Discrepancies among Measures of Executive Functioning in a Subsample of Young Adult Survivors of Childhood Brain Tumor: Associations with Treatment Intensity.
Discrepancies among Measures of Executive Functioning in a Subsample of Young Adult Survivors of Childhood Brain Tumor: Associations with Treatment Intensity.
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儿童脑肿瘤年轻成年幸存者子样本中执行功能测量的差异：与治疗强度的关联。
DOI：
10.1017/s1355617716000771
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Hocking,MatthewC
中科院分区：
文献类型：
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作者：
McCurdy,MarkD;Turner,EliseM;Barakat,LamiaP;Hobbie,WendyL;Deatrick,JanetA;Paltin,Iris;Fisher,MichaelJ;Hocking,MatthewC
目的儿童脑肿瘤（BT）的治疗会给神经发育带来实质性的风险，并导致成年后的神经心理缺陷。有证据表明，经历更严重神经损伤的个体可能缺乏对其神经认知局限性的认识。本研究比较了幸存者、母亲和基于表现的执行功能（EF）估计值，以及它们与治疗强度史的关联，该亚样本为儿童期bt的年轻成年幸存者。方法34例患者（52.9%为女性），年龄18 ~ 30岁（M=23.5； SD=3.4），诊断后16.1年（SD=5.9），进行自我报告和基于绩效的EF测量。母亲们还评估了幸存者的EF技能。根据治疗强度史将幸存者分为轻度、平均/中度或强化/最强化组。比较了幸存者、母亲和基于表现的EF估计之间的差异。结果幸存者报告和基于表现的测量不相关，尽管在母亲报告和表现测量之间发现了显著的关联。强化/最强化治疗组的幸存者表现出最大的评分差异，报告的执行功能障碍相对于母亲报告的F(2,31)=7.81, p< 0.01，基于表现的测量F(14,50)=2.54, p< 0.05。相反，与母亲相比，最小治疗组的幸存者报告了更大的EF困难t(8)=2.82, p< 0.05，但不是基于表现的估计（ps>.05）。结论：幸存者、母亲和基于表现的年轻成年BT幸存者的EF技能评估可能缺乏一致性，这些差异可能与治疗强度史有关。神经心理学家应该使用多方法、多报告者的方法来评估这一人群的EF。提供者也应该意识到这些差异，因为它们可能成为干预工作的障碍。（植物学报，2016,22,900-910）
ObjectivesTreatments for childhood brain tumors (BT) confer substantial risks to neurological development and contribute to neuropsychological deficits in young adulthood. Evidence suggests that individuals who experience more significant neurological insult may lack insight into their neurocognitive limitations. The present study compared survivor, mother, and performance-based estimates of executive functioning (EF), and their associations with treatment intensity history in a subsample of young adult survivors of childhood BTs.MethodsThirty-four survivors (52.9% female), aged 18 to 30 years (M=23.5; SD=3.4), 16.1 years post-diagnosis (SD=5.9), were administered self-report and performance-based EF measures. Mothers also rated survivor EF skills. Survivors were classified by treatment intensity history into Minimal, Average/Moderate, or Intensive/Most-Intensive groups. Discrepancies among survivor, mother, and performance-based EF estimates were compared.ResultsSurvivor-reported and performance-based measures were not correlated, although significant associations were found between mother-reported and performance measures. Survivors in the Intensive/Most-Intensive treatment group evidenced the greatest score discrepancies, reporting less executive dysfunction relative to mother-reported F(2,31)=7.81, p<.01, and performance-based measures F(14,50)=2.54, p<.05. Conversely, survivors in the Minimal treatment group reported greater EF difficulties relative to mothers t(8)=2.82, p<.05, but not performance-based estimates (ps>.05).ConclusionsThere may be a lack of agreement among survivor, mother, and performance-based estimates of EF skills in young adult survivors of childhood BT, and these discrepancies may be associated with treatment intensity history. Neuropsychologists should use a multi-method, multi-reporter approach to assessment of EF in this population. Providers also should be aware of these discrepancies as they may be a barrier to intervention efforts. (JINS, 2016, 22, 900–910)