A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder
A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder
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DOI：
10.1111/j.1530-0277.1997.tb03743.x
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发表时间：
1997-02-01
期刊：
影响因子：
--
通讯作者：
Smith, IE
中科院分区：
文献类型：
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作者：
Coles, CD;Platzman, KA;Smith, IE
患有胎儿酒精综合症（FAS）的儿童和其他产前酒精暴露的个体经常注意到行为缺陷，包括智力迟钝、学习问题、社会问题和注意力缺陷。由于注意缺陷多动障碍（ADHD）在FAS儿童和其他与酒精有关的出生缺陷中被诊断得如此频繁，因此有人猜测酒精是ADHD的病因之一。为了研究胎儿酒精暴露儿童的行为特征与诊断为多动症儿童的行为特征之间的关系，对149名低社会经济地位（SES）的非裔美国儿童（平均年龄= 7.63岁）进行了一系列神经心理学和行为测试。122人是产前酒精暴露纵向研究的子样本，而27人是在多动症诊所发现的。对儿童进行两组测试：(1)“传统模式”的ADHD和外化行为的常规行为和精神测量；(2)神经认知功能的测量反映了注意力组成部分的神经基础的四因素模型（Mirsky AF，《临床神经心理学的综合理论与实践》，Hillsdale， NJ, Lawrence Erlbaum Associates, 1989）。结果表明，具有与产前酒精暴露相关的身体特征的儿童和诊断为ADHD的儿童具有相同的智力能力，但两个临床组的表现都比来自相同社会地位和种族群体的对照儿童差。然而，两个临床组在行为和神经认知测量上有明显的区别，ADHD患者在对注意力问题和行为障碍敏感的常规测试中表现更差。当这两组人用米尔斯基设计的四种注意力因素模型进行比较时，他们被注意到有不同的缺陷模式。这些结果表明，受酒精影响的儿童与最初诊断为多动症的儿童没有相同的神经认知和行为特征。
Behavioral deficits are often noted in children with fetal alcohol syndrome (FAS) and other individuals with prenatal alcohol exposure, including mental retardation, learning problems, social problems, and deficits in attention. Because attention deficit, hyperactivity disorder (ADHD) has been diagnosed so frequently in children with FAS and other alcohol related birth defects, there has been speculation that alcohol is an etiological factor in ADHD. To examine the relationship between behavior characteristics of children with fetal alcohol exposure and those seen in children with a diagnosis of ADHD, 149 tow socioeconomic status (SES), African-American children (mean age = 7.63 years) were given a battery of neuropsychological and behavioral tests. One hundred and twenty-two were a subsample from a longitudinal study of prenatal alcohol exposure, whereas twenty-seven were identified in an ADHD Clinic. Children were given two sets of tests: (1) ''traditional model'' of conventional behavioral and psychiatric measures of ADHD and externalizing behavior; and (2) measures of neurocognitive functioning reflecting a four-factor model of the neurological basis of the components of attention (Mirsky AF, in Integrated Theory and Practice in Clinical Neuropsychology, Hillsdale, NJ, Lawrence Erlbaum Associates, 1989). Results indicated that children with the physical characteristics associated with prenatal alcohol exposure and those with a diagnosis of ADHD had equivalent intellectual abilities with both clinical groups performing more poorly than contrast children from the same SES and ethnic groups. However, there were clear distinctions on behavioral and neurocognitive measures between the two clinical groups with those with ADHD performing more poorly on conventional tests sensitive to attentional problems and conduct disorder. When these two groups were compared on measures designed to measure the model of the four factors of attention by Mirsky, they were noted to have distinct patterns of deficits. These results suggested that the alcohol-affected children did not have the same neurocognitive and behavioral characteristics as children with a primary diagnosis of ADHD.