注意缺陷多动障碍儿童执行功能和工作记忆特点的初步探讨  

The Executive Functions and Working Memory in Children with Attention Deficit Hyperactivity Disorder

作　　者：何淑华[1] 静进[2] 

机构地区：[1]中山大学公共卫生学院妇幼卫生系,广州510080 [2]广东省中山市博爱医院,中山528403

出　　处：《中国心理卫生杂志》2008年第6期419-422,共4页Chinese Mental Health Journal

基　　金：国家自然科学基金(30470579);广东省自然科学基金项目(04105345)

摘　　要：目的:探讨我国注意缺陷多动障碍(ADHD)儿童的执行功能和工作记忆特征。方法:采用修订版威斯康星卡片分类测验(WCST)和韦氏记忆量表(WMS)中代表工作记忆的分测验,对汉族57例ADHD儿童和63例正常儿童进行测试。结果:①ADHD儿童在WCST中的持续性错误数(RPE)、总错误数(RE)、持续性反应数(RP)、完成总应答数(RA)均多于对照组儿童(26.8±10.9/22.8±10.4、57.6±18.1/49.3±18.6、30.4±13.9/25.5±12.7、127.6±1.8/122.9±11.0,P=0.040、0.015、0.046、0.001),而完成分类数(CC)、正确应答数百分比(RCP)、概念化水平(RFP)均少于对照组儿童(2.9±1.5/3.8±1.8、55.0±14.0/60.5±13.4、40.8±17.6/47.8±17.7,P=0.003、0.028、0.033);②ADHD组顺背、倒背数字,数字广度、听故事理解、数字量表、积累量表得分低于对照组(7.5±1.3/8.0±1.3、4.3±1.2/4.9±1.7、11.7±1.9/13.5±2.8、6.4±3.1/8.8±3.3、9.1±2.7/10.8±3.6、9.2±3.1/11.0±2.5,P=0.025、0.029、0.001、0.000、0.011、0.002);③控制年龄后,ADHD组的故事理解粗分、理解量表分、听看故事分均与WCST的总错误数、非持续性错误呈负相关(r=-0.32^-0.43,P<0.05),与完成分类数、正确应答数、正确应答数百分比、概念化水平呈正相关(r=0.32~0.39,P<0.05)。结论:ADHD儿童存在执行功能、工作记忆等神经心理学功能缺陷,ADHD儿童的语音信息工作记忆存在缺陷;ADHD儿童的WCST成绩差与工作记忆能力缺陷有关。Objective：To analyze characteristics of executive functions and working memory in children with ADHD under Chinese cultural background.Methods：Tested 57 children with ADHD and 63 normal control children on revised edition WCST and Subtests of Wechsler Memory Scale（WMS） to evaluate the executive functions and working memory of subjects.Results：①Children with ADHD have significantly more RPE,RE,RP,RA（26.8±10.9 vs.22.8±10.4,57.6±18.1 vs.49.3±18.6,30.4±13.9 vs.25.5±12.7,127.6±1.8 vs.122.9±11.0,P=0.040,0.015,0.046,0.001）and less CC,RCP and RFP（2.9±1.5 vs.3.8±1.8,55.0±14.0 vs.60.5±13.4,40.8±17.6 vs.47.8±17.7,P=0.003,0.028,0.033）than that of normal children.②The scores of forward and backward order on the digit span,digit span,listening logical memory,standardized digit span and accumulation（7.5±1.3 vs.8.0±1.3,4.3±1.2 vs.4.9±1.7,11.7±1.9 vs.13.5±2.8,6.4±3.1 vs.8.8±3.3,9.1±2.7 vs.10.8±3.6,9.2±3.1 vs.11.0±2.5,P=0.025,0.029,0.001,0.000,0.011,0.002） among ADHD children were significantly lower than that of normal children.③After controlling the age,the RE,NRPE,CC,RC,RCP and RFP in WCST among ADHD children are connected with logical memory of original,standardized and listening-watching in working memory（r=0.32～0.43,P〈0.05）.Conclusion：Children with ADHD have the deficiency of neuropsychological function in executive functions and working memory.It suggested that ADHD children had impairment of verbal working memory.The poor performance in WCST among ADHD children was related with the impairment of verbal working memory.

关 键 词：神经心理学 威斯康星卡片分类测验 注意缺陷多动障碍 执行功能 工作记忆 

分 类 号：R749.94[医药卫生—神经病学与精神病学] B842[医药卫生—临床医学]