“热”执行对注意缺陷多动障碍和阅读障碍儿童言语工作记忆的影响

ADHD儿童在与背外侧前额叶(DLPFC)相关的"冷"执行功能上的缺陷已大量证实,但在与眼眶和中前额叶皮层(OMPFC)相关的"热"执行功能上,ADHD儿童是否存在缺陷则未可知。与儿童赌博任务实验范式(该任务中"热"启动对"冷"执行起到抑制作用)不同,本研究考察趣味言语N-back任务是否对ADHD和阅读障碍儿童的成绩有促进作用。枯燥N-back任务考察的是言语工作记忆的纯认知特征,而趣味任务则卷入了"热"执行对"冷"执行的影响。结果表明,在枯燥任务上,ADHD和阅读障碍儿童的成绩均明显低于正常儿童,二者之间差异不显著,在趣味任务成绩上,ADHD儿童与正常儿童的成绩没有显著差异,而阅读障碍儿童成绩落后于正常控制组和ADHD组,在成绩变化的趋势上,ADHD儿童在趣味任务上成绩明显提高,而阅读障碍儿童则无明显改善。结果说明ADHD和阅读障碍儿童的言语工作记忆均存在明显的缺陷,但是机制不同,"热"执行对提高ADHD的言语工作记忆有明显的促进作用,ADHD的"冷"执行缺陷能够通过"热"执行的调节得到改善。     

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。     

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。     

选择性注意的分心物加工机制对工作记忆的影响

通过实验法严格筛选被试,探讨了在有无分心物干扰的条件下,选择性注意的分心物加工机制(分心物抑制机制、分心物习惯化机制)对工作记忆的影响。结果揭示了,分心物抑制机制不仅能影响工作记忆的储存而且还影响工作记忆的加工;而习惯化机制只影响工作记忆的储存,不影响工作记忆的加工。     

工作记忆负荷对无意注意的影响

通过探讨工作记忆负荷对无意注意的影响,考察工作记忆的认知控制功能对选择性注意的作用机制。为了避免工作记忆和选择注意的目标或者干扰子之间的知觉注意资源的竞争,采用言语工作记忆任务和视觉空间位置辨别任务,同时视觉干扰刺激采用被试无法识别的韩语。结果发现,在高负荷条件下,干扰效应显著;而在低和中负荷条件下,没有观察到干扰效应。说明在高负荷条件下,被试没有额外的资源来抑制干扰加工,从而出现了显著的干扰效应。由此,本研究支持负荷理论的观点：工作记忆在选择性注意中执行认知控制功能。     

国内注意缺陷/多动障碍儿童干预效果的元分析

对国内过去12年间的62项注意缺陷/多动障碍干预研究结果进行了元分析,结果显示：（1）国内现有的ADHD干预措施取得了显著的干预效果;（2）在不同干预措施中,药物治疗与行为疗法或认知行为疗法相结合具有最佳疗效,单独的药物治疗次之,单独的行为疗法或认知行为疗法效果较低;（3）在各种效果指标中,学业指标上的效果量是最大的,这一结果与国外已有的元分析研究发现不一致;（4）在各种效果信息来源中,来自客观观察的效果量最高,来自父母评价的效果量次之,来自教师评定的效果量最差。（5）各种干预措施在不同效果指标上有不同的表现。药物治疗对于学业和行为指标的效果最强烈,而认知行为疗法和脑电反馈疗法对认知指标的效果最明显。最后,结合干预措施的选择、效果指标的采用以及研究质量问题进行了讨论     

国内注意缺陷多动障碍研究的综述

本文对国内近年来有关注意缺陷多动症的研究进行综述。首先介绍注意缺陷多动症的定义、诊断及成因。其次从执行功能、智力、共病性及发展性等四个方面阐述现有注意缺陷多动症研究的主要内容以及治疗该病症的主要方法,如生理治疗、亲子培训和学校辅导等。最后针对国内注意缺陷多动障碍研究不足和发展方向展开讨论。     

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。     

基于学校的儿童注意缺陷多动障碍综合干预

摘 要 对117名注意缺陷多动障碍（ADHD）儿童进行为期8周的综合干预,探讨其长短期的干预效果。综合干预以儿童行为干预和父母训练为主、药物治疗为辅,半年后随访长期效果。发现综合干预组只在短期效果上显著好于药物组与对照组,但长期效果不显著。综合干预组家长对综合干预的依从性显著高于其他两组,并能保持较长时间。不同类型ADHD儿童的长、短期效果不同。     

Memory Functioning in Children with Reading Disabilities and/or Attention Deficit/Hyperactivity Disorder: A Clinical Investigation of their Working Memory and Long-Term Memory Functioning

We examined memory functioning in children with reading disabilities (RD), Attention deficit/hyperactivity disorder (ADHD), and RD/ADHD using a clinic sample with a clinical instrument: the Children's Memory Scale, enhancing its generalizability. Participants included 23 children with RD, 30 with ADHD, 30 with RD/ADHD, and 30 controls. Children with RD presented with reduced verbal short-term memory (STM) but intact visual STM, central executive (CE), and long-term memory (LTM) functioning. Their deficit in STM appeared specific to tasks requiring phonetic coding of material. Children with ADHD displayed intact CE and LTM functioning but reduced visual-spatial STM, especially when off stimulant medication. Children with RD/ADHD had deficits consistent with both disorders.     

