成人注意缺陷多动障碍患者的时间洞察力

Time perspective in adults with attention deficit hyperactivity disorder

目的:探讨成人注意缺陷多动障碍(ADHD)的时间洞察力特点及其与症状的相关性。方法:纳入符合美国精神障碍诊断与统计手册第5版(DSM-5)的成人ADHD患者85例(18~35岁),和年龄、性别匹配的正常对照85例(19~34岁),采用ADHD评定量表(ADHD-RS)和津巴多时间洞察力量表(ZTPI)评估ADHD症状和时间洞察力。结果:ADHD组过去消极、现在享乐和现在宿命得分高于对照组,过去积极和未来得分低于对照组(均P<0.001)。女性和注意缺陷为主型ADHD的注意缺陷(IA)与未来得分负相关(r=-0.70、-0.65,均P<0.001);男性和混合型ADHD的多动冲动(HI)与现在享乐得分正相关(r=0.41、0.42,均P<0.05);共患病组的过去消极得分较高且与IA和HI得分正相关(均P<0.01)。结论:成人ADHD不平衡的时间洞察力与症状严重程度正相关,且与性别、亚型和共患病有关。

Objective:To investigate the difference in time perspective between adults with attention deficit hyperactivity disorder(ADHD)and normal controls,and to explore the relationship between time perspective and ADHD symptoms.Methods:Eighty-five adults aged from 18 to 35 years with ADHD who met the diagnostic crite-ria of the Diagnostic and Statistical Manual of Mental Disorders,Fith Edition(DSM-5),and 85 age-and sex-matched normal controls aged from 19 to 34 were enrolled.The ADHD Rating Scale(ADHD-RS)and Zimbardo Time Perspective Inventory(ZTPI)were used to evaluate ADHD symptoms and time perspective in all subjects in-dependently.Results:Compared to the control group,adult ADHD had higher scores of past negative,present hedo-nistic and present fatalistic and lower scores of past positive and future(Ps<0.001).The inattention(IA)scores in female patients and those with predominant inattention subtype were negatively correlated with the ZTPI scores of future(r=-0.70,-0.65,Ps<0.001).The hyperactivity and impulsivity(HI)scores in males with ADHD and those with combined subtype were positively correlated with the present hedonistic scores(r=0.41,0.42,Ps<0.05).The scores of past negative were higher in those with comorbidities than in those without comorbidities and positively correlated with the scores ofIA and HI(Ps<0.01).Conclusion:The time perspective of adult ADHD is biased and imbalanced,and its level of deviation from balanced time perspective is positively correlated with the se-verity of ADHD symptoms,and is influenced by gender,subtypes,and comorbidities.