This is an application for a Mentored Clinical Scientist Development Award with a focus on developing expertise in designing and evaluating early interventions for children with attention-deficit/hyperactivity disorder (ADHD) at risk for later substance use disorders (SUDs). While research has shown that children with ADHD are at heightened risk for SUDs, it has been difficult to identify characteristics of children with ADHD that are associated with subsequent SUDs. However, recent studies by the candidate and his colleagues have identified """"""""social disability"""""""" as a major risk factor for later SUDs in children with ADHD (after controlling for well-known risk factors such as conduct disorder, mood disorders, aggression, and severity of ADHD). Thus, social disability provides a mechanism for early identification of children with ADHD at greatest risk for later SUDs and affords the opportunity for early prevention efforts. Research Plan: The candidate proposes to refine and test an intervention for 8-10 year old socially disabled children with ADHD for the purpose of preventing later substance use and abuse. The 12-week intervention is intended as a departure from traditional consequence-oriented approaches emphasizing compliance, and will instead focus on reducing adversarial parent-child interactions, improving family communication and problem-solving, and training children in lacking skills in a manner that is matched to each child's individual needs and conducted in a family-therapy context to promote maintenance and generalization. It will be tested in a randomized controlled trial with proximal (3-month) and long-term (3-year) follow-up assessment. Environment: The proposed study will be based at the Massachusetts General Hospital and will complement a program of training, and supervised research under the mentorship of Joseph Biederman, MD and Co-Sponsorship of Timothy E. Wilens, MD, with consultation from experts in the areas of social impairment, childhood psychopathology, and assessment and prevention of SUDs. Career development plan: The candidate proposes to develop further expertise in the assessment and prevention of substance use disorders, on assessment of child psychopathology and social dysfunction, and in statistical approaches for analysis of complex longitudinal data. Coursework at the Harvard School of Public Health and tutorials in intervention research design, statistical methods, and methodology for longitudinal follow-up will complement supervision by the consultants. The candidate hopes to develop a critical fund of knowledge in SUDs, social impairment, child psychopathgology. prevention research, and statistical methodology which will lav the foundation for future independent investigation of intervention strategies for high-risk children.
| Branch, M N; Sizemore, G M (1988) Behavioral tolerance to cocaine in squirrel monkeys: acute and chronic effects on complex operant behavior. Pharmacol Biochem Behav 30:737-48 |
