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注意力缺陷多动障碍家族史阳性的未患病学龄前儿童的抑制控制和延迟厌恶

Inhibitory control and delay aversion in unaffected preschoolers with a positive family history of attention deficit hyperactivity disorder.

作者信息

Pauli-Pott Ursula, Roller Alisa, Heinzel-Gutenbrunner Monika, Mingebach Tanja, Dalir Silke, Becker Katja

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.

出版信息

J Child Psychol Psychiatry. 2014 Oct;55(10):1117-24. doi: 10.1111/jcpp.12230. Epub 2014 Mar 27.

Abstract

BACKGROUND

From current theories on the etiology of attention deficit hyperactivity disorder (ADHD), it can be inferred that delay aversion (DA) and deficits in inhibitory control (IC) constitute basic deficits or endophenotypes of the disorder that already occur in the preschool period. This implies an occurrence of the characteristics in unaffected preschoolers with a positive family history of ADHD. Thus, it is hypothesized that preschoolers who are not affected by ADHD but who have first-degree relatives who suffer, or have suffered, from ADHD show deficits in IC and heightened DA in comparison to preschoolers from the general population.

METHODS

Thirty unaffected preschoolers with a positive family history of ADHD were compared with 30 control children matched with respect to age in months, gender, intelligence, and maternal education level. The groups also did not differ in terms of maternal depressive symptoms and the number of psychosocial family risks. A set of age-appropriate neuropsychological tasks on executive IC (e.g. Puppet Says, Day-Night, relying on Go-NoGo and interference paradigms) and DA (e.g. Snack Delay, Gift Wrap, relying on delay of gratification paradigm) was conducted.

RESULTS

Unaffected preschoolers showed significantly higher DA than control children (t(29) = -2.57, p < .008). The result did not change when subclinical ADHD symptoms and symptoms of oppositional defiant disorder were controlled for (F(1,29) = 5.21, p < .031). Differences in IC did not reach statistical significance.

CONCLUSION

The results are compatible with the assumption that DA constitutes a familial vulnerability marker that can be validly assessed in the preschool period. As this is the first study to address this issue in preschoolers, more research is needed to confirm and further analyze the significance of DA assessments specifically at this developmental stage.

摘要

背景

从目前关于注意力缺陷多动障碍(ADHD)病因的理论可以推断,延迟厌恶(DA)和抑制控制(IC)缺陷构成了该障碍的基本缺陷或内表型,这些在学龄前阶段就已出现。这意味着在ADHD家族史阳性的未受影响的学龄前儿童中会出现这些特征。因此,假设与普通人群的学龄前儿童相比,未受ADHD影响但有一级亲属患有或曾患有ADHD的学龄前儿童表现出IC缺陷和更高的DA。

方法

将30名ADHD家族史阳性的未受影响的学龄前儿童与30名在月龄、性别、智力和母亲教育水平方面匹配的对照儿童进行比较。两组在母亲抑郁症状和社会心理家庭风险数量方面也没有差异。进行了一系列适合年龄的关于执行IC(如木偶说、白天 - 黑夜,依赖于停止信号和干扰范式)和DA(如零食延迟、礼物包装,依赖于延迟满足范式)的神经心理学任务。

结果

未受影响的学龄前儿童表现出比对照儿童显著更高的DA(t(29) = -2.57,p < .008)。在控制亚临床ADHD症状和对立违抗障碍症状后,结果没有改变(F(1,29) = 5.21,p < .031)。IC方面的差异未达到统计学显著性。

结论

结果与DA构成家族易感性标志物的假设相符,该标志物可在学龄前阶段有效评估。由于这是第一项针对学龄前儿童解决此问题的研究,需要更多研究来证实并进一步分析在这个特定发育阶段进行DA评估的意义。

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