Kado Yoko, Sanada Satoshi, Yanagihara Masafumi, Ogino Tatsuya, Abiru Kiyoko, Nakano Kousuke, Ohtsuka Yoko
The Joint of Graduate School in Science of School Education, Hyogo University of Teacher Education, Kato-gun, Hyogo.
No To Hattatsu. 2005 Sep;37(5):380-5.
The cases with attention deficit/hyperactivity disorder (AD/HD) are known to have difficulties in performing various neuropsychological tests related to the executive function. Among them, the Wisconsin Card Sorting Test (WCST) is already applied to many children with AD/HD. There are, however, differences in the measurement of WCST, and also in the background conditions of the patients, such as the status of medication and the level of Intelligence Quotient (IQ), and presumably as a result, the outcome of WCST shows a diversity. The Keio version WCST (KWCST) is a modified WCST by reducing the number of cards and presenting subjects in two steps separated by a short pause, during which a brief instruction is given. This study was undertaken to compare the performances of children with AD/HD to normal controls using KWCST according to full-scale IQ (FIQ) and also the subtypes of AD/HD. Subjects in this study were 21 unmedicated children with AD/HD, ranging from 5 to 15 years of age, and 21 normal controls who were matched on sex and age. Children with AD/HD whose FIQ was above 80 showed significant low scores in such indices as categories achieved (CA), total errors (TE) , and nonperseverative errors of Nelson (NPEN) in the second step. As to the analysis according to the subtypes, the predominantly inattentive type showed significant low scores in CA, TE and NPEN of the second step, while the combined and predominantly hyperactive-impulsive types showed no significant differences compared with the normal controls. These results suggest that patients with AD/HD have difficulties in effectively utilizing their experiences in the first step as well as instructions which are given before the second step, and also indicate the importance of the second step from a view of the clinical applications.
已知患有注意力缺陷/多动障碍（AD/HD）的患者在进行各种与执行功能相关的神经心理学测试时存在困难。其中，威斯康星卡片分类测验（WCST）已应用于许多AD/HD儿童。然而，WCST的测量方法存在差异，患者的背景条件也有所不同，如用药情况和智商（IQ）水平，可能正因如此，WCST的结果呈现出多样性。庆应义塾版WCST（KWCST）是对WCST的改良版，减少了卡片数量，并分两步向受试者呈现，两步之间有短暂停顿，在此期间会给出简短指示。本研究旨在使用KWCST，根据全量表智商（FIQ）以及AD/HD的亚型，比较AD/HD儿童与正常对照组的表现。本研究的受试者为21名未用药的AD/HD儿童，年龄在5至15岁之间，以及21名在性别和年龄上匹配的正常对照组。FIQ高于80的AD/HD儿童在第二步中的分类数（CA）、总错误数（TE）和尼尔森非持续性错误（NPEN）等指标上得分显著较低。根据亚型进行分析时，注意力不集中为主型在第二步的CA、TE和NPEN上得分显著较低，而混合型和多动冲动为主型与正常对照组相比无显著差异。这些结果表明，AD/HD患者在第一步有效利用自身经验以及第二步之前给出的指示方面存在困难，从临床应用角度也表明了第二步的重要性。
