A Longitudinal Study Of Cognition In Adolescents At Risk For Substance Abuse

对有药物滥用风险的青少年认知能力的纵向研究

• 批准号: 7593261
• 负责人: Elliot Stein
• 金额: $ 62.18万
• 依托单位: NATIONAL INSTITUTE ON DRUG ABUSE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7593261
• 关键词: Adolescent; Adult; Age; Agreement; Alcohol or Other Drugs use; Anger; Anxiety; Attention; Attention deficit hyperactivity disorder; Behavioral; Bipolar Disorder; Categories; Child; Childhood; Chronic; Clinical; Clinical Assessment Tool; Cognition; Color; Complex; Conduct Disorder; Data; Diagnosis; Diagnostic; Disease; Emotional; Emotions; Enrollment; Facial Expression Recognition; Guidelines; Hyperactive behavior; Impairment; Interview; Label; Longitudinal Studies; Major Depressive Disorder; Manic; Manuals; Measures; Mental disorders; Moods; National Institute of Mental Health; Numbers; Outcome Measure; Parents; Participant; Pattern; Performance; Purpose; Rate; Research; Risk; Sampling; Score; Scoring Method; Substance abuse problem; Task Performances; Testing; Youth; indexing; instrument; performance tests; showing emotion

Using data acquired from adolescents enrolled in this study, we evaluated the inter-rater reliability, internal consistency and/or temporal reliability of a number of the test instruments. We assessed the internal consistency and temporal stability of Conner's Continuous Performance Test (CCPT) as a clinical tool for the assessment of attention-deficit/hyperactivity disorder (ADHD) the CCPT in a sample of 51 adolescents, (19 with ADHD, 8 with ADHD and another disorder, and 24 controls). The CCPT has adequate split-half reliability, and performance was found to be moderately correlated over the span of 1.3 years. ADHD participants tended to perform worse than controls during the first, but not second, CCPT administration. The CCPT was found to be an insensitive indicator of diagnostic status and, while several CCPT performance measures correlated with parent ratings of ADHD symptomatology, the pattern of these correlations was largely independent of the interpretive guidelines provided in the test manual. We conclude that the poor diagnostic validity and the unclear functional relevance of CCPT scores might confound clinical interpretation of the CCPT. We assessed the inter-rater agreement and internal consistency of the Rey Complex Figure Test (RCFT) in a sample of adolescents enrolled in this study. We found each of the RCFT outcome measures to be associated with clinically acceptable inter-rater reliability estimates. Additionally, we found the copy and recall accuracy scores to be associated with clinically acceptable internal consistency. The organizational scoring method we evaluated, while associated with internal consistency that is acceptable for research purposes, was found to be somewhat below estimates associated with clinical acceptability. We assessed the short- and long-term stability of the Stroop Color and Word Test, a commercially-available version of Stroop s original task in 87 adolescents. Participants were tested an average of one month apart at baseline and twice more at approximately 15 month intervals. We found that all of the commonly used performance indices are associated with practice effects and that the three primary scores, but not the formula-derived interference score, were associated with acceptable reliability. Baseline data from participants in this longitudinal study were combined with data from other studies performed at NIMH on adolescents to examine whether face-emotion labeling deficits are illness-specific or an epiphenomenon of generalized impairment in pediatric psychiatric disorders involving mood and behavioral dysregulation. In total, data from two hundred fifty-two youths (718 years old) who had completed child and adult facial expression recognition subtests from the Diagnostic Analysis of Nonverbal Accuracy instrument were used. Forty-two participants had bipolar disorder, 39 had severe mood dysregulation (i.e., chronic irritability, hyperarousal without manic episodes), 44 had anxiety and/or major depressive disorders, 35 had attention-deficit/hyperactivity and/or conduct disorder, and 92 were controls. Dependent measures were number of errors labeling happy, angry, sad, or fearful emotions. We found that children with bipolar disorder and those with severe mood dysregulation made more errors than those presenting with anxiety and/or major depressive disorders, attention-deficit/hyperactivity and/or conduct disorder, or controls when labeling adult or child emotional expressions. Children with bipolar disorder and those with severe mood dysregulation did not differ in their emotion- labeling deficits. Therefore, we concluded that the face-emotion labeling deficits differentiate children with bipolar disorder and those with severe mood dysregulation from controls and those with anxiety and/or major depressive disorders or those with attention-deficit/hyperactivity and/or conduct disorder. The extent to which such deficits cause versus result from emotional dysregulation requires further study.

