注意力不足過動兒童注意力與臨床症狀的相關性研究

Abstract

目的：本研究之目的為探討6-8歲注意力不足過動症（ADHD）兒童在持續注意、工作記憶及抑制控制等認知能力發展與臨床注意力不足過動症狀的相關性。 方法：收集台北市某地區醫院15位ADHD兒童及大台北地區12位正常兒童分別接受電腦化注意力測驗TAP中警醒度、聽覺持續注意、視覺持續注意、工作記憶、抑制控制go/no-go等分項測驗。兒童的父母接受結構式診斷性會談（K-SADS-E）以提供兒童相關資訊並填寫柯能氏父母版量表。老師填寫柯能氏教師版量表。 結果：兩組兒童在抑制控制go/no-go測驗中假警報次數及聽覺持續注意中遺漏的次數有明顯差異，在其他項目的注意力測驗則無明顯差異。K-SADS-E ADHD症狀數與抑制控制go/no-go中假警報次數有顯著相關，對照組的魏氏兒童智力測驗綜合智商較ADHD組高，有顯著差異。以回歸分析調整綜合智商的影響後，ADHD組兒童仍比正常組兒童在抑制控制go/no-go有顯著較高的假警報次數，ADHD症狀數與抑制控制go/no-go中假警報次數仍有顯著相關。 結論：本研究為橫斷式分析，由結果顯示ADHD兒童在抑制控制的表現較正常組兒童差，而抑制控制能力與臨床症狀似有相關聯。為了更清楚了解症狀改變是否與抑制控制能力發展有關，未來得考慮以前瞻式追蹤研究設計，長期觀察ADHD症狀改變與抑制控制能力發展的關連性。

Objective: This study aimed to evaluate the association between the development of attention and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD). Methods: Samples included 15 children, aged 6 to 8 years old, who sought help at Child and Adolescent Psychiatric Clinic in Taipei Municipal hospital and were diagnosed with ADHD, and 12 children without ADHD and other psychiatric disorders from Taipei area. All subjects were tested by computerized program of attention tests including alertness, auditory sustained attention, visual sustained attention, inhibitory control go/no-go test and working memory. Their parents received a psychiatric interview to report on these children using the Chinese version of the Kiddi Schedule of Affective Disorders and Schizophrenia-Epidemiologic version (K-SADS-E) and completed the Chinese version of the Conners’ Parent Rating Scale-Revised: Short Form. Their teachers completed the Chinese version of the Conners’ teacher Rating Scale-Revised: Short Form. Result: The ADHD and normal group children differed significantly in the false alarm of go/no-go test and the omission of auditory sustained attention. The number of ADHD symptoms measured by the K-SADS-E was correlated significantly with the false alarm of go/no-go test。The normal group children had higher IQ. When IQ was adjusted, group difference in the false alarm of go/no-go test and the significant correlation between ADHD symptoms and the false alarm of go/no-go test still persisted. Conclusion: The major findings of this study are that ADHD children had higher false alarm rate in inhibitory control and the false alarm rate is associated with ADHD symptoms. To further confirm whether the improvement of clinical symptoms is correlated with the development of inhibitory control, a prospective follow up study should be carried out.