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| 注意缺陷多动障碍儿童的生态执行功能特点 |
| Characteristics of ecological executive function in children with attention deficit hyperactivity disorder |
| 投稿时间：2024-11-21 修订日期：2025-04-10 |
| DOI： |
| 中文关键词: 【】 儿童 注意缺陷多动障碍 智商 生态执行功能 |
| 英文关键词:Children Attention Deficit Hyperactivity Disorder Ecological execution function Intelligence |
| 基金项目:] 深圳市科技计划(RCYX20221008092849069、JCYJ20220818102800001、JCYJ20220530155416036),广东省高水平医院建设专项经费。 |
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| 中文摘要: |
| 【】 背景 执行功能缺陷被认为是注意缺陷多动障碍（ADHD）的核心问题，既往研究评估ADHD儿童的执行功能时，多采用在实验室实施的操作性神经心理测验。生态执行功能更侧重于评估个体在日常现实情景中处理复杂任务时的能力，更能反映ADHD儿童在现实中的认知能力。目前关于ADHD生态执行功能的研究相对匮乏。 目的 ?旨在从生态学纬度了解ADHD儿童执行功能的特点，从而为制定针对ADHD的个性化干预措施提供科学依据。方法 ?采用病例对照研究方法，选取了深圳市儿童医院儿童保健与心理健康中心于2017年6月至2020年12月期间就诊的ADHD患儿为研究对象，同时选取正常学生为对照，以美国精神障碍诊断与统计手册第4版为诊断标准，选择韦氏儿童智力量表第4版和学龄儿童执行功能行为评定量表家长版为工具测评其智商和生态执行功能。采用Mann-Whiter U检验分析两组儿童的智商及生态执行功能的差异，并进一步对两组儿童生态执行功能差异进行协方差分析。结果? 共纳入277例ADHD儿童及98例正常儿童，年龄7-16岁，平均年龄为9.3±1.5岁，其中男生286 人（76%），女生89人（24%）。ADHD组儿童的总智商及其四个指数均处于中等水平，但均显著低于正常组学生 (Z值=-3.4～-8.4，P值均<0.001)。在总智商作为协变量进行控制后，ADHD组儿童的行为管理维度（即抑制、转换、情感控制）和元认知维度（启动、工作记忆、计划、监控、启动、组织）的各因子得分均显著高于正常组学生（F值=60.9～247.9，P值均<0.001）。 结论 ?ADHD儿童的生态执行功能有多维度缺陷，临床可作为ADHD的随访观察指标，对于ADHD儿童的干预措施应充分考虑其生态维度的执行功能。 |
| 英文摘要: |
| 【】 Background ?Executive dysfunction is considered a core issue in attention deficit hyperactivity disorder (ADHD), and previous studies have often used laboratory conducted operant neuropsychological tests to evaluate executive function in children with ADHD. Ecological executive function focuses more on evaluating an individual"s ability to handle complex tasks in daily real-life situations, and can better reflect the cognitive abilities of ADHD children in reality. Currently, research on the ecological executive function of ADHD is relatively scarce. Objective? To study the characteristics of executive function in children with Attention Deficit Hyperactivity Disorder (ADHD) from ecological perspective and give a basis for designing personal intervention strategies for ADHD. Methods? Case control study was designed. Children with ADHD were selected from the Child Healthcare and Mental Health Center at Shenzhen Children"s Hospital from June 2017 to December 2020. Meanwhile, normal students were selected as controls. Diagnostic and Statistical Manual of Mental Disorders Fourth Edition( DSM-IV) was used as diagnosis criteria in the study. The Wechsler Intelligence Scale for Children Fourth Edition and the Parents" Version of Behavior Rating Inventory of Executive Function for school age children were selected as assessing tool to evaluate the intelligence and ecological executive function. Mann- In order to analyze the differences in ecological executive function and intelligence between ADHD and normal group, Whitney U test was used. Covariance analysis was additionally employed to explore the differences in ecological executive function between two groups. Results? Two hundred and seventy seven ADHD children and ninety eight normal students were enrolled. The age ranged from seven to sixteen and average age was 9.3±1.5 years, with 286 males (76%) and 89 females (24%). The total intelligence and four indexes of children with ADHD were all at a moderate level, but significantly lower than those in control group (Z=-3.4 to -8.4, P value<0.001). After controlling for total intelligence as a covariate, the scores of various factors which were the behavioral management dimension (inhibition, conversion, emotional control) and metacognitive dimension |
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