ATTENTIONAL DEFICIT CHILDREN: A DIMENSIONAL ANALYSIS

这项研究将描绘人格的某些维度 （冲动，焦虑倾向和感觉寻求）和实验室 神经系统敏感性的措施，在200异质，临床和 学校转介的注意力缺陷障碍（ADD）受试者（结构化 访谈诊断）和50名对照。 行为和生理 将在增减和信号期间获得措施 检测程序。 主要目标是构建决策树 这将增强DSM-III对ADD主题的诊断， 使其更能预测随访时的临床结果。 我们和其他人过去的研究表明， 程序，其中个人对增加的音调做出反应 强度，区分多动症儿童从控制， 预测治疗药物剂量。 我们将尝试复制， 使用信号检测技术扩展这些结果， 上级增强程序，以研究神经 系统敏感性和注意力过程。 俄罗斯调查人员指， 把敏感当成力量 这是由他们评估作为一个主题的 检测低强度刺激和/或承受强刺激的能力 刺激。 我们将这一定义扩展到包括四个假设的相对 独立维度：对低强度和高强度音调的敏感性， 对奖励和惩罚的敏感性。 这四项实验室措施将 与人格的维度相关，包括 冲动性、攻击性、焦虑倾向和寻求感觉。 受试者将以几种方式进行事后分组：（a）根据 （B）基于DSM-III和人格属性; (c)根据《诊断及统计手册》第三版的诊断及敏感指数;及（d）根据 DSM-III的基础，个性和敏感性测量。 我们 假设（B）、（c）和（d）将更能预测临床 结果是（a）。 我们还期望（B）与 实验室测量灵敏度高于（a），但预计（B）和（c） 结果的独立预测因素， 结果。 我们希望（d）是最好的预测结果， 特别是对于接受哌醋甲酯的儿童。

This study will map certain dimensional aspects of personality (impulsivity, anxiety-proneness, and sensation seeking) and laboratory measures of nervous system sensitivity in 200 heterogeneous, clinically and school referred attention deficit disordered (ADD) subjects (structured interview diagnosis) and 50 controls. Behavioral and physiological measures will be obtained during augmentation-reduction and signal detection procedures. The primary goal is to construct a decision tree that will enhance the DSM-III diagnosis of ADD subjects in the sense of making it more predictive of clinical outcome at follow-up. Past research of ours and others indicates that an augmentation-reduction procedure, in which the individual responds to tones of increasing intensity, differentiates hyperactive ADD children from controls and is predictive of therapeutic drug dose. We will attempt to replicate and extend these results using signal detection techniques which would appear to be superior to augmenting procedures for purposes of studying nervous system sensitivity and attentional processes. Russian investigators refer to sensitivity as strength. This is assessed by them as a subject's ability to detect stimuli low in intensity and/or to withstand strong stimuli. We extend this definition to include four hypothesized relatively independent dimensions: sensitivity to tones low and high in intensity and sensitivity to reward and punishment. These four laboratory measures will be correlated with dimensional aspects of personality, including impulsivity, aggressivity, anxiety-proneness, and sensation seeking. Subjects will be grouped post hoc in several ways: (a) on the basis of DSM-III diagnosis; (b) on the basis of DSM-III and personality attributes; (c) on the basis of DSM-III diagnoses and sensitivity indices; and (d) on the basis of DSM-III, personality, and sensitivity measures. We hypothesize that (b), (c) and (d) will be more predictive of clinical outcome than (a). We also expect (b) to correlate more closely with the laboratory measures of sensitivity than (a), but expect (b) and (c) to be independent predictors of outcome and to correlate about equally with outcome. And we expect (d) to be the best predictor of outcome, particularly for children receiving methylphenidate.