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。     

Project DyAdd: Visual attention in adult dyslexia and ADHD

In this study of the project DyAdd, three aspects of visual attention were investigated in adults (18–55 years) with dyslexia (n = 35) or attention deficit/hyperactivity disorder (ADHD, n = 22), and in healthy controls (n = 35). Temporal characteristics of visual attention were assessed with Attentional Blink (AB), capacity of visual attention with Multiple Object Tracking (MOT), and spatial aspects of visual attention with Useful Field of View (UFOV) task. Results showed that adults with dyslexia had difficulties performing the AB and UFOV tasks, which were explained by an impaired ability to process dual targets, longer AB recovery time, and deficits in processing rapidly changing visual displays. The ADHD group did not have difficulties in any of the tasks. Further, performance in the visual attention tasks predicted variation in measures of phonological processing and reading when all of the participants were considered together. Thus, difficulties in tasks of visual attention were related to dyslexia and variation of visual attention had a role in the reading ability of the general population.     

Parenting Behaviors During Risky Driving by Teens With Attention-Deficit/Hyperactivity Disorder

Parenting practices for teen drivers with ADHD were observed via a video monitor installed in vehicles. All teens had recently completed a driver education course and were in the driving permit stage of a graduated driver-licensing program. Parent behaviors were coded during drives when teens were driving safely and during drives when teens engaged in risky driving. The overall frequency of positive parenting strategies was low, regardless of whether teens drove safely or engaged in risky driving. Although the rate of negative feedback was also low, parents engaged in significantly more criticism and were rated by an observer to appear angrier when teens were driving in a risky manner. No other differences in parent behaviors associated with the quality of teen driving were observed. The inconsistencies between observed parenting behaviors and those parenting practices recommended as effective with teens with ADHD are discussed. The need for further research addressing effective strategies for teaching teens with ADHD to drive is highlighted.     

两种符号检索条件下注意缺陷多动障碍和阅读障碍儿童的表现

在传统工作记忆刷新和选择性注意任务上,在匹配反应阶段均涉及符号检索的心理加工过程,注意缺陷多动障碍和阅读障碍儿童的工作记忆和注意缺陷已经被证实,本研究关注于两种障碍儿童是否存在符号检索能力的缺陷。研究比较了18名ADHD儿童、11名阅读障碍儿童和17名控制组儿童在RSVP任务中序列搜索和平行搜索的成绩差异,搜索条件通过实验材料（字母和数字）和呈现方式加以操控。结果表明,在平行搜索和序列搜索条件下,障碍儿童的成绩均低于正常控制组,两组障碍儿童成绩差异不显著;在搜索效应上,三组儿童的差异不显著,这说明注意缺陷     

工作记忆负荷对注意缺陷多动障碍儿童过滤新异分心刺激能力的影响*

关于启动工作记忆负荷的强度与过滤分心刺激这两种认知资源的关系一直存在争论;并且对ADHD儿童来说,新异的分心刺激是提高了唤醒水平,还是干扰了任务进程也一直存在争论。本研究选取了ADHD儿童32名,正常儿童35名。采用视听跨通道oddball任务,通过操作视觉任务工作记忆负荷的高低,以及分心刺激与目标刺激之间的时间间隔,探讨不同工作记忆负荷对 ADHD 儿童过滤新异分心刺激能力的影响。结果发现：(1)在低工作记忆负荷条件下,分心刺激对两组儿童都起到了唤醒作用;在高工作记忆负荷条件下,分心刺激影响了两组儿童对任务本身的加工过程,使其判断的精确性下降。但是 ADHD 儿童受到的影响更大,表明其过滤分心刺激的能力落后。(2)当分心刺激与目标刺激同时出现时, ADHD儿童受到的干扰最大;但随着二者时间间隔的延长,并没有出现间隔越长干扰效应越小的趋势。在本研究条件下,得出以下结论：(1)两组儿童对跨通道新异分心刺激的过滤受到目标任务的工作记忆负荷强度的影响。(2)适度延长分心刺激与目标刺激之间的时间间隔可能会帮助ADHD的注意回归。     

Evaluation of a School-Based Social Skills Program for Children With Attention-Deficit/Hyperactivity Disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among school-aged children. An associated feature of the disorder is a deficit in social functioning, which can be detrimental in terms of long-term outcomes. Therefore, it is crucial to identify evidence-based interventions which can improve the social skills of children with ADHD. The current study was an evaluation of a school-based social skills training program, called Working Together: Building Children's Social Skills Through Folk Literature. The modified version of the program with generalization enhancers was delivered in three schools to 16 children over a 10-week period. Results indicated that this program was effective for improving social skills in children with ADHD, particularly for children with poor pragmatic language skills.     

The Successful Treatment of Diurnal and Nocturnal Enuresis and Encopresis

Two children, a boy aged six and a girl aged five-and-one half, were treated for diurnal enuresis. The boy was also treated for bedwetting and the girl for encopresis. The treatment program was conducted by the children's parents and featured daily, weekly, and monthly rewards, a feedback "star chart" and nonexclusionary timeout for accidents. The girl's daytime wetting and soiling were treated simultaneously with soiling being eliminated first. After the boy's daytime wetting had been eliminated, he was given dry-bed training (Azrin, Sneed, & Foxx, 1974) with equal success. Long term follow-ups revealed that all forms of toileting accidents had been eliminated.     

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

The Stroop Color-Word Interference Test as an Indicator of ADHD in Poor Readers

The performance on the Stroop Color-Word Interference Test of 36 boys with Attention Deficit Hyperactivity Disorder (ADHD) was compared with performances of a matched control sample. The control group outperformed their counterparts on the control and interference conditions of the Stroop test, suggesting ADHD-specific executive and reading deficits. When individuals with both ADHD and reading disorders were excluded from the analysis, the authors found a significant difference between the ADHD group and the control group on the color-word test, indicating that poor reading skills may produce false negatives on the Stroop test. However, fast and slow readers with ADHD did not perform differently from each other on the color-word test. The authors postulated the existence of two different causes of reading problems: phonological deficits and attentional deficits.