不同亚型注意缺陷多动障碍儿童的智力结构与注意特征研究  

Intelligence structure and attention properties in children with three subtypes of attention deficit hyperactivity disorder

作　　者：马岭[1] 蔡婧[1] 任艳玲[1] 张毅力[1] 高鹏[1] 王苏弘[1] 

机构地区：[1]苏州大学附属第三医院脑科学研究中心,常州213003

出　　处：《中华行为医学与脑科学杂志》2014年第5期416-419,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金资助项目（81101018）,常州市科技计划应用基础研究项目（CJ20112009;CJ20122016;CJ20130026）

摘　　要：目的 通过分析不同亚型注意缺陷多动障碍（ADHD）儿童的智力结构和注意特征,探讨ADHD注意和认知的相关性.方法 符合美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）诊断标准的90例ADHD儿童完成了韦氏儿童智力测验（C-WISC）和视听整合持续性操作测试（IVA-CPT）,其中注意缺陷为主型（ADHD-Ⅰ）24例,多动冲动为主型（ADHD-HI） 12例,混合型（ADHD-C） 54例,对三组的智力结构--言语智商（VIQ）、操作智商（PIQ）、总智商（FIQ）、A因子、B因子和C因子进行了比较,并与注意商数作了相关性分析.结果 （1）智力结构：ADHD儿童的VIQ、PIQ、FIQ、A因子、C因子间存在临床亚型的主效应：ADHD-HI型VIQ[（110.08± 10.64）分]高于ADHD-C型[（101.13± 13.20）分]、ADHD-Ⅰ型[（94.71±11.11）分];ADHD-HI型FIQ[（104.33±9.63）分]高于ADHD-Ⅰ型[（94.38± 10.48）分];ADHD-HI[（45.75±7.14）分]和ADHD-C型[（41.41±8.57）分]的A因子高于ADHD-Ⅰ型[（36.67±6.72）分];ADHD-HI型C因子[（33.42±5.42）分]高于ADHD-C型[（29.24±5.26）分]和ADHD-Ⅰ型[（29.13±5.39）分],以上均差异有统计学意义（P＜0.05）.（2）注意商数：ADHD-C型综合注意商数[（90.26±11.67）分]显著低于ADHD-Ⅰ型[（98.17±18.03）分]和ADHD-HI型[（99.25±15.58）分],差异有统计学意义（P＜0.05）,ADHD-Ⅰ型与ADHD-HI型间无明显差异;ADHD-C型听觉注意商数[（89.94± 14.16）分]显著低于ADHD-Ⅰ型[（99.00± 18.66）分],差异有统计学意义（P＜0.05）.（3）智力与注意的相关性分析：听觉注意商数和听觉反应控制商数与PIQ呈正相关（r=0.24,r=0.29）;视觉注意商数分别与PIQ、FIQ呈正相关（r=0.21,r=0.25）;综合注意商数分别与PIQ、FIQ呈正相关（r=0.27,r=0.24）.结论 不同亚型ADHD儿童的智力结构和注意受损存在一定的差异,认知与注意的关联性为临床诊断和制定治疗干预策略提供参考.Objective To investigate the intelligence structure and attention properties,and to explore the relationship between them in children with attention deficit hyperactivity disorder of the predominantly inattention type （ADHD-Ⅰ）,predominantly hyperactive-impulsive type （ADHD-HI） and combined type （ADHD-C）.Methods Children with ADHD-Ⅰ （n=24）,ADHD-HI（n=12） and ADHD-C （n=54） aged between 7-10 years were tested with Chinese Revised Wechsler Intelligence Scale for Children （C-WISC） and integrated visual and auditory continuous performance test （IVA-CPT）.Comparisons of cognitive profiles of C-WISC scores between subtypes of ADHD were performed.Additionally,the relationship between attention/response control quotients and cognitive profiles was investigated.Results （1） Intelligence structure：verbal intelligence （VIQ） of ADHD-HI （110.08± 10.64） was higher than that of ADHD-C （101.13± 13.20） and ADHD-Ⅰ （94.71± 11.11）.Full scale intelligence quotient （FIQ） of ADHD-HI （104.33±9.63） was higher than that of ADHD-Ⅰ （94.38± 10.48）.Factor A of ADHD-HI （45.75±7.14） and ADHD-C （41.41±8.57） were higher than that of ADHD-Ⅰ （36.67±6.72）.Factor C of ADHD-HI （33.42±5.42） was higher than that of ADHD-C （29.24±5.26） and ADHD-Ⅰ （29.13±5.39）.（2） Attention properties：Full scale attention quotient of ADHD-C （90.26± 11.67） was lower than that of ADHD-Ⅰ （98.17 ± 18.03） and ADHD-HI （99.25± 15.58）.Auditory attention quotient of ADHD-C （89.94± 14.16） was lower than that of ADHD-Ⅰ （99.00± 18.66）.（3） Relationship between intelligence and attention：the Pearson correlations of the auditory attention quotient and auditory control quotient with the PIQ were 0.24 and 0.29 respectively.The correlations of the visual attention quotient with the PIQ and FIQ were 0.21 and 0.25 respectively.The correlations of the full scale attention quotient with PIQ and FIQ were 0.27 and 0.24 respectively.Each of these cor

关 键 词：注意缺陷多动障碍 智力 注意 亚型 

分 类 号：R749.94[医药卫生—神经病学与精神病学]