Standard versus Culturally-Modified ADHD Treatment

摘要 注意力缺陷/多动障碍(ADHD)是最常见的精神健康诊断之一 儿童精神障碍，影响到大约5%的青年(APA，2013年)。长期的、发展的 ADHD的发展轨迹表明，这些儿童继续经历虚弱的症状，以及 成年后出现严重的学业、社会和家庭困难(Biederman等，2012年)。考虑到 与ADHD相关的功能障碍对个人和社会的影响，有效的 向尽可能多的受影响的青年提供多动症治疗。根据令人震惊的精神状态 对于美国一些快速增长的少数族裔群体，如拉丁裔，健康差距是 尤其重要的是要确保这些身体不适的儿童能够得到有效的治疗 在检查ADHD或其他疾病的父母管理培训的治疗结果研究中具有代表性 外部性障碍(Flores&TCOPR，2010；Miranda等人，2005；美国人口普查局，2008)。 与R21的目标一致，目前的试点研究旨在弥合我们现有知识的差距 关于为拉丁裔家庭提供有效的心理社会治疗的初步数据 文化改良治疗的可接受性和有效性，以及支持未来的可能的调节剂 R01。具体地说，目前的试点研究是一个更大的研究计划的第一步，目的是最终确定 确定文化改良治疗是否优于标准治疗在检查参与度和 可接受的结果，以及症状和父母的功能，如果是，是哪种治疗方法 修改是必要的，对谁来说也是必要的。参与者将是60名患有ADHD的拉丁裔儿童和他们的父母。 家庭将接受标准的循证治疗或文化改良的治疗。以下是 将探讨目标：1)文化改良的治疗是否会带来更好的参与度和可接受性 结果(即父母出勤率、保留率、参与度和满意度)比标准治疗和 这些影响的强度是什么？2)文化改良的治疗能改善ADHD吗？ 症状学，以及父母的功能(即，育儿压力和有效性)，修改后的 治疗的改善程度与标准治疗相似或更大，它们的优势是什么？ 影响，以及3)什么可能的调节因素(即社会经济地位以及行为和认知 文化适应)可以解释治疗类型(即标准与文化改良)之间的关系 和结果，以及这些互动的力量是什么。

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed mental health disorders in children, affecting approximately 5% of youth (APA, 2013). The long-term, developmental trajectory of ADHD suggests that these children continue to experience debilitating symptoms, as well as significant academic, social, and family difficulties into adulthood (Biederman et al., 2012). Given the impact of functional impairment associated with ADHD on the individual and society, it is imperative that effective treatment for ADHD be made available to as many affected youth as possible. In light of staggering mental health disparities for some of the fast growing ethnic minority groups in the United States, such as Latinos, it is particularly important to ensure effective treatment is available to these children who have not been well represented in treatment outcome studies examining parent management training for ADHD or other externalizing disorders (Flores & TCOPR, 2010; Miranda et al., 2005; U.S. Census Bureau, 2008).Thus, consistent with the goals of an R21, the current pilot study aims to close the existing gap in our knowledge about effective psychosocial treatments for Latino families by providing preliminary data regarding the acceptability and efficacy of a culturally-modified treatment and possible moderators that will support a future R01. Specifically, the current pilot study is the first step in a larger program of research aimed at definitively determining if culturally-modified treatment outperforms standard treatment when examining engagement and acceptability outcomes, as well as symptomatology and parental functioning, and if so, which treatment modifications are necessary and for whom. Participants will be 60 Latino children with ADHD and their parents. Families will receive either standard evidence-based treatment or culturally-modified treatment. The following aims will be explored: 1) does culturally-modified treatment result in better engagement and acceptability outcomes (i.e., parental attendance, retention, engagement, and satisfaction) than standard treatment and what is the strength of these effects, 2) does culturally-modified treatment result in improvements in ADHD symptomatology, as well as parental functioning (i.e., parenting stress and efficacy), does the modified treatment result in similar or greater improvements than standard treatment, and what is the strength of these effects, and 3) what possible moderators (i.e., socioeconomic status and behavioral and cognitive acculturation) may explain the relationship between treatment type (i.e., standard versus culturally-modified) and outcomes and what is the strength of these interactions.