序列刺激药物和多重多重多重多重多重多重多重多重多重多重多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多多
Joyce H L Lui1,2, Andrea Chronis-Tuscano3, Daniel Almirall4
1Department of Psychology, Concordia University, Montreal, Quebec, Canada.
The Journal of clinical psychiatry
|February 26, 2025
概括
对于被诊断患有注意力缺陷/多动障碍 (ADHD) 的多个孩子的家庭,在母亲服用兴奋剂药物 (MED) 之前开始行为家长培训 (BPT) 显示出儿童ADHD症状和育儿的最佳结果. 这一序列可能会改善多重ADHD家庭的结果.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 行为科学 行为科学
- 临床心理学 临床心理学
背景情况:
- 多重注意力缺陷/多动症 (ADHD) 家庭,多个孩子患有ADHD,存在独特的治疗挑战.
- 对于这些家庭来说,兴奋剂药物 (MED) 和行为家长培训 (BPT) 的最佳顺序仍然不清楚.
- 了解治疗顺序对于改善复杂家庭结构的结果至关重要.
研究的目的:
- 调查MED和BPT不同序列对儿童多动症症状,儿童损伤,母亲多动症症状和育儿的影响.
- 在试点测试顺序多重分配随机试验 (SMART) 设计中评估结果.
- 为了确定多重ADHD家庭最有效的治疗序列.
主要方法:
- 一个试点的SMART设计随机选择了35个符合ADHD标准的母婴双.
- 研究了四种治疗序列:MED-MED,BPT-BPT,MED-BPT,以及BPT-MED.
- 包括儿童和母亲ADHD症状,儿童损伤和育儿在内的结果在16周后进行了评估.
主要成果:
- BPT-MED序列显示了儿童ADHD症状 (效果大小 = -0.36) 和儿童损伤 (效果大小 -0.33至 -0.51) 的最有利结果.
- 涉及药物的序列同样影响了母亲的ADHD症状 (效果大小为-0.32到-0.48).
- BPT-MED对积极的育儿表现出最好的效果 (效果大小为0.30至0.35),而BPT-MED和BPT-BPT对负面的育儿结果表现最好.
结论:
- 组合治疗似乎对多个ADHD家庭有益.
- 开始使用BPT治疗,然后对母亲进行MED治疗 (BPT-MED) 显示出改善儿童ADHD症状,障碍和育儿的前景.
- 需要使用全功率的SMART设计进行进一步的复制;讨论了为这些家庭实施护理模式的考虑.
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