中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2014年
5期
416-419
,共4页
马岭%蔡婧%任艳玲%张毅力%高鹏%王苏弘
馬嶺%蔡婧%任豔玲%張毅力%高鵬%王囌弘
마령%채청%임염령%장의력%고붕%왕소홍
注意缺陷多动障碍%智力%注意%亚型
註意缺陷多動障礙%智力%註意%亞型
주의결함다동장애%지력%주의%아형
Attention deficit hyperactivity disorder%Intelligence%Attention%Subtypes
目的 通过分析不同亚型注意缺陷多动障碍(ADHD)儿童的智力结构和注意特征,探讨ADHD注意和认知的相关性.方法 符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的90例ADHD儿童完成了韦氏儿童智力测验(C-WISC)和视听整合持续性操作测试(IVA-CPT),其中注意缺陷为主型(ADHD-Ⅰ)24例,多动冲动为主型(ADHD-HI) 12例,混合型(ADHD-C) 54例,对三组的智力结构--言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)、A因子、B因子和C因子进行了比较,并与注意商数作了相关性分析.结果 (1)智力结构:ADHD儿童的VIQ、PIQ、FIQ、A因子、C因子间存在临床亚型的主效应:ADHD-HI型VIQ[(110.08± 10.64)分]高于ADHD-C型[(101.13± 13.20)分]、ADHD-Ⅰ型[(94.71±11.11)分];ADHD-HI型FIQ[(104.33±9.63)分]高于ADHD-Ⅰ型[(94.38± 10.48)分];ADHD-HI[(45.75±7.14)分]和ADHD-C型[(41.41±8.57)分]的A因子高于ADHD-Ⅰ型[(36.67±6.72)分];ADHD-HI型C因子[(33.42±5.42)分]高于ADHD-C型[(29.24±5.26)分]和ADHD-Ⅰ型[(29.13±5.39)分],以上均差异有统计学意义(P＜0.05).(2)注意商数:ADHD-C型综合注意商数[(90.26±11.67)分]显著低于ADHD-Ⅰ型[(98.17±18.03)分]和ADHD-HI型[(99.25±15.58)分],差异有统计学意义(P＜0.05),ADHD-Ⅰ型与ADHD-HI型间无明显差异;ADHD-C型听觉注意商数[(89.94± 14.16)分]显著低于ADHD-Ⅰ型[(99.00± 18.66)分],差异有统计学意义(P＜0.05).(3)智力与注意的相关性分析:听觉注意商数和听觉反应控制商数与PIQ呈正相关(r=0.24,r=0.29);视觉注意商数分别与PIQ、FIQ呈正相关(r=0.21,r=0.25);综合注意商数分别与PIQ、FIQ呈正相关(r=0.27,r=0.24).结论 不同亚型ADHD儿童的智力结构和注意受损存在一定的差异,认知与注意的关联性为临床诊断和制定治疗干预策略提供参考.
目的 通過分析不同亞型註意缺陷多動障礙(ADHD)兒童的智力結構和註意特徵,探討ADHD註意和認知的相關性.方法 符閤美國精神障礙診斷與統計手冊第4版(DSM-Ⅳ)診斷標準的90例ADHD兒童完成瞭韋氏兒童智力測驗(C-WISC)和視聽整閤持續性操作測試(IVA-CPT),其中註意缺陷為主型(ADHD-Ⅰ)24例,多動遲動為主型(ADHD-HI) 12例,混閤型(ADHD-C) 54例,對三組的智力結構--言語智商(VIQ)、操作智商(PIQ)、總智商(FIQ)、A因子、B因子和C因子進行瞭比較,併與註意商數作瞭相關性分析.結果 (1)智力結構:ADHD兒童的VIQ、PIQ、FIQ、A因子、C因子間存在臨床亞型的主效應:ADHD-HI型VIQ[(110.08± 10.64)分]高于ADHD-C型[(101.13± 13.20)分]、ADHD-Ⅰ型[(94.71±11.11)分];ADHD-HI型FIQ[(104.33±9.63)分]高于ADHD-Ⅰ型[(94.38± 10.48)分];ADHD-HI[(45.75±7.14)分]和ADHD-C型[(41.41±8.57)分]的A因子高于ADHD-Ⅰ型[(36.67±6.72)分];ADHD-HI型C因子[(33.42±5.42)分]高于ADHD-C型[(29.24±5.26)分]和ADHD-Ⅰ型[(29.13±5.39)分],以上均差異有統計學意義(P＜0.05).(2)註意商數:ADHD-C型綜閤註意商數[(90.26±11.67)分]顯著低于ADHD-Ⅰ型[(98.17±18.03)分]和ADHD-HI型[(99.25±15.58)分],差異有統計學意義(P＜0.05),ADHD-Ⅰ型與ADHD-HI型間無明顯差異;ADHD-C型聽覺註意商數[(89.94± 14.16)分]顯著低于ADHD-Ⅰ型[(99.00± 18.66)分],差異有統計學意義(P＜0.05).(3)智力與註意的相關性分析:聽覺註意商數和聽覺反應控製商數與PIQ呈正相關(r=0.24,r=0.29);視覺註意商數分彆與PIQ、FIQ呈正相關(r=0.21,r=0.25);綜閤註意商數分彆與PIQ、FIQ呈正相關(r=0.27,r=0.24).結論 不同亞型ADHD兒童的智力結構和註意受損存在一定的差異,認知與註意的關聯性為臨床診斷和製定治療榦預策略提供參攷.
