DSM-IV ADHD IN AN ETHNICALLY DIVERSE COMMUNITY SAMPLE

拟议的项目将测试DSM-IV注意缺陷/多动障碍在包括很大比例非裔美国人和西班牙裔儿童在内的不同种族人群中的内部和外部有效性。将在丹佛大都会地区的大社区样本中获得ADHD的家长和教师评级。拟议的研究将提供对非裔美国人和西班牙裔儿童中DSM-IV ADHD流行率的首次估计，以及DSM-IV ADHD三种诊断亚型中每一种的流行率。对ADHD患病率的种族差异的几种相互矛盾的解释将被测试，包括评分者的偏见和对偏见的反应。将使用探索性和验证性因素分析来测试诊断的内部结构是否随着种族的不同而变化。将评估人口统计变量，如社会经济状况、居住地点、暴露于环境压力源和评分者种族，以测试这些变量是否解释了不同种族儿童评级的差异。将采用功能障碍和共病精神病理学的测量方法来测试来自不同种族的ADHD儿童在这些领域是否表现出差异。为了评估非裔美国人儿童多动症的病因，将对200名患有多动症的先证者和从整个非裔美国人样本中挑选的200名对照先证者进行更广泛的评估。将对父母的ADHD进行评估，以测试ADHD在非裔美国人人口中是否具有显著的家族性，并将获得有关怀孕或分娩期间困难的数据，以测试围产期并发症是否与ADHD有关。DNA样本将从所有先证者、他们的父母以及在年龄上与先证者最接近的亲生兄弟姐妹那里获得。病例对照和同胞对比较，以及传递不平衡检验，将首次在AA样本中进行几个理论上可信的候选基因与ADHD之间的遗传关联。

The proposed project will test the internal and external validity of DSM-IV attention- deficit/hyperactivity disorder in an ethnically diverse population that includes a large proportion of African American and Hispanic children. Parent and teacher ratings of ADHD will be obtained for a large community sample of children in the Denver metropolitan area. The proposed study will provide the first estimates of the prevalence of DSM-IV ADHD among African American and Hispanic children, as well as the prevalence of each of the three diagnostic subtypes of DSM-IV ADHD. Several competing explanations for ethnic differences in the prevalence of ADHD will be tested, including rater bias and response to prejudice. Exploratory and confirmatory factor analysis will be used to test if the internal structure of the diagnosis varies as a function of ethnicity. Demographic variables such as socioeconomics status, location of residence, exposure to environmental stressors, and rater ethnicity will be assessed to test if these variables account for differences in the ratings of children from different ethnic groups. Measures of functional impairment and comorbid psychopathology will be administered to test if children with ADHD from different ethnic groups exhibit differences in these domains. In order to assess the etiology of ADHD in African American children, more extensive assessments will be conducted with 200 probands with ADHD and 200 comparison probands selected from the overall African American sample. Parental ADHD will be assessed to test if ADHD is significantly familial in an African American population, and data will be obtained regarding difficulties during pregnancy or delivery to test if perinatal complications are associated with ADHD. DNA samples will be obtained from all probands, their parents, and the biological sibling closest in age to the proband. Case- control and sib-pair comparisons, and the transmission disequilibrium test will be used to conduct the first for genetic association between several theoretically plausible candidates genes and ADHD in an AA sample.