共情联合执行功能对高功能孤独症谱系障碍与注意缺陷多动障碍的诊断分类研究  

Diagnosis and classification of high-functional autism spectrum disorder and attention deficit hyperactivity disorder by combining empathy and executive function

作　　者：王月 李赟[1] 王瑶[1] 李春燕 付林燕 金佩莹 翟梦瑶 成鑫 崔希雯 蒋佶颖 肖婷[1] 柯晓燕[1] Wang Yue;Li Yun;Wang Yao;Li Chunyan;Fu Linyan;Jin Peiying;Zhai Mengyao;Cheng Xin;Cui Xiwen;Jiang Jiying;Xiao Ting;Ke Xiaoyan(Child Mental Health Research Center,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院儿童心理卫生研究中心,210029

出　　处：《中华行为医学与脑科学杂志》2020年第2期120-124,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家重点研发计划"重大慢性非传染性疾病防控研究"重点专项(2016YFC1306105);江苏省医学重点人才项目(ZDRCA2016076)。

摘　　要：目的探讨共情及执行功能指标对孤独症谱系障碍(autism spectrum disorder,ASD)与注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)诊断分类的意义。方法依据DSM-Ⅴ诊断标准入组33名ASD儿童,30名ADHD儿童以及39名正常发育(typical development,TD)儿童青少年为研究对象,对比分析共情与执行功能特征,基于共情及执行功能指标用机器学习方法对三组被试进行诊断分类。结果三组被试在格里菲斯共情测验父母版(GEM)量表总分[ASD组:(0.67±0.64)分,ADHD组:(1.00±0.79)分,TD组:(0.98±0.73)分]及各因子得分(F=3.595~10.363,均P<0.05)、执行功能行为评定量表(BRIEF)量表总分[ASD组:(62.79±7.45)分,ADHD组:(59.47±8.77)分,TD组:(49.08±7.91)分]及各因子得分均差异有统计学意义(F=6.557~33.205,均P<0.01)。其中ASD、ADHD组在共情与执行功能得分普遍高于TD儿童(均P<0.05),联合BRIEF量表及GEM量表所有子成分指标时,三组被试分类准确率达62.75%。结论ASD与ADHD儿童在共情与执行功能上均存在损伤,联合共情与执行功能指标比单一指标更有助于诊断分类。Objective To explore the significance of empathy and executive function indexes in the diagnosis and classification of autism spectrum disorder(ASD)and attention deficit hyperactivity disorder(ADHD).Methods According to DSM-Ⅴdiagnostic criteria,33 children with ASD,30 children with ADHD and 39 typical development(TD)children and adolescents were enrolled as the research subjects.The empathy and executive function characteristics were compared and analyzed in the subjects.Based on empathy and executive function indicators,the three groups of subjects were diagnosed and classified by machine learning method.Results The total score of Griffith empathy measure parent ratings(GEM-PR)(ASD:(0.67±0.64),ADHD:(1.00±0.79),TD:(0.98±0.73))and each factor score(F=3.595-10.363,all P<0.05)and the total score of behavior rating inventory of executive function(BRIEF)(ASD:(62.79±7.45),ADHD:(59.47±8.77),TD:(49.08±7.91))and each factor score of the three groups were different(F=6.557-33.205,all P<0.01).Among them,the scores of empathy and executive function in ASD and ADHD groups were generally higher than those in TD children(all P<0.05).When combined with BRIEF scale and GEM scale,the classification accuracy of the three groups reached 62.75%.Conclusion Both ASD and ADHD children have damages in empathy and executive function.Combining empathy and executive function indexes are more helpful for diagnosis and classification than single index.

关 键 词：孤独症谱系障碍 注意缺陷多动障碍 共情能力 执行功能 诊断分类 

分 类 号：R74[医药卫生—神经病学与精神病学]