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| 学龄期儿童注意缺陷多动障碍伴情绪失调的执行功能及临床特征研究 |
| Executive function and clinical characteristics of Deficient Emotional Self-Regulation in Attention Deficit Hyperactivity Disorder in school-age children |
| 投稿时间：2024-04-23 修订日期：2024-07-07 |
| DOI： |
| 中文关键词: 注意缺陷/多动障碍 情绪失调；临床症状 执行功能 剑桥神经心理自动化成套测试软件 |
| 英文关键词:Attention deficit/hyperactivity disorder Deficient Emotional Self-Regulation Clinical symptoms Executive function Cambridge Neuropsychological Tests Automated Battery |
| 基金项目:成都市科技计划(批准号:2022-YF09-00010-SN)和成都市医产融合项目(批准号:HXDZ22014)资助。 |
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| 中文摘要: |
| 目的:注意缺陷多动障碍（ADHD）伴情绪失调（DESR）是指ADHD患者的情绪易受挫、变化迅速及易激惹，且出现的强度或频率与发育阶段、年龄、环境等因素不匹配。伴有情绪失调的ADHD具有更为严重的功能损害，进一步发展成为焦虑障碍或抑郁障碍的风险更高。目前针对这一ADHD特殊亚型的临床研究相对较少，探索伴情绪失调的注意缺陷多动障碍患儿临床症状及执行功能特点的研究，对于早期识别早期干预尤为重要。
方法:纳入满足ADHD诊断的7-12岁患儿 118名，使用CBCL-DESR量中的焦虑/抑郁、注意问题、攻击性行为三个分量表T分数将ADHD患儿分为伴有情绪失调（DESR）的ADHD患儿 68人，不伴情绪失调ADHD 患儿50人及正常对照54人。使用SNAP-IV家长评定量表评定患儿核心症状，应用 CANTAB 神经认知测试中的空间工作记忆、成套任务转换、剑桥长袜测试、快速 视 觉 信 息 处 理评估 ADHD和健康对照 儿童执行功能。
结果：不伴DESR的ADHD、伴有DESR的ADHD组和TDC组在SNAPIV上的得分显示SNAPIV-注意缺陷(F= 46.19, p < 0.01)、SNAPIV-多动冲动(F=36.46, p < 0.01)，SNAPIV-总分 (F= 56.36, p < 0.01)，SNAPIV-对立违抗（F= 23.59, p < 0.01）；空间工作记忆功能（CANTAB-SWM）：伴有DESR的ADHD比不伴DESR的ADHD组表现更差（F=6.67, p < 0.01），在内外空间成套转换任务中（CANTAB-IED）：伴有DESR的ADHD比不伴DESR的ADHD组表现更差（F=7.34, p < 0.01）。
结论:伴有DESR的ADHD组患者临床症状更为严重，执行功能表现更差，尤其体现在空间工作记忆和任务转换方面。 |
| 英文摘要: |
| Objective: Deficient Emotional Self-Regulation(DESR) in Attention Deficit Hyperactivity Disorder(ADHD)refers to the emotional frustration, rapid change and irritability of ADHD patients, and the intensity or frequency of occurrence does not match with developmental stage, age, environment and other factors. Deficient Emotional Self-Regulation(DESR) in Attention Deficit Hyperactivity Disorder(ADHD) has more severe functional impairment and a higher risk of further development into anxiety or depression disorders. At present, there are relatively few clinical studies on this special subtype of ADHD. Studies to explore the clinical symptoms and executive function characteristics of children with Deficient Emotional Self-Regulation(DESR) in Attention Deficit Hyperactivity Disorder(ADHD) are particularly important for early identification and intervention.Methods: A total of 118 children aged 7-12 years old who met the diagnosis of ADHD were included, and 68 children with ADHD were divided into those with Deficient Emotional Self-Regulationr (DESR) by using the T scores of anxiety/depression, attention problems and aggressive behavior subscales in the CBCL-DESR. There were 50 children with ADHD without Deficient Emotional Self-Regulationr and 54 normal controls. SNAP-IV Parent Rating Scale was used to assess the core symptoms of children with ADHD and executive function in healthy control children. CANTAB neurocognitive tests were used to assess spatial working memory, set task switching, Cambridge stockings test, and rapid visual information processing..Rueslts: The scores of ADHD without DESR, ADHD group with DESR and TDC group on SNAPIV showed SnapIV-attention deficit (F= 46.19, p < 0.01), SnapIV-hyperactive impulsivity (F=36.46, p < 0.01). Snapiv-total score (F= 56.36, p < 0.01), SNAPIV-oppositional defiance (F= 23.59, p < 0.01); Spatial working memory function (CANTAB-SWM) : ADHD with DESR performed worse than the ADHD group without DESR (F=6.67, p < 0.01), on a set of interspatial switching tasks (CANTAB-IED) : ADHD with DESR performed worse than those without DESR (F=7.34, p < 0.01).Conclusion: The ADHD group with DESR had more severe clinical symptoms and worse performance in executive function, especially in spatial working memory and task switching. |
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