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注意缺陷/多动障碍儿童多模式治疗研究中长期危险驾驶行为的预测因素

Predictors of Long-Term Risky Driving Behavior in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder.

作者信息

Johnson Jessica A, Jakubovski Ewgeni, Reed Margot O, Bloch Michael H

机构信息

1 Child Study Center, Yale University School of Medicine , New Haven, Connecticut.

2 Syracuse University , Syracuse, New York.

出版信息

J Child Adolesc Psychopharmacol. 2017 Oct;27(8):747-754. doi: 10.1089/cap.2017.0025. Epub 2017 Aug 3.

DOI:10.1089/cap.2017.0025
PMID:28771386
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5651934/
Abstract

OBJECTIVE

This study examines predictors of later risky driving behavior in children with attention-deficit/hyperactivity disorder (ADHD).

METHODS

Stepwise logistic regression and receiver operating characteristic (ROC) analysis were used to explore baseline predictors of risky driving behavior for adolescents who completed the 8-year follow-up assessment in the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA).

RESULTS

Stepwise logistic regression analysis explained 19% of the total variance in risky driving behavior. Increased likelihood of risky driving behavior was associated with parental history of conduct disorder, low parental monitoring and supervision, and increased age. ROC analysis identified discriminative predictors for adolescents older and younger than 16 years of age at follow-up. The most discriminative predictors of later risky driving behavior were parental stress at baseline (for children 16 years or older) and increased child-rated parental protectiveness (for children less than 16 years old).

CONCLUSION

Risky driving behavior was significantly predicted by baseline characteristics for the MTA cohort. Aspects of parenting behavior (or the child's perception of them), including parental stress levels, parental protectiveness, and parental levels of monitoring and supervision, were most informative in predicting these outcomes. Our results suggest that interventions to reduce high-risk behaviors in these high-risk children with ADHD might involve targeted parenting interventions.

摘要

目的

本研究探讨注意缺陷多动障碍(ADHD)儿童日后危险驾驶行为的预测因素。

方法

采用逐步逻辑回归和受试者工作特征(ROC)分析,探究在注意缺陷/多动障碍儿童多模式治疗研究(MTA)中完成8年随访评估的青少年危险驾驶行为的基线预测因素。

结果

逐步逻辑回归分析解释了危险驾驶行为总方差的19%。危险驾驶行为可能性增加与品行障碍的家族史、父母低监督和监管以及年龄增长有关。ROC分析确定了随访时16岁及以上和16岁以下青少年的判别性预测因素。日后危险驾驶行为最具判别性的预测因素是基线时的父母压力(16岁及以上儿童)和儿童评定的父母保护欲增加(16岁以下儿童)。

结论

MTA队列的基线特征可显著预测危险驾驶行为。养育行为的各个方面(或儿童对其的认知),包括父母压力水平、父母保护欲以及父母监督和监管水平,在预测这些结果方面最具参考价值。我们的结果表明,减少这些ADHD高危儿童高危行为的干预措施可能包括有针对性的养育干预。

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