四川精神卫生2024，Vol.37Issue(4)：307-311,5.DOI:10.11886/scjsws20240423002
伴情绪失调的注意缺陷多动障碍患儿执行功能与临床特征
Executive function and clinical characteristics in children with attention-deficit hyperactivity disorder and emotional dysregulation
摘要
Abstract
Background Comorbid attention-deficit/hyperactivity disorder(ADHD)and emotional dysregulation may represent a distinct subtype of ADHD,which is characterized by an increased risk of anxiety or depressive disorder and a poor clinical prognosis,so research is urgently required to explore its unique executive functioning profile and clinical characteristics.However,there is limited research comparing the clinical symptoms and executive function in children with ADHD in terms of the presence or absence of emotional dysregulation.Objective To explore the executive function and clinical characteristics of ADHD children with emotional dysregulation.Methods From June 2020 to December 2023,118 children aged 7 to 12 with ADHD attending the Mental Health Center of West China Hospital,Sichuan University and fulfilling the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)diagnostic criteria were enrolled.Children were classified into emotional dysregulation group(n=68)and non-emotional dysregulation group(n=50)based on the standard T-scores of Achenbach's Child Behavior Checklist(CBCL)-anxious/depressed,aggressive behavior and attention problems subscales.All children were then subjected to complete the Chinese version of Swanson Nolan and Pelham,Version IV Scale-parent form(SNAP-IV),Chinese Wechsler Intelligence Scale for Children(C-WISC),Weiss Functional Impairment Scale-Parent form(WFIRS-P)and 4 tests of the Cambridge Neuropsychological Test Automated Battery(CANTAB):①Stockings of Cambridge(SOC)testing spatial planning.②Intradimensional-extradimensional Set Shifting(IED)testing cognitive/attentional flexibility,adjusting the total errors across the task.③Spatial Working Memory(SWM)testing spatial working memory.④Rapid Visual Information Processing(RVP)testing sustained attention.Results The SNAP-IV Inattention,Hyperactivity/Impulsivity and Oppositional Defiant Disorder domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group(t=3.206,5.088,6.316,6.553,P<0.01).The WFIRS-P family,school learning,life skills,self-concept,social activities and risky activities domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group(t=6.074,4.406,4.143,3.984,6.575,6.662,8.254,P<0.01).In CANTAB,emotional dysregulation group made more total adjusted errors across the IED task compared with non-emotional dysregulation group(t=2.168,P<0.05).Conclusion Children with ADHD who exhibit emotional dysregulation have been observed to experience more severe core symptoms,impaired social functioning and poorer performance on tests assessing executive function,particularly in the area of cognitive flexibility.关键词
注意缺陷多动障碍/情绪失调/临床特征/执行功能Key words
Attention-deficit/hyperactivity disorder/Emotional dysregulation/Clinical symptoms/Executive function分类
临床医学引用本文复制引用
杨燕平,李思迅,王美雯,王卓,刘沛,罗婷婷,陶煜杰,黄颐..伴情绪失调的注意缺陷多动障碍患儿执行功能与临床特征[J].四川精神卫生,2024,37(4):307-311,5.基金项目
四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(项目名称:基于虚拟现实技术的儿童注意力评估与训练平台的研发,项目编号:2018HXFH045) Funded by 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University(number,2018HXFH045) （项目名称:基于虚拟现实技术的儿童注意力评估与训练平台的研发,项目编号:2018HXFH045）
