Tallberg Pia, Svanberg Kristina, Hallin Anne-Li, Rastam Maria, Gustafsson Peik, Perrin Sean
Child and adolescent psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden.
Child and Adolescent Psychiatry, Region Skane, Lund, Sweden.
Scand J Child Adolesc Psychiatr Psychol. 2022 Jul 3;10(1):72-86. doi: 10.2478/sjcapp-2022-0008. eCollection 2022 Jan.
Further knowledge is needed regarding long-term outcome of emotional symptoms, and the interplay between these symptoms and neuropsychological functioning in youth with attention deficit hyperactivity disorder (ADHD).
We aimed to explore the effect of performance-based neurocognitive functions and parent-rated behavioral executive functioning (EF) on self-rated and parent-rated internalizing symptoms longitudinally in clinically referred youth with ADHD (n = 137; mean age = 12.4 years). We also aimed to examine the change in self-rated emotional symptoms in the ADHD group and a Control group (n = 59; mean age = 11.9 years).
At baseline, and three years later, parents completed rating scales of their child's ADHD symptoms (Swanson Nolan Pelham Scale, Version IV - SNAP-IV), emotional symptoms (Five To Fifteen Questionnaire, Strengths, and Difficulties Questionnaire), and EF (Behavior Rating Inventory of Executive Function). At the same time, the child completed self-report measures of Anxiety, Depression, and Anger Inventories (the Beck Youth Inventories) and neurocognitive measures (Conner's Continuous Performance Test, Version II (CPT-II), Working Memory and Processing Speed composites (Wechsler Intelligence Scales). Statistical analyses were linear and logistic mixed models.
Using longitudinal data, parent- and self-ratings of emotional symptoms were associated with parent-ratings of EF behavior in youth with ADHD. Plan/organizing deficits were associated with Anxiety and Anger over and above other metacognitive subscales, while Emotional Control was related to Anger over and above other behavior regulation subscales. In the ADHD group, Anger symptoms improved across measuring points. When controlling for age, Anxiety, and Depression symptoms were largely stable in both groups, however at higher levels in the ADHD group. The differences in anxiety and depression symptoms across groups decreased over time.
The current study emphasizes the importance of identification, monitoring, and treatment of emotional symptoms, and behavioral aspects of EF in youth with ADHD.
关于情绪症状的长期结果，以及这些症状与注意力缺陷多动障碍（ADHD）青少年神经心理功能之间的相互作用，还需要更多的了解。
我们旨在纵向探讨基于表现的神经认知功能和家长评定的行为执行功能（EF）对临床转诊的ADHD青少年（n = 137；平均年龄 = 12.4岁）自我评定和家长评定的内化症状的影响。我们还旨在研究ADHD组和对照组（n = 59；平均年龄 = 11.9岁）自我评定情绪症状的变化。
在基线时以及三年后，家长完成对孩子ADHD症状（斯旺森·诺兰·佩勒姆量表，第四版 - SNAP-IV）、情绪症状（五至十五问卷、长处与困难问卷）和EF（执行功能行为评定量表）的评定量表。同时，孩子完成焦虑、抑郁和愤怒量表（贝克青少年量表）的自我报告测量以及神经认知测量（康纳连续操作测验，第二版（CPT-II）、工作记忆和加工速度分量表（韦氏智力量表））。统计分析采用线性和逻辑混合模型。
利用纵向数据，ADHD青少年情绪症状的家长评定和自我评定与家长评定的EF行为相关。计划/组织缺陷与焦虑和愤怒相关，超出其他元认知子量表，而情绪控制与愤怒相关，超出其他行为调节子量表。在ADHD组中，愤怒症状在各测量点有所改善。在控制年龄后，两组的焦虑和抑郁症状基本稳定，但ADHD组的症状水平更高。两组间焦虑和抑郁症状的差异随时间减少。
本研究强调了识别、监测和治疗ADHD青少年情绪症状以及EF行为方面的重要性。
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