使用从参与本研究的青少年获得的数据，我们评估了许多测试仪器的评估者间可靠性、内部一致性和/或时间可靠性。我们评估了康纳连续表现测试 (CCPT) 作为评估注意力缺陷/多动障碍 (ADHD) 的临床工具的内部一致性和时间稳定性，CCPT 的样本包括 51 名青少年（19 名患有 ADHD，8 名患有 ADHD 和另一种疾病，以及 24 名对照）。 CCPT 具有足够的分半可靠性，并且发现性能在 1.3 年的跨度内具有中等相关性。在第一次（而非第二次）CCPT 管理期间，ADHD 参与者的表现往往比对照组差。研究发现 CCPT 是诊断状态的不敏感指标，虽然一些 CCPT 表现测量与家长对 ADHD 症状的评分相关，但这些相关性的模式在很大程度上独立于测试手册中提供的解释指南。我们的结论是，CCPT 评分的诊断有效性差和功能相关性不明确可能会混淆 CCPT 的临床解释。我们在参与本研究的青少年样本中评估了雷伊复杂图形测试 (RCFT) 的评分者间一致性和内部一致性。我们发现每个 RCFT 结果测量都与临床可接受的评估者间可靠性估计相关。此外，我们发现复制和回忆准确度分数与临床可接受的内部一致性相关。我们评估的组织评分方法虽然与研究目的可接受的内部一致性相关，但被发现略低于与临床可接受性相关的估计值。我们评估了斯特鲁普颜色和单词测试的短期和长期稳定性，这是斯特鲁普原始任务的商业版本，在 87 名青少年中进行。参与者在基线时平均间隔 1 个月接受测试，并以大约 15 个月的间隔再接受两次测试。我们发现所有常用的表现指标都与实践效果相关，并且三个主要分数（而不是公式衍生的干扰分数）与可接受的可靠性相关。 这项纵向研究参与者的基线数据与 NIMH 对青少年进行的其他研究的数据相结合，以检查面部情绪标签缺陷是否是疾病特异性的，还是涉及情绪和行为失调的儿科精神疾病普遍损害的附带现象。 总共使用了 252 名青少年（718 岁）的数据，他们已完成非语言准确性诊断分析仪器的儿童和成人面部表情识别子测试。 42 名参与者患有双相情感障碍，39 名参与者患有严重情绪失调（即慢性烦躁、过度兴奋但不伴有躁狂发作），44 名参与者患有焦虑症和/或重度抑郁症，35 名参与者患有注意力缺陷/多动和/或品行障碍，92 名参与者为对照组。相关测量是标记快乐、愤怒、悲伤或恐惧情绪的错误数量。我们发现，患有双相情感障碍和严重情绪失调的儿童在标记成人或儿童情绪表达时，比患有焦虑和/或重度抑郁症、注意力缺陷/多动和/或品行障碍或对照的儿童犯更多错误。患有双相情感障碍的儿童和患有严重情绪失调的儿童在情绪标签缺陷方面没有差异。因此，我们得出的结论是，面部情绪标签缺陷将患有双相情感障碍和严重情绪失调的儿童与对照组儿童以及患有焦虑和/或重度抑郁症或患有注意力缺陷/多动和/或品行障碍的儿童区分开来。这种缺陷在多大程度上是由情绪失调造成的，需要进一步研究。

项目成果

Functional neuroimaging of autistic disorders.

自闭症的功能性神经影像学。

• DOI: 10.1002/1098-2779(2000)6:3<171::aid-mrdd4>3.0.co;2-n
• 发表时间: 2000
• 期刊: Mental retardation and developmental disabilities research reviews
• 作者: Rumsey,JM;Ernst,M
• 通讯作者: Ernst,M

Adrenergic and noradrenergic plasma levels in Lesch-Nyhan disease.

Lesch-Nyhan 病中的肾上腺素能和去甲肾上腺素能血浆水平。

• DOI: 10.1016/s0893-133x(99)00119-0
• 发表时间: 2000
• 期刊: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
• 作者: Ernst,M;Zametkin,AJ;Pascualvaca,D;Matochik,JA;Eisenhofer,G;Murphy,DL;Cohen,RM
• 通讯作者: Cohen,RM

Commentary: considerations on the characterization and treatment of self-injurious behavior.

评论：关于自伤行为的特征和治疗的考虑。

• DOI: 10.1023/a:1005507708636
• 发表时间: 2000
• 期刊: Journal of autism and developmental disorders
• 影响因子: 3.9
• 作者: Ernst,M