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題名 複合型注意力缺失／過動疾患兒童執行功能研究
Executive Function in Children with Attention-Deficit/ Hyperactivity Disorder Combined Type作者 黃敏怡
Huang, Min Yi貢獻者 姜忠信<br>葉啟斌
黃敏怡
Huang, Min Yi關鍵詞 注意力缺失過動疾患
複合型注意力缺失過動疾患
執行功能
ADHD
ADHD-combined type
executive function日期 2012 上傳時間 11-Jul-2013 17:49:42 (UTC+8) 摘要 研究目的 本研究欲了解ADHD-C兒童執行功能的表現型態，並檢視執行功能作業的區辨效能，年齡與智力對執行功能作業表現的預測能力，以及執行功能作業表現與ADHD症狀、行為問題的關聯性。研究方法 採納30名無與其他精神疾病共病的ADHD-C兒童與30名一般發展兒童作為受試者，探討他們的抑制正在進行反應、干擾控制、語言工作記憶、非語言工作記憶、認知彈性、計畫、語言流暢度、非語言流暢度等八項執行功能，並嘗試以執行功能作業表現區辨兩組兒童。接著，探討年齡與智力對執行功能作業的表現的預測能力，以及各項執行功能作業表現與ADHD症狀、行為問題間的相關。研究結果 ADHD-C兒童的干擾控制能力、非語言工作記憶能力、認知彈性能力顯著比一般發展兒童差，此三項執行功能作業區辨效能佳，對於ADHD-C兒童與一般發展兒童的整體區辨正確率近80%。而年齡與智力兩項因子只有對工作記憶與流暢度兩種執行功能作業有明顯預測能力。執行功能作業表現與兩組受試者注意力不集中、過動／易衝動症狀均無呈現明顯的關聯性。ADHD-C兒童干擾控制能力與教師所觀察到的焦慮／憂鬱、攻擊行為與呈現負相關、非語言工作記憶能力與注意力問題呈現負相關、認知彈性能力與思考問題呈現負相關。結論 ADHD-C兒童執行功能問題並非全面性，他們僅在干擾控制能力、非語言工作記憶能力、認知彈性能力這三項執行功能上比一般發展兒童差，這三項執行功能作業的區辨效能佳，這些執行功能問題也與教師觀察到的行為問題有顯著相關，但與ADHD症狀無明顯的關聯性。
Purposes This study examined the executive function pattern in children with ADHD-combined type, and then applied the performance to explore their discriminative ability. In addition, current study also investigated the predictability of age and intelligence on executive function function task performances, the relationship between the executive function task performances and ADHD symptoms, and the relationship between the executive function task performances and behavioral problems.Methods Thirty children with ADHD-combined type and thirty healthy control children participated in current study. Each participant was tested on the ability of eight different executive functions, including inhibition of an ongoing response, interference control, verbal working memory, non-verbal working memory, cognitive flexibility, planning , verbal fluency, and non-verbal fluency. Their performances were then used to distinguish between the ADHD-C group and the control group. Furthermore, investigate the predictability of age and intelligence on their executive function performance. In addition, examine the correlation between executive function performances and ADHD symptoms, and the correlation between the executive function performances and their behavioral problems reported by their parents and teacher.Results The performances in interference control, non-verbal working memory, and cognitive flexibility of ADHD-C group were significantly worse than the control group. The discriminative ability of the above three executive function tasks is good, and the overall correct discriminative rate for the ADHD-C group and control group is nearly 80%. Age and intelligence only showed significant predictability for the performance of working memory and fluency. There was no correlation found between participants’ executive function performance and their inattention and hyperactivity/ impulsivity symptoms. Negative correlation was found between interference control of ADHD-C group and anxiety/ depression, aggressive behavior reported by their teachers. In addition, negative correlation was also found between non-verbal working memory and attention problems, and also between cognitive flexibility and thinking problems.Conclusions The executive function problems on children with ADHD-combined type are not cross all executive function tasks. Current findings showed that children with ADHD-combined type only have difficulty in interference control, non-verbal working memory, and cognitive flexibility. Further analysis also showed good discriminative rate with the above three executive function performances. In addition, current findings showed correlation found only between these executive function performances and their behavioral problems reported by their teachers, but not between their executive function performances and the ADHD symptoms.