奖惩对ADHD患儿过滤新异分心刺激的影响

The Effects of Rewards and Punishments on the Filtering of Odd Distractors in Children With ADHD

目的:奖惩是儿童教育教学过程中经常使用的教学手段。研究旨在探讨奖惩在改善注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童注意品质问题中的作用。方法:研究选取ADHD儿童32名,对照组儿童33名。采用视听跨通道oddball范式,考察奖惩对ADHD儿童过滤新异刺激的影响。结果:儿童类型的主效应显著(F_(1,63)=14.522,p=0.001,ηp^(2)=0.187),相比于正常儿童,ADHD儿童的反应时更短,对奖惩更为敏感;奖惩和新异分心刺激的交互效应显著(F_(1,63)=10.285,p=0.002,ηp^(2)=0.140),对新刺激分心时,奖励更有助于儿童的表现,而在标准刺激分心时,惩罚更有助于儿童的表现;儿童类型与时间间隔交互效应显著(F_(1,63)=5.458,p=0.023),ADHD儿童早期对奖惩反馈的选择性注意相对完整,正确率高于后期反馈;奖惩与时间间隔、儿童类型的交互效应显著(F_(1,63)=5.760,p=0.019),在反应早期及时呈现奖赏刺激,奖励对ADHD儿童的强化作用高于正常儿童。结论:奖惩可以调节分心刺激对于ADHD儿童的认知加工。且相比于惩罚,奖赏能更好地引导ADHD儿童将注意从新异分心刺激转移到目标刺激。新异分心刺激与目标刺激的时间间隔恰当时,奖赏能够唤起ADHD儿童完成目标任务的认知状态,提高反应准确性。

Objective:Reward and punishment are commonly used means for children education.To explore the role of reward and punishment in improving the quality of attention in children with attention deficit hyperactivity disorder(ADHD).Methods:There was a selection of 32 children with ADHD and 33 children for the control group in the study.The effects of reward and punishment on the filtering of novel distractors in children with ADHD were investigated by using the cross-modal oddball task.Results:The main effect of children type was significant(F_(1,63)=14.522,p<0.000,ηp^(2)=0.187).Children with ADHD had a significantly faster reaction time and were more sensitive to reward and punishment compared to normal children.The interaction between reward and punishment and novel distractors was significant(F_(1,63)=10.285,p=0.002,ηp^(2)=0.14).In novel distraction,rewards were conducive to children’s performance.However,punishments were more conducive to children performance in standard distraction.The interaction between children type and time interval was significant(F_(1,63)=5.458,p=0.023).Selective attention of children with ADHD in early stage towards reward and punishment feedback was relatively intact,and the accuracy was higher than the feedback in the late stage.Reward and punishment’s interaction with the time interval and type of children was significant(F_(1,63)=5.760,p=0.019).When reward stimulation was timely presented in the early stage of response,the reinforcement effect of reward on children with ADHD was significantly higher than that of normal children.Conclusions:Reward and punishment can regulate the cognitive processing of distracted stimuli in children with ADHD.Compared with punishment,reward can better guide children with ADHD to shift their attention from novel distractors to target tasks.When the time interval between the novel distractors and the target task is appropriate,the rewards can arouse the cognitive state of children with ADHD to complete the target task and improve the response accuracy.