Department of Psychiatry & Human Behavior, Emma Pendleton Bradley Hospital , Providence, RI, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, RI, USA.
Child Neuropsychol. 2020 Aug;26(6):754-769. doi: 10.1080/09297049.2019.1708295. Epub 2019 Dec 26.
Despite preliminary research, there remain inconsistent findings with regard to the role of executive functioning (EF) deficits in childhood anxiety and depression. This report examined the association of The National Institute of Health (NIH) Toolbox to clinical neuropsychological measures and to childhood, anxiety/depressive symptomatology. Methods: One-hundred eight children and adolescents completed the three EF measures from the NIH Toolbox (List Sorting Working Memory Test [LSWMT], Dimensional Change Card Sorting Test [DCCST], and Flanker Test of Attention and Inhibition [Flanker]) in an outpatient neuropsychology program. These tests were compared to established measures of EF in terms of linear correlations and detection of impairment. Heaton's Global Deficit Score (GDS) was utilized to calculate impairment. The Toolbox-EF measures were paired with parent-reported EF symptoms (Behavior Rating Inventory of Executive Function [BRIEF2]) to identify the role of EF in childhood anxiety/depressive symptomatology.
Toolbox-EF measures displayed medium sized correlations with their clinically comparable counterparts, and generally did not differ in their detection of impairment. Toolbox-GDS was associated with depression diagnosis and clinically significant child-reported anxiety and depressive symptoms. Together, Toolbox/BRIEF2 accounted for 26.8-30.9% of elevated depressive symptom variance, but only 13.2-14% of elevated anxiety symptom variance. Further, EF impairment was associated with depression across self report, parent report, and clinical diagnosis.
The NIH Toolbox-EF measures display comparable psychometric properties to clinically available EF measures in a pediatric (primarily psychiatric) neuropsychology setting. The Toolbox appears to display an appropriate ability to detect EF deficits secondary to self-reported depression in childhood.
尽管有初步研究，但儿童焦虑和抑郁中执行功能（EF）缺陷的作用仍存在不一致的发现。本报告研究了国家卫生研究院（NIH）工具箱与临床神经心理学测量以及儿童焦虑/抑郁症状之间的关联。
108 名儿童和青少年在门诊神经心理学项目中完成了 NIH 工具箱的三项 EF 测量（列表排序工作记忆测试 [LSWMT]、维度变化卡片分类测试 [DCCST] 和注意和抑制 Flanker 测试 [Flanker]）。这些测试与 EF 的既定测量方法进行了线性相关和损伤检测的比较。使用 Heaton 的总体缺陷评分（GDS）计算损伤。Toolbox-EF 测量与父母报告的 EF 症状（执行功能行为评定量表 [BRIEF2]）配对，以确定 EF 在儿童焦虑/抑郁症状中的作用。
Toolbox-EF 测量与临床可比的对应物呈中等大小的相关性，并且在检测损伤方面通常没有差异。Toolbox-GDS 与抑郁诊断以及临床显著的儿童报告的焦虑和抑郁症状相关。总的来说，Toolbox/BRIEF2 占抑郁症状升高方差的 26.8-30.9%，但仅占焦虑症状升高方差的 13.2-14%。此外，EF 损伤与抑郁有关，无论是自我报告、父母报告还是临床诊断。
NIH Toolbox-EF 测量在儿科（主要是精神病学）神经心理学环境中与临床可用的 EF 测量具有可比的心理测量特性。在儿童时期，Toolbox 似乎具有适当的能力来检测自我报告的抑郁引起的 EF 缺陷。