Psychosocial Treatments for Children with Attention Deficit/Hyperactivity Disorder

This article reviews studies examining the efficacy of behavioral interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD). A specific emphasis is placed on evidence-based interventions that include parent training, classroom, academic, and peer interventions. Results indicate that school-aged children respond to behavioral interventions when they are appropriately implemented both at home and in the classroom setting. Combined treatments (behavioral management and stimulant medication) represent the gold standard in ADHD treatment and are often recommended as the first-line treatment option due to the many problems faced by children with ADHD. Diversity issues, although an important consideration in the treatment of ADHD, continue to remain an understudied area. Recommendations for future research are made pertaining to treatment sequencing with regard to behavior management as well as for subgroups of ADHD children who may respond best to specific treatments.     

错误意识判断对ADHD儿童错误觉察的影响特点

将GO/NO-GO任务范式和错误意识判断范式相结合,对21名ADHD儿童,27名正常儿童,在错误监控中的错误觉察水平进行考察,结果表明:1)ADHD儿童能够正常觉察到自己的错误反应;2)错误意识判断任务诱发出ADHD儿童的错误延迟效应,这种作用,既是因为该任务能够刺激ADHD儿童的有意觉察,又因为该任务无形中增加了GO/NO-GO任务中的刺激间隔时间。该结果表明,增加刺激间隔时间,可能会促使ADHD儿童改变错误后的反应策略,对错误反应进行错误调节,提高其错误监控水平。     

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。     

The Development of Selective Attention in Children With Attention Deficit Hyperactivity Disorder

The influence of age on a selective attention task was studied in a sample of children with and without Attention Deficit Hyperactivity Disorder (ADHD). The impact of methylphenidate (MPH) treatment on selective attention was also investigated in the children with ADHD. Two age groups of children with ADHD and two age groups of control children were tested using a timed computer task. The task consisted of identifying visual target stimuli under various distracter conditions. Distracters varied on the basis of modality (i.e., visual, auditory, or both) and task relevance (i.e., meaningful or irrelevant). Reaction times and accuracy were measured. Children with ADHD were less efficient on the selective attention task than were children without ADHD, and older children were more efficient than younger children in both groups. Children without ADHD were influenced more by the nature of distracters than were children with ADHD. For children with ADHD, MPH improved performance overall.     

Interference Control in Children with Attention Deficit/Hyperactivity Disorder

The view that Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a diminished ability to control interfference is controversial and based exclusively on results of (verbal)-visual interference tasks, primarily the Stroop Color Word task. The present study compares medication-naïve children with ADHD (n?=?35 and n?=?51 in Experiments 1 and 2, respectively) with normal controls (n?=?26 and n?=?32, respectively) on two interference tasks to assess interference control in both the auditory and the visual modality: an Auditory Stroop task and a Simon task. Both groups showed reliable but equal degrees of interference on both tasks, suggesting that children with ADHD do not differ from normal controls in their ability to control interference in either modality.     

Children with Attention Deficit Hyperactivity Disorder

ABSTRACT

It is estimated that there have been over 4,000 articles in the literature on the subject of attentional problems, addressing its etiology, epidemiology, assessment, diagnosis, and treatment. This article reviews recent and relevant literature with an eye toward functional conclusions and linkages between assessment and intervention. The article concludes by providing a problem-solving model that integrates parent or teachers' referral concerns, reasons for these concerns, assessment methods, and intervention strategies. In the end, four definitive conclusions are drawn, and the importance of multimodal strategies that collaboratively involve home, school, and community settings is emphasized.     

不同特征维度下ADHD儿童的任务切换特点

本研究采用双向刺激设置,通过操纵两实验的特征维度,以考察任务维度对ADHD儿童任务切换的影响。结果发现,在两个实验中,相对于正常组儿童,ADHD儿童在任务切换上都表现出缺损。当注意维度相同时,ADHD儿童在固定顺序上的切换损耗大于随机顺序,但在跨维度任务中,ADHD儿童在固定顺序上的切换损耗则小于随机顺序,这与正常儿童的表现模式不一致。该结果表明,工作记忆会对ADHD儿童产生影响,但这取决于任务的特征维度是否一致。