Although attention deficit hyperactivity disorder (ADHD) is among the most heritable psychiatric childhood disorders, social and gene–environment interactions seemingly play an important role in the etiology of ADHD. Consistent with this, this study finds that School-Wide Positive Behavioral Interventions and Supports (SWPBIS) reduced the likelihood of pharmacotherapeutic treatment for ADHD at age 14–16 by 12%, using population-wide Norwegian register data and a difference-in-difference design (N = 698,364, birth cohorts 1990–2002, 48.7% girls, 5.7% immigrant background). At-risk students in schools with high fidelity of implementation are driving these intervention effects. Overall, the findings indicate that children with a genetic disposition for ADHD are more likely to avoid medical treatment in an organized and predictable school setting with a focus on positive reinforcement.

中文翻译：

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学校环境对注意力缺陷多动障碍医学治疗的影响：对全校积极行为干预和支持的全人群注册数据研究

尽管注意力缺陷多动障碍 (ADHD) 是最具遗传性的儿童精神障碍之一，但社会和基因-环境相互作用似乎在 ADHD 的病因学中起着重要作用。与此一致，本研究发现，全校积极行为干预和支持 (SWPBIS) 将 14-16 岁 ADHD 药物治疗的可能性降低了 12%，使用全挪威人口登记数据和差异中的差异设计 ( N = 698,364，出生队列 1990-2002，48.7% 的女孩，5.7% 的移民背景）。高保真实施学校中的高危学生正在推动这些干预效果。总体而言，研究结果表明，具有 ADHD 遗传倾向的儿童更有可能避免在专注于积极强化的有组织和可预测的学校环境中接受治疗。