Sluggish Cognitive Tempo Symptoms Contribute to Heterogeneity in Adult Attention-Deficit Hyperactivity Disorder.
Sluggish Cognitive Tempo Symptoms Contribute to Heterogeneity in Adult Attention-Deficit Hyperactivity Disorder.
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DOI：
10.1007/s10862-017-9631-9
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发表时间：
2018-06
影响因子：
1.6
通讯作者：
Nikolas MA
中科院分区：
文献类型：
--
作者：
Kamradt JM;Momany AM;Nikolas MA
注意缺陷多动障碍(ADHD)在超过50%的病例中持续到成年，尽管其相关的症状特征、共病问题和神经心理缺陷在发育过程中会发生实质性变化。迟缓的认知节奏(SCT)症状可能有助于ADHD和共病问题之间的联系，并可能部分解释在其相关因素中观察到的实质性异质性。349名18~38岁成人(男性23.2，SD=4.5，男性54.7%，ADHD 61.03%)完成了多信息量诊断程序和综合神经心理成套检查。保留213例成人ADHD患者用于分析。潜伏期分析(LCA)揭示了ADHD患者的三种SCT症状，我们将其归类为轻度、中度或重度SCT。多元协方差分析(MANCOVA)显示这些特征之间存在显著差异，在控制ADHD症状和性别的持续性时仍然存在。总体而言，ADHD合并SCT症状(中度和重度)的成年人比没有SCT症状的ADHD成年人有更多的焦虑、抑郁和持续性注意力不集中的症状，并有更严重的职业和关系障碍。与中度或轻度SCT症状组相比，重度SCT组的抑郁症状和内化障碍症状最多，日常责任领域的损害最多。在控制性别和注意力不集中症状的持续性时，基于外在症状的显著差异没有出现，这表明中度和重度SCT组不仅仅反映了更多的症状。此外，后续的中介分析表明，SCT至少可以部分解释ADHD的异质性。研究结果对完善病因学概念、评估方法和干预策略具有重要意义。
Attention-deficit hyperactivity disorder (ADHD) persists into adulthood in over 50% of cases, although its associated symptom profiles, comorbid problems, and neuropsychological deficits change substantially across development. Sluggish cognitive tempo (SCT) symptoms may contribute to associations between ADHD and comorbid problems and may partially explain the substantial heterogeneity observed in its correlates. 349 adults aged 18–38 years (M = 23.2, SD = 4.5, 54.7% male, 61.03% with ADHD) completed a multi-informant diagnostic procedure and a comprehensive neuropsychological battery. Adults with ADHD (n = 213) were retained for analyses. Latent class analyses (LCA) revealed three profiles of SCT symptoms among those with ADHD, which we classified as minimal, moderate, or severe SCT. Multiple analysis of covariance (MANCOVA) revealed significant differences among these profiles, which remained when controlling for persistence of ADHD symptoms and sex. In general, adults with ADHD combined with SCT symptoms (moderate and severe) had significantly more symptoms of anxiety, depression, and persistent inattention, and had more severe professional and relational impairment compared to ADHD adults without SCT. Compared to those with moderate or minimal SCT symptoms, the severe SCT group had the most symptoms of depression and internalizing disorders, and the most impairment in the domain of daily responsibility. No significant differences based on externalizing symptoms emerged when controlling for sex and persistence of inattention symptoms, suggesting the moderate and severe SCT groups do not simply reflect more symptoms. Moreover, follow-up mediation analyses revealed that SCT might at least partially explain the heterogeneity in ADHD. Findings have implications for refinement of etiological conceptualization, assessment methods, and intervention strategies.
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影响因子：
1.8
作者：
Becker SP;Ciesielski HA;Rood JE;Froehlich TE;Garner AA;Tamm L;Epstein JN
通讯作者：
Epstein JN
影响因子：
3.4
作者：
Combs, Martha A.;Canu, Will H.;Nieman, David C.
通讯作者：
Nieman, David C.
DOI：
10.1207/s15374424jccp3101_14
发表时间：
2002-03-01
影响因子：
4.2
作者：
Carlson, CL;Mann, M
通讯作者：
Mann, M
影响因子：
5.9
作者：
BARKLEY, RA;DUPAUL, GJ;MCMURRAY, MB
通讯作者：
MCMURRAY, MB
影响因子：
3
作者：
Capdevila-Brophy, Connie;Artigas-Pallares, Josep;Obiols, Jordi E.
通讯作者：
Obiols, Jordi E.