MULTIMODAL TREATMENT STUDY OF CHILDREN WITH ADHD (MTA)

此竞争性续展申请需要多年的资金支持 06至10年的NIMH协同多模式治疗研究 注意缺陷多动障碍儿童(MTA研究)。 在一项平行分组设计中，576名被严格诊断为 7-9岁的ADHD(6个地点各96人)被随机分配到4个地点 治疗条件：(1)单纯药物治疗；(2)单纯心理社会治疗；(3) 综合(药物和心理社会)；或(4)评估-和- 仅限推荐。除了后者，所有人都接受了为期14个月的强化治疗， 所有受试者在基线、3、9、14和24个月进行评估。 因此，最初的MTA设计提供了短期(10个月后- 治疗)随访24个月，但资金和时间不足 阻止了较长期的随访。这一继续请求，一致 与05年的配套竞争副刊一起，将开始 随访辨证施治效果的长期随访 所有受试者至少完成他们的第五年(治疗后4年)。 继续的目标1是对假设进行验证性测试 联合治疗策略明显更有效 产生长期的治疗收益并防止新的精神病 病理学而不是药物或心理社会--单独治疗 这种差异在临床上是有意义的。续写目标2是 对系统性、集约化的假设进行验证性测试 治疗(所有3种有效的MTA治疗)明显更多 在产生长期治疗方面有效(统计和临床) 与通常的治疗方法相比，获得和预防新的精神病理学 在社区中受到欢迎。延续目标3是进行 对系统性治疗的假设的验证性检验 儿童早期的ADHD改变了随后的模式 药物使用和滥用，风险改变是临床上的 意义重大。继续的目标4是进行探索性分析 确定治疗前的个体差异(严重程度、 共病、父母功能、家族史)与 治疗效果的稳定/变化模式。续写目标5是 进行探索性分析以确定 治疗态度或归因的稳定性/变化模式和 与治疗相关的行为作为随机分配的函数而变化 治疗前后的功能差异，治疗后 治疗报告的满意度，以及既往存在的特点。

This Competing Continuation Application requests funding for Years 06 to 10 of the NIMH collaborative Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA Study). In a parallel-group design, 576 rigorously diagnosed children with ADHD (96 at each of 6 sites), age 7-9, are randomly assigned to four treatment conditions: (1) Medication-only; (2) Psychosocial-only; (3) Combined (medication & psychosocial); or (4) Assessment-and- Referral-only. All but the latter are treated intensively for 14 months, with assessments for all subjects at baseline, 3, 9, 14, and 24 months. The original MTA design thus provides short-term (10 months post- treatment) follow-up at 24 months, but insufficient funds and time prevented longer-term follow-up. This Continuation request, in concert with the companion Competing Supplement for Year 05, would begin the longer-term follow-up of differential treatment effects by following all subjects at least through their 5th year (4 yr post-treatment). Continuation Aim 1 is to conduct confirmatory tests of the hypothesis that a Combined Treatment strategy is significantly more effective in producing long-term therapeutic gains and preventing new psycho pathology than Medication or Psychosocial-treatment alone and that the difference is clinically meaningful. Continuation Aim 2 is to conduct confirmatory tests of the hypothesis that systematic, intensive treatments (all 3 active MTA treatments) are significantly more effective (statistically and clinically) in producing long-term therapeutic gains and preventing new psychopathology than treatments typically received in the community. Continuation Aim 3 is to conduct confirmatory tests of the hypothesis that systematic treatments for ADHD in early childhood alter the risk for subsequent patterns of substance use and abuse and that the risk alteration is clinically significant. Continuation Aim 4 is to conduct exploratory analyses to determine whether pre-treatment individual differences (severity, comorbidity, parent functioning, family history) are associated with patterns of stability/change in treatment effects. Continuation Aim 5 is to conduct exploratory analyses to determine the extent to which patterns of stability/change in therapeutic attitudes or attributions and in treatment-related behaviors vary as a function of randomly assigned treatment, pre- or post-treatment differences in functioning, post- treatment reports of satisfaction, and preexisting characteristics.