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探索成人 ADHD 中情绪调节不足:电生理学证据。

Exploring deficient emotion regulation in adult ADHD: electrophysiological evidence.

机构信息

Clinical Psychology and Psychotherapy, Department of Psychology, University of Kiel, Olshausenstr. 62, 24118, Kiel, Germany.

Clinical Psychology and Psychotherapy, Department of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):359-371. doi: 10.1007/s00406-017-0826-6. Epub 2017 Aug 2.

Abstract

Emotional dysregulation (ED) is being increasingly recognized as a core feature of attention-deficit/hyperactivity disorder (ADHD), but the pathophysiological underpinnings remain unclear. In this study, we provide meaningful electrophysiological evidence of ED in adult patients with ADHD (n = 39) compared to healthy controls (n = 40) by exploring the electrophysiological correlates of the emotion regulation strategies reappraisal, distraction, and expressive suppression. Event-related potentials (ERPs) were recorded during passive viewing of neutral and negative images, as well as during emotion regulation. The patients with ADHD exhibited increased frontal late positive potential (LPP) amplitudes during passive viewing of the aversive images and during emotion regulation. Compared with the healthy controls, a subgroup of medication-naïve patients with ADHD (n = 25) also exhibited larger centroparietal LPP amplitudes and provided more negative ratings of the aversive and neutral images. Both the frontal and centroparietal LPP amplitudes were associated with ADHD symptom severity. However, no significant deficit in LPP modulation during emotion regulation was found. These findings strongly support the clinical observation of increased emotional responsivity toward negative stimuli and difficulty during the implementation of emotion regulation strategies and thus encourage the implementation of emotion regulation modules in the treatment of adult patients with ADHD.

摘要

情绪调节障碍(ED)越来越被认为是注意力缺陷多动障碍(ADHD)的核心特征,但病理生理基础仍不清楚。在这项研究中,我们通过探索情绪调节策略再评价、分心和表达抑制的电生理相关性,为成年 ADHD 患者(n=39)与健康对照组(n=40)的 ED 提供了有意义的电生理证据。在被动观看中性和负性图像以及情绪调节期间记录事件相关电位(ERP)。与健康对照组相比,一组未经药物治疗的 ADHD 患者(n=25)在观看厌恶图像和情绪调节期间也表现出更大的额中央后正波(LPP)振幅,并对厌恶和中性图像给予更多的负面评价。额中和中央后 LPP 振幅均与 ADHD 症状严重程度相关。然而,在情绪调节期间,LPP 调节没有发现明显缺陷。这些发现强烈支持了对负性刺激的情绪反应增加和情绪调节策略实施困难的临床观察,因此鼓励在治疗成年 ADHD 患者时实施情绪调节模块。

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