參考文獻 何淑華、靜進（2008）。注意缺陷多動障礙兒童執行功能和工作記憶特點的初步 探討。中國心理衛生雜誌，22，419-422。花茂棽、張本聖、林克能、楊建銘、盧小蓉、陳心怡（2005）。魏氏記憶量表第 三版(中文版)指導手冊。台北：中國行為科學社。梅錦榮（1991）。神經心理學。台北：桂冠。陳榮華、陳心怡（2007）。魏氏兒童智力量表第四版（中文版）技術和解釋手冊。台北：中國行為科學社。陳怡群、黃惠玲、趙家琛修訂（2009）。阿肯巴克實證衡鑑系統計分手冊。台北：心理。黃惠玲（2008）。注意力缺陷過動疾患研究回顧。應用心理研究，40，197-219。楊娟、周世杰、張拉艷、丁宇、張剛、姚樹橋（2008）。心理理論和執行功能關 係的探討─來自孤獨症和多動症的證據。中國臨床心理學雜誌，16，225-242。李玉琇、蔣文祁譯（2006）。認知心理學。台北：雙葉。林美珍編譯（2004）。兒童認知發展－概念與應用。台北：心理。劉昱志、劉世愷、商志雍、林健禾、杜長齡、高淑芬（2006）。注意力缺陷過動 症中文版Swanson, Nolan, and Pelham, Version IV（SNAP-IV）量表之常模及 信效度。台灣精神醫學，4，290-303。American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorder text revision (2nd ed.). Wachington, DC: Author.American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorder text revision (3th ed.). Wachington, DC: Author.American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorder text revision (3rd ed., text rev.). Wachington, DC: Author.American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder text revision (4th ed.). Wachington, DC: Author.American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder text revision (4th ed., text rev.). Wachington, DC: Author.Arnsten, A. F. (2009). Toward a new understanding of attention-deficit hyperactivity disorder pathophysiology: an important role for prefrontal cortex dysfunction. CNS Drugs, 23, 33-41.Abikoff, H., Courtney, M., Pelham, W. E., Jr., & Koplexicz, H. S. (1993). Teacher’s ratings of disruptive behaviors: The influence of halo effects. Journal of Abnormal Child Psychology, 21, 519-533.Alderson, R. M., Rapport, M. D., & Kofler, M. J. (2007). Attention-deficit/hyperactivity disorder and behavioral inhibition: a meta-analytic review of the stop-signal paradigm. Journal of Abnormal Child Psychology, 35, 745-758.Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and exective functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.Barkley, R. A. (2006). Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (3rd ed.). New York: The Guilford Press.Brocki, K. C., & Bohlin, G. (2006). Developmental change in the relation between executive functions and symptoms of ADHD and co-occurring behaviour problems. Infant and Child Development, 15(1), 19-40.Berlin, L., Bohlin, G., & Rydell, A. (2003). Relations between inhibition, executive functioning, and ADHD symptoms: A longitudinal study from age 5 to 8½ years. Child Neuropsychology, 9(4), 255-266.Bohlin, G., Eninger L., Brocki, K. C., & Thorell, L. B. (2012). Disorganized attachment and inhibitory capacity: Predicting externalizing problem behaviors. Journal of Abnormal Child Psychology, 49, 449-458.Brocki, K. C., Eninger, L., Thorell, L. B., & Bohlin, G. (2010). Interrelations between executive function and symptoms of hyperactivity/ impulsivity and inattention in preschoolers: A two year longitudinal study. Journal of Abnormal Child Psychology, 38(2), 163-171.Boonstra, A. M., Kooij, J. J. S., Oosterlaan, J., Sergeant, J. A., & Buitelaar, J. K. (2010). To act or not to act, that’s the problem: primarily inhibition difficulties in adult ADHD. Neuropsychology, 24, 209-221.Biederman, J., Monuteaux, M. C., Doyle, A. E., Seidman, L. J., Wilens, T. E., Ferrero, F., et