两种亚型ADHD儿童在停止信号任务中的反应抑制

采用停止信号任务,操纵其中的反应冲突,探查两种亚型（注意缺陷型和混合型）ADHD儿童在不同抑制功能——反应冲突和反应停止上的表现,以及儿童在内源性和外源性两种注意条件下反应抑制的表现。结果发现,与正常儿童相比,ADHD儿童在两种反应抑制上都有不同程度的缺损,不仅冲突效应量更大,反应停止的错误率也更高;但在控制年龄因素后,未观察到两种亚型ADHD儿童之间在反应冲突和反应停止能力上有明显差异。研究还发现,儿童在内源性和外源性两种注意条件下反应抑制的表现模式相似,说明反应冲突和反应停止可能存在某些共同的神经机制,两种亚型ADHD儿童在这些机制的功能缺损上有类似之处。     

两种亚型ADHD儿童的促进和抑制加工

采用图片Stroop任务,对两种亚型ADHD儿童的促进和抑制加工进行了研究。结果发现,不论在反应时还是错误率上,ADHD儿童和正常儿童在促进效应上的表现模式相似,但ADHD儿童在错误率上比正常儿童表现出更大的抑制效应,混合型ADHD儿童的抑制效应更大于注意缺陷型儿童。由于ADHD儿童仅选择性地在抑制加工上受损,而促进加工正常,这一结果提示,促进和抑制可能是具有不同机制的、分离的加工过程。     

激活水平对两亚型ADHD儿童反应执行与抑制能力的影响

研究选取了混合型ADHD儿童14名,注意缺陷型ADHD儿童16名以及正常儿童18名,考察了在不同激活水平下,两亚型ADHD儿童之间,及其与正常儿童之间的反应执行能力与抑制能力的异同。采用传统的go/no-go任务,并将刺激间的时间间隔设置为1秒、4秒、8秒三种条件,分别对应高、中、低三种激活水平。结果发现,(1)与正常儿童相比,ADHD儿童的反应执行能力更容易受到激活水平的影响,且两亚型ADHD儿童受到的影响模式基本一致。具体而言:在高激活水平下,ADHD儿童与正常儿童差异最小;在中、低激活水平下,ADHD儿童与正常儿童差异增大,表明ADHD儿童状态调节能力落后。(2)两亚型ADHD儿童的功能缺损模式不同,混合型儿童在状态调节和反应抑制两方面都存在缺损,且其反应抑制缺陷不受激活水平影响;注意缺陷型儿童仅在状态调节方面受损。     

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     

奖惩对注意缺陷多动障儿童情感决策的影响

采用简化版儿童赌博任务,其中操纵了奖励和惩罚的强度,探察两种亚型(注意缺陷型和混合型)ADHD儿童的情感决策能力,同时采集儿童在任务中的皮肤电活动以探析ADHD儿童在情感决策中的生理机制.结果发现,在不同的奖惩强度下,ADHD儿童情感决策模式不同,在即刻奖励条件下,ADHD儿童情感决策的能力明显弱于正常对照组儿童,倾向于不利选择,所产生的预测性皮电振幅也明显低于正常对照组;在即刻惩罚条件下,ADHD儿童的情感决策能力未见异常.两种亚型ADHD儿童的表现模式相似.上述结果证明,ADHD儿童仅存在对奖励的异常敏感性,并确实影响了其决策能力,而其回避惩罚的能力正常.两种亚型ADHD儿童存在的问题相似.     

奖惩对注意缺陷多动障碍儿童情感决策的影响

采用简化版儿童赌博任务,其中操纵了奖励和惩罚的强度,探察两种亚型（注意缺陷型和混合型）ADHD儿童的情感决策能力,同时采集儿童在任务中的皮肤电活动以探析ADHD儿童在情感决策中的生理机制。结果发现,在不同的奖惩强度下,ADHD儿童情感决策模式不同,在即刻奖励条件下,ADHD儿童情感决策的能力明显弱于正常对照组儿童,倾向于不利选择,所产生的预测性皮电振幅也明显低于正常对照组;在即刻惩罚条件下,ADHD儿童的情感决策能力未见异常。两种亚型ADHD儿童的表现模式相似。上述结果证明,ADHD儿童仅存在对奖励的异常敏感性,并确实影响了其决策能力,而其回避惩罚的能力正常。两种亚型ADHD儿童存在的问题相似     

强迫症患者反应抑制缺陷及注意的调节作用

使用内外源线索结合不同冲突水平的侧抑制任务,考察强迫症患者对分心刺激的抑制有无缺陷、注意定向对分心刺激的干扰效应有无调节作用及在何水平上发挥作用。结果表明:强迫症患者不同冲突水平的侧抑制任务均无明显反应抑制缺陷,可能与其注意威胁性信息等有关;集中注意在知觉冲突水平上对强迫症患者和正常人的反应冲突进行调节且无显著性差异,可能与强迫症患者关注内容非空间定向有关。     

