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注意缺陷多动障碍合并对立违抗障碍儿童的冷热执行功能

Hot and Cool Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder.

作者信息

Antonini Tanya N, Becker Stephen P, Tamm Leanne, Epstein Jeffery N

机构信息

Cincinnati Children's Hospital Medical Center,Cincinnati,Ohio.

出版信息

J Int Neuropsychol Soc. 2015 Sep;21(8):584-95. doi: 10.1017/S1355617715000752.

Abstract

While neuropsychological deficits in both "hot" and "cool" executive functions (EFs) have been documented among individuals with attention-deficit/hyperactivity disorder (ADHD), these EF deficits are not universal across all individuals with this diagnosis. One potential moderator of executive dysfunction may be the presence of comorbid oppositional defiant disorder (ODD). This study examined the association between "hot" and "cool" EFs and comorbid ODD in children with ADHD. Thirty-three children with ADHD and comorbid ODD (ADHD+ODD), 67 with ADHD without ODD (ADHD-ODD), and 30 typically developing controls participated. Children were 7-12 years of age. "Cool" EFs were assessed with a spatial span task and a card sorting test. "Hot" EFs were assessed using a delay discounting task and a gambling task. ADHD-ODD and ADHD+ODD groups performed more poorly on "cool" EF tasks than controls, but did not differ from each other. Furthermore, the number of ADHD symptoms, but not ODD symptoms, was associated with "cool" EF scores. The three groups did not differ on "hot" EF tasks and the number of ADHD or ODD symptoms was unrelated to "hot" EF scores. In sum, children with ADHD presented with "cool" EF deficits which appear to be unrelated to ODD comorbidity. However, "hot" EF deficits were not present among children with ADHD, irrespective of comorbid ODD status.

摘要

虽然注意力缺陷多动障碍(ADHD)患者中已记录到“热”和“冷”执行功能(EFs)方面的神经心理缺陷,但这些执行功能缺陷在所有患有该诊断的个体中并不普遍。执行功能障碍的一个潜在调节因素可能是共病对立违抗障碍(ODD)的存在。本研究考察了ADHD儿童中“热”和“冷”执行功能与共病ODD之间的关联。33名患有ADHD且共病ODD(ADHD+ODD)的儿童、67名患有ADHD但无ODD(ADHD-ODD)的儿童以及30名发育正常的对照组儿童参与了研究。儿童年龄在7至12岁之间。“冷”执行功能通过空间跨度任务和卡片分类测试进行评估。“热”执行功能通过延迟折扣任务和赌博任务进行评估。ADHD-ODD组和ADHD+ODD组在“冷”执行功能任务上的表现比对照组更差,但两组之间没有差异。此外,ADHD症状的数量而非ODD症状的数量与“冷”执行功能得分相关。三组在“热”执行功能任务上没有差异,ADHD或ODD症状的数量与“热”执行功能得分无关。总之,患有ADHD的儿童存在“冷”执行功能缺陷,这似乎与共病ODD无关。然而,无论共病ODD状态如何,ADHD儿童中均不存在“热”执行功能缺陷。

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