ADHD symptoms in non-treatment seeking young adults: relationship with other forms of impulsivity.
ADHD symptoms in non-treatment seeking young adults: relationship with other forms of impulsivity.
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DOI：
10.1017/s1092852915000875
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发表时间：
2017-02
期刊：
影响因子：
3.3
通讯作者：
Grant JE
中科院分区：
文献类型：
--
作者：
Chamberlain SR;Ioannidis K;Leppink EW;Niaz F;Redden SA;Grant JE
注意力缺陷多动障碍（ADHD）与成年人冲动的各种表现有关，包括其他冲动性障碍，物质使用，基于情感的冲动性评分和神经认知测试的抑制性失调。ADHD和所有这些其他形式的冲动之间的关系还有待于在一个单一的综合研究的背景下进行探索。423名在前一年赌博≥5次的年轻人通过媒体广告招募，并进行详细的评估，包括结构化精神病学访谈，问卷调查和神经认知测试。使用成人ADHD自我报告量表筛选器（ASRS-V1.1）确定ADHD症状的参与者，并使用多变量方差分析（MANOVA）与对照组进行比较。在20.3%的样本中发现了ADHD症状，但这些受试者中只有7.3%接受过正式诊断。ADHD症状与生活质量显著降低、自尊心较低、情绪失调程度较高、冲动-强迫性问卷评分较高、互联网使用问题较多、精神疾病发生率较高以及停止信号反应时间受损相关。在这些变量中，停止信号反应时间和Barratt注意冲动是组分类的最强预测因子。ADHD症状在赌博的年轻人中很常见且诊断不足，并且与某些其他类型的冲动（基于问卷和认知的措施）和情绪失调联系最紧密，这表明这些都是理解疾病病理生理学的重要考虑因素，也是潜在的治疗目标。有必要质疑的是，除了疾病的核心诊断症状外，是否可以通过考虑自尊，情绪反应和抑制控制受损作为特定的治疗目标来加强成人ADHD的治疗。
Attention-Deficit Hyperactivity Disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity have yet to be explored within the context of a single comprehensive study. 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity-compulsivity questionnaire scores, more problematic internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets, in addition to the core diagnostic symptoms of the disorder.