Department of Psychology, University of California, Berkeley, CA 94720-16505, USA.
Child Neuropsychol. 2011;17(4):368-90. doi: 10.1080/09297049.2010.544649.
We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.
我们对一组患有 ADHD 的青春期前女孩（n=140）和与之匹配的对照组女孩（n=88）进行了为期 5 年的随访，从儿童中期到青春期早期/中期，目的是确定儿童时期的执行功能（EF）是否可以预测青少年多信息源的社会功能和精神病理学结果，包括外显和内隐症状之间的共病。预测因子是经过充分验证的计划、反应抑制和工作记忆的测量方法，以及精细运动控制的对照测量方法。无论 ADHD 与对照组的状态如何，（a）儿童时期的计划和反应抑制可以预测青少年时期的社会功能，（b）儿童时期的计划可以预测青少年时期的共病内外症状。亚组状态（ADHD-混合型、ADHD-注意力不集中型和对照组）调节了儿童期计划与青少年内外共病之间的关系，混合型表现出与基线计划和青少年共病之间特别强烈的关联。中介分析表明，青少年社会功能在从儿童期 EF 到随访时共病的预测中起中介作用；反过来，在患有 ADHD 的女孩中，青少年共病在从儿童期 EF 到随访时的社会功能的预测中起中介作用。我们的结论是，儿童期干预应该针对执行功能障碍，同时还要针对行为症状。
