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认知预测因子对极早产儿父母评定的注意力不集中的影响:工作记忆和处理速度的作用。

Cognitive predictors of parent-rated inattention in very preterm children: The role of working memory and processing speed.

机构信息

a School of Psychology , University of Nottingham , Nottingham , UK.

b Department of Health Sciences , University of Leicester , Leicester , UK.

出版信息

Child Neuropsychol. 2019 Jul;25(5):617-635. doi: 10.1080/09297049.2018.1510908. Epub 2018 Sep 19.

Abstract

Inattention is one of the most common neurobehavioral problems following very preterm birth. Attention problems can persist into adulthood and are associated with negative socio-emotional and educational outcomes. This study aimed to determine whether the cognitive processes associated with inattention differ between term-born and very preterm children. Sixty-five children born very preterm (<33+0 weeks' gestation) aged 8-11 years were recruited alongside 48 term-born controls (?37 20 +0 weeks' gestation). Both groups included children with a wide spectrum of parent-rated inattention (above average attention to severe inattention) measured as a continuous dimension using the Strengths and Weaknesses of ADHD and Normal-Behavior (SWAN) scale. The children completed tests to assess basic cognitive processes and executive function. A hierarchical multiple regression analysis was implemented to assess which neurocognitive processes explained variance in parent-rated inattention and whether these differed between preterm and term-born children. In both groups, poorer verbal and visuospatial short-term memory and poorer visuospatial working memory independently explained variance in parent-rated inattention. Slower motor processing speed explained variance in inattention among very preterm children only. The cognitive mechanisms associated with parent-rated inattention were predominantly overlapping between groups, but relationships between motor processing speed and inattention were unique to very preterm children. These associations may reflect risk factors for inattention in term and very preterm children. Future research should assess the efficacy of these cognitive processes as potential targets for intervention.

摘要

注意力不集中是极早产儿出生后最常见的神经行为问题之一。注意力问题可能会持续到成年期,并与负面的社会情感和教育结果相关。本研究旨在确定与注意力不集中相关的认知过程在足月出生和极早产儿之间是否存在差异。研究招募了 65 名极早产儿(<33+0 周妊娠)和 48 名足月出生的对照组儿童(?37 20 +0 周妊娠),年龄在 8-11 岁之间。这两组儿童都包括了父母评估的注意力不集中(注意力高于平均水平到严重注意力不集中)程度不同的儿童,使用注意力缺陷多动障碍和正常行为的强弱(SWAN)量表作为连续维度进行测量。儿童完成了测试,以评估基本认知过程和执行功能。实施了分层多元回归分析,以评估哪些神经认知过程可以解释父母评估的注意力不集中的差异,以及这些差异是否存在于早产儿和足月出生的儿童之间。在这两组儿童中,较差的言语和视空间短期记忆以及较差的视空间工作记忆都可以独立地解释父母评估的注意力不集中的差异。只有极早产儿的运动处理速度较慢才能解释注意力不集中的差异。与父母评估的注意力不集中相关的认知机制在组间主要是重叠的,但运动处理速度和注意力之间的关系仅存在于极早产儿中。这些关联可能反映了足月和极早产儿注意力不集中的风险因素。未来的研究应该评估这些认知过程作为潜在干预目标的效果。

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