注意缺陷多动障碍儿童的多维度工作记忆特点

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英文篇名：Multi-dimensional working memory profile in children with attention-deficit/hyperactivity disorder 作者：王鹏 ; 寇聪 ; 江家靖 ; 高兵玲 ; 钟苑心 ; 杨斌让 ; 王玉凤 英文作者：WANG Peng;KOU Cong;JIANG Jiajing;GAO Bingling;ZHONG Yuanxin;YANG Binrang;WANG Yufeng;Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University) ,National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital);Shenzhen Children's Hospital;Shougang Hospital; 关键词：注意缺陷多动障碍 ; 工作记忆 ; 生态效度 ; 对照研究 英文关键词：attention-deficit/hyperactivity disorder;;working memory;;ecological validity;;comparative study 中文刊名：ZXWS 英文刊名：Chinese Mental Health Journal 机构：北京大学第六医院,北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院);深圳市儿童医院;北京大学首钢医院; 出版日期：2019-05-24 08:47 出版单位：中国心理卫生杂志 年：2019 期：v.33 基金：深圳市医疗卫生三名工程项目(SZSM201612036) 语种：中文; 页：ZXWS201906003 页数：5 CN：06 ISSN：11-1873/R 分类号：17-21

摘要

目的:探讨注意缺陷多动障碍(ADHD)儿童多维度工作记忆的特点。方法:符合DSM-IV诊断标准的174例ADHD儿童,性别、年龄匹配的50例正常对照,采用中国儿童-韦氏智力测定量表(C-WISC)第四版、Rey复杂图形测试对被试进行实验室工作记忆评估,用学龄儿童执行功能行为评定量表(BRIEF量表)父母版评估生态工作记忆。结果:ADHD组C-WISC工作记忆指数低于对照[(89. 9±10. 9) vs.(97. 4±9. 4)]; Rey复杂图形即时结构[(2. 0±1. 9) vs.(3. 2±1. 9)]、即时细节[(6. 4±5. 3) vs.(10. 1±5. 4)]、延迟结构[(1. 9±1. 8) vs.(3. 2±1. 9)]、延迟细节[(5. 8±3. 6) vs.(10. 0±5. 6)]分低于对照; BRIEF工作记忆因子高于对照[(16. 9±7. 3) vs.(13. 2±2. 8)]。主成分分析显示BRIEF工作记忆因子(因子载荷0. 84)与C-WISC工作记忆指数(因子载荷0. 64)在同一主成分有较高因子载荷。结论:ADHD患儿工作记忆存在缺陷,其中听觉工作记忆与生态学指标密切相关,可作为临床评估随访的重要实验室指标。
        Objective: To explore the characteristics of multi-dimensional working memory of children with attention-deficit/hyperactivity disorder( ADHD). Methods: Totally 174 children who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition( DSM-Ⅳ) criteria in ADHD and 50 gender-and age-matched normal children were enrolled in this study. Laboratory and ecological working memory function were assessed with the Wechsler Intelligence Scale for Children( C-WISC),Rey complex figure test( RCFT) and the behavior rating scale of executive function(BRIEF). Results: ADHD children showed lower C-WISC working memory score [(89.9 ±10. 9) vs.(97. 4 ± 9. 4) ],lower scores of RCFT immediate structure[( 2.0 ± 1. 9) vs.(3. 2 ± 1. 9) ],immediate detail[(6. 4 ±5. 3) vs.(10. 1 ± 5. 4) ],recall structure [(1. 9 ± 1. 8) vs.(3. 2 ± 1. 9) ], recall detail [(5.8 ± 3. 6) vs.(10. 0 ±5. 6) ],and higher BRIEF working memory score[( 16. 9 ± 7. 3) vs.( 13. 2 ± 2. 8) ] than the normal controls. Principal component analysis showed that the BRIEF working memory score(factor loading 0. 84) and the CWISC working memory score( factor loading 0. 64) had higher factor load in the same principal component. Conclusion: Comparing with control group,ADHD children exhibit deficit in working memory,and auditory working memory may be closely related to ecological indicators and could be used as an important laboratory index for clinical evaluation and follow-up.

