Herpertz Sabine C, Mueller Bodo, Qunaibi Mutaz, Lichterfeld Christiane, Konrad Kerstin, Herpertz-Dahlmann Beate
Department of Psychiatry and Psychotherapy, Rostock University, Gehlsheimer Str. 20, D-18147 Rostock, Germany.
Am J Psychiatry. 2005 Jun;162(6):1100-7. doi: 10.1176/appi.ajp.162.6.1100.
Boys with conduct disorder are at risk of persistently showing antisocial behavior in adult life, particularly if they have an additional diagnosis of attention deficit hyperactivity disorder (ADHD). In the search for biological risk factors that predispose children to the development of antisocial personality disorder, research has provided substantial data suggesting that autonomic hyporesponsiveness indicates a greater likelihood of future antisocial behavior. The purpose of this study was to examine autonomic arousal in boys with conduct disorder, comorbid conduct disorder and ADHD, and ADHD only.
In addition to self-ratings, electrodermal responses to pleasant, neutral, and unpleasant slides were obtained for 21 boys with conduct disorder and 54 boys with ADHD plus conduct disorder. Forty-three boys with a diagnosis of ADHD only were recruited as a clinical comparison group, and 43 boys with no conduct disorder or ADHD were included as a healthy comparison group. All subjects were ages 8-13 years.
Compared to the healthy subjects and the subjects with ADHD only, the boys with conduct disorder and with ADHD plus conduct disorder reported lower levels of emotional response to aversive stimuli and lower autonomic responses to all slides independent of valence.
Although the self-report data supported a deficit in reactivity to explicit fear cues, the psychophysiological data indicated that boys with conduct disorder both with and without a comorbid condition of ADHD are characterized by a generalized deficit in autonomic responsivity in an experimental situation in which children were exposed to complex visual stimuli of unpredictable affective quality. Psychophysiological findings may point to a deficit in associative information processing systems that normally produce adaptive cognitive-emotional reactions.
患有品行障碍的男孩在成年后有持续表现出反社会行为的风险,尤其是当他们还被诊断患有注意力缺陷多动障碍(ADHD)时。在寻找使儿童易患反社会人格障碍的生物学风险因素的过程中,研究提供了大量数据表明自主神经反应低下预示着未来出现反社会行为的可能性更大。本研究的目的是检查患有品行障碍的男孩、患有品行障碍合并ADHD的男孩以及仅患有ADHD的男孩的自主神经唤醒情况。
除了自我评定外,还获取了21名患有品行障碍的男孩和54名患有ADHD合并品行障碍的男孩对愉快、中性和不愉快幻灯片的皮肤电反应。招募了43名仅被诊断患有ADHD的男孩作为临床对照组,并纳入了43名没有品行障碍或ADHD的男孩作为健康对照组。所有受试者年龄在8至13岁之间。
与健康受试者和仅患有ADHD的受试者相比,患有品行障碍的男孩以及患有ADHD合并品行障碍的男孩报告称对厌恶刺激的情绪反应水平较低,并且对所有幻灯片的自主神经反应较低,与效价无关。
虽然自我报告数据支持对明确恐惧线索的反应性存在缺陷,但心理生理学数据表明,患有品行障碍的男孩,无论是否合并ADHD,在儿童暴露于具有不可预测情感性质的复杂视觉刺激的实验情境中,其自主神经反应性普遍存在缺陷。心理生理学研究结果可能表明在通常产生适应性认知 - 情绪反应的联想信息处理系统中存在缺陷。