This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood psychiatric disorders, with a prevalence rate of 3-5%, and is primarily diagnosed based on hyperactivity, impulsivity, and inattention. The most common treatment for ADHD is stimulant medication, which successfully reduces symptoms in approximately two-thirds of cases. Previous studies have indicated that some children treated with stimulant medication also perform better on a specific type of attentional task, the Continuous Performance Task (CPT). However, a number of unanswered questions remain about the impact of this treatment for ADHD, for example, whether stimulant medications improve performance on other types of attentional tasks, whether stimulants improve other important cognitive functions (e.g. memory and learning), and the effect of stimulants on emotional and behavioral functioning. Finally, what affect do stimulant medications have on children with ADHD behaviors resulting not from ADHD but from exposure to traumatic-stress? If effects differ, it may mean that studies that look at ADHD treatment outcomes without controlling for histories of trauma will end up with confounded results. The current study seeks to improve understanding of the effects of traditional stimulant medications (e.g. Methylphenidate, Concerta) on attention as well as cognitive and emotional/behavioral functioning. After establishing IQ (using the Wechsler Abbreviated Scale of Intelligence; WASI) and academic functioning (using the Wechsler Individual Achievement Test- Second Edition Abbreviated; WIAT-II), study participants will be evaluated at two time points, one while taking their current stimulant medication and one while taking a placebo. Study participants will include 24 children with ADHD between the ages of 6 and 16 who have been on a stable dose of stimulant medication for at least 2 months who have been referred by their treating physician. Children will complete tests of attention, memory, and emotional functioning on two separate visits, one visit while taking their current medication and one while taking a placebo. Attention will be assessed using the Conners Continuous Performance Test and the Test of Everyday Attention for Children (TEA-Ch). Learning and memory will be assessed using the Children s Memory Scale (CMS). Emotional functioning will be examined via physiological measures (i.e., startle eyeblink magnitude, heart rate, skin conductance) and children s responses to a standardized set of stimuli (i.e., pleasant, unpleasant, neutral pictures). Parents of the children will be asked to complete the Conners Parent Rating Scale (CPRS-R:L), the CAPS-CA Life Events Checklist, the Child Psychopathy Scale (CPS), the Eyberg Child Behavior Inventory (ECBI), the Structured Clinical Interview for DSM-IV, a Parent Medication Questionnaire, Demographic Questionnaire, and a Drug Record Log. The Childhood version (UCLA PTSD Index for DSM-IV) will be administered to either children or parents, depending on the age of the child.
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