Bahçivan Saydam Reyhan, Ayvaşik H Belgin, Alyanak Behiye
Department of Child and Adolescent Psychiatry, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Department of Psychology, Orta Doğu Technical University Faculty of Arts and Sciences, Ankara, Turkey.
Noro Psikiyatr Ars. 2015 Dec;52(4):386-392. doi: 10.5152/npa.2015.8712. Epub 2015 Dec 1.
This study aims to evaluate executive functions (EF), such as inhibition, planning, working memory, and set shifting, in children with attention deficit hyperactivity disorder (ADHD) by comparing three ADHD subtype groups (ADHD-Inattentive, ADHD-Combined, and ADHD-Comorbid) and a normal control group.
Participants included 147 children. In total, 111 children were assigned to the ADHD groups of the study. Each child was matched according to the WISC-R Full-Scale IQ-score, sex, and age and was grouped as follows: ADHD-Inattentive group (ADHD-I; n=37), ADHD-Combined (ADHD-C; n=37), ADHD-Comorbid group (ADHD-Comorbid with oppositional defiant disorder and/or conduct disorder; n=37), and control group (n=36). The tests used to assess the children were Conners' Parent and Teacher Rating Scales; Wechsler Intelligence Scale-Revised; Tower of London test; Wisconsin Card Sorting Test; Stroop Color-Word Test, and verbal fluency test. The data were analyzed by one-way ANOVA between subjects for all dependent variables.
Children in the ADHD-I group had significantly better performances in verbal working memory and verbal category shifting than children in the ADHD-C group. There was no significant difference between the ADHD-I and ADHD-C groups in terms of inhibition, set shifting, verbal fluency, cognitive flexibility, and planning. The ADHD-Comorbid group displayed more severe impairments in EF measures than the ADHD-C group; however, the severity was not statistically significant. EF performances of children in the control group were similar to children in the ADHD-I group but better than children in the ADHD-C and ADHD-Comorbid groups.
The outcome of the study indicated that subjects in the ADHD-Comorbid and ADHD-C groups had more severe EF deficits than subjects in the ADHD-I and control groups.
本研究旨在通过比较三种注意缺陷多动障碍（ADHD）亚型组（注意力不集中型ADHD、混合型ADHD和共病型ADHD）与正常对照组，评估ADHD儿童的执行功能（EF），如抑制、计划、工作记忆和定势转换。
参与者包括147名儿童。总共有111名儿童被分配到该研究的ADHD组。每个儿童根据韦氏儿童智力量表修订版（WISC-R）的全量表智商得分、性别和年龄进行匹配，并分为以下几组：注意力不集中型ADHD组（ADHD-I；n = 37）、混合型ADHD组（ADHD-C；n = 37）、共病型ADHD组（合并对立违抗障碍和/或品行障碍的ADHD；n = 37）以及对照组（n = 36）。用于评估儿童的测试包括康纳斯父母与教师评定量表；韦氏智力量表修订版；伦敦塔测试；威斯康星卡片分类测试；斯特鲁普颜色-文字测试和言语流畅性测试。对所有因变量的数据采用组间单因素方差分析进行分析。
ADHD-I组儿童在言语工作记忆和言语类别转换方面的表现显著优于ADHD-C组儿童。ADHD-I组和ADHD-C组在抑制、定势转换、言语流畅性、认知灵活性和计划方面没有显著差异。共病型ADHD组在EF测量中的损伤比ADHD-C组更严重；然而，严重程度在统计学上不显著。对照组儿童的EF表现与ADHD-I组儿童相似，但优于ADHD-C组和共病型ADHD组儿童。
研究结果表明，共病型ADHD组和ADHD-C组的受试者比ADHD-I组和对照组的受试者存在更严重的EF缺陷。
