ABSTRACT

Objective

Children with ADHD often exhibit marked impairment in their social skills, but evidence-based psychosocial interventions for ADHD have shown limited efficacy in remediating these deficits. Co-occurring psychopathology exacerbates social deficits in children with ADHD and is a plausible moderator of treatment response. To identify factors contributing to variable social skills treatment response, we examined co-occurring externalizing, depression, and anxiety symptoms as moderators of social skills outcomes in a randomized controlled trial of the Collaborative Life Skills (CLS) program, an evidence-based collaborative school-home ADHD intervention.

Method

Participants were 159 children with ADHD (M age = 8.35 years, 28.3% female) at 27 schools in an urban public school district. Twenty-three schools were randomly assigned to CLS or usual services, with an additional four schools assigned to Spanish-adapted CLS or usual services. Multi-informant measures of co-occurring psychopathology and social skills were collected at baseline and post-treatment.

Results

Parent-rated externalizing and depression symptoms moderated treatment effects on social skills, whereby higher symptomatology in each domain was unrelated to social skills improvement in the CLS group but predicted worsening social skills in response to usual services. In contrast, teacher-rated anxiety moderated treatment effects on social skills, whereby higher anxiety predicted greater social skills improvement in response to CLS but was unrelated to social skills outcomes following usual services.

Conclusions

Findings reflect novel evidence that child psychopathology domains exhibit unique moderating effects on social skills treatment response in children with ADHD. We discuss implications for optimizing evidence-based interventions to target social impairment in this population.

中文翻译：

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在针对多动症儿童的学校与家庭合作干预的随机对照试验中，同时发生的精神病理学调节了社交技能的提高

摘要

客观的

患有多动症的儿童通常表现出社交技能明显受损，但针对多动症的循证心理社会干预措施在纠正这些缺陷方面效果有限。同时发生的精神病理学会加剧多动症儿童的社交缺陷，并且可能是治疗反应的调节因素。为了确定导致不同社交技能治疗反应的因素，我们在协作生活技能（CLS）项目（一个循证合作学校）的一项随机对照试验中，检查了同时发生的外化、抑郁和焦虑症状作为社交技能结果的调节因素。 -家庭多动症干预。

方法

参与者是城市公立学区 27 所学校的159 名 ADHD 儿童（男性年龄 = 8.35 岁，28.3% 女性）。23 所学校被随机分配到 CLS 或常规服务，另外 4 所学校被分配到西班牙语适应的 CLS 或常规服务。在基线和治疗后收集同时发生的精神病理学和社交技能的多信息测量。

结果

父母评价的外化和抑郁症状调节了治疗对社交技能的影响，其中每个领域的较高症状与 CLS 组社交技能的改善无关，但预示着对常规服务的反应社交技能会恶化。相比之下，教师评定的焦虑程度调节了治疗对社交技能的影响，较高的焦虑程度预示着 CLS 带来的社交技能改善更大，但与常规服务后的社交技能结果无关。

结论

研究结果反映了新的证据，表明儿童精神病理学领域对多动症儿童的社交技能治疗反应表现出独特的调节作用。我们讨论了优化基于证据的干预措施以针对该人群的社会障碍的影响。