a Graduate Institute of Behavioral Sciences, College of Medicine , Chang Gung University , Tao-Yuan.
b Department of Child Psychiatry , Chang Gung Memorial Hospital Linkou Branch.
J Clin Child Adolesc Psychol. 2019 May-Jun;48(3):455-468. doi: 10.1080/15374416.2018.1452151. Epub 2018 May 30.
Increased intrasubject variability in reaction times (RT-ISV) is frequently found in individuals with autism spectrum disorder (ASD). However, how dimensional attention deficit/hyperactivity disorder (ADHD) symptoms impact RT-ISV in individuals with ASD remains elusive. We assessed 97 high-functioning youths with co-occurring ASD and ADHD (ASD+ADHD), 124 high-functioning youths with ASD only, 98 youths with ADHD only, and 249 typically developing youths, 8-18 years of age, using the Conners Continuous Performance Test (CCPT). We compared the conventional CCPT parameters (omission errors, commission errors, mean RT and RT standard error (RTSE) as well as the ex-Gaussian parameters of RT (mu, sigma, and tau) across the four groups. We also conducted regression analyses to assess the relationships between RT indices and symptoms of ADHD and ASD in the ASD group (i.e., the ASD+ADHD and ASD-only groups). The ASD+ADHD and ADHD-only groups had higher RT-ISV than the other two groups. RT-ISV, specifically RTSE and tau, was significantly associated with ADHD symptoms rather than autistic traits in the ASD group. Regression models also revealed that sex partly accounted for RT-ISV variance in the ASD group. A post hoc analysis showed girls with ASD had higher tau and RTSE values than their male counterparts. Our results suggest that RT-ISV is primarily associated with co-occurring ADHD symptoms/diagnosis in children and adolescents with ASD. These results do not support the hypothesis of response variability as a transdiagnostic phenotype for ASD and ADHD and warrant further validation at a neural level.
在自闭症谱系障碍（ASD）患者中，常发现反应时（RT）的个体内变异性增加。然而，注意力缺陷/多动障碍（ADHD）的维度症状如何影响 ASD 患者的 RT-ISV 仍然难以捉摸。我们评估了 97 名共患 ASD 和 ADHD（ASD+ADHD）的高功能青少年、124 名仅患有 ASD 的高功能青少年、98 名仅患有 ADHD 的青少年和 249 名典型发育的青少年，年龄在 8 至 18 岁之间，使用康纳斯连续性能测试（CCPT）。我们比较了四个组之间的传统 CCPT 参数（遗漏错误、错误、平均 RT 和 RT 标准误差（RTSE）以及 RT 的外高斯参数（mu、sigma 和 tau）。我们还进行了回归分析，以评估 ASD 组（即 ASD+ADHD 和 ASD 仅组）中 RT 指数与 ADHD 和 ASD 症状之间的关系。ASD+ADHD 和 ADHD 仅组的 RT-ISV 高于其他两组。ASD 组中，RT-ISV，特别是 RTSE 和 tau，与 ADHD 症状显著相关，而与自闭症特征无关。回归模型还表明，性别在 ASD 组中部分解释了 RT-ISV 的变异性。事后分析显示，ASD 女孩的 tau 和 RTSE 值高于其男性对应值。我们的结果表明，RT-ISV 主要与 ASD 儿童和青少年共患的 ADHD 症状/诊断相关。这些结果不支持将反应变异性作为 ASD 和 ADHD 的跨诊断表型的假设，需要在神经水平上进一步验证。
