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注意缺陷多动障碍(ADHD)青少年的工作记忆“工作”成分中,哪些不起作用?

Which 'Working' Components of Working Memory aren't Working in Youth with ADHD?

机构信息

Center for Children and Families, Florida International University, 11200 SW 8th St., AHC1 - 140, Miami, FL, 33199, USA.

Department of Psychology, Florida State University, Tallahassee, FL, USA.

出版信息

J Abnorm Child Psychol. 2020 May;48(5):647-660. doi: 10.1007/s10802-020-00621-y.

Abstract

Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary 'working' subcomponents of the working memory system in these children. Children ages 8-13 with (n = 45) and without (n = 41) ADHD (40% female; M = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF = 4.64 × 10; d = 1.34) and updating (BF = 9.49; d = 0.64), but not dual-processing (BF = 1.33; d = 0.37). Overall, 67%-71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%-57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.

摘要

尽管有大量证据表明 ADHD 青少年存在工作记忆缺陷,但没有研究全面评估这些儿童的工作记忆系统的三个主要“工作”子成分。8-13 岁的 ADHD 儿童(n = 45)和无 ADHD 儿童(n = 41)(40%为女性;M = 10.5;65%为白人和非西班牙裔)完成了一个由九个任务组成的平衡电池组(每个构念三个任务),评估工作记忆的重新排序(在头脑中维持和重新排列信息)、更新(主动监控传入信息并将过时信息替换为相关信息)和双加工(在执行次要任务的同时在头脑中维持信息)。详细的分析计划已预先注册。贝叶斯 t 检验表明,在组水平上,患有 ADHD 的儿童在工作记忆重新排序(BF = 4.64×10;d = 1.34)和更新(BF = 9.49;d = 0.64)方面存在显著缺陷,但在双加工方面没有缺陷(BF = 1.33;d = 0.37)。总体而言,67%-71%的 ADHD 青少年在至少一个中央执行工作记忆域中表现出缺陷。重新排序表现出与 ADHD 相关性最强的缺陷,75%的儿童被归类为低于平均水平或受损,没有一个表现出优势。大多数 ADHD 儿童(52%-57%)在其余两个领域表现出平均或更好的能力,少数儿童在更新(8%)和双加工(20%)方面表现出优势。值得注意的是,域一般性中央执行工作记忆的缺陷,而不是个体子成分,预测了 ADHD 的严重程度,这表明共同的而不是特定的工作记忆机制可能是理解 ADHD 症状的关键。这些损伤估计值扩展了先前的工作,提供了初步证据表明,患有 ADHD 的儿童不仅在认知领域表现出异质性特征,而且在关键认知过程的子成分中也表现出显著的异质性。

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