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題名 | 注意力缺失/過動疾患-不注意型與合併型之多面向注意力功能分析=Differentiating the Deficit of Attention Components in Attention-Deficit/Hyperactivity Disorder--Combined and Inattentive Subtypes |
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作者姓名(中文) | 詹雅雯; 陳信昭; 郭乃文; | 書刊名 | 臨床心理學刊 |
卷期 | 3:2 民95.12 |
頁次 | 頁85-92 |
分類號 | 415.9517 |
關鍵詞 | 注意力缺陷/過動症; 亞型; 神經心理; 注意力; ADHD; Subtypes; Neuropsychology; Attention; |
語文 | 中文(Chinese) |
中文摘要 | 目的:本研究目的在探討注意力缺失/過動疾患-不注意型(ADHD Predominantly Inattentive Type,ADHD-I)與合併型(ADHD Combined Type,ADHD-C)於多向度注意力評估表現上之差異。了解該兩亞型兒童在注意力運作機制上的缺損,期能對該疾患的病理機制與認知復健訓練有進一步貢獻。方法:經醫師確定診斷為ADHD-I和ADHD-C的兒童各32名,兩組之年齡、智力分數與家庭社經地位相當。以廣泛性非語文注意力測驗(Comprehensive Non-verbal Attention Test Battery, CNAT)為衡鑑工具,此工具具有多層次、多向度的指標。結果:和常模相較,ADHD-C和ADHD-I在CNAT不同的分測驗上分別呈現出多項不同類型的錯誤。針對反應正確率達75%以上的分測驗討論反應時間,結果發現僅有ADHD-C在轉逆原則分測驗上的反應時間呈現缺損。而兩亞型相比,ADHD-C在集中、搜尋、抑制性注意力、與抗拒分心等分測驗的衝動錯誤,在集中注意力、搜尋注意力、與抗拒分心的漏失錯誤,在轉逆原則的違反錯誤,以及在各分項測驗之反應時間表現上均較ADHD-I差,而ADHD-I唯在搜尋注意力的遲緩錯誤數高於ADHD-C。結論:結果顯示正常智力的ADHD-C組在注意力缺損面向較ADHD-I來得廣,涵蓋Cohen所提到的知覺選擇、注意力持續、注意力資源、以及反應選擇之四面向。而ADHD-I特別呈現在go/no-go典範分測驗的衝動錯誤,和相較於ADHD-C有較多遲緩錯誤的問題,顯示其偏失於注意力的持續和反應的選擇。這些發現有助於未來為各亞型患者建立個別化的認知復健計畫。 |
英文摘要 | Objective: This study investigated the difference of attention problems between the subtypes of Attention-Deficit /Hyperactivity Disorder (ADHD) from a neuropsychological perspective. Methods: Participants were grouped by diagnosis: 31ADHD-C (combined type) and 31ADHD-I (inattentive type). There were no significant differences in age, IQ scores, and social economic status between subtypes. Each participant received a neuropsychological examination and was administered the comprehensive non-verbal attention test battery (CNAT). Results: The ADHD-C and ADHD-I groups showed different error patterns in every subtest as compared to normative data. A further analysis of the subtests' reaction times with 75% accuracy rates found that only the ADHD-C group showed deficit in the principle reverse task. When compared to the ADHD-I group, the ADHD-C group showed more impulse errors, missing errors, commission errors and a significantly longer reaction time in many of the subtests. However, the ADHD-I group had significantly more delayed errors in the searching task than the ADHD-C group. Conclusion: The results indicated that with average IQ score, the ADHD-C group had more deficits than the ADHD-I group in several attention components, including sensory selection, sustained attention, attention resource, and response selection based on Cohen's attention model. While the ADHD-I group had deficits in sustain attention and response selection. These findings would be helpful in designing individualized cognitive rehabilitation programs for the two ADHD subtypes. |
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