儿童ADHD的脑电图研究进展

儿童注意缺陷多动障碍是儿童期最常见的精神行为障碍之一,被认为是特殊大脑调节功能失调的外在表现。脑电描记技术作为一种对脑电活动的非侵入性检测手段被应用于ADHD的研究,已取得了一些成果,为ADHD病因的明确、类型划分及治疗提供一定的理论依据。     

Does maternal ADHD reduce the effectiveness of parent training for preschool children's ADHD?

OBJECTIVE: To assess the impact of maternal attention-deficit/hyperactivity disorder (ADHD) symptoms on the effectiveness of a parent training (PT) program for preschool ADHD. METHOD: Eighty-three 3-year-old children with ADHD and their mothers selected from two community cohorts living in Hampshire, England (1992-93 and 1995-96, respectively), completed an 8-week PT program. ADHD symptoms and a number of other parent and child factors, including adult ADHD symptoms, were measured prior to the start of treatment (week 1: T1), immediately after treatment (week 8: T2), and at 15 weeks follow-up (week 23: T3). RESULTS: Mothers were divided into three groups on the basis of their scores (T1) on the Adult AD/HD Rating Scale (high, medium, low). Children of mothers in the high-ADHD group displayed no improvement after PT, whereas the levels of ADHD symptoms of the children of mothers in either the medium or low ADHD groups reduced substantially (F(4,60) = 3.13, p < .05). This association persisted after other child and maternal factors were controlled for in multiple regression analyses (beta > .30, p < .05). CONCLUSIONS: High levels of maternal ADHD symptoms limit the improvement shown by children with ADHD after a program of PT. This effect was unrelated to other aspects of maternal mental health and child functioning. The treatment of parental ADHD may be a prerequisite for the success of psychosocial interventions for childhood ADHD.     

ADHD学生的校园干预策略

注意缺陷多动障碍(attention deficit hyperactivity disor-der,ADHD)俗称多动症,根据DSM-Ⅳ诊断标准,美国有3%-5%的儿童患ADHD,其中男孩是女孩的3倍以上[1]。ADHD有3个主要症状:注意缺陷、多动和冲动;DSM-Ⅳ诊断标准将ADHD分为3种亚型:以注意缺陷为主的ADHD-Ⅰ型、以多动冲动为主的ADHD-H型及混合以上症状的ADHD-C型[1]。ADHD学生不但受主要症状的困扰,而且还有大量共患问题,50%～60%的共患破坏性行为障碍,如对立违抗障碍(oppositional defiant disorder,ODD)、品行不良(conduct disorder,CD)[2]。ODD学生主要表现为违…     

Resting-State Neurophysiological Activity Patterns in Young People with ASD,ADHD, and ASD + ADHD

Altered power of resting-state neurophysiological activity has been associated with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which commonly co-occur. We compared resting-state neurophysiological power in children with ASD, ADHD, co-occurring ASD?+?ADHD, and typically developing controls. Children with ASD (ASD/ASD?+?ADHD) showed reduced theta and alpha power compared to children without ASD (controls/ADHD). Children with ADHD (ADHD/ASD?+?ADHD) displayed decreased delta power compared to children without ADHD (ASD/controls). Children with ASD?+?ADHD largely presented as an additive co-occurrence with deficits of both disorders, although reduced theta compared to ADHD-only and reduced delta compared to controls suggested some unique markers. Identifying specific neurophysiological profiles in ASD and ADHD may assist in characterising more homogeneous subgroups to inform treatment approaches and aetiological investigations.     

Examining Autistic Traits in Children with ADHD: Does the Autism Spectrum Extend to ADHD?

We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated ratings of core ASD traits (ADHD⁺) not accounted for by ADHD or behavioral symptoms. Further, analyses revealed greater oppositional behaviors, but not greater ADHD severity or anxiety, in the ADHD⁺ subgroup compared to those with ADHD only. These results highlight the importance of specifically examining autistic traits in children with ADHD for better characterization in studies of the underlying physiopathology and treatment.     

脑电生物反馈治疗儿童ADHD研究进展

综合国内外文献，对脑电生物反馈治疗儿童ADHD原理、方法、现状和前景进行综述。     

ADHD患者脑功能性磁共振研究现状

本文对有关注意缺陷与多动障碍的脑功能性磁共振成像的原理、特点、相关心理测验及一些研究结果进行了综述     

ADHD患儿补铁疗法的有效性研究

目的 探究补充铁剂对儿童注意缺陷多动障碍(ADHD)的疗效,为临床和家庭干预提供参考依据。方法 本研究初步纳入郑州大学附属儿童医院儿童保健科150例ADHD患儿,其中有72.4%的患儿血清铁蛋白水平低于30 ng·mL^-1。最终,纳入铁缺乏的患儿109例,其中男性比例为78.9%。研究采用间歇补铁法,口服蛋白琥珀酸铁,剂量为4 mg·kg^-1·w^-2,疗程为12 w。期间对患儿的症状进行评估,采用Conners家长评分量表(CPRS)、ADHD评定量表(ADHD RS)评估患儿在注意力、行为和学业等方面的表现。结果 铁剂补充后,患儿的血清铁蛋白水平明显提高,注意力和行为等方面也有了改善。具体来说,铁剂补充组的患儿注意力缺陷、多动冲动症状明显减轻,但学业问题改善不显著。结论 铁缺乏症被认为是ADHD的潜在危险因素,本研究的结果则证实了铁剂补充在改善ADHD症状的治疗上具有可行性。     

