注意缺陷多动障碍患儿学业功能损害与临床特征的关系

林裕雄; 江文庆; 李焱; 孙智信; 李楠; 杜亚松

doi:10.11852/zgetbjzz2025-0349

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中国儿童保健杂志 ›› 2026, Vol. 34 ›› Issue (6) : 588-593. DOI: 10.11852/zgetbjzz2025-0349

注意缺陷多动障碍专栏

注意缺陷多动障碍患儿学业功能损害与临床特征的关系

林裕雄¹, 江文庆¹, 李焱¹, 孙智信¹, 李楠², 杜亚松¹

作者信息 +

Association between academic impairment and clinical features in children with attention-deficit/hyperactivity disorder

LIN Yuxiong¹, JIANG Wenqing¹, LI Yan¹, SUN Zhixin¹, LI Nan², DU Yasong¹

Author information +

文章历史 +

摘要

目的研究注意缺陷多动障碍(ADHD)患儿学业功能损害与临床特征的关系,分析智力在其中的中介作用。方法纳入2020年6月—2021年11月在上海市精神卫生中心就诊的305例6~16岁未服药的ADHD患儿,采用Wechsler儿童智力量表第四版(WISC-Ⅳ)、SNAP-Ⅳ评定量表及Conners父母症状问卷(PSQ)评估智力、临床症状及学业功能。结果注意缺陷、多动冲动均与学习问题显著正相关(P<0.01),总智商及多个智商维度与学习问题呈负相关(P<0.01);多重线性回归分析提示注意缺陷(β=0.717,P＜0.001)和年龄(β=0.097,P=0.01)正向预测学习问题,工作记忆负向预测学习问题(β=-0.115,P=0.002);中介效应分析结果提示工作记忆在注意缺陷对学习问题的影响中存在部分中介作用(β=0.012,P＜0.01),知觉推理在多动冲动对学习问题的影响中存在部分中介作用(β=-0.013,P＜0.01)。结论 ADHD的临床症状和智力特征是学业功能损害的重要影响因素,其中临床症状对学习行为的影响占主导作用,工作记忆起到较小的部分中介作用。

Abstract

Objective To analyze the correlation between academic impairment and clinical features in children with attention-deficit/hyperactivity disorder (ADHD), and to analyze the mediating effects of intelligence. Methods A total of 305 medication-naive children with ADHD aged 6 - 16 years were enrolled from Shanghai Mental Health Center between June 2020 to November 2021.Intelligence, clinical symptoms, and academic function were assessed using the Wechsler Intelligence Scale for Children-Ⅳ (WISC-Ⅳ), the SNAP-Ⅳ Rating Scale, and the Conners Parent Symptom Questionnaire (PSQ), respectively. Results Both attention deficit and hyperactivity/impulsivity symptoms were positively correlated with learning problems (P<0.01), while full-scale intelligence quotient (IQ) and various IQ indices were negatively correlated with learning problems (P<0.01).Multivariate linear regression analysis showed that attention deficit (β=0.717, P<0.001) and age (β=0.097, P=0.010) positively predicted learning problems, whereas working memory negatively predicted learning problems (β=-0.115, P=0.002).Mediation analysis indicated that working memory partially mediated the effect of attention deficit on learning problems (β=0.012, P<0.01), and perceptual reasoning partially mediated the effect of hyperactivity/impulsivity on learning problems (β=-0.013, P<0.01). Conclusions Clinical symptoms and intellectual characteristics are important factors influencing academic function impairment in children with ADHD.Clinical symptoms play a dominant role in affecting learning behavior, with working memory and perceptual reasoning serving as partial mediators.

导出引用

林裕雄, 江文庆, 李焱, 孙智信, 李楠, 杜亚松. 注意缺陷多动障碍患儿学业功能损害与临床特征的关系[J]. 中国儿童保健杂志. 2026, 34(6): 588-593 https://doi.org/10.11852/zgetbjzz2025-0349

LIN Yuxiong, JIANG Wenqing, LI Yan, SUN Zhixin, LI Nan, DU Yasong. Association between academic impairment and clinical features in children with attention-deficit/hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2026, 34(6): 588-593 https://doi.org/10.11852/zgetbjzz2025-0349

中图分类号： R749.94

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