PSYCHOPHYSIOLOGICAL EFFECTS OF STIMULANT DRUGS IN CHILDREN

对自主神经系统(ANS)的活动和注意力进行了评估 34名被诊断为破坏性行为障碍的男孩 (DBD)谱系(品行障碍、对立违抗障碍和/或 注意缺陷多动障碍[ADHD])，选择 反社会和破坏性行为，以及33名正常对照男孩。我们 记录休息期间的皮肤电导(SC)和心率(HR)， 一系列无信号音调和一个简单的反应时间(RT)任务。 注意力通过两个已被广泛使用的RT任务来评估 在精神分裂症研究中：1)常量和变量的简单RT 准备时间间隔，以及2)简单、可选择的、跨模式的RT 灯光和音调。 DBD男生的心率较高，但在“唤醒”的SC指标上没有差异。 然而，在所有基线指标中，他们在发病前的增幅较小 RT任务的安全性高于对照组。SC响应潜伏期较短 DBD组，尽管RT较慢。它们对信号刺激的SC反应 习惯了更快的速度。这些结果与那些 之前用更多的‘纯’ADHD样本获得的。相关 对行为评级的分析表明，可能存在自主的 可能表现为临床症状的高反应和低反应亚组 不同之处对品行障碍的亚诊断有些倾斜。在……里面 总的来说，数据支持DBD谱的概念。DBD科目 5-羟色胺、去甲肾上腺素和多巴胺的代谢物水平较低 从脑脊液中检测到ANS普遍升高 责任感，特别是在RT任务中。RT任务显示DBD 当刺激的时机或方式时，男孩有特别的问题 是不确定的。对这些受试者的两年临床随访显示 低SC级别)年龄校正)显著预测 制度化。也有类似但不显著的趋势 ANS活性低可预测本组其他患者的不良结局 变量。 ANS和注意力测试正在对新的杨格样本进行重复 所有的男孩都有ADHS的诊断。

Autonomic nervous system (ANS) activity and attention has been assessed in 34 boys with diagnoses in the Disruptive Behavior Disorder (DBD)spectrum (Conduct Disorder, Oppositional Defiant Disorder and/or Attention Deficit Hyperactivity Disorder [ADHD]), selected for their antisocial and disruptive behavior, and in 33 normal control boys. We recorded skin conductance (SC) and heart rate (HR) during a rest period, a series of nonsignal tones, and a simple reaction time (RT) task. Attention was assessed by two RT tasks which have been used extensively in schizophrenia research: 1) Simple RT with constant and variable preparatory intervals, and 2) Simple, choice, and "crossmodal" RT to lights and tones. The DBD boys had higher HR but no differences in SC indices of "arousal." However they had smaller increases in all baseline measures to the onset of the RT task than controls. SC response latencies were shorter in the DBD group despite slower RT. Their SC responses to signal stimuli habituated at a faster rate. These results are different from those obtained previously with more 'pure' ADHD samples. Correlational analyses with behavior ratings suggest that there may be autonomically hyperresponsive and hyporesponsive subgroups who may show clinical differences somewhat oblique to the Conduct Disorder subdiagnosis. In general, the data support the concept of the DBD spectrum. DBD subjects with low levels of metabolites of serotonin, norepinephrine, and dopamine measured from cerebrospinal fluid showed generally elevated ANS Responsivity, particularly in the RT task. The RT tasks showed that DBD boys have particular problems when the timing or modality of the stimulus is uncertain. A 2-year clinical followup of these subjects revealed that low SC level )age corrected) significantly predicted institutionalization. There were similar but nonsignificant trends for low ANS activity to predict poor outcome in this group for other variables. The ANS and attention test are being repeated on a new sample of younger boys all of whom have a diagnosis of ADHS.