“冷”/“热”执行功能缺陷影响ADHD儿童核心症状的作用机制  

The mechanism of“cool”/“hot”executive function deficit acting on the core symptoms of ADHD children

作　　者：王雪珂 冯廷勇 WANG Xueke;FENG Tingyong(Faculty of Psychology,Southwest University,Chongqing 400715,China)

机构地区：[1]西南大学心理学部,重庆400715

出　　处：《心理科学进展》2023年第11期2106-2128,共23页Advances in Psychological Science

基　　金：国家重点研发计划项目(2022YFC2705201);重庆市博士研究生科研创新项目(CYB22099);国家自然科学基金面上项目(32271123,31971026);西南大学创新研究2035先导计划(SWUPilotPlan006)资助。

摘　　要：注意缺陷多动障碍(ADHD)是一种以注意缺陷和(或)多动、冲动为核心症状的神经发育障碍,与前额叶发育异常所致的执行功能缺陷密切相关。基于此,从神经−认知−行为的发展途径提出执行功能缺陷可能是认知层面上导致ADHD核心症状的发病机理,其中与背侧前额叶相关的“冷”执行功能缺陷可能是导致注意缺陷核心症状的主导因素,而与腹内侧前额叶相关的“热”执行功能缺陷可能是导致多动、冲动核心症状的主导因素。一方面,“冷”执行功能缺陷主要引起工作记忆表征维持失败、抑制控制能力不足、认知转换困难等方面,这些缺陷进一步导致了个体在注意持续、注意选择和注意转移上受到限制;另一方面,“热”执行功能缺陷则带来厌恶延迟、奖赏加工异常、动机失调等问题,使得个体行为抑制失败,更容易做出冲动性选择,从而表现出多动、冲动等核心症状。未来研究应进一步检验和完善“冷”、“热”执行功能缺陷影响ADHD核心症状的理论模型以及从认知神经层面上提供更多的实证证据,同时还需从生态层面考察“冷”和“热”执行功能缺陷对ADHD核心症状的交互影响,并基于执行功能开发对ADHD核心症状具有个性化、精准化、长效化的干预方案。Attention-deficit/hyperactivity disorder(ADHD)is a persistent neurodevelopmental disorder characterized by inattention and/or hyperactivity-impulsivity,which is closely related to the executive function deficits resulting from the dysplastic of prefrontal cortex.Based on the neuro-cognitive-behavioral developmental path,it is proposed that executive function deficits may be the pathogenesis of the core symptoms of ADHD at the cognitive level,among which the“cool”one related with the dorsal prefrontal cortex might be the dominant factor affecting inattention,and the“hot”one linked to the ventromedial prefrontal cortex could play the main role in the manifestation of hyperactivity-impulsivity.On the one hand,deficits in“cool”executive function mainly result in failures in working memory representation,lack of inhibitory control,and difficulties in cognitive flexibility,and further lead to limitations in attention maintenance,selection,and switching.On the other hand,deficits in“hot”executive function bring problems like delay aversion,reward abnormality and motivation disorders,which make one fail to inhibit behavior and more likely to make impulsive decisions,thereby displaying more symptoms of hyperactivityimpulsivity.Future studies are expected to examine and improve theoretical models of“hot”and“cold”executive function deficits affecting the core symptoms of ADHD,and provide more empirical evidence at the cognitive neural level.Meanwhile,future studies need to examine the mechanism mentioned above in ecological backgrounds,and further develop intervention projects with personalization,precision and long-acting to alleviate the core symptoms of ADHD based on executive function.

关 键 词：注意缺陷多动障碍 执行功能缺陷 核心症状 前额叶皮层 作用机制 

分 类 号：B845[哲学宗教—心理学]