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儿童癌症幸存者与注意力缺陷/多动障碍儿童的认知迟钝特征比较。

Sluggish cognitive tempo profiles in survivors of childhood cancer as compared to children with attention-deficit/hyperactivity disorder.

机构信息

Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Support Care Cancer. 2022 Sep;30(9):7553-7560. doi: 10.1007/s00520-022-07188-y. Epub 2022 Jun 8.

Abstract

PURPOSE

Neurocognitive late effects including problems with attention have been reported in pediatric oncology survivors. While some researchers have characterized these late effects as similar to symptoms of attention-deficit/hyperactivity disorder, inattentive presentation (ADHD-I), there remains some controversy as to whether these concerns in oncology patients are best conceptualized according to an ADHD-I or sluggish cognitive tempo (SCT) framework. The aim of this study was to describe SCT symptoms in children with ADHD-I or oncology diagnoses; identify groups of SCT symptoms among children with brain tumors (BT), acute lymphoblastic leukemia (ALL), or ADHD-I; and identify whether specific SCT profiles are associated with these diagnoses.

METHODS

The sample was comprised of 364 youth (146 BT, 149 ADHD-I, 69 ALL) referred for a neuropsychological evaluation at an academic medical center. Caregivers completed the SCT scale as part of the clinical evaluation.

RESULTS

Groups differed on mean scores for the SCT scales (Total, Sleepy/sluggish, Low initiation, and Daydreamy) by diagnosis (all p < 0.05), with the ADHD-I group having higher SCT symptoms on all scales. Latent profile analysis showed significant differences between latent SCT classes according to ADHD-I versus cancer diagnosis. The ADHD-I group was significantly more likely to be in the high SCT class compared to the oncology groups.

CONCLUSION

Findings add to the understanding of SCT symptoms in pediatric oncology survivors. There is utility in applying the SCT framework to the oncology population; however, pediatric survivors are likely to be rated differently than youth with ADHD-I. Implications and future directions are discussed.

摘要

目的

神经认知的晚期效应,包括注意力问题,已在儿科肿瘤幸存者中报告。虽然一些研究人员将这些晚期效应描述为类似于注意力缺陷/多动障碍(ADHD-I)的症状,但关于这些肿瘤患者的担忧是否最好根据 ADHD-I 或缓慢认知节奏(SCT)框架来概念化,仍存在一些争议。本研究的目的是描述 ADHD-I 或肿瘤诊断儿童的 SCT 症状;确定脑肿瘤(BT)、急性淋巴细胞白血病(ALL)或 ADHD-I 儿童的 SCT 症状群;并确定是否存在特定的 SCT 特征与这些诊断相关。

方法

该样本由 364 名青少年(146 名 BT、149 名 ADHD-I、69 名 ALL)组成,他们在学术医疗中心接受神经心理学评估。护理人员在临床评估中完成了 SCT 量表。

结果

各组在 SCT 量表(总评分、嗜睡/迟钝、低启动和白日梦)的平均得分上存在差异(均 p<0.05),ADHD-I 组在所有量表上的 SCT 症状均较高。潜在剖面分析显示,根据 ADHD-I 与癌症诊断,潜在 SCT 类之间存在显著差异。与肿瘤组相比,ADHD-I 组更有可能处于高 SCT 类。

结论

研究结果增加了对儿科肿瘤幸存者 SCT 症状的理解。应用 SCT 框架对肿瘤患者具有一定的适用性;然而,儿科幸存者可能会被评定为与 ADHD-I 青少年不同。讨论了其影响和未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/757a/10076037/ff2d0fda0288/nihms-1883877-f0001.jpg

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