MULTIMODAL TREATMENT STUDY OF CHILDREN WITH ADHD (MTA)

这一竞争延续申请要求多年的资金 06至10 NIMH合作多模式治疗研究 儿童注意力缺陷多动障碍（MTA研究）。 在一项平行组设计中，576名严格诊断为 ADHD（6个地点各96名），年龄7-9岁，被随机分配到4个 治疗条件：（1）仅药物治疗;（2） （3）综合治疗（药物治疗和 心理社会）治疗;或（4）仅评估和转诊 条件除后者外，所有人都接受了14个月的强化治疗， 所有受试者在基线、3、9、14和24个月时的评估。的 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 阻碍了长期随访。这一延续请求， 与同伴竞争补充04年和05年，将 开始对不同治疗效果的长期随访， 对所有受试者至少随访至第5年（术后4年）。 治疗）。目标1是对 假设联合治疗策略，整合药物 和心理社会成分，在生产方面更有效， 长期的治疗收益和预防新的精神病理学， 药物或心理治疗，区别在于 有临床意义。延续目标2是进行确证性 系统强化治疗（所有3种MTA） 治疗）显著更有效（统计学和临床）， 产生长期的治疗效果， 精神病理学比通常在社区接受的治疗。 目的3是对假设进行验证性检验 早期ADHD的系统性最先进的治疗方法 童年改变了随后使用药物的模式的风险， 滥用，并且风险改变具有临床意义。 延续目标4是进行探索性分析，以确定 治疗前个体差异（严重程度，合并症， 父母功能，家族史）与 治疗效果的稳定性变化。目标5：开展 探索性分析，以确定 治疗态度、归因、哲学的稳定性/变化， 治疗相关行为随随机分配的 治疗前后功能差异，治疗后 满意度报告和先前存在的特征。

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 )a Medication-only Treatment; (2) a Psychosocial-only Treatment; (3) a Combined (medication & psychosocial) Treatment; or (4) an Assessment-and Referral-only condition. 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-tenn (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 years 04 and 05, would begin the longer-term follow-up of differential treatment effects by following all subjects at least through heir 5th year (4 yr post- treatment). Continuation Aim 1 is to conduct confirmatory tests of the hypothesis that a Combined Treatment strategy, integrating medication & psychosocial components, is significantly more effective in producing long-term therapeutic gains and preventing new psychopathology 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 MTA treatments) 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, state-of-the-art 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, attributions, philosophies, and treatment-related behaviors vary as a function of randomly assigned treatment, pre-posttreatment differences in functioning, post-treatment reports of satisfaction, and preexisting characteristics.