Do Children With Attention-Deficit/Hyperactivity Disorder (ADHD) Have Set Shifting Deficits?
Do Children With Attention-Deficit/Hyperactivity Disorder (ADHD) Have Set Shifting Deficits?
复制标题
DOI：
10.1037/neu0000546
复制
发表时间：
2019-05-01
期刊：
影响因子：
2.4
通讯作者：
Groves, Nicole B.
中科院分区：
文献类型：
--
作者：
Irwin, Lauren N.;Kofler, Michael J.;Groves, Nicole B.
目标：设定转换，或认知灵活性，是一种核心执行功能，涉及快速有效地在心理设定之间来回转换的能力。荟萃分析表明，注意力缺陷/多动障碍（ADHD）患者存在中等程度的移动障碍。然而，这个结论可能是过早的，因为证据基础完全依赖于那些被批评为结构效度差的任务，可能更好地反映一般的神经心理功能，而不是具体的变化。方法：对有ADHD （n = 43）和无ADHD （n = 34）的77例8-13岁儿童（M = 10.46, SD = 1.54，女孩32例，白人/非西班牙裔占66%）进行特征比较，完成标准全局-局部集合转移任务和2个除关键过程外各方面相同的平衡控制任务。结果：实验操作在全局-局部和非移位控制任务中成功地唤起了设定移位需求（p < .001; omega(2) = .12-.14）。混合模型方差分析（ANOVAs）显示，ADHD组在变速控制任务上的变速成本与非变速控制任务没有不成比例的下降（p = 0.30; omega(2) = 0.002），这表明没有证据表明ADHD组的变速能力受损。相比之下，ADHD组比非ADHD组产生了不成比例的移位错误（p = .03; omega(2) = 0.03），这更容易归因于成功完成全局-局部任务所需的先决条件（非移位）过程。结论：ADHD儿童在轮班任务中的表现受损可能归因于在轮班前难以维持竞争性规则集和/或抑制当前活跃的规则集。然而，当这些高阶过程成功执行时，没有明显的证据表明ADHD中存在独特的集转移缺陷。一般科学总结已经提出多动症与在任务或活动之间灵活转换的执行能力缺陷有关。然而，由于用于测量这些儿童移动能力的测试存在问题，这一结论可能为时过早。通过精心控制的实验设计，目前的研究发现，在儿童多动症中，设置转移可能是完整的。换句话说，患有多动症的儿童似乎很难在转变之前维持/抑制竞争规则集。当这些高阶过程被成功执行时，患有多动症的孩子和他们的非多动症同龄人一样迅速地转变。
Objective: Set shifting, or cognitive flexibility, is a core executive function involving the ability to quickly and efficiently shift back and forth between mental sets. Meta-analysis suggests medium-magnitude shifting impairments in attention-deficit/hyperactivity disorder (ADHD). However, this conclusion may be premature because the evidence-base relies exclusively on tasks that have been criticized for poor construct validity and may better reflect general neuropsychological functioning rather than shifting specifically. Method: A well-characterized sample of 77 children ages 8-13 (M = 10.46, SD = 1.54; 32 girls; 66% Caucasian/non-Hispanic) with ADHD (n = 43) and without ADHD (n = 34) completed the criterion global-local set shifting task and 2 counterbalanced control tasks that were identical in all aspects except the key processes. Results: The experimental manipulation was successful at evoking set shifting demands during the global-local versus both nonshift control tasks (p < .001; omega(2) = .12-.14). Mixed-model analyses of variance (ANOVAs) revealed that the ADHD group did not demonstrate disproportional decrements in speed shift costs on the shifting versus nonshift control tasks (p = .30; omega(2) = .002), suggesting no evidence of impaired set shifting abilities in ADHD. In contrast, the ADHD group made disproportionately more shifting errors than the non-ADHD group (p = .03; omega(2) = 0.03) that were more parsimoniously attributable to prerequisite (nonshifting) processes necessary for successful performance on the global-local task. Conclusions: Children with ADHD's impaired performance on shifting tasks may be attributable to difficulties maintaining competing rule sets and/or inhibiting currently active rule sets prior to shifting. However, when these higher-order processes are executed successfully, there is no significant evidence to suggest a unique set shifting deficit in ADHD.General Scientific SummaryIt has been suggested that ADHD is associated with deficits in the executive ability to flexibly shift between tasks or activities. However, this conclusion may be premature because of problems with the tests used to measure shifting abilities in these children. Using a carefully controlled experimental design, the current study found that set shifting may be intact in pediatric ADHD. In other words, children with ADHD appear to have difficulty maintaining/inhibiting competing rule sets prior to shifting. When these higher-order processes are executed successfully, children with ADHD shift just as quickly as their non-ADHD peers.