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[注意力缺陷中的PASS神经认知功能障碍]

[PASS neurocognitive dysfunction in attention deficit].

作者信息

Pérez-Alvarez F, Timoneda-Gallart C

机构信息

Unidad de Neuropediatría/Unidad de Neuropsicopedagogía, Hospital Universitari Dr. J. Trueta, Girona, España.

出版信息

Rev Neurol. 2001;32(1):30-7.

Abstract

INTRODUCTION

Attention deficit disorder shows both cognitive and behavioral patterns.

OBJECTIVE

To determine a particular PASS (planning, attention, successive and simultaneous) pattern in order to early diagnosis and remediation according to PASS theory.

PATIENTS AND METHODS

80 patients were selected from the neuropediatric attendance, aged 6 to 12 years old, 55 boys and 25 girls. Inclusion criteria were inattention (80 cases) and inattention with hyperactive symptoms (40 cases) according to the Diagnostic and Statistical Manual (DSM-IV). Exclusion criteria were the criteria of phonologic awareness previously reported, considered useful to diagnose dyslexia. A control group of 300 individuals, aged 5 to 12 years old, was used, criteria above mentioned being controlled. DN:CAS (Das-Naglieri Cognitive Assessment System) battery, translated to native language, was given to assess PASS cognitive processes. Results were analyzed with cluster analysis and t-Student test. Statistical factor analysis of the control group had previously identified the four PASS processes: planning, attention, successive and simultaneous.

RESULTS

The dendrogram of the cluster analysis discriminated three categories of attention deficit disorder: 1. The most frequent, with planning deficit; 2. Without planning deficit but with deficit in other processes, and 3. Just only a few cases, without cognitive processing deficit. Cognitive deficiency in terms of means of scores was statistically significant when compared to control group (p = 0.001).

CONCLUSIONS

According to PASS pattern, planning deficiency is a relevant factor. Neurological planning is not exactly the same than neurological executive function. The behavioral pattern is mainly linked to planning deficiency, but also to other PASS processing deficits and even to no processing deficit.

摘要

引言

注意力缺陷障碍表现出认知和行为模式。

目的

根据PASS理论确定一种特定的PASS(计划、注意力、继时性和同时性)模式,以便进行早期诊断和矫正。

患者与方法

从神经儿科门诊选取80名患者,年龄在6至12岁之间,其中男孩55名,女孩25名。纳入标准为根据《精神疾病诊断与统计手册》(DSM-IV)存在注意力不集中(80例)以及伴有多动症状的注意力不集中(40例)。排除标准为先前报道的语音意识标准,该标准被认为有助于诊断诵读困难。使用一个由300名年龄在5至12岁之间的个体组成的对照组,并对上述标准进行把控。采用翻译成母语的DN:CAS(达斯-纳吉里认知评估系统)成套测验来评估PASS认知过程。结果采用聚类分析和t检验进行分析。对照组的统计因子分析先前已确定了四个PASS过程:计划、注意力、继时性和同时性。

结果

聚类分析的树形图区分出三类注意力缺陷障碍:1. 最常见的,存在计划缺陷;2. 无计划缺陷但在其他过程存在缺陷;3. 仅有少数病例,无认知加工缺陷。与对照组相比,得分均值方面的认知缺陷具有统计学意义(p = 0.001)。

结论

根据PASS模式,计划缺陷是一个相关因素。神经学上的计划与神经学上的执行功能并不完全相同。行为模式主要与计划缺陷相关,但也与其他PASS加工缺陷甚至与无加工缺陷有关。

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