목적 통과분석불동아형주의결함다동장애(ADHD)인동적지력결구화주의특정,탐토ADHD주의화인지적상관성.방법 부합미국정신장애진단여통계수책제4판(DSM-Ⅳ)진단표준적90례ADHD인동완성료위씨인동지력측험(C-WISC)화시은정합지속성조작측시(IVA-CPT),기중주의결함위주형(ADHD-Ⅰ)24례,다동충동위주형(ADHD-HI) 12례,혼합형(ADHD-C) 54례,대삼조적지력결구--언어지상(VIQ)、조작지상(PIQ)、총지상(FIQ)、A인자、B인자화C인자진행료비교,병여주의상수작료상관성분석.결과 (1)지력결구:ADHD인동적VIQ、PIQ、FIQ、A인자、C인자간존재림상아형적주효응:ADHD-HI형VIQ[(110.08± 10.64)분]고우ADHD-C형[(101.13± 13.20)분]、ADHD-Ⅰ형[(94.71±11.11)분];ADHD-HI형FIQ[(104.33±9.63)분]고우ADHD-Ⅰ형[(94.38± 10.48)분];ADHD-HI[(45.75±7.14)분]화ADHD-C형[(41.41±8.57)분]적A인자고우ADHD-Ⅰ형[(36.67±6.72)분];ADHD-HI형C인자[(33.42±5.42)분]고우ADHD-C형[(29.24±5.26)분]화ADHD-Ⅰ형[(29.13±5.39)분],이상균차이유통계학의의(P＜0.05).(2)주의상수:ADHD-C형종합주의상수[(90.26±11.67)분]현저저우ADHD-Ⅰ형[(98.17±18.03)분]화ADHD-HI형[(99.25±15.58)분],차이유통계학의의(P＜0.05),ADHD-Ⅰ형여ADHD-HI형간무명현차이;ADHD-C형은각주의상수[(89.94± 14.16)분]현저저우ADHD-Ⅰ형[(99.00± 18.66)분],차이유통계학의의(P＜0.05).(3)지력여주의적상관성분석:은각주의상수화은각반응공제상수여PIQ정정상관(r=0.24,r=0.29);시각주의상수분별여PIQ、FIQ정정상관(r=0.21,r=0.25);종합주의상수분별여PIQ、FIQ정정상관(r=0.27,r=0.24).결론 불동아형ADHD인동적지력결구화주의수손존재일정적차이,인지여주의적관련성위림상진단화제정치료간예책략제공삼고.
Objective To investigate the intelligence structure and attention properties,and to explore the relationship between them in children with attention deficit hyperactivity disorder of the predominantly inattention type (ADHD-Ⅰ),predominantly hyperactive-impulsive type (ADHD-HI) and combined type (ADHD-C).Methods Children with ADHD-Ⅰ (n=24),ADHD-HI(n=12) and ADHD-C (n=54) aged between 7-10 years were tested with Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and integrated visual and auditory continuous performance test (IVA-CPT).Comparisons of cognitive profiles of C-WISC scores between subtypes of ADHD were performed.Additionally,the relationship between attention/response control quotients and cognitive profiles was investigated.Results (1) Intelligence structure:verbal intelligence (VIQ) of ADHD-HI (110.08± 10.64) was higher than that of ADHD-C (101.13± 13.20) and ADHD-Ⅰ (94.71± 11.11).Full scale intelligence quotient (FIQ) of ADHD-HI (104.33±9.63) was higher than that of ADHD-Ⅰ (94.38± 10.48).Factor A of ADHD-HI (45.75±7.14) and ADHD-C (41.41±8.57) were higher than that of ADHD-Ⅰ (36.67±6.72).Factor C of ADHD-HI (33.42±5.42) was higher than that of ADHD-C (29.24±5.26) and ADHD-Ⅰ (29.13±5.39).(2) Attention properties:Full scale attention quotient of ADHD-C (90.26± 11.67) was lower than that of ADHD-Ⅰ (98.17 ± 18.03) and ADHD-HI (99.25± 15.58).Auditory attention quotient of ADHD-C (89.94± 14.16) was lower than that of ADHD-Ⅰ (99.00± 18.66).(3) Relationship between intelligence and attention:the Pearson correlations of the auditory attention quotient and auditory control quotient with the PIQ were 0.24 and 0.29 respectively.The correlations of the visual attention quotient with the PIQ and FIQ were 0.21 and 0.25 respectively.The correlations of the full scale attention quotient with PIQ and FIQ were 0.27 and 0.24 respectively.Each of these correlations reached the level of significance at the 5％ level.Conclusion Cognitive profile and attention properties analysis reveal that children with different subtypes of ADHD have distinct weakness in intelligence structure.The understanding of relationship between intelligence structure and attention properties in children with subtypes of ADHD is useful for ADHD diagnosis and treatment.
