视觉选择性注意对注意缺损多动障碍儿童数字距离效应的影响

采用Posner的内源性和外源性线索实验范式,材料为1~9的阿拉伯数字(不包括5),以判断目标数字是否大于5为任务,考察视觉选择性注意中的内源性注意和外源性注意对注意缺陷型多动障碍儿童(ADHD)数字加工距离效应的影响。结果发现:(1)内源性和外源性注意条件下,正常儿童在数字判断加工任务中的反应时短于ADHD儿童;(2)内源性有效线索提示条件下,ADHD儿童和正常儿童均表现出显著的数字距离效应;而无效线索提示条件下,ADHD儿童的大小数字距离效应均不明显,正常儿童仍然表现出显著的数字距离效应;(3)外源性有效线索提示条件下,ADHD儿童的小数字距离效应显著,但大数字距离效应不明显,正常儿童则表现出显著的大小数字距离效应;而无效线索提示条件下,只有正常儿童表现出显著的数字距离效应,ADHD儿童的数字距离效应不显著。     

两亚型注意缺陷多动障碍(ADHD)儿童的内隐注意定向

研究探讨注意缺陷障碍儿童与正常儿童之间,混合型与注意缺陷型ADHD儿童之间在内源与外源注意定向功能的差异。ADHD儿童及与之匹配的正常儿童对照组分别参与了两个实验,实验一采用了内源性内隐注意定向任务,实验二采用了外源性内隐注意定向任务。研究表明：（1）ADHD儿童与正常儿童相比,在注意定向过程（注意解除、转移与施加）上有一定缺陷。（2）ADHD儿童注意定向网络功能有缺陷,与反应水平上动作准备有关的注意功能可能受损。（3）两种亚类型儿童注意定向功能缺陷模式不同。在内原定向上,混合型与注意缺陷型相比较,混合型ADHD儿童表现为有较强的反应冲动性;注意缺陷型儿童,主要表现为注意加工过程比较缓慢,注意更易涣散。在外源定向上,混合型儿童在反应的运动准备及运动控制方面的缺陷要大于注意缺陷型儿童     

注意缺陷多动障碍儿童在不同加工阶段的干扰控制

采用刺激－刺激和刺激－反应相容性任务范式,将信息加工在知觉和反应阶段的冲突效应分离开来,考察注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder,简称ADHD）儿童在知觉和反应阶段冲突控制的模式和时间轨迹。结果发现,在反应阶段,ADHD儿童的干扰控制能力明显弱于正常对照组儿童,混合型ADHD儿童的能力更弱于注意缺陷型ADHD儿童;在知觉阶段,ADHD儿童没有明显的干扰抑制缺损,两组ADHD儿童（注意缺陷型和混合型）的表现模式相似;儿童抑制冲突干扰所遵循的时间轨迹在知觉和反应阶段有所不同：与知觉阶段相比,反应阶段需要更长的时间才能抑制冲突干扰。但ADHD儿童和正常儿童之间的表现模式相似     

反馈对注意缺损多动障碍儿童错误监控能力的影响

研究选取了注意缺损多动障碍(ADHD)儿童39名,正常儿童40名,采用两项选择任务,考察在无反馈和有反馈的情况下,ADHD儿童的错误监控能力是否存在缺损。结果发现,(1)无论是否提供反馈,与正常儿童相比,ADHD儿童的错误察觉能力正常,但是错误更正能力落后,这可能是由于ADHD儿童动作调节控制能力落后导致的;(2)反馈提高了ADHD儿童和正常儿童的认知加工速度,但同时降低了他们的警醒水平,导致错误监控能力下降。     

儿童注意缺陷多动障碍(ADHD)的“冷”“热”执行功能

近30多年来,对注意缺陷多动障碍(ADHD)的认知缺损机制的关注一直停留在"冷"执行功能领域,为更全面地揭示其执行缺损机制,文章旨在从"冷""热"执行功能的角度来探讨ADHD的缺陷。论文简要回顾了注意缺陷多动障碍的界定、生理基础和若干理论模型,着重阐述ADHD儿童在经典"冷""热"两类执行功能任务上的表现差异。总结认为ADHD儿童并非在所有类型的"热"执行任务上表现落后,ADHD儿童的表现要视情感和动机的卷入对不同任务情景的作用性质是消极还是积极而定,文章也比较分析了几位研究者相关的理论解释。     

