Integrated Tx for Depressed Mothers of ADHD Children

描述（由申请人提供）：注意力缺陷/多动障碍（ADHD）儿童的父母经历了大量的养育压力，并且比非障碍儿童的父母更有可能自己经历精神病理学。理论上，这样的父母问题可能会对父母产生负面影响，从而加剧儿童行为问题，在ADHD儿童的家庭中产生负面亲子互动的互惠模式。父母的精神病理学对儿童治疗也有重要的影响。鉴于儿童多动症的行为和药物治疗都依赖于父母（特别是母亲）获得和持续给予治疗，因此父母的精神病理学（特别是母亲的抑郁症）预测儿童治疗反应较差也就不足为奇了。然而，现有的ADHD治疗在很大程度上未能直接解决父母的问题。拟议项目的目标是开发和评估一种新颖的，综合的方法，为患有ADHD的儿童的母亲进行行为父母培训，以促进治疗后的成功结果。在第一阶段，我们将完成手动治疗的开发和完善，整合两种经验验证的治疗方法：认知行为抑郁干预（具体来说，应对抑郁课程）和ADHD的行为父母培训。在第二阶段，将招募88名患有ADHD和抑郁症状升高的儿童的母亲，并随机分配到：1）标准行为父母培训或2）综合父母干预（IPI-A）。结果测量包括母亲自我报告的抑郁情绪（主要），父母的压力，自尊，期望和归因于儿童行为，父母的能力感，自我报告和观察的父母的行为和父母报告的儿童行为和相关的家庭损害。根据这项初步试验的结果，IPI-A方案将进一步完善，并为更大规模的临床试验做好准备。

DESCRIPTION (provided by applicant): Parents of children with attention-deficit/hyperactivity disorder (ADHD) experience a great deal of parenting stress and are far more likely than parents of non-disordered children to experience psychopathology themselves. It has been theorized that such parental problems may negatively impact parenting, which then exacerbates child behavior problems, creating a reciprocal pattern of negative parent-child interactions within the families of children with ADHD. There are also important implications of parental psychopathology on child treatment. Given that both behavioral and pharmacological treatments for childhood ADHD rely on parents (particularly mothers) to obtain and consistently administer treatment, it is no surprise that parental psychopathology (particularly maternal depression) predicts poorer child treatment response. Yet, existing ADHD treatments largely fail to directly address parental problems. The objective of the proposed project is to develop and evaluate a novel, integrated approach to behavioral parent training for mothers of children with ADHD with elevated depressive symptoms in order to facilitate successful outcomes following treatment. In Phase 1, we will complete the development and refinement of a manualized treatment, integrating the two empirically validated treatments: cognitive-behavioral depression intervention (specifically, the Coping with Depression Course) and behavioral parent training for ADHD. In Phase 2, 88 mothers with children with ADHD and elevated depressive symptoms will be recruited and randomly assigned to either: 1) standard behavioral parent training or 2) integrated parent intervention (IPI-A). Outcome measures include maternal self-reports of depressed mood (primary), parenting stress, self-esteem, expectations and attributions for child behavior, parenting sense of competence, self-reported and observed parenting behavior and parental reports of child behavior and associated family impairment. Based on the outcome of this preliminary trial the IPI-A protocol will be further refined and prepared for larger-scale clinical trials.