Biederman Joseph, Lanier Jane, DiSalvo Maura, Noyes Elizabeth, Fried Ronna, Woodworth K Yvonne, Biederman Itai, Faraone Stephen V
Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
J Psychiatr Res. 2019 Oct;117:15-23. doi: 10.1016/j.jpsychires.2019.06.012. Epub 2019 Jun 18.
The objective of this study was to investigate the prevalence and clinical correlates of ADHD patients with mind wandering. 255 consecutively referred 18- to 55-year-old adults of both sexes with ADHD were assessed. Subjects completed a demographic interview, the Mind Wandering Questionnaire (MWQ), the ADHD Rating Scale (ADHD RS), the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A), the Social Responsiveness Scale - Second Edition (SRS-2) Adult Self-Report Form, the Adult Self-Report (ASR), the Barkley Emotional Dysregulation Scale, and the Quality of Life Enjoyment & Satisfaction Questionnaire (Q-LES-Q). We used receiver operator characteristic (ROC) curves to identify the optimal cut-off on the MWQ to categorize patients as having high-versus low-level mind wandering and compared demographic and clinical characteristics between the two groups. Participants were categorized by ROC analysis as having high- (N = 127) and low-level (N = 128) mind wandering based on an MWQ total score ≥ or < than 24, respectively. Compared with low-level mind wandering participants, those with high-level mind wandering had significantly more Inattentive and Hyperactive symptoms (all p < 0001), worse executive functioning as measured by the BRIEF-A, more impaired mean (all p ≤ 0.001) and dichotomized scores (t-score ≥65) (all p < 0.005) on subscales and composite ASR scales, more impaired scores on the Barkley Emotional Dysregulation Scale (p < 0.001), and more impaired quality of life scores. High-level mind wandering is prevalent in adults with ADHD and is associated with more severe ADHD symptoms, more executive function deficits, more emotional dysregulation, higher levels of associated psychopathology, and more impaired quality of life.
本研究的目的是调查患有注意力不集中的多动症（ADHD）患者的患病率及其临床相关因素。对255名年龄在18至55岁之间、连续转诊的ADHD成年男女患者进行了评估。受试者完成了一份人口统计学访谈、注意力不集中问卷（MWQ）、ADHD评定量表（ADHD RS）、执行功能行为评定量表-成人版（BRIEF-A）、社会反应量表-第二版（SRS-2）成人自评表、成人自评量表（ASR）、巴克利情绪失调量表以及生活质量享受与满意度问卷（Q-LES-Q）。我们使用受试者工作特征（ROC）曲线来确定MWQ上的最佳截断点，以将患者分类为高水平与低水平注意力不集中，并比较两组之间的人口统计学和临床特征。根据ROC分析，参与者分别根据MWQ总分≥或＜24被分类为高水平（N = 127）和低水平（N = 128）注意力不集中。与低水平注意力不集中的参与者相比，高水平注意力不集中的参与者有明显更多的注意力不集中和多动症状（所有p＜0.001），BRIEF-A测量的执行功能更差，在ASR分量表和综合量表上的平均分（所有p≤0.001）和二分法得分（t分数≥65）（所有p＜0.005）受损更严重，巴克利情绪失调量表得分受损更严重（p＜0.001），生活质量得分受损更严重。高水平注意力不集中在患有ADHD的成年人中很普遍，并且与更严重的ADHD症状、更多的执行功能缺陷、更多的情绪失调、更高水平的相关精神病理学以及更受损的生活质量相关。