阅读障碍与注意缺陷多动障碍儿童的语言加工和反应抑制

阅读障碍与注意缺陷多动障碍(ADHD)高度共病,以往研究结果显示两种障碍在语言加工、执行功能等领域的缺陷既相似又不同。本研究采用语音意识测验、快速命名测验、语素意识测验和停止信号任务,以及阅读广度测验,分别考察四组被试（阅读障碍组、ADHD组、双重障碍组、正常控制组）的基础语言加工、反应抑制和言语工作记忆能力,结果发现：阅读障碍组和双重障碍组在语言加工任务上的成绩均显著差于ADHD组和正常组;ADHD组和双重障碍组在停止信号任务上的成绩显著差于阅读障碍组和正常组;所有障碍组在阅读广度测验上的成绩显著差于正常组。表明阅读障碍的特异性缺陷体现在语言加工过程上,而注意缺陷多动障碍的特异性缺陷体现在反应抑制上。这对于今后单一障碍的研究及临床诊断和干预具有重要的参考价值。     

注意缺陷多动障碍(ADHD)儿童的工作记忆:基础加工缺陷还是执行功能问题

为探索注意缺陷多动障碍(ADHD)儿童言语工作记忆缺陷的机制,研究采用了言语n-back任务比较了正常儿童与注意缺陷多动障碍儿童的工作记忆成绩。结果表明:在更新水平为0次时,ADHD儿童与正常儿童的成绩没有显著差异,但在更新水平为1次和2次时,ADHD儿童的记忆成绩均显著低于正常儿童,效应量指标(Cohen′d)分别达到了1.31和1.63;另外,在更新难度对记忆成绩的影响上,ADHD儿童表现出了更大的更新代价,效应量指标(Cohen′d)达到了1.54,处在很高的水平。结论认为ADHD儿童在记忆的基础性加工上并不存在明显缺陷,其更大的更新代价表明ADHD儿童在言语工作记忆的执行加工(更新操作)上的缺陷。     

成人注意缺陷多动障碍诊断与心理治疗的研究进展

注意缺陷多动障碍（ADHD）是指一种以注意缺陷、多动、冲动的行为表现为主要特征的精神病理障碍。对儿童注意缺陷多动障碍的研究有了长足的进步,但对成人注意缺陷多动障碍的研究相对较少。本文阐明了国际上对成人注意缺陷多动障碍的诊断与心理治疗的研究进展,希望引起国内临床心理学家、精神病学家和心理咨询师等的充分重视。     

反向眼跳的实验范式、机制及影响因素

反向眼跳任务是研究内源性眼跳的主要方法。1978年,Hallett在研究中首次使用了反向眼跳的实验任务。实验中要求被试抑制对外围目标的注视,并注视它的相反位置。反向眼跳任务是研究行为控制以及注意功能的有效范式。目前认为反向眼跳任务中的朝向眼跳和反向眼跳计划是同时加工并相互竞争的,并且反向眼跳的产生与额顶叶皮层下组织有关。反向眼跳会受到多种因素的影响,例如,空白效应、工作记忆、认知老化、目标离心率等。     

