注意缺陷多动障碍儿童干扰反应抑制与注意缺陷冲动行为障碍的关联

Association between interference inhibition deficit with attention deficit and behavior disorder among ADHD children

目的探讨注意力缺陷多动障碍(ADHD)儿童的干扰反应抑制缺陷与注意缺陷、冲动行为障碍的关系,为开展特殊儿童群体心理健康干预提供参考。方法选取2016年2—12月到浙江省立同德医院就诊的32名ADHD儿童作为研究对象,来自当地某小学的36名正常儿童为对照组,采用被试内实验设计。以视觉持续性测验(CPT)、相似图形匹配测验(MFFT)评估ADHD儿童的注意缺陷、冲动行为障碍;采用Simon任务对ADHD儿童的干扰抑制缺陷进行检测,以被试的错误率效应量为干扰抑制缺陷指标。结果 Simon任务中,ADHD儿童的错误率效应量为(11.00±8.09),正常儿童组为(4.79±4.70),差异有统计学意义(t=3.85,P<0.01); Simon任务错误率效应量与视觉CPT漏报率的相关无统计学意义(r=0.16,P>0.05),与MFFT错误数相关有统计学意义(r=0.48,P<0.01),但线性回归无统计学意义(P=0.06)。ADHD组与对照组儿童Simon任务中的错误率效应量9.16可考虑作为ADHD的划界值。结论 ADHD儿童存在干扰反应抑制缺陷,干扰抑制缺陷与冲动行为障碍存在正相关,与注意缺陷无相关性。被试在Simon任务中的错误率效应量若高于9.16,可考虑为ADHD儿童。

Objective This study aims to examine the association between the interference inhabitation deficit with attention deficit and behavior disorder among ADHD children. Methods A total of 32 children aged 6-14 years met the DSM-V criteria for ADHD were recruited. Another 36 school-age healthy children were recruited as the control group. Visual Continuous Performance Task（ CPT） and Matching Familiar Figures Test（ MFFT） were used to investigate attention deficit and impulsive behavior. Simon Task was used to assess the interference inhibition,which consisted of 180 trails. Error rates for Simon Task（ Simon effect） was indexed as the measurement of interference inhibition. Results The error rate for Simon task among ADHD children was（ 11.00±8.09）,which was significantly higher than the control group（ 4.79±4.70）（ P〈0.01）. The effect size of error rate P〈0sitively correlated with greater number of incorrect answers in Matching Familiar Figures Test（ r = 0.48,P〈0.01）,but not associated with miss rate in CPT task（ r = 0.16,P〉0.05）. No correlation between the error rate for Simon task with number of incorrect answers in MFFT in the regression model adjusting variable confounders. In ROC curve analysis,error rate for Simon task higher than 9.16 was suggested to the appropriate cut-off P〈0int. Conclusion Interference inhibition deficit significantly associates with impulsive behaviors,but not attention deficit among ADHD children. The error rate for Simon task higher than 9.16 could be considered as cutoff P〈0int for ADHD screening.