利用剑桥自动化神经心理测验包探查注意缺陷多动障碍儿童多维度执行功能缺陷

doi:10.11852/zgetbjzz2024-0355

中国儿童保健杂志 ›› 2024, Vol. 32 ›› Issue (10): 1149-1154.DOI: 10.11852/zgetbjzz2024-0355

利用剑桥自动化神经心理测验包探查注意缺陷多动障碍儿童多维度执行功能缺陷

董超¹, 张琳琳¹, 钟蕴瑜¹, 刘云¹, 刘娟¹, 王鹏², 王玉凤³, 杨斌让¹, 吴赵敏¹, 李颖¹

1.深圳市儿童医院儿童保健与心理健康中心,广东深圳 518026;
2.中国医学科学院阜外医院;
3.北京大学精神卫生研究所/第六医院/卫生部精神病学重点实验室

收稿日期:2024-03-28 修回日期:2024-08-18 发布日期:2024-10-11 出版日期:2024-10-10
通讯作者: 李颖,E-mail:maxiaopeng@126.com
作者简介:董超(1989-),女,主管护师,本科学历,主要研究方向为注意缺陷多动障碍的神经心理特征。
基金资助:
国家自然科学基金(82101613);广东省高水平医院建设专项经费(2022);深圳市科技计划(RCYX20221008092849069,JCYJ20220530155416036)

Multidimensional executive function deficits in children with attention deficit hyperactivity disorder assessed by Cambridge Neuropsychological Test Automated Battery

DONG Chao¹, ZHANG Linlin¹, ZHONG Yunyu¹, LIU Yun¹, LIU Juan¹, WANG Peng², WANG Yufeng³, YANG Binrang¹, WU Zhaomin¹, LI Ying¹

1. Children′s Care and Mental Health Center, Shenzhen Children′s Hospital, Shenzhen,Guangdong 518026, China;
2. Cardiac Rehabilitation Center, Fuwai Hospital, CAMS & PUMC;
3. Peking University Sixth Hospital/ Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)

Received:2024-03-28 Revised:2024-08-18 Online:2024-10-10 Published:2024-10-11
Contact: LI Ying, E-mail:maxiaopeng@126.com

摘要/Abstract

摘要： 目的探讨剑桥自动化神经心理测验包(CANTAB)在注意缺陷多动障碍(ADHD)儿童中的应用,分析ADHD儿童临床症状、智力水平与执行功能损害之间的关系。方法 2017年9月—2020年9月,选取就诊于深圳市儿童医院保健与心理健康中心的441名ADHD儿童为研究对象,同时选取85名健康儿童为对照。所有儿童采用剑桥自动化神经心理测验包(CANTAB)中的持续注意任务、加工速度任务、反应抑制任务和空间工作记忆任务进行评估。同时采用ADHD症状评定量表(父母版)评估ADHD症状严重程度,Conners量表评估ADHD儿童的行为问题,以及WISC-Ⅳ评估ADHD儿童的各项智商指数。采用协方差分析比较ADHD组与对照组各项执行功能指标的差异,偏相关分析ADHD症状严重程度和智商指数与CANTAB指标的相关性,并利用中介模型探讨各项指标之间的因果关系。结果 ADHD儿童对比对照组在执行功能各项指标中除快速信息加工错误率(RVPPFA)外,其他均存在明显的执行功能缺陷(F值: 4.46~25.90,P<0.05)。ADHD儿童的临床核心症状严重程度与其执行功能损害无显著相关(r值:-0.017~0.130,P>0.05)。反之,各项智商指数与多个执行功能指标存在显著相关(r值:-0.36~0.24,P<0.05)。智力水平是ADHD患儿执行功能损害的有效中介因子 (P<0.05)。结论 ADHD儿童的执行功能缺陷受智力水平影响,利用全自动化的神经心理测验包CANTAB能有效检测ADHD儿童的执行功能缺陷。