“冷”/“热”执行功能缺陷影响ADHD儿童核心症状的作用机制

注意缺陷多动障碍(ADHD)是一种以注意缺陷和(或)多动、冲动为核心症状的神经发育障碍,与前额叶发育异常所致的执行功能缺陷密切相关。基于此,从神经-认知-行为的发展途径提出执行功能缺陷可能是认知层面上导致ADHD核心症状的发病机理,其中与背侧前额叶相关的“冷”执行功能缺陷可能是导致注意缺陷核心症状的主导因素,而与腹内侧前额叶相关的“热”执行功能缺陷可能是导致多动、冲动核心症状的主导因素。一方面,“冷”执行功能缺陷主要引起工作记忆表征维持失败、抑制控制能力不足、认知转换困难等方面,这些缺陷进一步导致了个体在注意持续、注意选择和注意转移上受到限制;另一方面,“热”执行功能缺陷则带来厌恶延迟、奖赏加工异常、动机失调等问题,使得个体行为抑制失败,更容易做出冲动性选择,从而表现出多动、冲动等核心症状。未来研究应进一步检验和完善“冷”、“热”执行功能缺陷影响ADHD核心症状的理论模型以及从认知神经层面上提供更多的实证证据,同时还需从生态层面考察“冷”和“热”执行功能缺陷对ADHD核心症状的交互影响,并基于执行功能开发对ADHD核心症状具有个性化、精准化、长效化的干预方案。     

经颅直流电刺激在注意缺陷多动障碍治疗中的应用

经颅直流电刺激(tDCS)治疗注意缺陷多动障碍(ADHD)主要是选取患者的背外侧前额叶(DLPFC)作为刺激区域, 通过调节其皮层兴奋性, 从而缓解其ADHD的症状和改善其受损的认知功能。针对tDCS在ADHD治疗研究中的问题, 未来可从有效性、确定最佳刺激参数、个体差异、不同亚型及与其他疗法联合使用等五个方面来进一步研究。     

Stimulus-dependent dopamine release in attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is related to an attenuated and dysfunctional dopamine system. Normally, a high extracellular dopamine level yields a tonic dopaminergic input that down-regulates stimuli-evoked phasic dopamine responses through autoreceptors. Abnormally low tonic extracellular dopamine in ADHD up-regulates the autoreceptors so that stimuli-evoked phasic dopamine is boosted. The authors propose that these boosted phasic responses yield hypersensitivity to environmental stimuli in ADHD. Stimuli evoking moderate brain arousal lead to well-functioning performance, whereas either too little or too much stimuli attenuate cognitive performance. Strong, salient stimuli may easily disrupt attention, whereas an environment with impoverished stimuli causes low arousal, which is typically compensated for by hyperactivity. Stochastic resonance is the phenomenon that makes a moderate noise facilitate stimulus discrimination and cognitive performance. Computational modeling shows that more noise is required for stochastic resonance to occur in dopamine-deprived neural systems in ADHD. This prediction is supported by empirical data.     

Adult ADHD and/or Sleep Apnea? Differential Diagnostic Considerations with Six Case Studies

An increased interest in the persistence of attention-deficit hyperactivity disorder (ADHD) into adulthood brings concern that adult ADHD may become overdiagnosed. As with ADHD in childhood, various other adult psychological and medical disorders may be associated with ADHD in adulthood, and these related disorders may be mislabeled and mistreated as simple ADHD. One such medical condition is sleep apnea. This paper reviews similarities and differences between ADHD and sleep apnea and presents case histories of six adult patients diagnosed with ADHD who were subsequently found to have at least comorbid obstructive sleep apnea (OSA). Clinicians who diagnose and treat patients with ADHD are advised to become familiar with sleep apnea as a life-threatening condition that presents with overlapping symptoms.     

Significance of Childhood Conduct Problems to Later Development of Conduct Disorder Among Children With ADHD: A Prospective Follow-Up Study

This study investigates whether low to moderate levels of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys (ages 6-12) with ADHD free of conduct disorder diagnoses. Parent and teacher ratings were obtained. Participants were assessed at mean age 18 by clinicians blind to childhood status. A non-ADHD group (recruited in adolescence) was also studied. ODD behavior ratings did not predict CD in adolescence, whereas CD behavior ratings did. No single ODD or CD behavior predicted adolescent outcome. ADHD probands with very low ratings (Not at all, Just a little) by parents and teachers on all CD behaviors were still at significantly increased risk for CD in adolescence, compared to non-ADHD controls. The same relationships were found between childhood ODD and CD behaviors, and antisocial personality disorder in adulthood (mean age, 25). We conclude that childhood ADHD is a developmental precursor of later antisocial disorder, even in the absence of comorbid ODD or CD in childhood. However, low levels of CD-type problems are not innocuous, because they predict later CD among children with ADHD without comorbid CD.     

Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD; n = 142) were prospectively monitored into adolescence (13-18 years old) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD (n = 100). Probands reported higher levels of alcohol, tobacco, and illicit drug use than did controls. Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses. Within probands, severity of childhood inattention symptoms predicted multiple substance use outcomes: childhood oppositional defiant disorder/conduct disorder (ODD/CD) symptoms predicted illicit drug use and CD symptoms. Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls. Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted.     

Big five dimensions and ADHD symptoms: links between personality traits and clinical symptoms

Attention-deficit/hyperactivity disorder (ADHD) in adulthood is conceptualized as originating in childhood. Despite considerable theoretical interest, little is known about how ADHD symptoms relate to normal personality traits in adults. In 6 studies, the Big Five personality dimensions were related to ADHD symptoms that adults both recalled from childhood and reported concurrently (total N = 1,620). Substantial effects emerged that were replicated across samples. First, the ADHD symptom cluster of inattention-disorganization was substantially related to low Conscientiousness and, to a lesser extent, Neuroticism. Second, ADHD symptom clusters of hyperactivity-impulsivity and oppositional childhood and adult behaviors were associated with low Agreeableness. Results were replicated with self-reports and observer reports of personality in community and clinical samples. Findings support theoretical connections between personality traits and ADHD symptoms.     

Attention-deficit/hyperactivity disorder: perspectives from neuroimaging

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood behavioral disorder most often characterized by inattentiveness, impulsivity, and hyperactivity. Current etiologic theories suggest that ADHD stems from abnormalities in dopaminergic and possibly noradrenergic brainstem nuclei that act to regulate a cortico-striato-thalamo-cortical network, believed to be critical for executive functions and the regulation of behavioral responses such as arousal, attention, and inhibition. Noninvasive structural and functional neuroimaging techniques provide a new avenue for exploring the validity of these theories. Despite their limitations, neuroimaging studies have provided a unique and otherwise inaccessible, biological perspective of ADHD. Collectively, the studies reviewed here reveal that dysfunction in arousal, behavioral inhibition, and attention associated with ADHD may result from structural abnormalities in frontostriatal regions that in turn result in diminished activity essential for normal function.     

Classical conditioning in children with attention deficit hyperactivity disorder (ADHD) and anxiety disorders: A test of Quay's model

Quay (1988) put forward a model of childhood mental disorders based on Gray's (1982) theory that there exists within the brain a behavioral inhibition system (BIS), which processes signals related to aversive or punishing stimuli. According to this model, children with attention deficit hyperactivity disorder (ADHD) show lower than optimal levels of activity in this system, which leads to less responsiveness at a physiological level to signals related to punishment. Children with ADHD and controls were compared on a classical conditioning paradigm. Skin conductance and cardiac responses were measured in response to a conditioned stimulus that had been paired with an aversive unconditioned stimulus. There were no differences between the groups, suggesting that, in terms of classical conditioning, ADHD children are equally responsive to signals related to punishment as controls.This work was supported by a National Institute of Mental Health grant K11 MH00731.     

Examining Latino Family Participation in Treatment for Childhood ADHD: The Role of Parental Cultural Factors and Perceptions

Attention-deficit/hyperactivity disorder (ADHD) is a common mental health disorder in childhood. Unfortunately, Latino youth and their families are at increased risk of demonstrating poor treatment outcomes. The current study examined the impact of parental cultural factors and perceptions on Latino family participation in a psychosocial intervention for childhood ADHD. Sixty-one Latino youth and at least one of their primary parents and teachers participated in the current study. Results indicated that parental acculturation, attitudes regarding treatment, and baseline severity of child symptomatology and functional impairment were related to treatment participation outcomes. Implications and future directions are discussed.