ADHD的抑制缺陷和厌恶延迟—来自双通道理论的解释

行为抑制理论认为抑制功能的落后是ADHD的核心缺损所在,Sonuga-Barke的厌恶延迟理论认为ADHD起因是厌恶延迟而非抑制缺损,但该理论并不能解释ADHD的全部症状,Sonuga-Barke将厌恶延迟理论作了修正,提出了双通道模型。该模型认为ADHD的抑制缺陷和厌恶延迟同时存在,相互独立,模型的认知发展通道关注抑制控制缺陷对ADHD的影响,而动机发展通道则认为ADHD儿童是因奖励回路紊乱而引起异常的厌恶延迟的动机风格。本文介绍了双通道理论及相关的研究及其应用于ADHD诊断和干预的价值和局限性。     

正念冥想在ADHD儿童干预中的应用

正念冥想是有意识、非评判地将注意集中于当下经验的方法。近年来,正念冥想作为一种潜在的方法被引进到ADHD儿童干预领域。因为ADHD儿童的特异性,为了增加正念冥想方案对ADHD儿童的适切性,研究者从练习设置、奖励系统、解释方式和家长纳入几个方面对标准的正念减压训练方案做了改编。越来越多的研究证据表明,正念冥想训练能有效地减轻ADHD儿童的核心缺陷、改善其内外化症状和亲子关系。本文通过对已有相关实证研究的分析认为这些积极的影响可能与ADHD儿童的执行功能与去中心化等心理功能的改善有关,而大脑相关区域激活模式的变化和结构的积极改变可能是正念冥想影响ADHD儿童的神经基础。文章也提出已有研究在内容和方法学上的不足及其以后的探究方向。     

视觉障碍儿童人格特征的比较研究

以《缺陷儿童人格诊断量表》为工具对视觉障碍儿童进行人格评定,并将其测验分数与先前有关其他特殊儿童和正常儿童的同一量表测验结果加以比较。比较结果表明．视觉障碍儿童与正常儿童、智力落后儿童的人格特性有明显差异,而与听觉障碍儿童的人格差异相对要小一些。随年龄、障碍程度的不同．视觉障碍儿童的人格特性也有明显差异。     

弱智儿童视觉-动作控制的实验研究

该研究探讨了弱智儿童视觉-动作控制能力。弱智儿童被试30人,平均年龄13.5岁,平均智商53.9。实验结果与正常人的结果作了比较。结果显示,弱智儿童的视觉-动作控制能力只相当五六岁正常儿童的水平,远落后于正常中青年及老年的水平。这表明,智力缺陷与发展水平对人的视觉-动作控制能力有明显影响。     

3—7岁儿童与成人筷子使用动作模式的比较研究

通过比较3—7岁儿童与成人的筷子使用动作模式类型、特征和使用率,初步探讨了筷子使用动作模式的特点及发展趋势。研究结果表明：(1)儿童与成人中均存在八种筷子使用动作模式,各种模式在手指的分工、配合及完成任务的稳定性、适应性等方面表现出不同的特点,具有不同的效率水平;(2)随年龄的增长,个体筷子使用动作模式日趋转向效率较高的类型,表现为高效模式的使用率从3岁组的3．7％增加到成人组的50％,而低效模式的使用率从59．3％下降到10％。     

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。     

“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。     

注意缺陷多动障碍的研究与治疗

注意缺陷多动障碍(ADHD)的发病群体多为5岁以后的儿童,主要临床表现是多动、冲动,注意力无法集中,对一项任务不能够有规划进行下去,而且脾气暴躁、易怒.近年来.心理学界、神经科学界和教育学界等对ADHD的研究取得了很多进展.本文概括性地介绍了ADHD病症的基本特征,目前对于患者脑机制损害的研究,并从药理学和行为学等方面讨论了ADHD的治疗方法和手段.     

