注意缺陷多动障碍儿童优势反应抑制缺陷与注意缺陷、冲动行为的关联研究  

Association of deficits in prepotent response inhibition with attention deficit and impulsive behavior among children with attention deficit hyperactivity disorder

作　　者：何佳 徐方忠 汤路瀚[2] 余鸽 韩煜昉[1] HE Jia;XU Fangzhong;TANG Luhan;YU Ge;HAN Yufang(Department of Psychology,Zhejiang Sci-Tech University,Hangzhou,Zhejiang 310018,China;Tongde Hospital of Zhejiang Province,Hangzhou,Zhejiang 310012,China)

机构地区：[1]浙江理工大学心理学系,浙江杭州310018 [2]浙江省立同德医院,浙江杭州310012

出　　处：《预防医学》2023年第9期766-769,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省自然科学基金项目(LQ20C090001);浙江省中医药科技计划科研基金项目(2022ZB062)。

摘　　要：目的探讨注意缺陷多动障碍(ADHD)儿童优势反应抑制缺陷与注意缺陷、冲动行为的关系,为ADHD反应抑制功能训练改善患儿临床症状提供依据。方法选取2022年3—12月在杭州市某三甲医院临床心理科就诊的ADHD儿童57例纳入ADHD组,按年龄、性别匹配从杭州市某小学选取正常儿童55人纳入对照组。采用抑制冲突任务评估优势反应抑制,采用视觉持续性操作测验(CPT)评估注意缺陷,采用相似图形匹配测验(MFFT)评估冲动行为。采用多重线性回归模型分析优势反应抑制缺陷与注意缺陷、冲动行为的关联,采用受试者工作特征曲线(ROC曲线)分析优势反应抑制缺陷对预测ADHD的价值。结果ADHD组儿童年龄(8.77±1.60)岁;男童44例,占77.19%。对照组儿童年龄(9.20±1.77)岁;男童42人,占76.36%。ADHD组儿童抑制冲突任务错误率、视觉CPT漏报率和MFFT错误数分别为22.50%(12.50%)、24.00%(30.00%)和(8.67±3.32)个,均高于对照组的8.75%(7.00%)、7.50%(7.00%)和(4.47±3.16)个(均P<0.05)。多重线性回归分析结果显示,抑制冲突任务错误率与视觉CPT漏报率(R^(2)=0.092,β=0.009,P<0.001)、MFFT错误数(R^(2)=0.135,β=0.091,P<0.001)呈正向关联。ROC曲线下面积为0.891,灵敏度为93.00%,特异度为80.00%,抑制冲突任务错误率临界值为13.13%。结论ADHD儿童优势反应抑制缺陷与注意缺陷、冲动行为存在正向关联。Objective To investigate the associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior in children with attention deficit hyperactivity disorder(ADHD),so as to provide insights into re⁃sponse inhibition training in ADHD to relieve clinical symptoms.Methods From March to December 2022,57 chil⁃dren with ADHD were selected from the clinical psychology department of a tertiary hospital in Hangzhou City as the ADHD group,and 55 normal children matched by age and gender were selected from a primary school as the control group.Prepotent response inhibition,attention deficit and impulsive behavior were assessed by inhibition conflict task,vi⁃sual continuous performance test(CPT)and matching familiar figures test(MFFT),respectively.The associations of defi⁃cits in prepotent response inhibition with attention deficit and impulsive behavior were analyzed using multiple linear re⁃gression model,and the predictive value of deficits in prepotent response inhibition on ADHD was evaluated using receiver operating characteristic(ROC)curve.Results The children included in the ADHD group had a mean age of(8.77±1.60)years and 44 males(77.19%),and the children included in the control group had a mean age of(9.20±1.77)years and 42 males(76.36%).The error rate of inhibition conflict task,missing report rate of visual CPT and the number of MFFT errors were higher in the ADHD group than in the control group[22.50%(12.50%)vs.8.75%(7.00%),24.00%(30.00%)vs.7.50%(7.00%),8.67±3.32 vs.4.47±3.16;all P<0.05].Multiple linear regression model showed that the error rate of inhibition conflict task was positively associated with the missing report rate of visual CPT(R^(2)=0.135,β=0.091,P<0.001)and the number of MFFT errors(R^(2)=0.092,β=0.009,P<0.001).The area under the ROC curve was 0.891,the sensitivity was 93.00%,the specificity was 80.00%,and the cut-off was 13.13%.Conclusions The deficits in prepotent response inhibition are positively associated with attention deficit and impulsive

关 键 词：注意缺陷多动障碍 优势反应抑制 注意缺陷 冲动行为 儿童 

分 类 号：R195[医药卫生—卫生统计学]