Coutinho Thales Vianna, Reis Samara Passos Santos, da Silva Antonio Geraldo, Miranda Debora Marques, Malloy-Diniz Leandro Fernandes
Laboratório de Investigações em Neurociência CLínica, Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
iLumina Neurociências, Belo Horizonte, Brazil.
Front Psychiatry. 2018 Jan 22;8:299. doi: 10.3389/fpsyt.2017.00299. eCollection 2017.
Problems in inhibitory control are regarded in Psychology as a key problem associated with attention-deficit/hyperactivity disorder (ADHD). They, however, might not be primary deficits, but instead a consequence of inattention. At least two components have been identified and dissociated in studies in regards to inhibitory control: interference suppression, responsible for controlling interference by resisting irrelevant or misleading information, and response inhibition, referring to withholding a response or overriding an ongoing behavior. Poor error awareness and self-monitoring undermine an individual's ability to inhibit inadequate responses and change course of action. In non-social contexts, an individual depends on his own cognition to regulate his mistakes. In social contexts, however, there are many social cues that should help that individual to perceive his mistakes and inhibit inadequate responses. The processes involved in perceiving and interpreting those social cues are arguably part of a self-protection system (SPS). Individuals with ADHD not only present impulsive behaviors in social contexts, but also have difficulty perceiving their inadequate responses and overriding ongoing actions toward more appropriate ones. In this paper, we discuss that those difficulties are arguably a consequence of an impaired SPS, due to visual attention deficits and subsequent failure in perceiving and recognizing accurately negative emotions in facial expressions, especially anger. We discuss evidence that children with ADHD exhibit problems in a series of components involved in the activation of that system and advocate that the inability to identify the anger expressed by others, and thus, not experiencing the fear response that should follow, is, ultimately, what prevents them from inhibiting the ongoing inappropriate behavior, since a potential threat is not registered. Getting involved in high-risk situations, such as reckless driving, could also be a consequence of not registering a threat and thus, not experiencing fear.
在心理学中，抑制控制方面的问题被视为与注意力缺陷多动障碍（ADHD）相关的关键问题。然而，它们可能并非主要缺陷，而是注意力不集中的结果。关于抑制控制的研究至少已识别并区分出两个组成部分：干扰抑制，负责通过抵制无关或误导性信息来控制干扰；反应抑制，指抑制反应或推翻正在进行的行为。较差的错误意识和自我监控会削弱个体抑制不适当反应并改变行动方向的能力。在非社交情境中，个体依靠自身认知来纠正错误。然而，在社交情境中，有许多社交线索应有助于个体察觉自己的错误并抑制不适当反应。感知和解读这些社交线索所涉及的过程可以说是自我保护系统（SPS）的一部分。患有ADHD的个体不仅在社交情境中表现出冲动行为，而且难以察觉自己不适当的反应，也难以将正在进行的行为转变为更合适的行为。在本文中，我们讨论了这些困难可以说是由于视觉注意力缺陷以及随后无法准确感知和识别面部表情中的负面情绪（尤其是愤怒）导致的SPS受损的结果。我们讨论了证据表明患有ADHD的儿童在该系统激活所涉及的一系列组成部分中存在问题，并主张无法识别他人表达的愤怒，进而无法体验随之而来的恐惧反应，最终导致他们无法抑制正在进行的不适当行为，因为潜在威胁未被察觉。参与高风险情况，如鲁莽驾驶，也可能是未察觉威胁因而未体验到恐惧的结果。
