学习障碍儿童认知功能的某些特点

目的:探讨学习障碍(LD)儿童的脑认知功能特点.方法:对30例LD儿童和30例正常儿童进行威斯康星卡片(WCST)及儿童韦氏智力测验和比较.结果:1.与正常对照组相比,LD组WCST完成分类数(4.31±1.28/5.10±1.17)和正确应答数低,持续错误数(38.57±10.71/23.87±8.41)、总应答数和错误应答数较高,差异均有显著性(P<0.05).2.LD组总智商(89.00±14.26/112.63±17.03)、言语和操作智商以及算术、理解、积木和拼图因子分均低于正常对照组(P<0.05).3.LD组智力结构失衡发生率(80%)高于正常对照组(30%)(P<0.01).4.相关分析表明,LD儿童智商与WCST完成分类和正确应答数呈正相关(r>0.3),与总应答数、错误应答数和持续错误数呈负相关(r>-0.3).结论:LD儿童存在额叶执行功能障碍,有认知功能缺陷.     

维吾尔族抑郁症患者认知功能研究

目的探讨维吾尔族抑郁症患者认知功能情况。方法采用威斯康星卡片分类测验(WCST)分别对38例住院抑郁症患者(研究组)及30例对照者(正常组)进行WCST测验。结果研究组正确应答数(115.37±11.67)、概念化水平百分数(60.37±19.37)较正常对照组低(P<0.05);而完成分类数(1.58±1.43)、总应答数(2.66±1.52)、错误应答数(55.00±13.31)、持续性应答数(32.11±14.71)、持续性错误数(8.76±14.91)、不能维持完整分类数(64.29±15.81)等项目数值则高于正常对照组(P<0.05)。结论维吾尔族抑郁症患者认知功能有一定损害。     

注意缺陷多动障碍患儿执行功能特征

目的:探讨注意缺陷多动障碍患儿的执行功能特征。方法:符合DSM-Ⅳ诊断标准的ADHD儿童114名,正常对照组76名。采用威斯康星分类卡片测验、持续性操作测验、STROOP字色干扰测验评定其执行功能。结果:WCST测验ADHD组总应答数、完成第一个分类所需应答数和持续性应答数得分均高于正常对照组(P0.05);而其完成分类数、正确思考时间和不能维持完整分类数得分均显著低于正常对照组(P0.01);CPT测验ADHD组错误数和漏报数得分均明显高于正常对照组(P0.01);STROOP测验ADHD组色词阅读错误数、颜色命名错误数和颜色干扰命名错误数得分均明显高于正常对照组(P0.01);差异均具有统计学意义。结论:ADHD患儿存在执行功能的缺陷,以持续性注意缺陷、行为抑制为主要特征。     

精神分裂症患者攻击行为与执行功能的相关性

目的:探讨精神分裂症患者攻击行为与执行功能的关系。方法:采用修改版外显攻击行为量表(MOAS)对142例精神分裂症患者进行攻击行为评估,分为攻击组(n=62)和非攻击组(n=80)。采用威斯康星卡片分类测验(WCST)评估执行功能,阳性与阴性症状量表(PANSS)评估临床症状,比较两组WCST成绩并对MOAS分与相关因素进行分析。结果:两组患者在性别、婚姻、受教育程度、职业、年龄、病程方面差异均无统计学意义。攻击组PANSS总分、阳性症状分、阴性症状分和一般精神病理分高于非攻击组(t=5.193,3.926,2.419,2.983;P均0.01)。在WCST中,攻击组非持续错误数、持续错误数、完成第一个分类所需应答数高于非攻击组(t=3.445,5.809,2.703;P均0.01),完成分类数和正确应答数低于非攻击组(t=-2.449,-2.468;P均0.01)。MOAS分与PANSS总分、阳性症状分、阴性症状分和一般精神病理分呈显著正相关(r=0.391,0.472,0.257,0.418;P均0.01)。MOAS分与WCST完成分类数(Cc)、非持续错误数(nRpe)、持续错误数(Rpe)、正确应答数(Rc)、完成第一个分类所需应答数(Rf)5个变量指标评分的相关系数有统计学意义,呈显著正相关(r=0.382,0.315,0.438,0.240,0.423;P均0.01)。结论:精神分裂症攻击行为与执行功能损害有关,伴攻击行为的精神分裂症患者存在更差的执行功能。执行功能受损可能是发生攻击行为的病理基础之一。     

