Predicting Impairment in Major Life Activities and Occupational Functioning in Hyperactive Children as Adults: Self-Reported Executive Function (EF) Deficits Versus EF Tests
Predicting Impairment in Major Life Activities and Occupational Functioning in Hyperactive Children as Adults: Self-Reported Executive Function (EF) Deficits Versus EF Tests
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DOI：
10.1080/87565641.2010.549877
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发表时间：
2011-01-01
影响因子：
1.5
通讯作者：
Fischer, Mariellen
中科院分区：
文献类型：
--
作者：
Barkley, Russell A.;Fischer, Mariellen
儿童多动症或注意力缺陷多动障碍（ADHD）与成年后各种主要生活活动的障碍有关，特别是职业功能。ADHD似乎涉及执行功能（EF）的缺陷。以前的研究没有检查这些赤字的贡献，成人损伤一般和职业调整，特别是在纵向研究多动/多动症儿童。我们通过自我报告和测试评估EF，并在10个主要生活活动领域和12项职业损害措施中使用自我和他人评定的损害。我们研究了多动（H; N = 135）和社区对照儿童（C; N = 75），随后到成年（平均年龄27岁）。使用改良的DSM-IV标准，将H病例细分为ADHD持续存在（ADHD-P）和不持续存在（ADHD-NP）的病例。在所有五个EF量表上，ADHD-P组的自我报告EF缺损比ADHD-NP组和C组更严重，ADHD-NP组的三个量表比C组更严重。大多数ADHD-P病例在自我报告的EF中属于临床受损范围，极少数ADHD-NP病例也是如此，但很少有人在EF测试中被归类为这样。职业功能障碍预测的EF评级在更大程度上比EF测试。大多数EF测试与工作历史无关，但五点测试除外。我们的结论是，EF评分是更好的预测功能障碍的主要生活活动一般和职业功能，特别是在成人后续比EF测试。我们假设，这种矛盾产生于每种方法评估不同层次的层次组织EF元结构简要讨论。
Hyperactivity in children, or attention deficit hyperactivity disorder (ADHD), is associated with impairments in various major life activities by adulthood, particularly occupational functioning. ADHD appears to involve deficits in executive functioning (EF). Prior studies have not examined the contribution of these deficits to adult impairment generally and occupational adjustment specifically in longitudinal studies of hyperactive/ADHD children. We did so assessing EF by both self-report and tests and using self and other-rated impairment in 10 domains of major life activities and 12 measures of occupational impairment. We studied hyperactive (H; N = 135) and community control children (C; N = 75) followed to adulthood (mean age 27 years). The H cases were subdivided into those whose ADHD did (ADHD-P) and did not persist (ADHD-NP) using modified DSM-IV criteria. Self-reported EF deficits were more severe on all five EF scales in the ADHD-P than both the ADHD-NP and C groups and on three scales in the ADHD-NP compared to C groups. Most ADHD-P cases fell in the clinically impaired range on self-reported EF as did a substantial minority of ADHD-NP cases but few were so classified on the EF tests. Impairments in occupational functioning were predicted by the EF ratings to a greater degree than by the EF tests. Most EF tests were unrelated to work history with the exception of the Five-Points Test. We conclude that EF ratings are better predictors of impairment in major life activities generally and occupational functioning specifically at adult follow-up than are EF tests. We hypothesize that this paradox arises from each method assessing different levels of a hierarchically organized EF meta-construct briefly discussed herein.