注意缺陷多动障碍的研究与治疗

注意缺陷多动障碍（ADHD）的发病群体多为5岁以后的儿童,主要临床表现是多动、冲动,注意力无法集中,对一项任务不能够有规划进行下去,而且脾气暴躁、易怒。近年来,心理学界、神经科学界和教育学界等对ADHD的研究取得了很多进展。本文概括性地介绍了ADHD病症的基本特征,目前对于患者脑机制损害的研究,并从药理学和行为学等方面讨论了ADHD的治疗方法和手段。     

正常老化对视觉早期注意的影响——来自ERP的证据

选择性注意能够作用于视觉信息加工的不同阶段。各个注意阶段均受到老化过程的影响,其中注意早期阶段的老化研究对于理解认知老化的发生机制有重要意义。本文系统地梳理了刺激前的注意预期阶段以及刺激后200 ms内的早期感知注意阶段的正常老年人和青年人ERP比较研究,以探讨正常老化对视觉早期注意的影响。现有证据表明,相对于青年人,正常老年人：(1)多个早期ERP注意效应(包括注意预期ADAN,早期空间注意N1,以及特征注意SP和SN)在潜伏期上都存在显著延迟;(2)在振幅上,不同ERP注意效应的老化表现存在差异：某些ERP成分(包括注意预期EDAN,以及早期空间注意P1)的注意效应没有明显减弱,而某些ERP成分(包括注意预期alpha,早期空间注意N1,以及特征注意SN)的注意效应受到老化调控;(3)一些注意效应(包括特征注意SP成分,以及客体注意P1和N1成分)的目标增强机制保留,而干扰抑制机制缺损。目前已有研究在老化对注意效应振幅的调控上还存在不一致,这可能与研究的信噪比、任务难度、注意机制分离以及老年人的个体差异有关。未来研究应考虑这些因素以更好地探究正常老化对视觉早期注意的影响。     

Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse

Attention deficit disorder and attention deficit/hyperactivity disorders (ADD/ADHD) are found in approximately 5% to 10% of school-aged children. This study examined whether childhood physical abuse was associated with ADD/ADHD. Data were derived from a population-based sample of 13,054 adults from the 2005 Canadian Community Health Survey. We used logistical regression analysis in 2 models, both of which had ADD/ADHD as the criterion variable. There were 7 times higher odds of ADD/ADHD among those who reported they had been abused after controlling for several potential mediating factors, including age, race, gender, and 3 other types of adverse childhood experiences (parental divorce, parental addictions, and long-term parental unemployment) in comparison to those who were not abused. The results of this analysis show a strong link between childhood abuse and ADD/ADHD, an association that requires further study.     

Inhibition and Attention Deficit Hyperactivity Disorder

This paper updates the author's earlier hypothesis that Attention Deficit Hyperactivity Disorder (ADHD) reflects underactivity in Gray's Behavioral Inhibition System. Five areas of research are reviewed: (1) studies using the stop-signal task, (2) studies of errors of commission, (3) a study of inhibition indexed by eye movements, (4) a neuroimaging study of the corpus callosum, and (5) a study on the prediction of response to methylphenidate. Data from the many different dependent variables in these studies are interpreted as supporting disinhibition as a core deficit in ADHD.     

Language Abilities in Children with Attention Deficit Hyperactivity Disorder, Reading Disabilities, and Normal Controls

Research has demonstrated a high prevalence of language impairments (LI) and reading disabilities (RD) in children with attention deficit hyperactivity disorder (ADHD). Since RD is also associated with LI, it is unclear whether the language impairments are specific to ADHD or associated with comorbid RD. The language abilities of ADHD children with and without RD were investigated in a task requiring recall of a lengthy narrative, and in tests assessing knowledge of the semantic aspects of language. The study was conducted with 50 boys—14 ADHD, 14 ADHD + RD, 8 RD, and 14 normal controls, aged 7 to 11. Children with ADHD (ADHD-only, ADHD + RD) exhibited difficulties in organizing and monitoring their story retelling. Children with RD (RD-only, ADHD + RD) demonstrated deficits in receptive and expressive semantic language abilities on the language processing tests. The comorbid group (ADHD + RD) exhibited the deficits of both ADHD and RD children. The deficiencies of ADHD children are consistent with higher-order executive function deficits while the deficits of RD children are consistent with deficits in the basic semantics of language processing.     

Confirming the Factor Structure of Attention Deficit Hyperactivity Disorder Symptoms in Adult, Nonclinical Samples

Three separate models have been proposed to describe the factor structure of attention deficit hyperactivity disorder (ADHD) in the past 20 years. The Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III, 1980) proposed 3 separate factors of inattention, hyperactivity, and impulsivity. The DSM-III-R (1987) proposed a single factor. The DSM-IV (1994) described the disorder as having 2 factors: hyperactivity/impulsivity and inattention. The following 2 studies employed confirmatory factor analysis to compare each of these models and 3 alternative models. University students completed questionnaires that assessed each of the 18 symptoms listed in the DSM-IV for ADHD. The 3-factor model fit the data significantly better than each of the other models in both studies. These findings suggest that a 3-factor model of inattention, hyperactivity, and impulsivity describes adult ADHD symptoms better than current alternatives.     

