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神经认知和行为预测 ADHD 患者的社会问题:一个贝叶斯框架。

Neurocognitive and behavioral predictors of social problems in ADHD: A Bayesian framework.

机构信息

Department of Psychology.

Curry School of Education, University of Virginia.

出版信息

Neuropsychology. 2018 Mar;32(3):344-355. doi: 10.1037/neu0000416.

Abstract

OBJECTIVE

Social problems are a key area of functional impairment for children with attention deficit hyperactivity disorder (ADHD), and converging evidence points to executive dysfunction as a potential mechanism underlying ADHD-related social dysfunction. The evidence is mixed, however, with regard to which neurocognitive abilities account for these relations.

METHOD

A well-characterized group of 117 children ages 8-13 (M = 10.45, SD = 1.53; 43 girls; 69.5% Caucasian/Non-Hispanic) with ADHD (n = 77) and without ADHD (n = 40) were administered multiple, counterbalanced tests of neurocognitive functioning and assessed for social skills via multi-informant reports.

RESULTS

Bayesian linear regressions revealed strong support for working memory and cross-informant interfering behaviors (inattention, hyperactivity/impulsivity) as predictors of parent- and teacher-reported social problems. Working memory was also implicated in social skills acquisition deficits, performance deficits, and strengths based on parent and/or teacher report; inattention and/or hyperactivity showed strong correspondence with cross-informant social problems in all models. There was no evidence for, and in most models strong evidence against, effects of inhibitory control and processing speed. The ADHD group was impaired relative to the non-ADHD group on social skills (d = 0.82-0.88), visuospatial working memory (d = 0.89), and phonological working memory (d = 0.58). In contrast, the Bayesian ANOVAs indicated that the ADHD and non-ADHD groups were equivalent on processing speed, IQ, age, gender, and socioeconomic status (SES). There was no support for or against group differences in inhibition.

CONCLUSIONS

These findings confirm that ADHD is associated with impaired social performance, and implicate working memory and core ADHD symptoms in the acquisition and performance of socially skilled behavior. (PsycINFO Database Record

摘要

目的

社会问题是注意力缺陷多动障碍(ADHD)儿童功能障碍的一个关键领域,越来越多的证据表明执行功能障碍是 ADHD 相关社会功能障碍的潜在机制。然而,哪种神经认知能力与这些关系有关,证据并不一致。

方法

对 117 名 8-13 岁(M=10.45,SD=1.53;43 名女孩;69.5%为白种人/非西班牙裔)的 ADHD 儿童(n=77)和无 ADHD 儿童(n=40)进行了多项神经认知功能的测试,并通过多 informant 报告评估了社会技能。

结果

贝叶斯线性回归强烈支持工作记忆和跨 informant 干扰行为(注意力不集中、多动/冲动)作为父母和教师报告的社会问题的预测因素。工作记忆也与基于父母和/或教师报告的社会技能获取缺陷、表现缺陷和优势有关;在所有模型中,注意力不集中和/或多动与跨 informant 社会问题都有很强的对应关系。没有证据表明抑制控制和处理速度有影响,而且在大多数模型中都强烈反对这种影响。ADHD 组在社会技能(d=0.82-0.88)、视空间工作记忆(d=0.89)和语音工作记忆(d=0.58)方面比非 ADHD 组差。相比之下,贝叶斯 ANOVA 表明 ADHD 组和非 ADHD 组在处理速度、智商、年龄、性别和社会经济地位(SES)方面没有差异。没有证据支持或反对抑制作用的差异。

结论

这些发现证实了 ADHD 与社会表现受损有关,并表明工作记忆和 ADHD 的核心症状与获得和表现社会技能行为有关。

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