关键词: 注意缺陷多动障碍, 执行功能, 智力水平, 剑桥自动化神经心理测验包

Abstract: Objective To explore the validity of Cambridge Neuropsychological Test Automated Battery (CANTAB) in detecting executive function deficits in children with attention deficit hyperactivity disorder (ADHD), and to analyze the correlation among ADHD symptoms, intellectual level and executive function deficits. Methods A total of 441 children with ADHD in Children′s Care and Mental Health Center, Shenzhen Children′s Hospital were selected into this study from September 2017 toSeptember 2020, meanwhile 85 healthy children were enrolled as controls. All children were assessed using the continuous performance task, processing speed task, response inhibition task, and spatial working memory task from the CANTAB. The severity of ADHD symptoms was evaluated using the ADHD Symptom Rating Scale (parent version), behavioral problems in children with ADHD were assessed using the Conners′ Rating Scales, ana Covariance analysis was used to compare differences in executive function measures between the ADHD group and the control group. Partial correlation analysis was used to examine the correlations of the severity of ADHD symptoms with IQ indices and CANTAB measures. Mediation models were built to explore causal relationships among these measures. Results Compared with the control group, children with ADHD performed worse in all executive function domains, except for the RVPPFA (F= 4.46 - 25.90, P <0.05). There were no significant correlations between the ADHD core symptom severity and the executive function deficits (r: -0.017 - 0.13, P>0.05). However, IQ was significantly associated with executive function performances (r=-0.36 - 0.24, P <0.05). IQ served as an effective mediating factor for executive function impairments in children with ADHD(P<0.05). Conclusions CANTAB is a valid tool for detecting executive function deficits in children with ADHD. The executive function in ADHD children is affected by their IQ.

Key words: attention deficit hyperactivity disorder, executive function, intelligence cevel, Cambridge Neuropsychological Test Automated Battery (CANTAB)

中图分类号:

R749.94

董超, 张琳琳, 钟蕴瑜, 刘云, 刘娟, 王鹏, 王玉凤, 杨斌让, 吴赵敏, 李颖. 利用剑桥自动化神经心理测验包探查注意缺陷多动障碍儿童多维度执行功能缺陷[J]. 中国儿童保健杂志, 2024, 32(10): 1149-1154.

DONG Chao, ZHANG Linlin, ZHONG Yunyu, LIU Yun, LIU Juan, WANG Peng, WANG Yufeng, YANG Binrang, WU Zhaomin, LI Ying. Multidimensional executive function deficits in children with attention deficit hyperactivity disorder assessed by Cambridge Neuropsychological Test Automated Battery[J]. Chinese Journal of Child Health Care, 2024, 32(10): 1149-1154.