Teacher Ratings of Attention Deficit Hyperactivity Disorder Symptoms in Hispanic Children

This study compared teacher's ratings of attention deficit hyperactivity disorder in groups of nonreferred Hispanic and non-Hispanic White children via the Teacher Report Form, the Attention Deficit Hyperactivity Disorder Scales—IV, and the Conners Abbreviated Teacher Rating Scale. A total of 61 non-Hispanic White teachers completed behavior ratings of 61 Hispanic and non-Hispanic White children between 6 and 11 years old. Significant differences were found between boys and girls, with girls showing fewer behavior problems and fewer hyperactive/inattentive symptoms compared to boys. In addition, Hispanics scored similar or lower than non-Hispanic Whites on multiple subscales measuring symptomatology related to attention deficit hyperactivity disorder and overall behavioral disorders. In no instance did Hispanic children score as more pathological than non-Hispanic White children. The need to consider the rater's ethnicity is discussed, and findings are explained in terms of childhood socialization patterns that might help to discern the behavior displayed by Hispanic children in classroom settings.     

Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder,Attention Deficit Hyperactivity Disorder,and Oppositional Defiant Disorder Symptoms

Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from > 600 Finnish twin pairs, who completed standardized interviews at age 14. Behavior genetic methods were used to examine how genetic/environmental factors contribute to each disorders symptoms and to their covariation. We found significant genetic effects on each disorder with only modest evidence of shared environmental influences. Our data suggest the comorbidity among CD, ADHD, and ODD is primarily explained by shared genetic influences; however, each disorder was also under unique genetic influence, supporting the distinction of each disorder.     

Creative Thinking in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD)

A widened attentional focus, that is typically associated with ADHD, has been postulated to be accompanied by enhanced creative ability. However, creativity has been only limitedly examined in ADHD. Performance across several creativity measures were investigated in three groups: adolescents with ADHD, those with conduct disorder, and a healthy control sample. The ADHD group exhibited selective cognitive advantages and disadvantages by demonstrating an enhanced ability in overcoming the constraining influence of examples, but a reduced capacity to generate a functional invention during an imagery task. These findings are interpreted with reference to inhibitory control mechanisms and the contextual modulation of creative cognition.     

Predicting the Early Developmental Course of Symptoms of Attention Deficit Hyperactivity Disorder

Data from the National Institute of Child Health and Human Development Study of Early Child Care were examined to test whether: attention deficit/hyperactivity disorder (ADHD) symptoms remain stable from 54 months through early elementary school; behavioral inhibition and attention deficits assessed at 54 months predict ADHD symptoms in elementary school, even after controlling for their temporal stability; and early behavioral inhibition and attention deficits moderate the longitudinal stability in ADHD symptoms. Data were examined using continuous and categorical measures of symptoms. Modest stability in ADHD symptoms from 54 months to third grade was found. Measures of inhibition and inattention predicted later teacher ratings uniquely, but no evidence was found for moderation. Measures of preschool behavioral inhibition also predicted “persistently at risk status” defined by elevated teacher ratings over time. Results are discussed in terms of executive and motivational facets of inhibition that may be related to early signs of ADHD.     

Quantitative EEG Assessment During Neuropsychological Task Performance in Adults with Attention Deficit Hyperactivity Disorder

This study evaluated the neuropsychological performance of adults with and without Attention Deficit Hyperactivity Disorder (ADHD) during the Paced Auditory Serial Addition Test (PASAT), Wisconsin Card Sorting Test: Computerized Version 3 (WCST), and the Integrated Visual and Auditory Continuous Performance Test (IVA). Quantitative electroencephalographic (QEEG) data were also collected during task performance to examine differences in cortical activity between groups and tasks. Results suggest that adults with ADHD demonstrated lower levels of performance on the PASAT and IVA, tasks that involve working memory and processing speed, and sustained attention, respectively. Adults with ADHD also had more upper alpha activity during the IVA. Lastly, for the ADHD group, an increased theta/beta ratio during the IVA was significantly related to poorer attentional performance. The current results support reinforcing specific types of cortical activity though EEG operant conditioning (neurofeedback) as a treatment option in adults with ADHD. This paper is based largely in part on a dissertation by J. Noland White in partial fulfillment of the requirements of his doctoral program at The University of Tennessee. Portions of this study have been presented in summary form at several professional conferences.