注意缺陷多动障碍儿童的执行功能与行为问题的相关研究

Correlation between Executive Function and Behavioral Problems in Children with Attention Deficit Hyperactivity Disorder

摘要: 目的：探索ADHD儿童的IA型和CT型的执行功能和行为问题，以及执行功能与行为问题之间的关联性。方法：随机选取ADHD儿童42例，按年龄、性别、家庭因素匹配对照组42例，采用视听混合的持续性操作测验评价ADHD儿童与对照组的执行功能，Conners父母用症状问卷和父母版长处与困难问卷评价ADHD儿童与对照组的行为问题，并分析两组间的执行功能与行为问题的关联性。结果：ADHD儿童与对照组的IVA-CPT的6个综合商数均有统计学差异(P < 0.01)，Conners父母用症状问卷的品行问题、学习问题、冲动/多动、多动指数均有统计学差异(P < 0.01)，长处与困难问卷的总分、同伴交往、多动缺陷、影响因子均有统计学差异(P < 0.05或P < 0.01)。IA型、CT型和对照组的两两比较，IA型和CT型在执行功能和行为问题均较对照组出现显著损害(P < 0.05或P < 0.01)。ADHD儿童的IVA-CPT的综合商数与品行问题、学习问题、冲动/多动、多动指数、同伴交往、多动缺陷、影响因子等存在显著相关性(P < 0.05或P < 0.01)。结论：ADHD儿童的IA型和CT型均存在执行功能和行为症状，执行功能与行为症状有较强的关联性，为病因探索提供理论依据，并提示我们可以探索通过训练和强化执行功能来改善行为症状，达到治疗和康复的效果。

Abstract: Objective: To explore the executive function and behavior problems of predominantly inattentive type (Type IA) and combined type (Type CT) with attention deficit hyperactivity disorder (ADHD), and the correlation between executive function and behavioral problems. Methods: 42 cases of ADHD children were selected by random sampling, 42 cases of control group were matched by age, sex and family factors. The executive function of ADHD children and controls were evaluated by Integrated Visual and Auditory Continuous Performance Test (IVA-CPT). The behavioral problems were evaluated by Conners Parent Symptom Questionnaire (PSQ) and Parent Strengths Difficulties Questionnaire (SDQ). The correlation between executive function and behavioral problems within the two groups was analyzed. Results: There were statistical significances in 6 comprehensive quotients of IVA-CPT between ADHD children and controls (P < 0.01). There were also statistical significances in learning problem, impulse/hyperactivity and hyperactivity index of PSQ and the total score of SDQ, peer association, hyperactivity defect and influence factor of SDQ (P < 0.05 or P < 0.01). Type IA and Type CT had significant impairment in executive function and behavioral problems compared with control group (P < 0.05 or P < 0.01). The 6 comprehensive quotients of IVA-CPT in ADHD children have significant correlation with the problem of character, learning problem, impulse/hyperactivity, hyperactivity index, peer interaction, hyperactivity defect and influence factor (P < 0.05 or P < 0.01). Conclusions: The Type IA and CT of ADHD children have executive function and behavioral symptoms, and the executive function and behavioral symptoms have strong relevance. It provides a theoretical basis for the exploration of etiology, and suggests that we can explore the effect of treatment and rehabilitation by training and strengthening the executive function to improve the behavior symptoms.