将烟草预防技能纳入针对多动症青少年的循证干预:试点效果随机对照试验的结果。

Rosalie Corona, Melissa R Dvorsky, Stephanie Romo, Amanda M Parks, Elizaveta Bourchtein, Zoe R Smith, Melissa Avila, Joshua Langberg
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摘要

患有注意力缺陷/多动障碍(ADHD)的青少年是烟草使用的高危人群,但烟草使用预防策略并未被定期纳入以证据为基础的ADHD干预中。我们开展了一项试点随机对照试验,以确定将烟草使用预防技能纳入多动症行为治疗的可行性,并提供初步疗效数据,比较综合(多动症+烟草)干预(40 人)与仅针对多动症的干预(23 人)对烟草风险结果的影响。63名患有多动症的青少年(72%为男性;13-17岁)及其照顾者被随机分配到不同的条件下,其家人则被蒙蔽。在基线、干预后即刻、3 个月和 9 个月的随访评估中收集了家长和青少年的评分。综合干预措施(1)实施的忠实度很高(94%);(2)受到家长和青少年的欢迎,表现在治疗出席率高(82%)和对干预措施的满意度高;(3)与家长和青少年报告的烟草使用风险降低有关。相对于ADHD干预,综合干预能缓冲烟草使用风险的增加,包括减少吸烟意向和不良社会规范信念,并增强父母的控制力、家庭凝聚力和家庭对药物使用的沟通。治疗后的效果大小在小到中等范围内。总之,这项研究为家长-青少年行为治疗辅以家庭烟草预防策略提供了初步支持。这种方法以已经接受多动症治疗的家庭为目标,减少了家庭在接受多动症治疗的同时参加多疗程预防项目时出现的障碍。
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Integrating Tobacco Prevention Skills into an Evidence-Based Intervention for Adolescents with ADHD: Results from a Pilot Efficacy Randomized Controlled Trial.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at high risk for tobacco use, but tobacco use prevention strategies are not regularly incorporated into evidence-based ADHD interventions. We conducted a pilot randomized-controlled trial to determine the feasibility of integrating tobacco use prevention skills into a behavioral treatment for ADHD and to provide preliminary efficacy data comparing a combined (ADHD + tobacco) intervention (N = 40) to an ADHD only intervention (N = 23) on tobacco risk outcomes. Sixty-three adolescents (72% male; 13-17 years) with ADHD and their caregivers were randomly assigned to condition and families were masked to condition. Parent and adolescent ratings were collected at baseline, immediate post-intervention, and at 3- and 9-month follow-up assessments. The combined intervention was (1) implemented with high fidelity (94%), (2) well received by parents and adolescents as evidenced by high levels of treatment attendance (82%) and satisfaction with the intervention, and (3) associated with parent- and adolescent-reported reductions in tobacco use risk. Relative to the ADHD intervention, the combined intervention buffered against increases in tobacco risk, including reduced intentions to smoke and maladaptive social normative beliefs, and increased parental control, family cohesion, and family communication about substance use. Effect sizes at post-treatment were in the small to moderate range. Overall, this study provides preliminary support for a parent-adolescent behavioral treatment supplemented with family-based tobacco prevention strategies. This approach targets families already in treatment for ADHD, reducing barriers that occur when families attend multi-session prevention programs in addition to ADHD treatment.

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期刊介绍: Research on Child and Adolescent Psychopathology brings together the latest innovative research that advances knowledge of psychopathology from infancy through adolescence. The journal publishes studies that have a strong theoretical framework and use a diversity of methods, with an emphasis on empirical studies of the major forms of psychopathology found in childhood disorders (e.g., disruptive behavior disorders, depression, anxiety, and autism spectrum disorder). Studies focus on the epidemiology, etiology, assessment, treatment, prognosis, and developmental course of these forms of psychopathology. Studies highlighting risk and protective factors; the ecology and correlates of children''s emotional, social, and behavior problems; and advances in prevention and treatment are featured. Research on Child and Adolescent Psychopathology is the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.
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