Am J Psychiatry. 2013 Oct;170(10):1205-11. doi: 10.1176/appi.ajp.2012.12101360.
This longitudinal study examined if changes in neuropsychological functioning were associated with the trajectory of symptoms related to attention deficit hyperactivity disorder (ADHD) and impairment between preschool and school age.
The sample consisted of 3- and 4-year-old children (N=138) who were identified as being at risk for ADHD based on parent and teacher reports. Neuropsychological functioning was measured annually using the NEPSY at four time points (mean ages, 4.19, 5.36, 6.35, and 7.35 years). ADHD symptoms and impairment were assessed with semiannual parent and teacher reports using the ADHD Rating Scale-IV and the Children's Problems Checklist at 10 time points (mean ages at baseline and final assessment, 4.19 and 8.81 years, respectively). Hierarchical linear modeling was used to assess the trajectories of change in neuropsychological functioning and ADHD severity as well as the association of change in neuropsychological functioning with change in ADHD severity over time.
Baseline neuropsychological functioning was not significantly associated with the slope of change in ADHD severity. However, the magnitude of change in neuropsychological functioning was linearly associated with the trajectory of ADHD symptom severity and impairment, such that individuals with greater neuropsychological growth over time had a greater diminution of ADHD severity and impairment. Family socioeconomic status at baseline was significantly associated with initial ADHD severity and impairment, but not with change over time.
Interventions that enhance neuropsychological functioning at an early age may be beneficial in attenuating long-term ADHD severity and impairment.
本纵向研究旨在探讨神经心理学功能的变化是否与注意力缺陷多动障碍（ADHD）相关症状的轨迹以及学龄前至学龄期的损伤有关。
该样本由 3 岁和 4 岁的儿童（N=138）组成，这些儿童根据父母和教师的报告被确定为患有 ADHD 的风险较高。使用 NEPSY 在四个时间点（平均年龄分别为 4.19 岁、5.36 岁、6.35 岁和 7.35 岁）每年测量神经心理学功能。使用 ADHD 评定量表-IV 和儿童问题清单，通过半年度的父母和教师报告，在 10 个时间点（基线和最终评估的平均年龄分别为 4.19 岁和 8.81 岁）评估 ADHD 症状和损伤。使用分层线性模型评估神经心理学功能和 ADHD 严重程度的变化轨迹，以及神经心理学功能变化与 ADHD 严重程度随时间变化的相关性。
基线神经心理学功能与 ADHD 严重程度变化的斜率无显著相关性。然而，神经心理学功能的变化幅度与 ADHD 症状严重程度和损伤的轨迹呈线性相关，即随着时间的推移，神经心理学功能增长较大的个体，ADHD 严重程度和损伤的下降幅度也越大。基线时的家庭社会经济地位与初始 ADHD 严重程度和损伤显著相关，但与随时间的变化无关。
在早期增强神经心理学功能的干预措施可能有益于减轻长期 ADHD 的严重程度和损伤。
