注意缺陷多动障碍青少年情绪调节与错误监测的关系。

The Relationship Between Emotion Dysregulation and Error Monitoring in Adolescents with ADHD.

机构信息

Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA.

Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.

出版信息

Res Child Adolesc Psychopathol. 2024 Apr;52(4):605-620. doi: 10.1007/s10802-023-01127-z. Epub 2023 Oct 16.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is emblematic of the limitations of existing diagnostic categories. One potential solution, consistent with the Research Domain Criteria (RDoC) initiative, is to interrogate psychological mechanisms at the behavioral and physiological level together to try and identify meaningful subgroups within existing categories. Such approaches provide a way to revise diagnostic boundaries and clarify individual variation in mechanisms. Here, we illustrate this approach to help resolve heterogeneity in ADHD using a combination of behaviorally-rated temperament measures from the Early Adolescent Temperament Questionnaire; cognitive performance on three difference conditions of an emotional go/no-go task; and electroencephalogram (EEG)-measured variation in multiple stages of error processing, including the error-related negativity (ERN) and positivity (Pe). In a large (N = 342), well-characterized sample of adolescents with ADHD, latent profile analysis identified two ADHD temperament subgroups: 1) emotionally regulated and 2) emotionally dysregulated (with high negative affect). Cognitive and EEG assessment in a subset of 272 adolescents (nADHD = 151) found that the emotionally dysregulated group showed distinct patterns of change in early neural response to errors (ERN) across emotional task conditions as compared to emotionally-regulated ADHD adolescents and typically-developing controls. Both ADHD groups showed blunted later response to errors (Pe) that was stable across emotional task conditions. Overall, neural response patterns identified important differences in how trait and state emotion interact to affect cognitive processing. Results highlight important temperament variation within ADHD that helps clarify its relationship to the ERN, one of the most prominent putative neural biomarkers for psychopathology.

摘要

注意缺陷多动障碍(ADHD)是现有诊断类别局限性的典型代表。一个潜在的解决方案是与研究领域标准(RDoC)计划保持一致,从行为和生理水平一起探究心理机制,以尝试在现有类别中识别有意义的亚组。这种方法为修订诊断界限和阐明个体机制变化提供了一种途径。在这里,我们使用早期青少年气质问卷中的行为评定气质测量、三种不同情绪 Go/No-Go 任务条件下的认知表现以及脑电图(EEG)测量的多个错误处理阶段(包括错误相关负性(ERN)和正性(Pe))的变化,来结合说明这种方法有助于解决 ADHD 的异质性。在一个具有 ADHD 的大型(N=342)、特征良好的青少年样本中,潜在剖面分析确定了两个 ADHD 气质亚组:1)情绪调节和 2)情绪失调(具有高负性情绪)。在 272 名青少年(nADHD=151)的一个亚组中进行认知和 EEG 评估发现,与情绪调节 ADHD 青少年和典型发育对照组相比,情绪失调组在情绪任务条件下对错误的早期神经反应(ERN)表现出明显的变化模式。两个 ADHD 组都表现出对错误(Pe)的反应迟钝,这种反应在情绪任务条件下是稳定的。总体而言,神经反应模式确定了特质和状态情绪如何相互作用影响认知处理的重要差异。结果突出了 ADHD 内重要的气质变化,有助于阐明其与 ERN 的关系,ERN 是精神病学中最突出的潜在神经生物标志物之一。

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