Improving working memory in children with attention-deficit/hyperactivity disorder: the separate and combined effects of incentives and stimulant medication.
Improving working memory in children with attention-deficit/hyperactivity disorder: the separate and combined effects of incentives and stimulant medication.
复制标题
改善注意力缺陷/多动症儿童的工作记忆：激励措施和兴奋剂药物的单独和综合作用。
DOI：
10.1007/s10802-012-9627-6
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发表时间：
2012
影响因子：
3.6
通讯作者：
Waxmonsky,JamesG
中科院分区：
文献类型：
--
作者：
Strand,MichaelT;HawkJr,LarryW;Bubnik,Michelle;Shiels,Keri;PelhamJr,WilliamE;Waxmonsky,JamesG
工作记忆（WM）被认为是注意力缺陷/多动障碍（ADHD）的核心缺陷，许多研究表明ADHD儿童的WM受损。我们测试了ADHD儿童的WM通过基于表现的激励（一种行为干预的模拟）得到改善的程度。在两项研究中，WM性能进行了评估，使用的视觉空间n回任务。研究1比较了ADHD合并型儿童（9-12岁）（n= 24）和一组典型发育（TD）儿童（n= 32）。研究1在ADHD儿童中复制了WM缺陷。激励措施改善了WM，特别是ADHD儿童。提供激励措施将ADHD与对照组的差异减少了大约一半，但并没有使WM正常化。研究2在17名ADHD混合型儿童中考察了激励和兴奋剂药物的单独和联合作用。两种激励和中等剂量的长效哌醋甲酯（MPH; ~0.3 mg/kg t.i.d.）等效）相对于无激励的安慰剂条件稳健地改善WM。奖励和药物的组合改善WM显着超过单独的奖励或MPH。这些研究表明，意外事件显着改善儿童的注意力缺陷多动障碍综合征的WM，效果大小相当于一个中等剂量的兴奋剂药物。更广泛地说，这项工作呼吁注意动机在研究ADHD认知缺陷和测试ADHD多因素模型中的作用。
Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatialn-back task. Study 1 compared children (ages 9–12 years) with ADHD–Combined type (n= 24) to a group of typically developing (TD) children (n= 32). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM. Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ~0.3 mg/kg t.i.d. equivalent) robustly improved WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with ADHD–Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.