Xu Manfei, Jiang Wenqing, DU Yasong, Li Yan, Fan Juan
Shanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai 200030, China.
Shanghai Arch Psychiatry. 2017 Aug 25;29(4):228-236. doi: 10.11919/j.issn.1002-0829.216104.
Oppositional defiant disorder (ODD) that is characterized by markedly defiant, disobedient, and disruptive behavior in younger children has been regarded as disruptive behavior disorder (DBD), together with conduct disorder (CD). However, in contrast to CD, ODD does not include severe aggressive or antisocial behavior.
This study aimed to examine executive function (EF) features of children with oppositional defiant disorder (ODD).
Cross sectional design was used in this study. The EF of children with ODD and pure attention deficit hyperactivity disorder (ADHD) were compared with children without a psychiatric disorder, using the Stroop Color-Word Tests A and B, Wechsler Intelligence Scale for Children (Fourth Edition; WISC-IV), Wisconsin Card Sorting Test (WCST), and Cambridge Neuropsychological Test Automated Battery (CANTAB) corrected for age. Logistic regression analysis was conducted to identify risk factors for EF deficits characteristic of ODD and ADHD.
The ODD group exhibited significantly lower scores in both Stroop Color-Word Tests, the backwards digital span of the WISC-IV, and the categories completed and perseverative responses of the WCST, and significantly higher scores in spatial working memory (SWM) between errors, and the strategy in SWM of the CANTAB compared with the control group. When the ODD group was designated as 1 and the ADHD group was designated as 0, digital span (X1) fit the regression equation very well.
Children with ODD perform substantially worse in EF tasks. Responsive inhibition appears to be uniquely associated with ODD development, while responsive inhibition and working memory appear to be associated with ADHD.
对立违抗性障碍（ODD）在年幼儿童中表现为明显的违抗、不服从和破坏性行为，与品行障碍（CD）一起被视为破坏性行为障碍（DBD）。然而，与CD不同的是，ODD不包括严重的攻击或反社会行为。
本研究旨在探讨对立违抗性障碍（ODD）儿童的执行功能（EF）特征。
本研究采用横断面设计。使用Stroop色词测验A和B、韦氏儿童智力量表（第四版；WISC-IV）、威斯康星卡片分类测验（WCST）以及针对年龄校正的剑桥神经心理测试自动化成套测验（CANTAB），将ODD儿童和单纯注意力缺陷多动障碍（ADHD）儿童的EF与无精神障碍的儿童进行比较。进行逻辑回归分析以确定ODD和ADHD特有的EF缺陷的危险因素。
与对照组相比，ODD组在Stroop色词测验、WISC-IV的倒序数字广度、WCST完成的类别和持续性反应中的得分显著更低，而在错误之间的空间工作记忆（SWM）以及CANTAB的SWM策略中的得分显著更高。当将ODD组指定为1，ADHD组指定为0时，数字广度（X1）与回归方程拟合得非常好。
ODD儿童在EF任务中的表现明显更差。反应抑制似乎与ODD的发展独特相关，而反应抑制和工作记忆似乎与ADHD相关。