成人注意缺陷多动障碍在内外源冲突时的表现:眼动的证据

在注意定向与维持上,注意缺陷多动障碍(ADHD)个体更容易受到外部刺激的干扰而导致目标任务加工进程受阻,表现出了注意定向反应的缺陷,但导致任务失败的原因是由于对突然出现的外部无关刺激的过度兴奋还是对内源性目标刺激的持续维持能力减弱,尚不清楚。研究采用反向眼跳范式、记忆导向眼跳范式和视觉导向眼跳范式,来探索成人ADHD内外源注意定向反应的情况,以及当二者发生冲突时,成人ADHD失败的可能机制。结果发现,在反向眼跳任务上,成人注意缺陷多动障碍组错误率更高,并且差异性显著。但在记忆导向眼跳任务中,成人注意缺陷多动障碍组与正常组的差异不显著。在视觉导向眼跳任务中,成人注意缺陷多动障碍组的正确眼跳潜伏期比正常组要短,且二者之间的差异显著。这说明,在内外源刺激反应的冲突导致的情境中,成人注意缺陷多动障碍的反应明显落后于正常个体,这种缺陷并非由于其维持内源性注意产生定向反应落后所导致的,而是与其外源注意定向反应过强有关。     

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。     

ADHD儿童的选择性抑制

采用较传统停止信号任务更为精确的选择性停止信号任务,探索ADHD的选择性抑制缺陷的机制。结果发现,ADHD儿童在选择性停止信号任务上,抑制失败的比率明显高于正常儿童,但是其执行加工速度和抑制加工速度与正常儿童没有差异,另外,ADHD儿童表现出了更大的反应变异性。研究认为,ADHD在选择性停止信号任务上的抑制缺陷并非由于抑制加工速度过慢所导致,而是由于其不能很好地维持最佳的激活状态所导致,状态调节理论更能反映ADHD的本质。     

Academic Achievement Over 8 Years Among Children Who Met Modified Criteria for Attention-deficit/Hyperactivity Disorder at 4–6 Years of Age

The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4–6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.     

Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes

Compared 16 children with attention deficit hyperactivity disorder (ADHD) combined type (ADHD-C), 14 children with ADHD predominantly inattentive type (ADHD-I), and 17 controls on parent and teacher ratings of social status and performance, self-report of social knowledge and performance, and observations of behavior on an emotional regulation task. Analyses revealed distinct patterns of social dysfunction between ADHD subgroups. Children with ADHD-C were rated as showing more aggressive behavior; furthermore, they displayed emotional dysregulation characterized by high intensity and high levels of both positive and negative behavior. In contrast, children with ADHD-I were perceived as displaying social passivity and showed deficits in social knowledge on the self-report measure but did not evidence problems in emotional regulation. Regression analyses revealed that social performance, emotional regulation, and, to a lesser degree, social knowledge, were predictive of social status. The application of these findings to understanding the nature of the social deficits in the ADHD subtypes and directions for future research are discussed.     

Evaluating the endophenotype model of ADHD neuropsychological deficit: results for parents and siblings of children with ADHD combined and inattentive subtypes

Neurogenetic models predict neuropsychological weaknesses in the relatives of children with attention-deficit/ hyperactivity disorder (ADHD). The authors examined executive and regulatory measures in 386 relatives (307 parents, 79 siblings) of children with ADHD combined type, ADHD inattentive type, and controls. Predicted deficits were seen on trailmaking (relatives of ADHD combined type only), stop-signal reaction times (relatives of girls only), and response variability (mothers only) but not on naming or output speed. Effects generally held, even with relatives' ADHD status controlled. A neuropsychologically impaired subgroup of children with ADHD had relatives with clear neuropsychological weaknesses. The authors conclude that a neurogenetic model of ADHD etiology is supportable only for a subset of executive functions and that neuropsychological heterogeneity warrants more examination in ADHD.     

Peer-based differences among boys with ADHD

Examined the peer interactions and peer acceptance of three groups of boys ages 8 to 11 1/2 years: attention deficit hyperactivity disorder (ADHD), predominantly inattentive type; ADHD, combined type; and nonclinical controls (N = 45). Peer nominations were obtained from each boy's classroom. Newly acquainted peers consisting of boys from each of the 3 groups were observed for 3 play sessions, after which peer nominations were obtained. Both ADHD groups were more likely than nonclinical controls to receive lower social preference scores from peers in the classroom but not in the play groups. In both settings, boys from the predominantly inattentive group were more likely to be nominated as very shy, whereas boys from the combined type group were more likely to be nominated for starting fights and arguments. Observations of the play group showed that boys from the predominantly inattentive group displayed a marked pattern of social withdrawal. The findings suggest that the peer rejection experienced by these 2 groups may result from very different social behavior patterns.     

Behavioral Characteristics of DSM-IV ADHD Subtypes in a School-Based Population

From an ethnically diverse sample of 2,744 school children, 221 attention deficit hyperactivity disorder (ADHD) [123 (4.5%) predominantly inattentive (IA), 47 (1.7%) predominantly hyperactive/impulsive (HI), and 51 (1.9%) combined type (C)] were identified using teacher ratings on a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) symptom checklist. Subjects were compared to 221 controls on teacher ratings of behavioral, academic, and social functioning. The results revealed relatively independent areas of impairment for each diagnostic group. The IA children were impaired in all areas, but were rated as displaying more appropriate behavior and fewer externalizing problems than HI or C children. The HI group displayed externalizing and social problems, but was rated as no different than controls in learning or internalizing problems. The C group demonstrated severe and pervasive difficulties across domains. These findings support the validity of the DSM-IV ADHD subtypes; all ADHD groups demonstrated impairment relative to controls, but show different patterns of behavioral characteristics.