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哌甲酯对注意力缺陷/多动障碍患者决策的影响。

The effects of methylphenidate on decision making in attention-deficit/hyperactivity disorder.

作者信息

DeVito Elise E, Blackwell Andrew D, Kent Lindsey, Ersche Karen D, Clark Luke, Salmond Claire H, Dezsery Anna Maria, Sahakian Barbara J

机构信息

Department of Psychiatry, University of Cambridge, Cambridge, UK.

出版信息

Biol Psychiatry. 2008 Oct 1;64(7):636-9. doi: 10.1016/j.biopsych.2008.04.017. Epub 2008 May 27.

DOI:10.1016/j.biopsych.2008.04.017
PMID:18504036
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2577132/
Abstract

BACKGROUND

Children with attention-deficit/hyperactivity disorder (ADHD) frequently display poor judgment and risk taking in their everyday behavior, but there are little empirical data on decision-making cognition in this disorder. The objectives of the study were to assess the effects of stimulant medication on decision making in ADHD and compare performance on the Cambridge Gamble Task between boys with and without ADHD.

METHODS

Twenty-one boys (aged 7-13) diagnosed with ADHD underwent a double-blind, placebo-controlled trial of methylphenidate (.5 mg/kg) during which they performed the Cambridge Gamble Task (CGT). A healthy age-matched control group was tested on two occasions off drug.

RESULTS

The ADHD group bet more conservatively on the methylphenidate session than on the placebo session. In comparison with healthy control subjects, the ADHD group made more poor decisions, placed their bets more impulsively, and adjusted their bets less according to the chances of winning. Poor decision making was correlated with parent-reported symptoms and disruptive behavior in the ADHD group.

CONCLUSIONS

Methylphenidate reduced risk-prone betting behavior on the CGT. Compared with control subjects, children with ADHD display a number of decision-making deficits on the task, and the measure of rational decision making may serve as an ecologically valid neuropsychological marker of impairment.

摘要

背景

注意力缺陷多动障碍（ADHD）患儿在日常行为中常常表现出判断力差和冒险行为，但关于该障碍决策认知的实证数据较少。本研究的目的是评估兴奋剂药物对ADHD患儿决策的影响，并比较患ADHD男孩和未患ADHD男孩在剑桥赌博任务中的表现。

方法

21名被诊断为ADHD的男孩（7 - 13岁）接受了哌甲酯（0.5mg/kg）的双盲、安慰剂对照试验，在此期间他们完成了剑桥赌博任务（CGT）。一个年龄匹配的健康对照组在两次未服药的情况下接受测试。

结果

ADHD组在服用哌甲酯期间比服用安慰剂期间下注更为保守。与健康对照组相比，ADHD组做出的糟糕决策更多，下注更冲动，并且根据获胜几率调整下注的幅度更小。ADHD组中糟糕的决策与家长报告的症状及破坏性行为相关。

结论

哌甲酯减少了CGT中易冒险的下注行为。与对照组相比，ADHD患儿在该任务中表现出一些决策缺陷，理性决策的测量可能作为一种具有生态学效度的神经心理学损伤指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1220/2577132/3d36f2e68c9c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1220/2577132/c10779c798bf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1220/2577132/3d36f2e68c9c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1220/2577132/c10779c798bf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1220/2577132/3d36f2e68c9c/gr2.jpg

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