Follow-up studies of children with Attention Deficit Disorders (ADD) into their adolescent years suggest that at least 30 to 40 percent continue to experience clinically significant symptoms while another 30 to 40 percent persist in having serious adjustment problems despite declines in the severity of their primary symptoms. However, the vast majority of these adolescents display significant behavior management problems for their families and schools. Despite the major problems with social behavior of ADD adolescents, no research exists on the specific nature of these social interaction problems. The present study proposes to continue a project currently underway to re-evaluate a large sample of ADD and normal children who participated in a previously funded NIMH grant on the family interaction patterns of ADD and normal children and the effects of methylphenidate on the interactions of the ADD group. The children were originally seen in 1979-81 and, upon re-evaluation, will have been assessed 7 to 8 years later during their adolescent years. The currently funded NIMH grant (2 RO1 MH42181-01) was for a one year period in order to conduct this re-evaluation. However, the research team has been far more successful than expected in locating and recruiting the original subject pool that we expect to be able to evaluate twice as many subjects as planned. This proposal is for an additional year of funding to permit re-evaluation of this much larger sample. The re-evaluation is employing a large number of dependent measures, particularly objective measures of parent-adolescent interactions in order to assess the specific nature of family conflicts in ADD adolescents, their relationship to the primary ADD symptoms in adolescents, and their relationship to various family characteristics, such as parental psychopathology, marital discord, etc. We originally planned to locate at least 40 (and perhaps 70) of the original sample of 135 ADD children and 40 (and perhaps 50) of the 75 normal children. Given a sufficiently large enough sample, we were to subdivide each group into two age levels (12-14 years & 15-17 yrs.) to evaluate possible age differences in family conflicts in these groups. We have been able to relocate 122 of the original ADD sample and expect to re-evaluate at least 90 to 100 of these. We have also relocated 70 of the original normal sample and expect to evaluate 60 to 65 of these. Each family receives a 3 hour evaluation that includes rating scales, laboratory tests and measures, and interviews spanning a wide range of outcome variables. Important results on the outcome of ADD will be obtained.
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