提供有关拉丁美洲家庭的初步数据， 文化修饰治疗的可接受性和有效性，以及支持未来治疗的可能调节剂 R01。具体来说，目前的试点研究是一个更大的研究计划的第一步， 在检查参与度时，确定文化修饰治疗是否优于标准治疗， 可接受性结局，以及泌尿学和父母功能，如果是，哪种治疗 修改是必要的，为谁。参与者将是60名患有ADHD的拉丁裔儿童及其父母。 家庭将接受标准循证治疗或文化改良治疗。以下 目的将探讨：1）文化修饰的治疗是否会导致更好的参与和接受 结果（即，父母的出勤率、保留率、参与度和满意度）高于标准治疗， 这些影响的强度是什么，2）文化改变的治疗是否会改善ADHD 以及父母的功能（即，父母的压力和效能），是否修改 治疗结果与标准治疗相似或更大的改善，这些治疗的优势是什么？ 影响，以及3）什么可能的调节器（即，社会经济地位以及行为和认知 文化适应）可以解释治疗类型（即，标准与文化修饰） 以及这些互动的强度。

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed mental health disorders in children, affecting approximately 5% of youth (APA, 2013). The long-term, developmental trajectory of ADHD suggests that these children continue to experience debilitating symptoms, as well as significant academic, social, and family difficulties into adulthood (Biederman et al., 2012). Given the impact of functional impairment associated with ADHD on the individual and society, it is imperative that effective treatment for ADHD be made available to as many affected youth as possible. In light of staggering mental health disparities for some of the fast growing ethnic minority groups in the United States, such as Latinos, it is particularly important to ensure effective treatment is available to these children who have not been well represented in treatment outcome studies examining parent management training for ADHD or other externalizing disorders (Flores & TCOPR, 2010; Miranda et al., 2005; U.S. Census Bureau, 2008).Thus, consistent with the goals of an R21, the current pilot study aims to close the existing gap in our knowledge about effective psychosocial treatments for Latino families by providing preliminary data regarding the acceptability and efficacy of a culturally-modified treatment and possible moderators that will support a future R01. Specifically, the current pilot study is the first step in a larger program of research aimed at definitively determining if culturally-modified treatment outperforms standard treatment when examining engagement and acceptability outcomes, as well as symptomatology and parental functioning, and if so, which treatment modifications are necessary and for whom. Participants will be 60 Latino children with ADHD and their parents. Families will receive either standard evidence-based treatment or culturally-modified treatment. The following aims will be explored: 1) does culturally-modified treatment result in better engagement and acceptability outcomes (i.e., parental attendance, retention, engagement, and satisfaction) than standard treatment and what is the strength of these effects, 2) does culturally-modified treatment result in improvements in ADHD symptomatology, as well as parental functioning (i.e., parenting stress and efficacy), does the modified treatment result in similar or greater improvements than standard treatment, and what is the strength of these effects, and 3) what possible moderators (i.e., socioeconomic status and behavioral and cognitive acculturation) may explain the relationship between treatment type (i.e., standard versus culturally-modified) and outcomes and what is the strength of these interactions.