Department of Psychology, Washington State University.
Department of Psychology, Pennsylvania State University.
J Consult Clin Psychol. 2013 Jun;81(3):481-493. doi: 10.1037/a0032302. Epub 2013 Apr 1.
To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD).
Cardiac preejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), an index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4-6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed 1 of 2 versions of the Incredible Years parent and child interventions.
Main effects of PEP activity and reactivity and of RSA activity and reactivity were found. Although samplewide improvements in behavior were observed at posttreatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment.
We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children.
评估心脏活动和反应的测量值，作为对经验支持的注意缺陷/多动障碍（ADHD）行为干预治疗反应的前瞻性生物标志物。
在 99 名患有 ADHD 的学龄前儿童（年龄 4-6 岁）中，评估心脏射前期（PEP），这是一种与交感神经相关的心脏活动指数，以及呼吸窦性心律失常（RSA），这是一种与副交感神经相关的心脏活动指数，在参与者及其父母完成 2 种难以置信的年份家长和孩子干预版本之一之前，在休息和对行为挑战的反应中进行评估。
发现 PEP 活动和反应性以及 RSA 活动和反应性的主要影响。尽管在治疗后观察到行为的全面改善，但那些在休息时 PEP 延长且对激励的 PEP 反应性降低的人，在治疗前后的行为问题和攻击行为测量中得分更高。相比之下，基线 RSA 较低且 RSA 撤退较大的儿童在治疗前后的亲社会行为得分较低。最后，RSA 撤退较大的儿童在治疗前后的情绪调节得分较低。
我们根据（a）支持食欲（即接近）动机、情绪调节和社会联系的潜在神经生物学系统的个体差异，以及（b）需要针对神经生物学脆弱儿童开发更密集的干预措施，讨论这些发现。
