Integrated Multi-Setting Psychosocial Treatment for ADHD-Inattentive Type

ADHD-注意力不集中型的综合多环境心理社会治疗

• 批准号: 8299152
• 负责人: STEPHEN HINSHAW
• 金额: $ 63.13万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8299152
• 关键词: Academic achievement; Age; Attention; Attention deficit hyperactivity disorder; Behavior Therapy; Child; Childhood; Clinic; Communities; Complement; Consultations; Control Groups; DSM-IV; Data; Decision Making; Disease; Educational Curriculum; Effectiveness; Evaluation; Family; Functional disorder; Funding; Goals; Grant; Home environment; Hyperactive behavior; Impairment; Impulsivity; Intervention; Language; Life; Literature; Measures; Medicine; Mental disorders; Modeling; Modification; Neurocognitive; Outcome; Parent-Child Relations; Parenting behavior; Parents; Pharmaceutical Preparations; Protocols documentation; Publishing; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Rehabilitation therapy; Relative (related person); Research; Schools; Site; Social Functioning; Structure; Symptoms; Testing; Training; Treatment outcome; Work; active method; base; behavior change; blind; design; evidence base; follow-up; improved; inattention; intervention effect; novel; peer; programs; psychosocial; public health relevance; skills; skills training; social; teacher; therapy development; treatment as usual; treatment effect; trial comparing

DESCRIPTION (provided by applicant): Attention Deficit Hyperactivity Disorder-Predominantly Inattentive Type (ADHD-I) is a highly prevalent and serious childhood psychiatric disorder [with evidence that impairment is severe and persistent]. Children with ADHD-I have a profile of attention deficits, comorbid disorders, social impairments, and neurocognitive dysfunction that differs from that associated with ADHD-Combined Type (ADHD-C). The extent of these differences precludes straightforward assumptions that treatment outcome findings for ADHD-C can be generalized to ADHD-I. Through funding from an R21 Treatment Development grant, we have developed a novel psychosocial treatment (Integrated Multi-Setting Psychosocial Treatment--IPT) for ADHD-I. IPT combines a standard behavioral treatment for ADHD (parent training) that has been adapted for ADHD-I, with child life skills training (supportive strategies drawn from rehabilitation medicine) and with teacher consultation. As part of the R21, we conducted a small-scale randomized controlled trial comparing IPT to an untreated control group and demonstrated (a) significant treatment effects on inattention, and academic and social impairment, and (b) feasibility and acceptability of the model. These positive outcomes justify the current application, which aims to provide a dual-site, randomized clinical trial of IPT. We will randomize [210] children with ADHD-I ages 7-11 (2nd-5th grades) to IPT ([N=78]), Parent-Focused Training (PFT, [N=78]), or Treatment as Usual, TAU ([N=54]). The goal of the RCT is to test whether IPT provides superior reduction of DSM-IV inattention symptoms as rated by parents and teachers (the primary endpoint), in comparison to standard community treatment, TAU; and to [PFT], which constitutes an active treatment that is effective at reducing symptoms of ADHD. We will include medicated and unmedicated children and will recruit from a broad array of clinics and schools, consistent with our goal of increasing generalizability. Secondary analyses will evaluate the effects of the intervention across multiple domains of impairment including academic and social functioning and on objective measures of attention and parenting derived from observations during standard clinic-based tasks, and on curriculum-based measures of academic achievement. We predict that ADHD-I symptoms will be significantly lower and, secondarily, that academic and social functioning will be significantly higher, in IPT relative to TAU]. We hypothesize that ADHD-I symptoms will be significantly lower and, secondarily, that academic and social functioning will be significantly higher, in the IPT group relative to [PFT]. We will also examine the durability of treatment gains at [5-7] month follow-up. We predict that ADHD-I symptoms will remain lowest and academic/social functioning will remain highest in the IPT group relative to the other groups at follow-up. PUBLIC HEALTH RELEVANCE STATEMENT Attention-deficit\Hyperactivity Disorder, Predominantly Inattentive type is a prevalent and serious childhood psychiatric disorder which severely and persistently impacts a child's functioning at school, at home, and with peers. This study aims to evaluate the effectiveness of a behavioral intervention, integrating school, home and child skills components, for improving attentional symptoms and academic and social functioning in these children.

