Guénolé Fabian, Speranza Mario, Louis Jacqueline, Fourneret Pierre, Revol Olivier, Baleyte Jean-Marc
CHU de Caen, service de psychiatrie de l'enfant et de l'adolescent, avenue Clemenceau, 14033 Caen Cedex 9, France; INSERM, unité 1077, Neuropsychologie et neuroanatomie fonctionnelle de la mémoire humaine, avenue de la côte de Nacre - CS 30001, 14033 Caen Cedex 9, France.
Hôpital Mignot, service de psychiatrie de l'enfant et de l'adolescent, 177 rue de Versailles, 78150 Le Chesnay, France; Université de Versailles-Saint-Quentin-en-Yvelines, faculté de médecine, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
Eur J Paediatr Neurol. 2015 Jul;19(4):402-10. doi: 10.1016/j.ejpn.2015.03.006. Epub 2015 Mar 24.
BACKGROUND/PURPOSE: It is common that intellectually gifted children (IQ ≥ 130) are referred to paediatric or child neuropsychiatry clinics for socio-emotional problems and/or school underachievement or maladjustment. Among them, those displaying developmental asynchrony - a heterogeneous developmental pattern reflected in a significant verbal-performance discrepancy (SVPD) on Wechsler's intelligence profile - are thought to be more emotionally and behaviourally impaired than others. Our purpose was to investigate this clinical dichotomy using a cognitive psychopathological approach.
Trait-anxiety and emotional dysregulation were investigated in two groups of referred gifted children (n = 107 and 136, respectively), a pilot-study of reasoning processes on extensive Piaget-like tasks was also performed in an additional small group (n = 12).
Compared to those with a homogenous Wechsler profile, children with a SVPD exhibited: 1) a decreased prevalence of social preoccupation-anxiety (11.1% versus 27.4%; p < 0.05); 2) an increased prevalence of emotional dysregulation (58.7% versus 41.3%; p < 0.05); and 3) an increased prevalence of pathological cognitive disharmony on Piaget-like tasks (87.5% versus 0.0%; p < 0.05).
The results support a clinical dichotomy of behaviourally-impaired children with intellectual giftedness, with developmentally asynchronous ones exhibiting more severe psychopathological features. This suggests that developmental asynchrony matters when examining emotional and behavioural problems in gifted children and call for further investigation of this profile.
背景/目的:智力超常儿童(智商≥130)因社会情感问题和/或学业成绩不佳或适应不良而被转介到儿科或儿童神经精神病诊所的情况很常见。其中,那些表现出发育不同步的儿童——一种异质性发育模式,体现在韦氏智力剖面图上显著的言语-操作差异(SVPD)——被认为比其他儿童在情感和行为方面受到的损害更大。我们的目的是采用认知心理病理学方法研究这种临床二分法。
对两组被转介的超常儿童(分别为n = 107和136)进行特质焦虑和情绪调节障碍调查,还对另外一个小群体(n = 12)进行了一项关于广泛类皮亚杰任务推理过程的初步研究。
与韦氏剖面图同质的儿童相比,患有SVPD的儿童表现出:1)社交专注性焦虑的患病率降低(11.1%对27.4%;p < 0.05);2)情绪调节障碍的患病率增加(58.7%对41.3%;p < 0.05);3)在类皮亚杰任务上病理性认知失调的患病率增加(87.5%对0.0%;p < 0.05)。
结果支持了智力超常且行为受损儿童的临床二分法,发育不同步的儿童表现出更严重的心理病理特征。这表明在检查超常儿童的情绪和行为问题时,发育不同步很重要,并呼吁对这一特征进行进一步研究。