Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Programa de Transtornos de Ansiedade na Infância e Adolescência, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil.
Trends Psychiatry Psychother. 2020 Jun;42(2):161-170. doi: 10.1590/2237-6089-2019-0051. Epub 2020 Jul 17.
Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen's d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.
有研究表明，患有焦虑障碍的儿童在言语流畅性、转换和注意力方面存在缺陷，而在工作记忆及其子成分方面的结果则不一致。本研究通过分析患有焦虑障碍的儿童在广泛的神经心理学功能中的表现，扩展了先前的研究结果。
我们根据《精神障碍诊断与统计手册》第 5 版（DSM-5）的诊断标准，使用神经心理学测试的子测试，对 54 名患有原发性焦虑障碍的儿童进行了评估。焦虑障碍的严重程度使用儿童焦虑量表（PARS）进行评估。我们计算了神经心理学障碍的频率（低于正常样本的 1.5 个标准差）。基于焦虑症状的严重程度以及是否存在一种或多种焦虑障碍的诊断，对组间进行了比较。
我们发现，焦虑儿童的视空间工作记忆（23.1%）、语义记忆（27.8%）、口头语言（35.4%）和书面语言（44.4%）受损更为严重。此外，焦虑程度较高的儿童在视空间工作记忆、推理处理、单词阅读、写作理解、临摹书写和语义言语流畅性方面表现较差（d=0.49 至 0.96[Cohen's d]）。焦虑诊断的数量越多，在情景记忆和口头及书面语言方面的表现越差（d=0.56 至 0.77）。
我们的数据表明，一些患有焦虑障碍的儿童存在记忆（视空间工作记忆和语义记忆）和语言缺陷（口头和书面语言）。焦虑的严重程度和诊断数量与儿童时期记忆和语言领域的表现下降有关。
