胎儿酒精谱系障碍儿童的心理理论
Theory of Mind in Children with Fetal Alcohol Spectrum Disorders.
作者信息
Lindinger Nadine M, Malcolm-Smith Susan, Dodge Neil C, Molteno Christopher D, Thomas Kevin G F, Meintjes Ernesta M, Jacobson Joseph L, Jacobson Sandra W
机构信息
ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa.
Department of Psychiatry and Behavioural Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
出版信息
Alcohol Clin Exp Res. 2016 Feb;40(2):367-76. doi: 10.1111/acer.12961.
BACKGROUND
Theory of mind (ToM) refers to the ability to understand and make inferences about other people's intentions, feelings, and beliefs. Although children with fetal alcohol spectrum disorders (FASD) are known to have deficits in social-cognitive function, little is known about ToM in FASD.
METHODS
ToM ability was assessed using a developmentally sensitive ToM battery, including the reading the mind in the eyes (RME) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. IQ and executive function (EF) were assessed as potential mediating variables. The battery was administered to 63 children (aged 9 to 11 years) from Cape Town, South Africa, whose mothers had been prospectively recruited during pregnancy. Children with fetal alcohol syndrome (FAS; n = 8) and partial FAS (PFAS; n = 19), as well as nonsyndromal heavily exposed children (n = 17), were compared to children born to abstaining or light drinkers (n = 19) from the same community.
RESULTS
No FASD group differences were found on the less challenging ToM tasks. By contrast, children with FAS and PFAS performed more poorly than controls on a more challenging ToM task, the RME test. A continuous measure of prenatal alcohol exposure (PAE) was more sensitive than FASD diagnosis in that it was related to 4 higher-order ToM measures, particularly the ability to attribute mental states assessed on RME. IQ only partially mediated the effect of exposure on RME performance, and these effects were not mediated by EF. Hence, the data suggest that these ToM measures tap into a specific alcohol-related social-cognitive deficit that does not merely reflect poorer EF. FASD diagnosis and PAE were each also related to RME after control for attention deficit/hyperactivity disorder.
CONCLUSIONS
These findings suggest that deficits in higher-order ToM function may play a significant role in the social-cognitive behavioral impairment in FASD.
背景
心理理论（ToM）是指理解并推断他人意图、情感和信念的能力。尽管已知患有胎儿酒精谱系障碍（FASD）的儿童存在社会认知功能缺陷，但对于FASD中的心理理论了解甚少。
方法
使用一套对发育敏感的心理理论测试组合来评估心理理论能力，包括眼神读心（RME）测试，这是一种心理推理能力的测量方法，已发现其在其他临床人群中受损。智商和执行功能（EF）作为潜在的中介变量进行评估。该测试组合应用于来自南非开普敦的63名儿童（9至11岁），这些儿童的母亲在孕期被前瞻性招募。将患有胎儿酒精综合征（FAS；n = 8）和部分胎儿酒精综合征（PFAS；n = 19）的儿童，以及非综合征性重度暴露儿童（n = 17）与来自同一社区的戒酒或轻度饮酒母亲所生的儿童（n = 19）进行比较。
结果
在难度较低的心理理论任务上未发现FASD组间差异。相比之下，患有FAS和PFAS的儿童在更具挑战性的心理理论任务即RME测试中表现比对照组更差。产前酒精暴露（PAE）的连续测量比FASD诊断更敏感，因为它与4项高阶心理理论测量相关，特别是在RME上评估的心理状态归因能力。智商仅部分介导了暴露对RME表现的影响，且这些影响未由EF介导。因此，数据表明这些心理理论测量反映了一种特定的与酒精相关的社会认知缺陷，而不仅仅是较差的执行功能。在控制注意力缺陷/多动障碍后，FASD诊断和PAE各自也与RME相关。
结论
这些发现表明高阶心理理论功能缺陷可能在FASD的社会认知行为损害中起重要作用。
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