Molina Brooke S G, Flory Kate, Hinshaw Stephen P, Greiner Andrew R, Arnold L Eugene, Swanson James M, Hechtman Lily, Jensen Peter S, Vitiello Benedetto, Hoza Betsy, Pelham William E, Elliott Glen R, Wells Karen C, Abikoff Howard B, Gibbons Robert D, Marcus Sue, Conners C Keith, Epstein Jeffery N, Greenhill Laurence L, March John S, Newcorn Jeffrey H, Severe Joanne B, Wigal Timothy
J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):1028-1040. doi: 10.1097/chi.0b013e3180686d96.
To compare delinquent behavior and early substance use between the children in the Multimodal Treatment Study of Children With ADHD (MTA; N = 487) and those in a local normative comparison group (n = 272) at 24 and 36 months postrandomization and to test whether these outcomes were predicted by the randomly assigned treatments and subsequent self-selected prescribed medications.
Most MTA children were 11 to 13 years old by 36 months. Delinquency seriousness was coded ordinally from multiple measures/reporters; child-reported substance use was binary.
Relative to local normative comparison group, MTA children had significantly higher rates of delinquency (e.g., 27.1% vs. 7.4% at 36 months; p = .000) and substance use (e.g., 17.4% vs. 7.8% at 36 months; p = .001). Children randomized to intensive behavior therapy reported less 24-month substance use than other MTA children (p = .02). Random effects ordinal growth models revealed no other effects of initial treatment assignment on delinquency seriousness or substance use. By 24 and 36 months, more days of prescribed medication were associated with more serious delinquency but not substance use.
Cause-and-effect relationships between medication treatment and delinquency are unclear; the absence of associations between medication treatment and substance use needs to be re-evaluated at older ages. Findings underscore the need for continuous monitoring of these outcomes as children with attention-deficit/hyperactivity disorder enter adolescence.
比较注意力缺陷多动障碍儿童多模式治疗研究（MTA；N = 487）中的儿童与当地正常对照组（n = 272）的儿童在随机分组后24个月和36个月时的违法行为及早期物质使用情况，并测试这些结果是否由随机分配的治疗方法及随后自行选择的处方药所预测。
到36个月时，大多数MTA儿童年龄在11至13岁。根据多种测量方法/报告者对违法行为的严重程度进行顺序编码；儿童报告的物质使用情况为二元变量。
相对于当地正常对照组，MTA儿童的违法行为发生率（如36个月时为27.1%对7.4%；p = .000）和物质使用发生率（如36个月时为17.4%对7.8%；p = .001）显著更高。随机接受强化行为治疗的儿童在24个月时报告的物质使用情况少于其他MTA儿童（p = .02）。随机效应顺序增长模型显示，初始治疗分配对违法行为严重程度或物质使用无其他影响。到24个月和36个月时，处方药服用天数越多与更严重的违法行为相关，但与物质使用无关。
药物治疗与违法行为之间的因果关系尚不清楚；药物治疗与物质使用之间缺乏关联这一情况需要在儿童年龄更大时重新评估。研究结果强调，随着注意力缺陷/多动障碍儿童进入青春期，需要持续监测这些结果。
