Hovik Kjell Tore, Plessen Kerstin J, Cavanna Andrea E, Skogli Erik Winther, Andersen Per Normann, Øie Merete
Innlandet Hospital Trust, Division Mental Health Care, Lillehammer, Norway.
University of Oslo, Institute of Psychology, Oslo, Norway.
PLoS One. 2015 Dec 16;10(12):e0144874. doi: 10.1371/journal.pone.0144874. eCollection 2015.
This two-year follow-up study investigates the course of and association among measures of cognitive control, focused attention, decision-making and symptom severity (anxiety, depression and behavior) in children and adolescents with Tourette's Syndrome (TS) or Attention-Deficit/Hyperactivity Disorder-Combined subtype (ADHD-C).
19 children with TS, 33 with ADHD-C, and 50 typically developing children (TDC) were examined with a battery of psychometric measures and rating forms at baseline and two-years later.
All three groups improved likewise in measures of cognitive control over time, whereas only the TDC improved in focused attention. The group of children with TS with comorbidities performed more similar to the children with ADHD-C in cognitive control at T1 and T2, whereas the children with TS without comorbidities performed more similar to the TDC in cognitive control at T1 and T2. In the decision-making task, the children with TS (with or without comorbidities) preferred a safer strategy in selecting advantageous choices than the children with ADHD-C and the TDC at T2. Children with TS and children with ADHD-C showed higher symptoms of anxiety and depression and more problems with emotional control compared with TDC at both time points. Finally, children with ADHD-C self-reported more depression symptoms than those with TS at both assessments. For the TS group, safer decision-making was related to better emotional control, and this relationship was stronger for the TS subgroup without comorbidities.
This study emphasizes the importance of addressing symptoms of anxiety and depression in children with TS or ADHD-C, identifying the effect of comorbidities in children with TS, and that children with TS or ADHD-C likely differ in their sensitivity to reinforcement contingencies.
这项为期两年的随访研究调查了患有抽动秽语综合征(TS)或注意力缺陷多动障碍合并型(ADHD-C)的儿童和青少年在认知控制、集中注意力、决策以及症状严重程度(焦虑、抑郁和行为)方面的发展过程及其相互关系。
对19名患有TS的儿童、33名患有ADHD-C的儿童以及50名发育正常的儿童(TDC)在基线时和两年后进行了一系列心理测量和评定量表检查。
随着时间的推移,所有三组在认知控制测量方面均有同样程度的改善,而只有TDC组在集中注意力方面有所改善。在T1和T2时,患有共病的TS儿童组在认知控制方面的表现与ADHD-C儿童组更为相似,而无共病的TS儿童组在认知控制方面的表现与TDC组在T1和T2时更为相似。在决策任务中,在T2时,患有TS(无论有无共病)的儿童在选择有利选项时比ADHD-C儿童组和TDC儿童组更倾向于选择更安全的策略。在两个时间点,与TDC相比,患有TS的儿童和患有ADHD-C的儿童表现出更高的焦虑和抑郁症状以及更多的情绪控制问题。最后,在两次评估中,患有ADHD-C的儿童自我报告的抑郁症状比患有TS的儿童更多。对于TS组,更安全的决策与更好的情绪控制相关,并且这种关系在无共病的TS亚组中更强。
本研究强调了应对患有TS或ADHD-C的儿童的焦虑和抑郁症状、确定共病对患有TS的儿童的影响的重要性,以及患有TS或ADHD-C的儿童对强化意外情况的敏感性可能存在差异。