Cognitive inflexibility in Japanese adolescents and adults with autism spectrum disorders.
Cognitive inflexibility in Japanese adolescents and adults with autism spectrum disorders.
复制标题
DOI：
10.5498/wjp.v4.i2.42
复制
发表时间：
2014-06
影响因子：
3.1
通讯作者：
Y. Yasuda;R. Hashimoto;K. Ohi;H. Yamamori;M. Fujimoto;S. Umeda‐Yano;H. Fujino;M. Takeda
中科院分区：
文献类型：
--
作者：
Y. Yasuda;R. Hashimoto;K. Ohi;H. Yamamori;M. Fujimoto;S. Umeda‐Yano;H. Fujino;M. Takeda
目的研究日本青少年和成人自闭症谱系障碍（ASD）患者与日本对照组的执行功能。方法33名ASD患者和33名对照者参加了研究。ASD和对照组的人口统计学变量在性别上是匹配的（男/女：20/13 vs 20/13），年龄（26.1 ± 11.5 vs 26.8 ± 9.6），受教育年限（13.2 ± 2.9 vs 14.2 ± 1.9），全量表智商（IQ）（103.0 ± 16.7 vs 103.7 ± 14.7），操作智商（96.2 ± 16.1 vs 97.8 ± 15.0）和言语智商（107.9 ± 16.3 vs 107.7 ± 14.4）。参与者进行了威斯康星州卡片分类测试（WCST），该测试评估了解决问题和认知灵活性的执行过程，以及持续表现测试（CPT），该测试评估了注意力和冲动性。自闭症谱系商数日本版（AQ-J）的症状进行了评估。首先，我们使用Mann-Whitney U检验比较了各组之间的WCST评分，并以类别档案评分和CPT评分作为协变量对变量进行了协方差分析。其次，用Pearson相关系数分析ASD组WCST与AQ-J的相关性。结果ASD组的总错误数（TE）及米尔纳型（%PEM）和纳尔逊型（%PEN）持续错误数占TE的百分比均显著低于对照组（ASD vs对照组：TE：16.0 ± 6.2 vs 12.6 ± 3.5，P = 0.012; %PEM：11.7 ± 10.7 vs 6.6 ± 8.9，P = 0.037; %PEN：20.1 ± 14.5 vs 8.7 ± 10.4，P = 0.0011）。相比之下，两组在WCST或CPT上的分类得分没有显著差异。协方差分析显示，两组的PEN %评分存在显著差异（P = 0.0062），但TE或PEM %评分无显著差异。这些结果表明，患有ASD的日本青少年和成人具有认知能力。此外，我们的研究结果表明，日本青少年和成人ASD可能有困难，使用负反馈，因为坚持错误的纳尔逊型表明坚持选择不正确的反应。相比之下，WCST和AQ-J评分之间没有显著相关性。结论：我们证实了日本青少年和成人ASD患者存在认知障碍。我们的研究结果还表明，ASD患者可能无法有效地使用负反馈。
AIM To investigate executive function in Japanese adolescents and adults with autism spectrum disorders (ASD) compared to Japanese controls. METHODS Thirty-three individuals with ASD and 33 controls participated. The ASD and control groups' demographic variables were matched for gender (male/female: 20/13 vs 20/13), age (26.1 ± 11.5 vs 26.8 ± 9.6), years of education (13.2 ± 2.9 vs 14.2 ± 1.9), full-scale intelligence quotient (IQ) (103.0 ± 16.7 vs 103.7 ± 14.7), performance IQ (96.2 ± 16.1 vs 97.8 ± 15.0), and verbal IQ (107.9 ± 16.3 vs 107.7 ± 14.4). Participants performed the Wisconsin Card Sorting Test (WCST), which assesses the executive processes involved in problem solving and cognitive flexibility, and the Continuous Performance Test (CPT), which assesses attention and impulsivity. Symptoms were assessed by the Autism-Spectrum Quotient Japanese version (AQ-J). First, we compared the scores of the WCST between the groups using a Mann-Whitney U-test and conducted an analysis of covariance for the variables with the scores of category archives and CPT scores as covariates. Second, we analyzed the correlation between the scores of the WCST and the AQ-J in the ASD group using Pearson's r. RESULTS The total errors (TE) and the percentages of perseverative errors of the Milner type (%PEM) and Nelson type (%PEN) among the TE in the ASD group were significantly worse compared with the control group (ASD vs Control, respectively: TE: 16.0 ± 6.2 vs 12.6 ± 3.5, P = 0.012; %PEM: 11.7 ± 10.7 vs 6.6 ± 8.9, P = 0.037; %PEN: 20.1 ± 14.5 vs 8.7 ± 10.4, P = 0.0011). In contrast, no significant difference was observed between the two groups in the scores of categories achieved on the WCST or the CPT. An analysis of covariance revealed significant differences between the groups in the %PEN scores (P = 0.0062) but not in the TE or the %PEM scores. These results suggest that Japanese adolescents and adults with ASD have cognitive inflexibility. Furthermore, our results suggest that Japanese adolescents and adults with ASD may have difficulties using negative feedback because perseverative errors of the Nelson type indicate persistence in choosing the incorrect reaction. By contrast, there was no significant correlation between the WCST and AQ-J scores. CONCLUSION We confirmed the presence of cognitive inflexibility in Japanese adolescents and adults with ASD. Our results also indicated that subjects with ASD may not use negative feedback effectively.