Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA.
Department of Psychology, Williams College, Williamstown, MA, USA.
J Child Psychol Psychiatry. 2019 Jul;60(7):762-772. doi: 10.1111/jcpp.13047. Epub 2019 Mar 25.
ADHD is a neurodevelopmental disorder with a complex pathogenesis. Individual differences in temperamental reactivity - in particular, anger reactivity - are predictive of ADHD. The goal of this study was to examine the moderating (maternal caregiving behaviors; MCB) and mediating (inhibitory control) variables of reactivity using a 9-year multimethod prospective longitudinal design.
Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social-emotional development. Anger reactivity was assessed by observation of facial anger during an arm restraint task, and MCB were observed during a series of semi-structured mother-infant tasks, both at 9 months of age. Inhibitory control was assessed by performance on a go/no-go task at 5 years of age. ADHD symptoms were assessed by parent and teacher report questionnaires at 7 and 9 years, respectively.
Anger reactivity and poor inhibitory control were predictive of later ADHD symptoms. Results supported a moderated mediation model, in which the indirect effects of anger reactivity on ADHD symptoms through inhibitory control were conditional on quality of early MCB. Inhibitory control mediated the effect of anger reactivity on ADHD symptoms, but only among children exposed to lower-quality MCB.
Infant anger reactivity exerts a direct effect on later ADHD from infancy, suggesting anger reactivity as a very early indicator of ADHD risk. Higher-quality caregiving did not buffer against the direct risk of anger reactivity on ADHD but did buffer against the indirect risk by reducing the negative effect of anger reactivity on inhibitory control. Thus, in the developmental pathway from anger reactivity to ADHD, more sensitive, less intrusive parenting supports the development of protective mechanisms (i.e. inhibitory control) to remediate ADHD risk.
ADHD 是一种具有复杂发病机制的神经发育障碍。气质反应性的个体差异 - 尤其是愤怒反应性 - 可预测 ADHD。本研究的目的是使用 9 年多方法前瞻性纵向设计，检查反应性的调节（母婴育儿行为；MCB）和中介（抑制控制）变量。
参与者包括 291 名儿童（135 名男性；156 名女性），他们参加了一项关于气质和社会情感发展的更大规模研究。愤怒反应性通过观察手臂约束任务期间的面部愤怒来评估，MCB 在一系列半结构化母婴任务中进行观察，均在 9 个月大时进行。抑制控制通过 5 岁时的 Go/No-Go 任务进行评估。ADHD 症状分别通过父母和教师在 7 岁和 9 岁时的报告问卷进行评估。
愤怒反应性和较差的抑制控制是后来 ADHD 症状的预测因素。结果支持了一个调节中介模型，即愤怒反应性通过抑制控制对 ADHD 症状的间接影响取决于早期 MCB 的质量。抑制控制中介了愤怒反应性对 ADHD 症状的影响，但仅在暴露于低质量 MCB 的儿童中。
婴儿期的愤怒反应性对婴儿期以后的 ADHD 具有直接影响，这表明愤怒反应性是 ADHD 风险的一个非常早期指标。较高质量的育儿并没有减轻愤怒反应性对 ADHD 的直接风险，但通过降低愤怒反应性对抑制控制的负面影响来减轻间接风险。因此，在从愤怒反应性到 ADHD 的发育途径中，更敏感、侵入性较小的养育方式支持了保护性机制（即抑制控制）的发展，以减轻 ADHD 风险。