额叶肿瘤患者执行功能研究

目的:①研究额叶肿瘤患者的执行功能是否存在损害。②比较左额叶肿瘤患者与右额叶肿瘤患者的执行功能损害差异。方法:27名左额叶肿瘤患者、27名右额叶肿瘤患者、30名正常对照者,选用威斯康辛卡片分类测验(WCST)和连线测验进行执行功能评估。结果:①在WCST的完成分类数、完成第一次分类所需应答数、概念化水平百分数、持续性应答数以及持续性错误百分数5个指标上,左额叶组均显著差于右额叶组(P0.05)以及正常组(P0.05);而右额叶组的5个指标也显著的差于正常组(P0.05)。②连线测验A的完成时间,连线测验B的完成时间与错误数上,左额叶组均显著差于右额叶组(P0.05)和正常组(P0.05);右额叶组在连线A完成时间与正常组没有显著差异(P=0.525),但在连线B完成时间和错误数上也显著差于正常组。结论:额叶肿瘤严重损害了成年人的执行功能,左额叶肿瘤对执行功能的损害程度更严重。     

注意缺陷多动障碍儿童执行功能和工作记忆特点的初步探讨

目的:探讨我国注意缺陷多动障碍(ADHD)儿童的执行功能和工作记忆特征.方法:采用修订版威斯康星卡片分类测验(WCST)和韦氏记忆量表(WMS)中代表工作记忆的分测验,对汉族57例ADHD儿童和63例正常儿童进行测试.结果:①ADHD儿童在WCST中的持续性错误数(RPE)、总错误数.(RE)、持续性反应数(RP)、完成总应答数(BA)均多于对照组儿童(26.8±10.9/22.8±10.4、57.6±18.1/49.3±18.6、30.4±13.9/25.5±12.7、127.6±1.8/122.9±11.0,P=0.040、0.015、0.046、0.001),而完成分类数(CC)、正确应答数百分比(RCP)、概念化水平(RFP)均少于对照组儿童(2.9±1.5/3.8±1.8、55.0±14.0/60.5±13.4、40.8±17.6/47.8±17.7,P=0.003、0.028、0.033);②ADHD组顺背、倒背数字,数字广度、听故事理解、数字量表、积累量表得分低于对照组(7.5±1.3/8.0±1.3、4.3±1.2/4.9±1.7、11.7±1.9/13.5±2.8、6.4±3.1/8.8±3.3、9.1±2.7/10.8±3.6、9.2±3.1/11.0±2.5,P=0.025、0.029、0.001、01000、0.011、0.002);③控制年龄后,ADHD组的故事理解粗分、理解量表分、听看故事分均与WCST的总错误数、非持续性错误呈负相关(r=-0.32～-0.43,P<0.05),与完成分类数、正确应答数、正确应答数百分比、概念化水平呈正相关(r=0.32～0.39,P<0.05).结论:ADHD儿童存在执行功能、工作记忆等神经心理学功能缺陷,ADHD儿童的语音信息工作记忆存在缺陷;ADHD儿童的WCST成绩差与工作记忆能力缺陷有关.     

HIV阳性男男同性性行为者的执行功能及自评抑郁

目的:探讨HIV阳性男男同性性行为者(MSM)执行功能、自评抑郁的特征及两者的关系。方法:选取HIV感染MSM的患者209例及年龄、受教育程度匹配的HIV阴性MSM 84例。用威斯康星卡片分类测验64张卡片版(WCST-64)评估执行功能,流调中心抑郁量表(CES-D)评估抑郁状态。结果:HIV阳性MSM的WCST-64错误应答数、随机错误数高于HIV阴性MSM,完成分类数低于HIV阴性MSM(均P0.05)。HIV阳性MSM中,抑郁组WCST-64错误应答数高于无抑郁组,概念化水平百分数低于无抑郁组(均P0.05)。多元回归分析显示,HIV阳性MSM的年龄、CES-D得分与WCST-64错误应答数正向关联(β=0.33、0.15)、最低CD4+T细胞数与WCST-64错误应答数负向关联(β=-0.15)。结论:HIV阳性男男同性性行为者的执行功能低于HIV阴性者,且与抑郁状态负相关。     

