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对立违抗性障碍和品行障碍儿童的抑制控制缺陷与注意缺陷/多动障碍的比较:系统评价和荟萃分析。

Inhibitory Control Deficits in Children with Oppositional Defiant Disorder and Conduct Disorder Compared to Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis.

机构信息

School of Applied Psychology, Menzies Health Institute of Queensland, Griffith University, Mt Gravatt, Quensland, 4122, Australia.

出版信息

Res Child Adolesc Psychopathol. 2021 Jan;49(1):39-62. doi: 10.1007/s10802-020-00713-9. Epub 2020 Oct 13.

Abstract

Inhibitory control deficits are known to be characteristic of Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Attention-Deficit/Hyperactivity Disorder (ADHD); but it is unclear whether children with ODD/CD have inhibitory control problems independent of ADHD comorbidity. Previous reviews of inhibitory control and ODD/CD have only focused on one type of measure of inhibitory control or used non-clinical samples. The current meta-analysis explored inhibitory control problems of children with ODD/CD by systematically reviewing studies where children have a diagnosis of ODD and/or CD. Comparisons were made across 25 studies between children with ODD/CD, ODD/CD + ADHD, ADHD, and healthy controls (HC) on various measures of inhibitory control and ADHD symptomatology to explore impacts of ADHD comorbidity. A small significant effect (g = -0.58, p < .001) suggested children with ODD/CD are likely to have more difficulties with inhibitory control than healthy children. However, comparisons between clinical groups suggested this effect may be due to ADHD symptomatology present in each group. As difficulties with inhibitory control are similar, across clinical groups, a dimensional approach to understanding ODD/CD and ADHD may be more useful to consider in future diagnostic criteria. Similarities across clinical groups highlight that therapeutic approaches that assist children with disruptive behaviours could benefit from teaching children and their families how to cope with inhibitory control deficits.

摘要

抑制控制缺陷是对立违抗性障碍(ODD)、品行障碍(CD)和注意缺陷多动障碍(ADHD)的特征;但尚不清楚是否 ODD/CD 患儿的抑制控制问题独立于 ADHD 共病。之前关于抑制控制和 ODD/CD 的综述仅关注一种抑制控制的测量方法,或使用非临床样本。目前的荟萃分析通过系统地回顾具有 ODD 和/或 CD 诊断的儿童的研究,探讨了 ODD/CD 儿童的抑制控制问题。在各种抑制控制和 ADHD 症状学测量中,将 ODD/CD、ODD/CD+ADHD、ADHD 和健康对照组(HC)的 25 项研究进行了比较,以探讨 ADHD 共病的影响。一项小的显著效应(g=-0.58,p<.001)表明,与健康儿童相比,患有 ODD/CD 的儿童可能在抑制控制方面存在更多困难。然而,临床组之间的比较表明,这种影响可能是由于每个组中都存在 ADHD 症状。由于在临床组中抑制控制困难相似,因此,在未来的诊断标准中,可能更需要考虑从维度上理解 ODD/CD 和 ADHD。临床组之间的相似性突出表明,有助于患有破坏性行为的儿童的治疗方法可能受益于教导儿童及其家庭如何应对抑制控制缺陷。

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