引文

[1]Polanczyk G,Laranjeira R,Zaleski M,et al.ADHD in a representative sample of the Brazilian population:estimated prevalence and comparative adequacy of criteria betw een adolescents and adults according to the item response theory[J].Int J M ethods Psychiatr Res,2010,19(3):177-184.
    [2]Kane M J,Conw ay AR,M iura TK,et al.Working memory,attention control,and the N-back task:a question of construct validity[J].J Exp Psychol Learn M em Cogn,2007,33(3):615-22.
    [3]Kane M J,Hambrick DZ,Conw ay AR.Working memory capacity and fluid intelligence are strongly related constructs:comment on Ackerman,Beier,and Boyle(2005)[J].Psychol Bull,2005,131(1):72-75.
    [4]Sonuga-Barke EJ,Dalen L,Daley D,et al.Are planning,w orking memory,and inhibition associated w ith individual differences in preschool ADHD symptoms?[J].Dev Neuropsychol,2002,21(3):255-272.
    [5]Loe IM,Feldman HM.Academic and educational outcomes of children w ith ADHD[J].J Pediatr Psychol,2007,32(6):643-654.
    [6]M artinussen R,Tannock R.Working memory impairments in children w ith attention-deficit hyperactivity disorder w ith and w ithout comorbid language learning disorders[J].J Clin Exp Neuropsychol,2006,28(7):1073-1094.
    [7]姚洪秀,李国海.注意缺陷多动障碍儿童记忆和执行功能的研究[J].中国临床康复,2003,7(30):4090-4091.
    [8]徐桂凤,王静进,麦坚凝,等.混合型注意缺陷多动障碍儿童工作记忆特征的神经心理研究[J].中国儿童保健杂志,2011,19(3):217-219.
    [9]廖文静,金嘉郦,李海梅,等.注意缺陷多动障碍共患抽动障碍儿童的执行功能[J].中国心理卫生杂志,2017,31(11):865-871.
    [10]帅澜,王玉凤.共患学习困难的注意缺陷多动障碍男孩的执行功能特点[J].北京大学学报(医学版),2007,39(5):526-530.
    [11]刘栋梁,高倩,程嘉,等.注意缺陷多动障碍共患抑郁障碍儿童的执行功能特点[J].中国心理卫生杂志,2016,30(11):829-834.
    [12]钱英,王玉凤.学龄儿童执行功能行为评定量表父母版的信效度[J].北京大学学报(医学版),2007,39(3):277-283.
    [13]M cguire A.Diagnostic and statistical manual of mental disorders[M]NY:American Psychiatric Association,1994.
    [14]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):980-988.
    [15]刘豫鑫,刘津,王玉凤.简明儿童少年国际神经精神访谈(父母版)的信效度[J].中国心理卫生杂志,2011,25(1):921-925.
    [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,2009,(5):1177-1179.
    [17]龚耀先,蔡太生.中国修订韦氏儿童智力量表[J].中国临床心理学杂志,1994,(1):1-6.
    [18]赵艳春.脑血管病患者视觉记忆障碍的研究[J].中华物理医学与康复杂志,2002,24(11):692-692.
    [19]Jacobson LA,Ryan M,M artin RB,et al.Working memory influences processing speed and reading fluency in ADHD[J].ChildNeuropsychol 2011,17(3):209-224.
    [20]Simone AN,Bédard AC,M arks DJ,et al.Good Holders,Bad Shufflers:An Examination of Working M emory Processes and M odalities in Children w ith and w ithout Attention-Deficit/Hyperactivity Disorder[J].J Int Neuropsychol Soc,2016,22(1):1-11.
    [21]杨斌让,李建英,杨思渊,等.注意缺陷多动障碍儿童的工作记忆损害特征[J].中国心理卫生杂志,2012,26(1):41-45.
    [22]帅澜,王玉凤.共患破坏性行为障碍的注意缺陷多动障碍男孩的执行功能特点[J].北京大学学报(医学版),2007,39(3):241-246.
    [23]林文璇,王馨,吴婕翎,等.韦氏儿童智力量表第四版在注意缺陷多动障碍儿童智力结构分析中的应用[J].中国儿童保健杂志,2012,20(1):58-61.
    [24]丁怡,杨凌燕,郭奕龙,等.爯韦氏儿童智力量表-第四版爲性能分析[J].中国特殊教育,2006,(9):37-44.
    [25]苏怡,钱英,高倩,等.高智商注意缺陷多动障碍男性儿童的生态学执行功能特点[J].中国心理卫生杂志,2012,26(6):415-419.
    [26]郑惠,林文璇,胡华芸,等.不同亚型注意缺陷多动障碍患儿的认知行为特征研究[J].中国儿童保健杂志,2010,18(4):275-277.