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极早产儿和/或极低出生体重的学龄前儿童注意缺陷多动障碍是否会导致其抑制控制能力变差?

Does ADHD worsen inhibitory control in preschool children born very premature and/or with very low birth weight?

机构信息

Programa de Pós-Graduação em Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Programa de Transtorno de Déficit de Atenção/Hiperatividade (ProDAH), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.

出版信息

Trends Psychiatry Psychother. 2020 Oct-Dec;42(4):340-347. doi: 10.1590/2237-6089-2019-0075.

Abstract

INTRODUCTION

Deficits in executive functioning, especially in inhibitory control, are present in children born very premature and/or with very low birth weight (VP/VLBW) and in children with attention-deficit/hyperactivity disorder (ADHD).

OBJECTIVE

To evaluate whether ADHD imposes additional inhibitory control (IC) deficits in preschoolers born VP/VLBW.

METHODS

79 VP/VLBW (4 to 7 years) children were assessed for ADHD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children - Present and Lifetime Version (K-SADS-PL). IC was measured with Conners' Kiddie Continuous Performance Test (K-CPT 2) and the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P).Results: No significant differences were found between ADHD (n = 24) and non-ADHD children (n = 55) for any of the measures (p = 0.062 to p = 0.903). Both groups had deficits in most K-CPT 2 scores compared to normative samples, indicating poor IC and inconsistent reaction times.

CONCLUSIONS

ADHD does not aggravate IC deficits in VP/VLBW children. Either neuropsychological tasks and parent reports of executive functions (EFs) may not be sensitive enough to differentiate VP/VLBW preschoolers with and without ADHD, or these children's EFs are already so impaired that there is not much room for additional impairments imposed by ADHD.

摘要

简介

执行功能缺陷,尤其是抑制控制缺陷,存在于极早产和/或极低出生体重(VP/VLBW)的儿童以及注意力缺陷/多动障碍(ADHD)的儿童中。

目的

评估 ADHD 是否会对 VP/VLBW 早产儿的学龄前儿童造成额外的抑制控制(IC)缺陷。

方法

对 79 名 VP/VLBW(4 至 7 岁)儿童使用儿童情绪障碍和精神分裂症诊断性访谈表-现病史版(K-SADS-PL)进行 ADHD 评估。使用康纳斯儿童连续操作测试(K-CPT 2)和行为评定量表-执行功能学前版(BRIEF-P)测量 IC。结果:在任何测量指标上,ADHD 组(n = 24)和非 ADHD 组(n = 55)之间均无显著差异(p = 0.062 至 p = 0.903)。与正常样本相比,两组在大多数 K-CPT 2 评分中均存在缺陷,表明 IC 差和反应时不一致。

结论

ADHD 不会加重 VP/VLBW 儿童的 IC 缺陷。神经心理学任务和执行功能(EFs)的父母报告可能不够敏感,无法区分有和没有 ADHD 的 VP/VLBW 学龄前儿童,或者这些儿童的 EFs 已经受损严重,以至于 ADHD 造成的额外损害没有太多余地。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a75b/7879083/ad42748e40e0/2238-0019-trends-42-04-0340-gf01.jpg

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