男性酒精依赖者冲动行为与执行功能

目的 探讨男性酒精依赖者冲动行为与执行功能的相关性.方法 采用Barratt-11冲动性量表中文版(BIS-11)和威斯康星(WCST)卡片分类测验,对60例男性酒精依赖者进行测试,并与60例正常人作对照研究.结果 ①依赖组BIS-11总分和各因子分(认知因子、冲动因子、无计划因子)高于正常对照组(t=8.31,10.16,7.046,7.316;P＜0.001);②在WCST评分中,依赖组在完成第一类分类所需应答数、错误应答数、持续错误数、总应答数、持续应答数中得分明显高于对照组(t=7.751,13.254,8.370,7.578,6.159;P＜0.05),而在完成分类数中的得分低于对照组(t=-6.322,P＜0.001);③BIS总分与完成第一分类需要数、WCST的持续应答数与动机性冲动、无计划性冲动呈显著性正相关(r=0.260,0.30,0.253;P＜0.05)结论 酒精依赖者冲动行为较强烈而执行功能受到抑制.     

双相障碍患者不同临床分期认知功能特点比较

目的:探讨双相障碍患者不同临床分期阶段认知功能损害的差异性。方法:选取患者190例,根据Berk等描述的分期模型为依据进行分期分成A组(首次情感发作)、B组(复发后完全缓解)、C组(难治性病程),与60例正常对照组进行比较。通过采用连线测验、迷宫、数字广度测验、威斯康星卡片分类4个神经心理测验(共11项)对入组患者与正常对照组进行认知功能的评定。结果:使用方差分析比较A组、B组、C组和对照组在连线测验、迷宫、数字广度(倒背)及威斯康星卡片分类测验(总应答数、完成分类数、持续性应答数、持续性错误数)差异均有统计学意义(F=2.93~15.08,P0.05)。进一步进行LSD检验,在注意力和处理速度上,C组花费时间高于A组(F=4.29,P0.05);在记忆力上,A组得分大于B组大于C组(F=12.48,P0.05);在执行功能上,C组应答数高于B组高于A组(总应答数F=15.08,P0.05;持续性应答数F=13.79,P0.05)。结论:双相障碍患者存在认知功能的损害,随着临床分期阶段进展,患者的认知功能损害逐渐加重尤其在记忆力、执行能力方面,临床分期有利于对双相障碍的病情评估。     

Wisconsin卡片分类测验用于酒依赖者认知障碍的研究

目的 :了解酒依赖者认知功能状况。方法 :对完成脱酒治疗的 3 7例男性酒依赖者和 3 4例男性非依赖者进行Wisconsin卡片分类测验 (WCST)评定。结果 :两组间分类数 (t =5 44 )、正确应答百分数 (t=4 75 )、错误应答数 (t=5 96)、持续应答数 (t=4 78)、持续性错误数 (t =4 70 )、概念化应答百分数 (t=)的比较均显示 ,酒依赖组成绩较非依赖组差 (P <0 0 1)。相关因素分析提示 ,饮酒时间与认知功能受损程度呈正相关 (r=0 3 2～ 0 3 8,P <0 0 5 )。结论 :酒依赖者存在认知功能缺损     

Executive functioning in children with autism and Tourette syndrome

The main aims of this study were to investigate if children with high-functioning autism (HFA) and children with Tourette syndrome (TS) can be differentiated in their executive functioning (EF) profile compared to normal controls (NCs) and compared to each other and to investigate whether children with HFA or children with TS and a comorbid group of children with both disorders are distinct conditions in terms of EF, Four groups of children participated in this study: HFA, TS, comorbid HFA + TS, and a NC group. All children were in the age range of 6 to 13 years. The groups were compared on five major domains of EF: inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. Children with HFA scored lower than NC children on all the EFs measured. Children with TS and NC children showed the same EF profile. The HFA group scored lower than the TS group for inhibition of a prepotent response and cognitive flexibility. Children with HFA performed poorer than children with comorbid HFA + TS on all functions, with the exception of inhibiting an ongoing response, interference control, and verbal fluency. Children with TS and children with comorbid HFA + TS could not be differentiated from one another in terms of EF. This study indicates that EF deficits are highly characteristic of children with HFA in comparison to children with TS and NC. The results suggest that for the comparison between HFA and TS groups, it is important to take into account comorbidity. A reevaluation of the EF hypothesis in children with TS is suggested.     