参考文献

[1] Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China:Diagnostic data from detailed clinical assessments of 17,524 individuals[J]. J Child Psychol Psychiatry, 2022, 63(1):34-46.
[2] Faraone SV, Asherson P, Banaschewski T, et al. Attention-deficit/hyperactivity disorder[J]. Nat Rev Dis Primers, 2015, 1:15020.
[3] Souissi S, Chamari K, Bellaj T. Assessment of executive functions in school-aged children: A narrative review[J]. Front Psychol, 2022, 13:991699.
[4] Gunzenhauser C, Nuckles M. Training executive functions to improve academic achievement: Tackling avenues to far transfer[J]. Front Psychol,2021, 12:624008.
[5] Kofler MJ, Irwin LN, Soto EF, et al. Executive functioning heterogeneity in pediatric ADHD[J]. J Abnorm Child Psychol,2019, 47(2):273-286.
[6] Willcutt EG, Doyle AE, Nigg JT, et al. Validity of the executive function theory of attention-deficit/hyperactivity disorder:A meta-analytic review[J]. Biol Psychiatry, 2005, 57(11):1336-46.
[7] 袁靖, 裴栩瑶, 范自立, 等. 应用CANTAB测评注意缺陷多动障碍儿童执行功能缺陷[J]. 中国心理卫生杂志[J]. 2020, 34(3):201-205.
Yuan J, Pei XY, Fan ZL, et al. Assessment of executive function deficit throught use of the CANTAB in children with attention deficit/hyperactivity disorder[J]. Chinese Mental Health Journal, 2020, 34(3):201-205. (In Chinese)
[8] Miranda A, Colomer C, Mercader J, et al. Performance-based tests versus behavioral ratings in the assessment of executive functioning in preschoolers: Associations with ADHD symptoms and reading achievement[J]. Front Psychol[J]. 2015, 6:545.
[9] Milioni AL, Chaim TM, Cavallet M, et al. High IQ may "Mask" the diagnosis of ADHD by compensating for deficits in executive functions in treatment-naive adults with ADHD[J]. J Atten Disord, 2017, 21(6):455-464.
[10] Mahone EM, Hagelthorn KM, Cutting LE, et al. Effects of IQ on executive function measures in children with ADHD[J]. Child Neuropsychol, 2002, 8(1):52-65.
[11] Jepsen JR, Fagerlund B, Mortensen EL. Do attention deficits influence IQ assessment in children and adolescents with ADHD?[J]. J Atten Disord, 2009, 12(6):551-562.
[12] Gau SS, Shang CY. Executive functions as endophenotypes in ADHD: Evidence from the Cambridge Neuropsychological Test Battery (CANTAB)[J]. J Child Psychol Psychiatry[J]. 2010, 51(7):838-849.
[13] Kaufman J, Birmaher B, Brent D, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data[J]. J Am Acad Child Adolesc Psychiatry, 1997, 36(7):980-8.
[14] 李梦瑶, 杜亚松. 学龄期儿童注意缺陷多动障碍标准化评估量表的临床应用[J]. 中华实用儿科临床杂志[J]. 2014, 29(24):1893-1897.
Li MY, Du YS. Clinical application of standardized rating scales for attention deficit hyperactivity disorder in school-age children[J]. Chinese Journal of Applied Clinical Pediatrics[J]. 2014, 29(24):1893-1897. (In Chinese)
[15] 范娟, 杜亚松, 王立伟. Conners父母用症状问卷的中国城市常模和信度研究[J]. 上海精神医学, 2005, 17(6):321-323.
Fan J, Du YS, Wang LW. The norm and reliability of the Conners Parent Symptom Questionnaire in Chinese urban children[J]. Shanghai Archives of Psychiatry, 2005, 17(6):321-323. (In Chinese)
[16] 张厚粲. 韦氏儿童智力量表第四版(WISC-Ⅳ)中文版的修订[J]. 心理科学[J]. 2009, 5:1177-1179.
Zhang HC. Revision of the Chinese Version of the Wechsler Intelligence Scale (fourth edition)[J]. Psychological Science. 2009, 5:1177-1179.(in Chinese)
[17] Tseng WL, Gau SS. Executive function as a mediator in the link between attention-deficit/hyperactivity disorder and social problems[J]. J Child Psychol Psychiatry[J]. 2013, 54(9):996-1004.
[18] Shroff DM, Dunn NC, Green CD, et al. Predictors of executive function trajectories in adolescents with and without ADHD: Links with academic outcomes[J]. Dev Psychopathol[J]. 2023:1-14.
[19] Fosco WD, Kofler MJ, Alderson RM, et al. Inhibitory control and information processing in ADHD: Comparing the dual task and performance adjustment hypotheses[J]. J Abnorm Child Psychol, 2019, 47(6):961-974.
[20] van Aken BC, Rietveld R, Wierdsma AI, et al. Self-report versus performance based executive functioning in people with psychotic disorders[J]. Schizophr Res Cogn[J]. 2023, 34:100293.
[21] Starcke K, Wiesen C, Trotzke P, et al. Effects of acute laboratory stress on executive functions[J]. Front Psychol, 2016, 7:461.
[22] Tallberg P, Rastam M, Hallin AL, et al. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD[J]. Appl Neuropsychol Child, 2023, 12(4):259-271.
[23] Kibby MY, Vadnais SA, Jagger-Rickels AC. Which components of processing speed are affected in ADHD subtypes?[J]. Child Neuropsychol, 2019, 25(7):964-979.
[24] Schreiber JE, Possin KL, Girard JM,et al. Executive function in children with attention deficit/hyperactivity disorder: The NIH EXAMINER battery[J]. J Int Neuropsychol Soc, 2014, 20(1):41-51.
[25] Gau SS, Chiu CD, Shang CY, et al. Executive function in adolescence among children with attention-deficit/hyperactivity disorder in Taiwan[J]. J Dev Behav Pediatr, 2009, 30(6):525-34.
[26] Dai DWT, Wouldes TA, Brown GTL, et al. Relationships between intelligence, executive function and academic achievement in children born very preterm[J]. Early Hum Dev, 2020, 148:105122.

