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儿童的执行功能:住院的对立违抗性障碍(ODD)儿童、ODD/注意力缺陷多动障碍(ADHD)儿童与正常对照组的比较

Executive functioning in children: a comparison of hospitalised ODD and ODD/ADHD children and normal controls.

作者信息

van Goozen Stephanie H M, Cohen-Kettenis Peggy T, Snoek Heddeke, Matthys Walter, Swaab-Barneveld Hanna, van Engeland Herman

机构信息

Department of Child and Adolescent Psychiatry, University Medical Centre Utrecht, The Netherlands.

出版信息

J Child Psychol Psychiatry. 2004 Feb;45(2):284-92. doi: 10.1111/j.1469-7610.2004.00220.x.

Abstract

BACKGROUND

Deficits in executive functioning are supposed to have a predisposing influence on impulsive or aggressive behaviour. We tested the hypothesis that oppositional-defiant disorder (ODD) children with or without attention deficit hyperactivity disorder (ADHD) have problems in executive functioning.

METHOD

Seventy-seven 7- to 12-year-old children (15 ODD, 26 ODD/ADHD, and 36 normal controls), all with normal IQ, completed 7 neuropsychological measures of executive functioning, assessing the abilities of set shifting, planning, working memory, inhibition/attention, and impulsivity. Some of these tasks involved the possibility of monetary rewards with a view to testing the prediction of a specific motivational inhibitory deficit.

RESULTS

We found no evidence of deficits in working memory, planning, inhibition, or impulsivity. However, the ODD/ADHD group was worse than the normal control (NC) group in set shifting, and both the ODD and ODD/ADHD groups performed worse on a response perseveration task. Moreover, on the basis of one variable derived from a motivational inhibition task, 77% of the children could be correctly classified as ODD or NC.

CONCLUSIONS

The findings do not support the hypothesis that ODD and ODD/ADHD children have a deficit in executive inhibitory control; rather, they emphasise that they have problems in regulating their behaviour under motivational inhibitory conditions.

摘要

背景

执行功能缺陷被认为对冲动或攻击行为具有诱发影响。我们检验了以下假设:患有或未患有注意力缺陷多动障碍(ADHD)的对立违抗障碍(ODD)儿童在执行功能方面存在问题。

方法

77名7至12岁儿童(15名ODD儿童、26名ODD/ADHD儿童和36名正常对照儿童),所有儿童智商均正常,完成了7项执行功能的神经心理学测量,评估了转换任务、计划、工作记忆、抑制/注意力和冲动性等能力。其中一些任务涉及金钱奖励的可能性,以测试特定动机抑制缺陷的预测。

结果

我们没有发现工作记忆、计划、抑制或冲动性存在缺陷的证据。然而,ODD/ADHD组在转换任务方面比正常对照组(NC)差,并且ODD组和ODD/ADHD组在反应持续性任务上的表现都更差。此外,基于一项源自动机抑制任务的变量,77%的儿童能够被正确分类为ODD或NC。

结论

研究结果不支持ODD和ODD/ADHD儿童存在执行抑制控制缺陷的假设;相反,研究结果强调他们在动机抑制条件下调节行为存在问题。

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