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气质、执行功能与青少年注意缺陷多动障碍(ADHD):努力控制的中介作用。

Temperament, executive function, and attention-deficit/hyperactivity disorder (ADHD) in adolescents: The mediating role of effortful control.

机构信息

a Department of Clinical Psychology and Psychobiology, Faculty of Psychology , University of Barcelona , Barcelona , Spain.

b Institute of Neuroscience , University of Barcelona (UBneuro) , Barcelona , Spain.

出版信息

J Clin Exp Neuropsychol. 2019 Aug;41(6):615-633. doi: 10.1080/13803395.2019.1599824. Epub 2019 Apr 21.

Abstract

: Temperament dimensions may be related to executive functions (EF) and may be involved in the expression and maintenance of symptoms of attention-deficit/hyperactivity disorder (ADHD). The current study aimed to assess whether effortful control (EC) mediates the relationship between EF and inattentive symptoms, and whether surgency (S) and negative affectivity (NA) mediate the relationships between EF and hyperactive-impulsive ADHD symptoms in adolescents. : Working individually, participants aged between 12 and 16 years ( = 118; 75 with ADHD) performed tests of cognitive EF (working memory, planning, flexibility, and inhibition), and parents and teachers completed a multi-informant assessment focusing on measures of ADHD symptoms and temperament dimensions (EC, S, and NA). : There were significant differences between ADHD and control participants in EF and temperament dimensions. ADHD participants had lower scores than controls in working memory, planning, and inhibition EF; they also had lower scores in EC and higher scores in S and NA. Structural equation modeling indicated differential associations between EC, S, and NA temperament dimensions, and working memory, planning and inhibition EF, and ADHD symptoms. Mediation analysis suggested that EF exerted indirect effects on the inattentive and hyperactive-impulsive symptoms, via EC; higher EF abilities were related to higher levels of EC, which in turn were related to lower scores of inattentive and hyperactive-impulsive ADHD symptoms. S and NA did not mediate relations among EF and hyperactive-impulsive symptoms. : The findings expand on those of previous studies of the complex relationship between temperament dimensions and EF and confirm the differential association between impairments in some EF, low EC, and the expression of inattentive and hyperactive-impulsive symptoms in adolescents, which may account for the ADHD-control group differences.

摘要

气质维度可能与执行功能(EF)有关,并且可能与注意缺陷/多动障碍(ADHD)的症状表现和维持有关。本研究旨在评估努力控制(EC)是否在 EF 与注意力不集中症状之间起中介作用,以及冲动性(S)和负性情绪(NA)是否在 EF 与多动冲动 ADHD 症状之间起中介作用。

参与者单独工作,年龄在 12 至 16 岁之间(n=118;75 名患有 ADHD),进行认知 EF(工作记忆、计划、灵活性和抑制)测试,父母和教师完成多信息源评估,重点是 ADHD 症状和气质维度(EC、S 和 NA)的测量。

ADHD 患者和对照组在 EF 和气质维度方面存在显著差异。ADHD 患者在工作记忆、计划和抑制 EF 方面的得分低于对照组;他们在 EC 方面的得分较低,在 S 和 NA 方面的得分较高。结构方程模型表明,EC、S 和 NA 气质维度与工作记忆、计划和抑制 EF 以及 ADHD 症状之间存在不同的关联。中介分析表明,EF 通过 EC 对注意力不集中和多动冲动症状产生间接影响;较高的 EF 能力与较高的 EC 水平相关,而较高的 EC 水平又与注意力不集中和多动冲动 ADHD 症状的评分较低相关。S 和 NA 不能介导 EF 与多动冲动症状之间的关系。

这些发现扩展了之前关于气质维度和 EF 之间复杂关系的研究,并证实了某些 EF 损伤、低 EC 与注意力不集中和多动冲动症状表现之间的差异关联,这可能解释了 ADHD 对照组之间的差异。

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