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31.
Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation 总被引:5,自引:0,他引:5
Wells KC Pelham WE Kotkin RA Hoza B Abikoff HB Abramowitz A Arnold LE Cantwell DP Conners CK Del Carmen R Elliott G Greenhill LL Hechtman L Hibbs E Hinshaw SP Jensen PS March JS Swanson JM Schiller E 《Journal of abnormal child psychology》2000,28(6):483-505
The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased 相似文献
32.
Hinshaw SP Owens EB Wells KC Kraemer HC Abikoff HB Arnold LE Conners CK Elliott G Greenhill LL Hechtman L Hoza B Jensen PS March JS Newcorn JH Pelham WE Swanson JM Vitiello B Wigal T 《Journal of abnormal child psychology》2000,28(6):555-568
To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting. 相似文献
33.
Wells KC Epstein JN Hinshaw SP Conners CK Klaric J Abikoff HB Abramowitz A Arnold LE Elliott G Greenhill LL Hechtman L Hoza B Jensen PS March JS Pelham W Pfiffner L Severe J Swanson JM Vitiello B Wigal T 《Journal of abnormal child psychology》2000,28(6):543-553
Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD. 相似文献
34.
Evidence for 40-Hz oscillatory short-term visual memory revealed by human reaction-time measurements
Elliott MA Müller HJ 《Journal of experimental psychology. Learning, memory, and cognition》2000,26(3):703-718
Four experiments show that presentation of a synchronous premask frame within a 40-Hz, flickering premask matrix primes subsequent detection of a Kanizsa-type square by generation of a 40-Hz prime. Reaction time (RT) priming effects indicated a 150-200-ms prime duration following premask display. RTs were also found to be sensitive to the phase relationship between offset of the premask display relative to the onset time of the target: Priming effects were maximal when the target was presented out of phase with premask presentation (i.e., at interstimulus intervals displaced by 180 degrees relative to the 40-Hz rhythm of premask-frame presentation). Taken together, these results demonstrate the existence of a very short-term visual memory that oscillates at 40 Hz. The findings are discussed in the context of complementary psychological and neurophysiological findings related to visual-object coding and the role of gamma-band activity in the brain. 相似文献
35.
This paper reviews the international scientific evidence on the effectiveness of secondary prevention interventions for young drug users. The review provides insight into the effectiveness of interventions that have been evaluated using moderately strong research designs. Most of the studies included are from the United States of America. Some interventions are effective in reducing drug use and associated problems while others have no or mixed effect. Those successful in reducing drug use include behavior therapy, Minnesota 12-step programs, residential care, and general drug treatment. Those with either no effect or mixed effect include schools interventions. Involving parents and other agencies may enhance an intervention's effect. There is a lack of good quality studies outside the USA. Future interventions should focus on either low- or high-risk groups of young drug users. Future research should be conducted on a wider range of services for young people and include non-medical outcomes such as communication skills, schooling, employment, family relations, and economic costs. 相似文献
36.
37.
We examined individual and developmental differences in the disruptive effects of irrelevant sounds on serial recall of printed lists. In Experiment 1, we examined adults (N = 205) receiving eight-item lists to be recalled. Although their susceptibility to disruption of recall by irrelevant sounds was only slightly related to memory span, regression analyses documented highly reliable individual differences in this susceptibility across speech and tone distractors, even with variance from span level removed. In Experiment 2, we examined adults (n = 64) and 8-year-old children (n = 63) receiving lists of a length equal to a predetermined span and one item shorter (span-1). We again found significant relationships between measures of span and susceptibility to irrelevant sounds, although in only two of the measures. We conclude that some of the cognitive processes helpful in performing a span task may not be beneficial in the presence of irrelevant sounds. 相似文献
38.
The study is focused on the training, demographics, perceived emotional and physical health, past traumatic experience histories, and attachment styles of mental health professionals in the field of trauma (members of the International Society for Traumatic Stress Studies). While the data set is limited by a low response rate of 20%, the uniqueness of the sample and distinctive themes yield insight into the experience of trauma and its association with attachment style. 相似文献
39.
Learning to optimize speed, accuracy, and energy expenditure: a framework for understanding speed-accuracy relations in goal-directed aiming 总被引:1,自引:0,他引:1
Over the last century, investigators have developed a number of models to explain the relation between speed and accuracy in target-directed manual aiming. The models vary in the extent to which they stress the importance of feedforward processes and the online use of sensory information (see D. Elliott, W. F. Helsen, & R. Chua, 2001, for a recent review). A common feature of those models is that the role of practice in optimizing speed, accuracy, and energy expenditure in goal-directed aiming is either ignored or minimized. The authors present a theoretical framework for understanding speed-accuracy tradeoffs that takes into account the strategic, trial-to-trial behavior of the performer. The strategic behavior enables individuals to maximize movement speed while minimizing error and energy expenditure. 相似文献
40.