The Autism-Spectrum Quotient (AQ) Japanese version: evidence from high-functioning clinical group and normal adults

Baron-Cohen, Wheelwright, Skinner, Martin, and Clubley (2001) constructed brief, self-administered instruments named the Autism-Spectrum Quotient (AQ), for measuring the degree to which an adult with normal intelligence has the traits associated with the autistic spectrum. In this paper, we report on a Japanese version of this new instrument. Three groups of Japanese subjects were assessed. Group 1 (n = 57) consisted of adults with Asperger Syndrome (AS) or high-functioning autism (HFA). The other two groups were control groups. Subjects of Group 2 (n = 194) were normal adults and those of Group 3 (n = 1 050) were students selected from five Universities in Tokyo and Chiba. The adults with AS/HFA had a mean AQ score of 37.9 (SD = 5.31), which was significantly higher than the two control groups (Group 2: X = 18.5, SD = 6.21, and Group 3: X = 20.7, SD = 6.38). While eighty-eight percent of the adults with AS/HFA scored more than 33 points, only 3% of subjects in the two control groups indicated those points. Among the controls, males scored slightly but significantly higher than females. The reliability of the AQ in both test-retest and inter-rater measures were significantly high.     

Systemizing empathy: teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia

This study evaluated Mind Reading, an interactive systematic guide to emotions, for its effectiveness in teaching adults with Asperger syndrome (AS) and high-functioning autism (HFA) to recognize complex emotions in faces and voices. Experiment 1 tested a group of adults diagnosed with AS/HFA (n = 19) who used the software at home for 10-15 weeks. Participants were tested on recognition of faces and voices at three different levels of generalization. A matched control group of adults with AS/HFA (n = 22) were assessed without any intervention. In addition, a third group of general population controls (n = 24) was tested. Experiment 2 repeated the design of Experiment 1 with a group of adults with AS/HFA who used the software at home and met in a group with a tutor on a weekly basis. They were matched to a control group of adults with AS/HFA attending social skills training and to a general population control group (n = 13 for all three groups). In both experiments the intervention group improved significantly more than the control group on close, but not distant, generalization tasks. Verbal IQ had significant effects in Experiment 2. Using Mind Reading for a relatively short period of time allows users to learn to recognize a variety of complex emotions and mental states. However, additional methods are required to enhance generalization.     

自闭症儿童执行功能的研究

目的：考察自闭症儿童执行功能的特点，探讨自闭症执行功能障碍说。方法：19名3-15岁的自闭症儿童接受了视空间工作记忆任务、stmop任务和WSCT三种执行功能任务以及龚氏非文字智力测验。结果：自闭症组在空间后退（P〈0．05）、stroop任务（P〈O．01）和WSCT的完成分类组数（P〈0．05）这3项指标上的得分明显低于正常组，其余各项指标未体现出显著差异。结论：自闭症儿童执行功能发展水平落后于同龄正常儿童．存在执行功能障碍。     

Asperger综合征儿童的心理理论测试

目的：研究Asperger综合征（AS）儿童心理理论测试的完成情况。方法：使用中文版“心理理论”测试工具和图片词汇测验（PPVT）测试7～12岁AS儿童32名和正常对照儿童30名。结果：AS儿童表情辨认测试通过率94%,与正常对照组通过率（100%）比较差异无统计学意义（P=0.494）,表情归因测试通过率低于正常对照组（81%,100%,χ2=4.23,P=0.039）。“地点变换”和“内容变换”两项错误信念测试通过率分别为69%和63%,均明显低于正常对照组通过率（100%,97%,χ2=8.99、10.91,P=0.003,0.001）。结论：部分学龄期AS儿童缺乏表情归因和判断他人错误信念的能力。     

