奖励敏感性和基于副交感神经的调节在注意缺陷/多动和破坏性行为障碍儿童中的特异性。
Specificity of Reward Sensitivity and Parasympathetic-Based Regulation among Children with Attention-Deficit/Hyperactivity and Disruptive Behavior Disorders.
机构信息
Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA.
出版信息
J Abnorm Child Psychol. 2018 Jul;46(5):965-977. doi: 10.1007/s10802-017-0343-0.
Attention-deficit/hyperactivity disorder (ADHD) is associated with disruptionsin reward sensitivity and regulatory processes. However, it is unclear whether thesedisruptions are better explained by comorbid disruptive behavior disorder (DBD)symptomology. This study sought to examine this question using multiple levels ofanalysis (i.e., behavior, autonomic reactivity). One hundred seventeen children (aged 6 to 12 years; 72.6% male; 69 with ADHD) completed theBalloon-Analogue Risk Task (BART) to assess external reward sensitivity behaviorally.Sympathetic-based internal reward sensitivity and parasympathetic-based regulationwere indexed via cardiac pre-ejection period (PEP) and respiratory sinus arrhythmia(RSA), respectively. Children with ADHD exhibited reduced internal reward sensitivity (i.e.,lengthened PEP; F(1,112)=4.01, p=0.047) compared to healthy controls and werecharacterized by greater parasympathetic-based dysregulation (i.e., reduced RSAaugmentation F(1,112)=10.12, p=0.002). However, follow-up analyses indicated theADHD effect was better accounted for by comorbid DBD diagnoses; that is, childrenwith ADHD and comorbid ODD were characterized by reduced internal rewardsensitivity (i.e., lengthened PEP; t=2.47, p=0.046) and by parasympathetic-baseddysregulation (i.e., reduced RSA augmentation; t=3.51, p=0.002) in response to rewardwhen compared to typically developing youth. Furthermore, children with ADHD and comorbid CD exhibited greater behaviorally-based external reward sensitivity (i.e.,more total pops; F(3,110)= 5.96, p=0.001) compared to children with ADHD only (t=3.87, p=0.001) and children with ADHD and ODD (t=3.56, p=0.003). Results suggest that disruptions in sensitivity to reward may be betteraccounted for, in part, by comorbid DBD.Key Words: attention-deficit/hyperactivity disorder, autonomic nervous system,disruptive behavior disorders, reward sensitivityPowered.
注意缺陷多动障碍（ADHD）与奖赏敏感性和调节过程的中断有关。然而，这些中断是否可以更好地用共患的破坏性行为障碍（DBD）症状来解释还不清楚。本研究试图使用多个分析层面（即行为、自主反应性）来检验这个问题。117 名儿童（年龄 6 至 12 岁；72.6%为男性；69 名患有 ADHD）完成了气球模拟风险任务（BART），以评估外部奖赏敏感性行为。基于交感神经的内部奖赏敏感性和基于副交感神经的调节分别通过心脏射前期（PEP）和呼吸窦性心律失常（RSA）来标记。与健康对照组相比，ADHD 儿童表现出内部奖赏敏感性降低（即 PEP 延长；F(1,112)=4.01，p=0.047），并且表现出更大的基于副交感神经的调节障碍（即 RSA 增强减少；F(1,112)=10.12，p=0.002）。然而，后续分析表明，ADHD 效应可以更好地用共患的 DBD 诊断来解释；也就是说，患有 ADHD 和共患 ODD 的儿童表现出内部奖赏敏感性降低（即 PEP 延长；t=2.47，p=0.046）和基于副交感神经的调节障碍（即 RSA 增强减少；t=3.51，p=0.002），以响应奖赏，与发育正常的青少年相比。此外，患有 ADHD 和共患 CD 的儿童表现出更强的基于行为的外部奖赏敏感性（即更多的总点击数；F(3,110)=5.96，p=0.001），与仅患有 ADHD 的儿童相比（t=3.87，p=0.001）和患有 ADHD 和 ODD 的儿童相比（t=3.56，p=0.003）。结果表明，奖赏敏感性的中断在一定程度上可以更好地用共患的 DBD 来解释。
关键词
注意缺陷多动障碍，自主神经系统，破坏性行为障碍，奖赏敏感性
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