描述（由申请人提供）：注意力缺陷多动障碍（ADHD-I）是一种高度普遍且严重的儿童精神障碍[有证据表明损害是严重且持续的]。患有 ADHD-I 的儿童具有与 ADHD 合并型 (ADHD-C) 相关的注意力缺陷、共病障碍、社交障碍和神经认知功能障碍的特征。这些差异的程度排除了 ADHD-C 的治疗结果结果可以推广到 ADHD-I 的直接假设。通过 R21 治疗开发赠款的资助，我们开发了一种针对 ADHD-I 的新型心理社会治疗（综合多环境心理社会治疗 - IPT）。 IPT 结合了适用于 ADHD-I 的 ADHD 标准行为治疗（家长培训）、儿童生活技能培训（来自康复医学的支持策略）以及教师咨询。作为 R21 的一部分，我们进行了一项小规模随机对照试验，将 IPT 与未经治疗的对照组进行比较，并证明了 (a) 对注意力不集中、学业和社交障碍的显着治疗效果，以及 (b) 该模型的可行性和可接受性。这些积极的结果证明了当前申请的合理性，该申请旨在提供 IPT 的双中心、随机临床试验。我们将 [210] 名 7-11 岁（2-5 年级）患有 ADHD-I 的儿童随机分为 IPT（[N=78]）、以家长为中心的培训（PFT，[N=78]）或常规治疗、TAU（[N=54]）。 RCT 的目标是测试与标准社区治疗 TAU 相比，IPT 是否能显着减少 DSM-IV 注意力不集中症状（如家长和教师评价）（主要终点）；以及[PFT]，它是一种积极的治疗方法，可有效减轻多动症的症状。我们将包括接受药物治疗和未接受药物治疗的儿童，并将从广泛的诊所和学校招募儿童，这符合我们提高普遍性的目标。二次分析将评估干预对多个损伤领域的影响，包括学术和社会功能，以及对基于标准临床任务期间观察的注意力和养育的客观衡量标准，以及对基于课程的学业成就衡量标准的影响。我们预测，相对于 TAU，IPT 中 ADHD-I 症状将显着降低，其次，学业和社会功能将显着提高]。我们假设，相对于 [PFT]，IPT 组的 ADHD-I 症状将显着降低，其次，学业和社会功能将显着提高。我们还将在[5-7]个月的随访中检查治疗效果的持久性。我们预测，在随访中，相对于其他组，IPT 组的 ADHD-I 症状将保持最低，学业/社会功能将保持最高。公共卫生相关声明 注意力缺陷\多动症（主要是注意力不集中型）是一种普遍且严重的儿童精神疾病，严重且持续地影响儿童在学校、家庭以及与同龄人相处的功能。本研究旨在评估行为干预的有效性，整合学校、家庭和儿童技能成分，以改善这些儿童的注意力症状以及学业和社会功能。

项目成果

Negative social preference in relation to internalizing symptoms among children with ADHD predominantly inattentive type: girls fare worse than boys.

• DOI: 10.1080/15374416.2013.828298
• 发表时间: 2013
• 期刊: Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
• 作者: Becker SP;McBurnett K;Hinshaw SP;Pfiffner LJ
• 通讯作者: Pfiffner LJ

Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type.

家庭和学校针对儿童多动症注意力不集中型行为心理社会治疗的成本效益。

• DOI: 10.1007/s10488-018-0857-y
• 发表时间: 2018
• 期刊: Administration and policy in mental health
• 作者: Tran,JenniferLA;Sheng,Rena;Beaulieu,Allyson;Villodas,Miguel;McBurnett,Keith;Pfiffner,LindaJ;Wilson,Leslie
• 通讯作者: Wilson,Leslie

Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type.

• DOI: 10.1080/15374416.2016.1228461
• 发表时间: 2018
• 期刊: Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
• 作者: Owens EB;Hinshaw SP;McBurnett K;Pfiffner L
• 通讯作者: Pfiffner L

Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation.

家长认知的改善与多动症（主要是注意力不集中）儿童的立即和后续治疗结果相关。

• DOI: 10.1016/j.beth.2017.11.007
• 发表时间: 2018
• 期刊: Behavior therapy
• 影响因子: 3.7
• 作者: Jiang,Yuanyuan;Haack,LaurenM;Delucchi,Kevin;Rooney,Mary;Hinshaw,StephenP;McBurnett,Keith;Pfiffner,LindaJ
• 通讯作者: Pfiffner,LindaJ