Disorganization: the forgotten executive dysfunction in high-functioning autism (HFA) spectrum disorders

Executive function (EF) abilities were investigated in 72 children with high-functioning autism (HFA) spectrum disorders through the collection of parent ratings and performance on laboratory measures of EF. In addition, discrepancy analysis was used to isolate executive functioning on tasks that carry multiple demands. Comparison of HFA and Asperger Disorder (AD) groups did not reveal consistent differences in EF. Results did indicate global EF deficits in the combined group of children with HFA and AD. Within the EF domain, specific deficits in flexibility and organization were most prominent.     

酒精依赖患者执行功能

目的了解酒精依赖患者执行功能损害情况。方法选取32名符合国际疾病诊断与分类第10版诊断标准的酒精依赖综合征患者,选取30名年龄、受教育年限匹配的正常对照者。采用Stroop色词测验对患者组和对照组进行评定。结果酒依赖患者A部分反应时、正确阅读数与对照组相比差异无统计学意义(t=1.588,-0.692;P0.05),酒依赖患者Stroop色词测验C部分反应时长于对照组(t=4.686,P0.001)、正确阅读数低于对照组(t=-3.478,P0.01);B部分反应时长于对照组(t=3.026,P0.01),正确阅读数差异无统计学意义(t=-0.883,P0.05)。酒依赖患者干扰量高于对照组(t=3.647,P0.01)。结论酒依赖患者存在执行功能损害,临床工作中应给予针对性的认知干预,将有助于促进康复。     

抑郁症患者威斯康星卡片分类测验和连续操作测验的初步研究

目的 :通过与精神分裂症患者和正常对照的比较 ,探讨抑郁症患者的执行功能和注意功能。方法 :采用威斯康星卡片分类测验 (WCST)、连续操作测验 (CPT) ,对 66例精神分裂症患者、 42例抑郁症患者和 5 0名对照者的执行功能和注意功能进行评估。结果 :两组患者WCST中的总测验次数、持续错误数和随机错误数均明显多于对照组 (P <0 0 1) ;其中精神分裂症组WCST的三项成绩明显差于抑郁症组 (P <0 0 1) ;无干扰刺激时 ,精神分裂症组的认对数明显差于抑郁症组和对照组 (P <0 0 1) ,而抑郁症组与对照组之间的差异无显著性 (P >0 0 5 ) ;有干扰刺激时 ,精神分裂症组与对照组的差异有显著性 (P <0 0 1) ,抑郁症组与其它两组的差异均无显著性 (P >0 0 5 )。结论 :抑郁症组有执行功能障碍 ,介于精神分裂症组和对照组之间 ;在抑郁症组中没有发现有明显的注意障碍。     

Executive function profile of children with attention deficit hyperactivity disorder

We explored the neuropsychological profile for executive functions of children with attention deficit hyperactivity disorder (ADHD) to assess whether problems associated with the two most cited relevant processes-inhibition and attentional problems-were the core of any executive function difficulty. A battery of executive function tests was administered to 31 children with a clinical diagnosis of ADHD and to 33 normal control participants, all aged between 7 and 12. The executive function battery encompassed a number of tasks, selected because each had multiple measures: a sustained attention reaction time task, a related vigilance task, an adaptation of the Hayling Sentence Completion Test, an adaptation of the Brixton Spatial Rule Attainment Test, a Letter Fluency task, a number Stroop task, and an “n-back” working memory task. The overall pattern of the results fit well with those obtained in previous studies as far as abnormalities of the ADHD group in the domain of inhibitory processes, attentional functions, and executive functions. The children with ADHD, although performing well on baseline tasks, performed more poorly than the controls on all the experimental tasks with one borderline exception: Letter Fluency, where the children with ADHD showed a very different pattern than most adult frontal lobe subgroups. However, there was no specific impairment on measures of inhibitory processes. In addition, strategy generation and use were severely affected in the ADHD group. Particular findings fitted well with disorders of a high-level effort system and of a monitoring system.