Attentional functioning in children with ADHD – predominantly hyperactive-impulsive type and children with ADHD – combined type

Summary. Although particular importance has been attributed to attention deficits in attention deficit hyperactivity disorder (ADHD), there is no consensus as to the exact nature of inattention in ADHD or which components of attention are affected. The present study was based on a neuropsychological model of attention and assessed various components of attention in 23 children with ADHD/predominantly hyperactive-impulsive type (ADHD-H), 32 children with ADHD/combined type (ADHD-C) and healthy children (N₁ = 23 and N₂ = 32). A computerized test battery consisting of reaction time tasks of low complexity was used for the assessment of attention (alertness task, vigilance task, divided attention task, visual scanning task, incompatibility task, test of crossmodal integration, flexibility task). In comparison to healthy participants, patient groups were impaired in measures of vigilance, divided attention, selective attention and flexibility but not in measures of alertness. Analysis of the test performance of patient groups revealed no differences between children with ADHD-H and children with ADHD-C. The results of the present study suggest that both children with ADHD-H and children with ADHD-C are seriously impaired in attentional functioning. Children with ADHD-H and children with ADHD-C produced comparable results in measures of attention.     

ADHD患者脑功能性磁共振研究现状

本文对有关注意缺陷与多动障碍的脑功能性磁共振成像的原理、特点、相关心理测验及一些研究结果进行了综述。     

儿童ADHD的社会心理病因研究进展

儿童注意缺陷多动障碍(ADHD)已不再认为是由单一因素造成的,而是多源性的,是生物一心理一社会多因素形成的疾病模型。较新研究认为生物学因素是ADHD形成的主要因素和基础,家庭和社会环境因素则对ADHD有诱发和加重的作用。本文对ADHD的气质特征、亲子依恋、家庭环境、养育方式等社会心理学方面近年来的研究进展进行综述。     

儿童精神分裂症患儿伴ADHD的行为特征分析

目的探讨儿童精神分裂症患儿伴注意缺陷/多动障碍(ADHD)的行为特征。方法选取2012-01—2014-12就诊于我院的儿童精神分裂症患儿75例,其中伴ADHD者40例(53.33%),不伴ADHD者35例(46.67%)。采用自编量表调查患儿的基本情况;Achenbach儿童行为量表评估患儿行为特征。结果合并ADHD组的家长与未合并组相比,更多地对患儿严厉管教以及经常打骂;更多地采用打骂方式对待儿童的不良行为。与未合并组相比,合并组的父亲急燥易怒者更多(P0.05);合并组的起病年龄及就诊年龄相对较早(P0.05);在CBCL行为问题总分、违纪因子分,多动因子分、交往不良因子分及攻击因子分数上,合并组均显著高于未合并组,差异具有统计学意义(P0.01)。结论在违纪、多动、交往不良及攻击行为问题上,儿童精神分裂症合并ADHD的患儿表现更为明显,家长对儿童的教养方式和不良行为处理的方式影响着儿童精神分裂症的发生;提示要及早重视儿童精神分裂症伴ADHD的早期干预。     

Does the definition of ADHD affect heritability?

OBJECTIVE: A twin study design was used to examine the genetic validity of attention-deficit hyperactivity disorder (ADHD)-related phenotypes. METHOD: Questionnaires covering ADHD symptoms were sent to the families of 2,846 school-age twins. Parent-rated symptoms were obtained for 2,082 twin pairs and teacher-rated symptoms were available for 1,470 twin pairs. RESULTS: Broadly defined parent-rated, teacher-rated, and "pervasive" (both parent- and teacher-rated) ADHD categories were found to be highly heritable. Significant shared environmental effects were also detected for teacher-rated ADHD. A common genetic factor was found to have a modest influence on both parent- and teacher-rated symptom scores and categories, but additional genetic and environmental influences were also found forteacher-rated ADHD. Consistent with previous findings, ADHD symptom scores were again found to be highly heritable. Maternal contrast effects were found for the Rutter A scale items but could not be detected for the DuPaul ADHD rating scale. CONCLUSIONS: Broadly defined pervasive ADHD appears to be as heritable as ADHD behaviors defined by maternal reports alone. A common genetic factor influences maternally rated and teacher-rated ADHD but does not account for all of the genetic variance for teacher-rated ADHD. ADHD symptom scores are highly heritable, and maternal contrast effects appear to vary for different measures.     

Are Stimulants Overprescribed for Youths with ADHD?

Critics of stimulant treatment for youths with attention deficit hyperactivity disorder (ADHD) have increased their rhetoric of late, contending that the leading medication for it, Ritalin^®, is vastly overprescribed. Additionally, they claim that Ritalin (methylphenidate) is inherently dangerous and that the entire system of the diagnosis and treatment of ADHD is seriously flawed. The critics view the underlying reason for the epidemic as societal, due to our modern pace of living, our competitive society, and our consumer emphasis. Rejoinders to and clarifications of the more tangible points of the critics are presented, followed by a discussion of some more practical and legitimate concerns for researchers in this area. These concerns include changes within the ADHD category, the clinical need for multiple sources of diagnostic data, infrequent teacher–physician communication, problematic ADHD/conduct disorder comorbidity in adolescence, and the limited amount of community-based research.