从精神病理学和神经心理学特征中识别注意力缺陷/多动障碍亚组。

IF 2 4区 心理学 Q2 PSYCHOLOGY
Shan-hong Zhang, Tian-xiao Yang, Zhao-min Wu, Yu-feng Wang, Simon S. Y. Lui, Bin-rang Yang, Raymond C. K. Chan
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引用次数: 0

摘要

研究领域标准(RDoC)主张采用维度法来描述精神障碍。我们遵循 RDoC 标准,根据认知和精神病理学领域对多动症儿童进行特征描述。我们旨在识别和验证具有不同临床特征和功能障碍的多动症亚型。我们招募了 362 名未经药物治疗的多动症儿童和 103 名发育正常的对照组儿童。根据儿童行为检查表(CBCL)和执行功能行为评定量表(BRIEF)进行聚类分析,以确定亚组。亚组的临床特征和功能障碍通过 WEISS 功能障碍评定量表-家长报告(WFIRS-P)和康纳斯家长症状问卷(PSQ)进行评估。聚类分析得出了四个亚组:(1)精神病理学和执行功能(EF)严重受损的多动症;(2)轻度执行功能障碍和正常水平精神病理学的多动症;(3)严重外化问题的多动症;(4)严重执行功能障碍的多动症。这些亚组显示出不同的临床特征和功能障碍程度。执行功能障碍组比外化组表现出更严重的学习问题和更差的生活技能。存在外化问题的两组(即严重障碍组和外化组)均表现出较高的合并亚型多动症比率和较高的合并 ODD 比率。不同亚型的多动症表现出不同的内化和外化问题以及执行功能障碍程度。特别是,执行功能严重受损的亚型表现出更多的学习问题和更差的生活技能,这表明执行功能是干预多动症儿童的关键目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identifying subgroups of attention-deficit/hyperactivity disorder from the psychopathological and neuropsychological profiles

The Research Domain Criteria (RDoC) advocates the dimensional approach in characterizing mental disorders. We followed RDoC to characterize children with ADHD using profiling based on the cognitive and psychopathological domains. We aimed to identify and validate ADHD subtypes with different clinical characteristics and functional impairments. We recruited 362 drug-naïve children with ADHD and 103 typically developing controls. The cluster analysis was used to identify subgroups based on the Child Behaviour Checklist (CBCL) and the Behaviour Rating Inventory of Executive Function (BRIEF). The subgroups' clinical characteristics and functional impairments were assessed using the WEISS Functional Impairment Rating Scale-Parent Report (WFIRS-P) and the Conners Parent Symptom Questionnaire (PSQ). The cluster analysis yielded four subgroups: (1) ADHD with severe impairment in psychopathology and executive functions (EF), (2) ADHD with mild executive dysfunctions and normal-level psychopathology, (3) ADHD with severe externalizing problems and (4) ADHD with severe executive dysfunctions. These subgroups showed different clinical characteristics and degrees of functional impairment. The EF impairment group displayed more serious learning problems and worse life skills than the externalizing group. The two groups with externalizing problems (i.e. the severe impairment group and the externalizing group) both exhibited higher rates of the combined subtype of ADHD and higher rates of comorbid ODD. Different subtypes of ADHD displayed different profiles of internalizing and externalizing problems and levels of executive dysfunctions. In particular, the subtype with severe impairment in EF exhibited more learning problems and worse life skills, suggesting EF is a critical target for intervention in children with ADHD.

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来源期刊
Journal of Neuropsychology
Journal of Neuropsychology 医学-心理学
CiteScore
4.50
自引率
4.50%
发文量
34
审稿时长
>12 weeks
期刊介绍: The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including: • clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups • behavioural or pharmacological treatment regimes • cognitive experimentation and neuroimaging • multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science The following types of paper are invited: • papers reporting original empirical investigations • theoretical papers; provided that these are sufficiently related to empirical data • review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications • brief reports and comments • case reports • fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors) • special issues.
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