ADHD的抑制缺陷和厌恶延迟——来自双通道模型的解释  

The Inhibition Deficit and Delay Aversion of Attention Deficit Hyperactivity Disorder:the Explanation from the Dual Pathway Model

作　　者：何梅[1,2,3] 张微[1,2] 宋红艳[4] 

机构地区：[1]青少年网络心理与行为教育部重点实验室,武汉430079 [2]华中师范大学心理学院暨湖北省人的发展与心理健康重点实验室,武汉430079 [3]南宁市第五人民医院心理科,南宁530001 [4]汉口学院学工部,武汉430079

出　　处：《心理科学》2012年第4期1018-1022,共5页Journal of Psychological Science

基　　金：全国"十一五"教育规划国家青年基金项目(CBA090119);湖北省人的发展与心理健康重点实验室项目(200903);华中师范大学中央高校基本科研业务费项目(ccnu12A02003)的资助

摘　　要：行为抑制理论认为抑制功能的落后是ADHD的核心缺损所在,Sonuga-Barke的厌恶延迟理论认为ADHD起因是厌恶延迟而非抑制缺损,但该理论并不能解释ADHD的全部症状,Sonuga-Barke对厌恶延迟理论进行了修正,提出了双通道模型。该模型认为ADHD的抑制缺陷和厌恶延迟的特征同时存在,相互独立,模型的认知发展通道关注抑制控制缺陷对ADHD的影响,而动机发展通道则认为ADHD儿童是因奖励回路紊乱而引起异常的厌恶延迟的动机风格。本文介绍了双通道模型及相关的研究及双通道模型应用于ADHD诊断和干预的价值和局限性。Historically,there have been difficulties in precisely specifying the symptom structure of ADHD because of the heterogeneity and the close associations with other problems of childhood.A number of important theories have been proposed to explain the psychological mechanisms of ADHD.The behavioral inhibition theory regards disinhibition as the core deficit of ADHD,but Sonuga-Barke＇s delay aversion theory deems that delayed aversion contributes to the nature of ADHD.Delayed aversion cannot explain all the symptoms of ADHD,so Sonuga-Barke modified his theory and proposed the dual pathway model of ADHD.According the dual pathway theory, psychological accounts have characterized attention-deficit/hyperactivity disorder（ADHD） as either a neuro-cognitive disorder of regulation or a motivational style.Poor inhibitory control is thought to underpin ADHD children＇s dysregulation while delay aversion is a dominant characteristic of their motivational style.Delayed aversion and poor inhibitory control are independent co-existing characteristics of ADHD.Sonuga-Barkes dual pathway model of ADHD recognizes two quite distinct subtypes of the disorder.The DTAP pathway emphasizes the defective inhibitory control of ADHD.ADHD is the result of the dysregulation of action and thought resulting from poor inhibitory control.And the inhibitory control is associated with the meso-cortical branch of the dopamine system projecting in the cortical control centers.The MSP pathway emphasizes that the abnormality of the reward circuit causes the stronger delayed aversion.ADHD is a motivational style characterized by an altered delay of reward gradient linked to the meso-limbic dopamine branch associated with the reward circuits.The two pathways are further distinguished at the levels of symptoms,cognitive and motivation profiles and genetic and non-genetic origins.This article introduces the empirical researches,diagnosis and intervention and the limitation related to the dual pathway theory.

关 键 词：注意缺陷多动障碍 抑制缺陷 厌恶延迟 双通道模型 

分 类 号：R749.94[医药卫生—神经病学与精神病学]