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与标准注意力缺陷多动障碍病例相比,有严重机构剥夺史的注意力不集中/多动儿童:简要报告。

Inattentive/overactive children with histories of profound institutional deprivation compared with standard ADHD cases: a brief report.

作者信息

Sonuga-Barke E J S, Rubia K

机构信息

Developmental Brain-Behaviour Laboratory, School of Psychology, University of Southampton, Southampton, UK.

出版信息

Child Care Health Dev. 2008 Sep;34(5):596-602. doi: 10.1111/j.1365-2214.2008.00863.x.

Abstract

BACKGROUND

The Inattention/Overactivity/Impulsiveness (I/OA) behavioural cluster diagnostic of ADHD is recognized as a characteristic outcome of early institutional care.

METHODS

We compared the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA: n=13) with standard clinical ADHD cases (S-ADHD; N=20) and children who had experienced deprivation but were not pervasively I/OA (ERA-controls; n=22). The mean age of testing was around 13 years. D-I/OA and ERA-controls were selected from the English and Romanian Adoptees (ERA) study and had spent their early lives in the extremely depriving Romanian institutions of the Ceausescu regime and were later adopted into UK families.

RESULTS

ADHD symptoms for male D-I/OA and S-ADHD cases showed marked similarities across symptom domains. In contrast, girls with D-I/OA were more similar to ERA controls than to ADHD cases. Longitudinal data suggested that this was due to a remission of symptoms in D-I/OA girls. Neuropsychological profiles of males and females with D-I/OA, however, were similar: both were more impaired than S-ADHD and ERA controls.

DISCUSSION

Children with D-I/OA were more neuropsychologically impaired than S-ADHD despite the fact that only boys showed a persistent pattern of ADHD symptoms. These results need replication in a larger sample with groups matched for gender.

摘要

背景

注意力不集中/多动/冲动(I/OA)行为集群是多动症的诊断标准,被认为是早期机构照料的典型结果。

方法

我们比较了有I/OA病史和早期严重剥夺经历的儿童(D-I/OA组:n = 13)、标准临床多动症病例(S-ADHD组;N = 20)以及有剥夺经历但无普遍I/OA症状的儿童(ERA对照组;n = 22)的症状和神经心理学特征。测试的平均年龄约为13岁。D-I/OA组和ERA对照组选自英国和罗马尼亚领养儿童(ERA)研究,他们早年生活在齐奥塞斯库政权下极度贫困的罗马尼亚机构中,后来被英国家庭收养。

结果

男性D-I/OA组和S-ADHD组病例在症状领域表现出明显的相似性。相比之下,患有D-I/OA的女孩与ERA对照组更为相似,而与多动症病例不同。纵向数据表明,这是由于D-I/OA组女孩的症状缓解。然而,患有D-I/OA的男性和女性的神经心理学特征相似:两者都比S-ADHD组和ERA对照组受损更严重。

讨论

尽管只有男孩表现出持续的多动症症状模式,但患有D-I/OA的儿童在神经心理学方面比S-ADHD组受损更严重。这些结果需要在更大样本中进行重复验证,且各组要按性别匹配。

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