VALIDITY OF DSM-N SUBTYPES OF ADHD FOR YOUNG CHILDREN

注意缺陷多动障碍（ADHD）的DSM-IV定义 区分了一种新的ADHD亚型，这种亚型在DSM-III或DSM-III中没有被识别出来， R.符合主要多动-冲动型标准的儿童 型（PreH）表现出高水平的多动症和冲动，但 没有报告说有缺陷的注意力被认为是 多动症的标志这种亚型在发育方面是有区别的： 因为四分之三的PreH型儿童< 7岁， 年龄，这是假设他们代表了较轻的情况下，充分多动症 注意力缺陷尚不明显的幼儿综合征。 随着患有这种亚型ADHD的儿童年龄的增长，预计他们会 将被报告表现出更高水平的注意力不集中， 被置于更具挑战性的教育环境中， 他们轻微但仍在损害的注意力缺陷。因此新 PreH亚型可能有助于在学龄前早期识别ADHD 注意力不集中的年龄不能很好地测量。是非常重要 然而，测试这种发展模式，因为有重要的原因， 担心PreH类型实际上可能导致不正确的 识别没有注意力的正常活跃儿童 缺陷，没有功能受损，谁将很快超越他们的 运动机能亢进不像同龄的多动症儿童 综合征，PreH型与对照组在任何指标上均无差异， 同伴社会关系受损或学龄前适应 DSM-IV现场试验（仅在全球范围内被成年人评为受损） 措施）。因此，学龄前儿童PreH类型的有效性 将在拟议的研究中通过检验假设， 与对照组相比， 受试者在挑战情境中会暴露出他们的注意力 赤字，并将表现出更大的损害比控制措施， 社会能力和母子互动，更敏感， 与DSM-IV田间试验中使用的那些相比，有效性 的PreH型也将通过测试的发展进行审查， 假设他们将被报告表现出越来越多的 注意力不集中症状和学业障碍超过四年的结果 越来越具有挑战性的教育需求。患儿 注意力不集中多动-冲动综合征 合并类型）预计将显示相同形式的减值， PreH型，但在相同年龄时严重程度更高。此外该 拟议的研究将是第一个研究的稳定性的诊断 ADHD在学龄前儿童中随时间的变化， 研究青少年早期出现的严重品行问题 ADHD儿童

The DSM-IV definition of Attention-deficit Hyperactivity Disorder (ADHD) distinguishes a new subtype of ADHD not identified in DSM-III or DSM-III- R. Children who meet criteria for the Predominantly Hyperactive-impulsive Type (PreH) exhibit high levels of hyperactivity and impulsivity, but are not reported to have the deficits in attention considered to be the hallmark of ADHD. This subtype was distinguished on developmental grounds: Because three-quarters of children with the PreH Type are < 7 years of age, it was assumed that they represent milder cases of the full ADHD syndrome in young children whose attention deficits are not yet evident. As children with this subtype of ADHD grow older, it is expected that they will be reported to exhibit higher levels of inattention as a result of being placed in more challenging educational environments that reveal their mild, but still impairing attention deficits. Therefore, the new PreH subtype may facilitate the early identification of ADHD at preschool ages when inattention cannot be measured well. It is very important to test this developmental model, however, as there are important reasons for concern that the PreH Type may actually lead to the incorrect identification of normal, active children who do not have attention deficits, are not functionally impaired, and who will soon outgrow their motor hyperactivity. Unlike children of the same age with the full ADHD syndrome, the PreH Type did not differ from controls on any measure of impairment in peer social relationships or preschool adjustment in the DSM-IV Field Trials (they were only rated as impaired by adults on global measures). Therefore, the validity of the PreH Type in preschool children will be examined in the proposed study by testing the hypothesis that they will exhibit significantly less attending behavior than matched control subjects in challenge situations that will reveal their attention deficits, and will exhibit greater impairment than controls on measures of social competence and mother-child interaction that are more sensitive and age-appropriate than those used in the DSM-IV Field Trials. The validity of the PreH Type also will be examined developmentally by testing the hypothesis that they will be reported to exhibit progressively more inattention symptoms and academic impairment over four years as a result of increasingly more challenging educational demands. Children with the full syndrome of inattention and hyperactivity-impulsivity (DSM-IV Combined Type) are expected to show the same forms of impairment as the PreH Type, but with greater severity at the same ages. In addition, the proposed study would be the first study of the stability of the diagnosis of ADHD over time in preschool children and the first prospective examination of the early emergence of serious conduct problems in young children with ADHD.