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迟缓认知节奏作为成人注意力缺陷多动障碍与内化症状之间的跨诊断联系

Sluggish Cognitive Tempo as a Transdiagnostic Link Between Adult ADHD and Internalizing Symptoms.

作者信息

Kamradt Jaclyn M, Eadeh Hana-May, Nikolas Molly A

机构信息

Department of Psychological and Brain Sciences, University of Iowa.

出版信息

J Psychopathol Behav Assess. 2022 Sep;44(3):699-712. doi: 10.1007/s10862-021-09926-8. Epub 2022 Feb 15.

Abstract

OBJECTIVE

Although absent from traditional diagnostic nosologies, Sluggish Cognitive Tempo (SCT) may have transdiagnostic utility given its robust associations with ADHD and internalizing symptoms as well as with cognitive impairments common to these conditions. Within-person variation in SCT symptoms may also serve to link ADHD, cognitive deficits, and internalizing psychopathology, however, few studies have utilized intensive longitudinal designs to probe within-person variation in SCT and its links to cognitive deficits and psychopathology.

METHOD

Ecological Momentary Assessment was used to measure between and within-person variance in SCT 4 times per day across 7 days (28 time-points) in 158 college students (approximately 51% with elevated ADHD and/or internalizing symptoms). Participants also completed ratings of current and childhood ADHD symptoms, cognitive function and internalizing psychopathology. Parameters derived from longitudinal multilevel models indexing between and within person variation in SCT were examined as mediators of the associations between (1) ADHD and internalizing symptoms and (2) self-reported cognitive functioning and internalizing symptoms.

RESULTS

Results indicated that between-person differences in SCT, but not within-person variability, linked current and childhood ADHD and internalizing symptoms. Similarly, problems in time-management and organization influenced internalizing psychopathology via between-person differences in SCT.

CONCLUSION

Results found that SCT may be a transdiagnostic link bridging mental health comorbidities, cognitive dysfunction, and internalizing psychopathology.

摘要

目的

尽管传统诊断分类中没有“认知节奏迟缓(SCT)”,但鉴于其与注意力缺陷多动障碍(ADHD)、内化症状以及这些病症常见的认知障碍之间存在紧密关联,SCT可能具有跨诊断效用。SCT症状的个体内部差异也可能有助于将ADHD、认知缺陷和内化精神病理学联系起来,然而,很少有研究采用密集纵向设计来探究SCT的个体内部差异及其与认知缺陷和精神病理学的联系。

方法

采用生态瞬时评估法,对158名大学生(约51%患有ADHD和/或内化症状)在7天内每天进行4次测量(共28个时间点),以测量SCT的个体间和个体内差异。参与者还完成了对当前和童年期ADHD症状、认知功能和内化精神病理学的评分。将纵向多水平模型得出的、指示SCT个体间和个体内差异的参数作为以下两组关联的中介因素进行检验:(1)ADHD与内化症状之间的关联;(2)自我报告的认知功能与内化症状之间的关联。

结果

结果表明,SCT的个体间差异而非个体内差异,与当前和童年期的ADHD及内化症状相关。同样,时间管理和组织方面的问题通过SCT的个体间差异影响内化精神病理学。

结论

研究结果发现,SCT可能是连接心理健康共病、认知功能障碍和内化精神病理学的跨诊断纽带。

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