利用剑桥自动化神经心理测验包探查注意缺陷多动障碍儿童多维度执行功能缺陷

Multidimensional executive function deficits in children with attention deficit hyperactivity disorder assessed by Cambridge Neuropsychological Test Automated Battery

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	毛广惠, 王丹, 李丽丽, 季忆婷, 王琪玉, 冯晨霞, 赵晓燕, 何璐, 蔡世忠, 陈艳. 学龄期注意缺陷多动障碍儿童的人体成分分析[J]. 中国儿童保健杂志, 2024, 32(9): 1029-1033.
[2]	邓梁琼, 梁媛媛, 岑诗, 胡敏, 李红辉, 曾烜, 廖林燕. 新森林教养方案对注意缺陷多动障碍儿童干预疗效的研究[J]. 中国儿童保健杂志, 2024, 32(8): 856-861.
[3]	章依文. 注意缺陷多动障碍共病智力障碍的诊治挑战[J]. 中国儿童保健杂志, 2024, 32(6): 581-585.
[4]	冯廷勇, 王雪珂. 注意缺陷多动障碍儿童多模态评估的现状与建议[J]. 中国儿童保健杂志, 2024, 32(6): 586-590.
[5]	刘子奇, 刘思奇, 陶梦娇, 任永颖, 李冠男, 孙静, 王昕, 张建昭, 杨健. 不同注意力、控制力水平注意缺陷多动障碍儿童认知功能特点[J]. 中国儿童保健杂志, 2024, 32(6): 591-596.
[6]	张琳琳, 吴赵敏, 王鹏, 操小兰, 刘娟, 王玉凤, 杨斌让. 高焦虑水平注意缺陷多动障碍儿童社会功能损害特征[J]. 中国儿童保健杂志, 2024, 32(6): 597-601.
[7]	郭春燕, 宋丽, 王亚哲, 于茹梦, 张定方, 殷梦华. 注意缺陷多动障碍共患学习障碍儿童的执行功能研究[J]. 中国儿童保健杂志, 2024, 32(6): 602-607.
[8]	卢鋆锋, 李甦. 注意缺陷多动障碍儿童语用性语言障碍研究进展[J]. 中国儿童保健杂志, 2024, 32(6): 643-647.
[9]	胡旖婷, 江克文. 注意缺陷多动障碍儿童执行功能性别差异及机制研究进展[J]. 中国儿童保健杂志, 2024, 32(6): 648-652.
[10]	吴泳华, 于敬龙, 周康宁, 王俊宏. 基于CiteSpace的近十年国内外注意缺陷多动障碍认知功能的可视化分析[J]. 中国儿童保健杂志, 2024, 32(6): 661-667.
[11]	任苗苗, 陈立. 药物遗传学对注意缺陷多动障碍儿童盐酸哌甲酯治疗的影响[J]. 中国儿童保健杂志, 2024, 32(3): 296-300.
[12]	李梦滔, 代梦琴, 罗尧竞, 赵小燕. 学龄期注意缺陷多动障碍儿童社交焦虑现状及影响因素[J]. 中国儿童保健杂志, 2024, 32(3): 344-348.
[13]	王蕾蕾, 赵鹏军. 睡眠碎片化对儿童认知功能影响的研究进展[J]. 中国儿童保健杂志, 2024, 32(11): 1241-1245.
[14]	陆彦婷, 陈亮亮, 刘秀梅. 先兆冲动在共患注意缺陷多动障碍与抽动障碍儿童抽动严重程度关联中的中介作用[J]. 中国儿童保健杂志, 2024, 32(10): 1050-1054.
[15]	张沥文, 秦星, 李娟, 宋紫霞, 吴玮玮. 脑电生物反馈联合盐酸哌甲酯治疗儿童注意缺陷多动障碍的疗效及对脑血流和血清皮质醇水平的影响[J]. 中国儿童保健杂志, 2024, 32(10): 1135-1139.