Psychosocial Treatment for ADHD Inattentive Type 1

描述（由申请人提供）：本申请旨在开发和评价一种针对注意力缺陷多动障碍，主要是注意力不集中型（ADHD-I）的综合心理社会治疗（PST）。ADHD-I是一种高度流行和严重的儿童精神疾病，具有显著的学业和社会障碍。ADHD-I儿童与已被广泛研究的ADHD-C儿童的不同之处在于，他们具有不适应的注意力不集中水平，但较少出现多动，冲动和反社会行为的问题。最近的研究还表明，ADHD-I中存在独特的认知问题，其特征是认知克里思缓慢。没有经验研究的心理干预与ADHD-I可用，虽然这些干预措施可能是治疗ADHD病例的第一线没有严重的多动症/冲动或共病的破坏性行为障碍，如那些与ADHD-I。具体目标是：（1）开发针对ADHD-I的手动心理社会干预，旨在减少多个领域的症状严重程度和功能障碍（例如，（2）通过开放试验（N=12）进行干预试验，并根据临床结果和参与者、临床医生和研究调查者的反馈进行必要的修改;（3）在诊断为ADHD-1的儿童的初始随机临床试验中使用修改后的治疗手册（N=60），包括治疗组和社区对照组，以评估干预的短期疗效;（4）在2个月随访时检查治疗收益的持久性。长期目标是在更大规模的随机试验中应用这种治疗方法，包括与兴奋剂药物和多模式治疗组合进行比较。建议的治疗强调实用性，易于复制和普遍性，重要的是我们的额外的长期计划，研究治疗的有效性在社区和传播干预学校和精神卫生从业人员。我们还期望获得基于个体对治疗的反应的信息，以进一步了解ADHD-I。

DESCRIPTION (provided by applicant): This is an application to develop and evaluate an integrated psychosocial treatment (PST) for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive type (ADHD-I). ADHD-I is a highly prevalent and serious childhood psychiatric disorder with significant academic and social impairment Children with ADHD-I differ from those with the well-studied ADHD-Combined Type (ADHD-C) in that they have maladaptive levels of inattention, but fewer problems of hyperactivity, impulsivity and antisocial behavior. Recent work also suggests unique cognitive problems in ADHD-I characterized by a sluggish cognitive tempo. No empirical studies of psychosocial interventions with ADHD-I are available, although these interventions may be the first line of treatment for ADHD cases without severe hyperactivity/impulsivity or comorbid disruptive behavior disorders, such as those with ADHD-I. The specific aims are to: (1) Develop a manualized psychosocial intervention for ADHD-I aimed at reducing symptom severity and functional impairment across multiple domains (e.g., academic, social, family, other externalizing and internalizing psychopathology); (2) Pilot the intervention through an open trial (N=12) and modify it as needed based on clinical outcomes and feedback from participants, clinicians, and study investigators; (3) Utilize the modified treatment manual in an initial randomized clinical trial of children diagnosed with ADHD-I (N=60), including a treated group and a community control group, to evaluate the short-term efficacy of the intervention; (4) Examine the durability of treatment gains at 2-month follow-up. The long-terms aims are to apply the treatment in larger-scale randomized trials including comparisons with stimulant medication and multimodal treatment combinations. The proposed treatment emphasizes practicality, ease of replication, and generalizability, important to our additional long-term plans of studying the treatment's effectiveness in the community and disseminating the intervention to schools and mental health practitioners. We also anticipate obtaining information, based on individual response to treatment, to further our understanding of ADHD-I.