PHARMACOLOGIC AND PSYCHOSOCIAL INTERVENTIONS FOR ADHD

根据申请请求(RFA)MH-92-03，本提案 详细计划受试者招募、受试者选择、兴奋剂 药物评估和长期心理社会治疗程序 与多地点/多模式治疗研究有关的儿童 注意力缺陷多动障碍(ADHD)。明显的风险在于 健康、社会关系、学业成就和预后 由患有ADHD的儿童引起的需要仔细检查组合 有效的干预方式。事实上，有必要 受控良好的多模式治疗研究得到了强调 缺乏充分的单一干预模式，包括 兴奋剂药物和行为矫正程序，这两个 对这种疾病研究最多的治疗方法。因此，这项提案提供了 与(A)基础广泛的科目征聘程序有关的信息； 旨在获得广泛的种族多样性，并包括大量 患有多动症的女孩人数；(B)多重门控评估程序， 这将产生8-10岁儿童的最终样本，这些儿童 ADHD和世卫组织严格的包容性和排除性标准 表示与多动症有关的并存诊断的范围；(C) 刺激性药物的受试者内试验--包括哌醋甲酯和 右旋苯丙胺--产生与最佳制剂相关的信息和 每个参与者的剂量；和(D)随机分配到四个人中的一个 心理社会/药物治疗组合，包括社区 治疗控制，药物治疗，没有系统的心理社会 干预，药物加一揽子心理社会干预，以及 药物治疗加上量身定做的心理社会治疗。干预将跨越 两年，在仔细监测治疗完整性的情况下 加强受试者及其成员持续参与的程序 家庭，并有一个结果小组跨越多个线人和 功能领域。首要目标是评估合并的 药物治疗和强化心理社会治疗对更年期的疗效 ADHD的病程。

In accordance with Request for Applications (RFA) MH-92-03, this proposal details plans for subject recruitment, subject selection, stimulant medication assessments, and long-term psychosocial treatment procedures relevant to a multisite/multimodal treatment study for children with attention-deficit hyperactivity disorder (ADHD). The clear risks to health, social relationships, academic success, and prognosis that are incurred by children with ADHD mandates close examination of combinations of efficacious intervention modalities. Indeed, the need for well-controlled, multimodality treatment research is underscored by the lack of sufficiency of single intervention modalities, including stimulant medication and behavior modification procedures, the two best-researched treatments for the disorder. This proposal thus provides information relevant to (a) broad-based subject recruitment procedures, designed to obtain wide ethnic diversity and to include substantial numbers of girls with ADHD; (b) multiple-gating assessment procedures, which will yield a final sample of 8-10 year-old children who meet stringent inclusionary and exclusionary criteria for ADHD and who represent the range of comorbid diagnoses that pertain to ADHD; (c) within-subject trials of stimulant medications--both methylphenidate and dextroamphetamine--to yield information related to the optimal agent and dose for each participant; and (d) random assignment to one of four psychosocial/ pharmacologic treatment combinations, including community treatment control, medication without systematic psychosocial intervention, medication plus packaged psychosocial intervention, and medication plus tailored psychosocial treatment. Intervention will span two years, with careful monitoring of treatment integrity, with procedures to enhance continued participation of the subjects and their families, and with an outcome battery spanning multiple informants and domains of functioning. The overarching goal is to assess the combined efficacy of medication and intensive psychosocial treatments for altering the course of ADHD.