注意缺陷多动障碍和自闭症中执行功能缺陷的特异性如何?

How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism?

作者信息

Geurts Hilde M, Verté Sylvie, Oosterlaan Jaap, Roeyers Herbert, Sergeant Joseph A

机构信息

Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, The Netherlands.

出版信息

J Child Psychol Psychiatry. 2004 May;45(4):836-54. doi: 10.1111/j.1469-7610.2004.00276.x.

Abstract

BACKGROUND

The objective of this study is to identify intact and deficient cognitive processes in children with attention deficit hyperactivity disorder (ADHD) and children with high functioning autism (HFA).

METHOD

Three rigorously diagnosed groups of children aged between 6 and 12 years (54 ADHD, 41 HFA, and 41 normal controls) were tested on a wide range of tasks related to five major domains of executive functioning (EF): inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. In addition, the role of comorbid oppositional defiant disorder (ODD) and comorbid conduct disorder (CD) in ADHD was investigated by directly comparing 20 children with ADHD and 34 children with comorbid ADHD + ODD/CD.

RESULTS

ADHD was associated with EF deficits in inhibiting a prepotent response and verbal fluency. Children with HFA demonstrated deficits in all EF domains, except interference control and working memory. The HFA group showed more difficulties than the ADHD group with planning and cognitive flexibility. The comorbid ADHD + ODD/CD group did not show a distinctive pattern of performance on the EF tests compared to the ADHD group.

CONCLUSION

The present study indicates that children with HFA exhibit more generalised and profound problems with EF tasks compared to children with ADHD.

摘要

背景

本研究的目的是识别注意力缺陷多动障碍(ADHD)儿童和高功能自闭症(HFA)儿童完整和存在缺陷的认知过程。

方法

对三组经过严格诊断的6至12岁儿童(54名ADHD儿童、41名HFA儿童和41名正常对照)进行了一系列与执行功能(EF)五个主要领域相关的任务测试:抑制、视觉工作记忆、计划、认知灵活性和言语流畅性。此外,通过直接比较20名ADHD儿童和34名合并ADHD + 对立违抗障碍(ODD)/品行障碍(CD)的儿童,研究了ODD和CD共病在ADHD中的作用。

结果

ADHD与抑制优势反应和言语流畅性方面的EF缺陷相关。HFA儿童在除干扰控制和工作记忆外的所有EF领域均表现出缺陷。与ADHD组相比,HFA组在计划和认知灵活性方面存在更多困难。与ADHD组相比,合并ADHD + ODD/CD组在EF测试中未表现出独特的表现模式。

结论

本研究表明,与ADHD儿童相比,HFA儿童在EF任务上表现出更广泛、更严重的问题。

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