al. (2004). Impact of executive function deficits and attention-deficit/ hyperactivity disorder (ADHD) on academic outcomes in children. Journal of Consulting and Clinical Psychology, 72, 757-766.Brocki, K. C., Nyberg, L., Thorell, L. B., & Bohlin, G. (2007). Early concurrent and longitudinal symptoms of ADHD and ODD: relations to different types of inhibitory control and working memory. Journal of Child Psychology and Psychiatry, 48(10), 1033-1041.Brocki, K. C., Randall, K. D., Bohlin, G., & Kerns, K. A. (2008). Working memory in school-aged children with attention-deficit/hyperactivity disorder combined type: Are deficits modality specific and are they independent of impaired inhibitory control? Journal of Clinical and Experimental Neuropsychology, 30, 749-759.Chess, S. (1960). Diagnosis and treatment of the hyperactive child. New York State Journal of Medicine, 60, 2379-2385.Cohen, J. (1988). Statostical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Corbett, B. A., Constantine, L. J., Hendren, R., Rocke, D., & Ozonoff, S. (2009). Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Research, 166, 210-222.Chhabildas, N., Pennington, B. F., & Willcutt, E.G. (2001). A comparison of the neuropsychological profiles of the DSM-IV subtypes of ADHD. Journal of Abnormal Child Psychology, 29, 529-540.Dawson P., & Guare R. (2004). Executive skills in children and adolescents: A practical guide to assessment and intervention. New York: Guilford.Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., et al. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35, 279-293.Geurts, H. M., Verte, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Journal of Child Psychology and Psychiatry, 45, 834-854.Geurts, H. M., Verte, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2005). ADHD subtypes: do they differ in their executive functioning profile? Archives of Clinical Neuropsychology, 20, 457-477.Ciairano, S., Visu-Petra, L., & Settanni, M. (2007). Executive inhibitory control and cooperative behavior during early school years: A follow-up study. Journal of Abnormal Child Psychology, 35(3), 335-345.Hoffman, H. (1945). Struwwelpeter. London: Blackie.Huberty, C. (1994). Applied Discriminant Analysis (Wiley Series in Probability and Statistics), Wiley-Interscience.Hairm J. F., Andersin, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed.). Upper Saddle River, NJ: Prentice-Hall.Hosenbocus, S., & Chahal, R. (2012). A Review of Executive Function Deficits and Pharmacological Management in Children and Adolescents. Journal of The Canadian Academy of Child and Adolescent Psychiatry, 21(3), 223-229.Holmes, J., Gathercole, S. E., Place, M., Alloway, T. P., Elliott, J. G., & Hilton, K. A. (2010). The diagnostic utility of executive function assessments in the identification of ADHD in children. Child and Adolescent Mental Health, 15, 37-43.Korkman, M., Kirk, U., & Kemp, S. (1998). NEPSY：A Developmental Neuropsychological Assessment Menual. Kempton, S., Vance, A., Maruff, P., Luk, E., Costin, J., & Pantelis, C. (1999). Executive function and attention deficit hyperactivity disorder: stmulant medication and better excutive function perdormance in children. Psycholgical Medicine, 29, 527-538.Lezak, M. D.（1995）. Neuropsychological assessment. Oxford New York: Oxford University Press.Lyon, G. R., & Krasnegor, N. A. (1996). Attention, memory and executive function. Baltimore: Paul H. Brookes.Lockwood, K. A., Marcotte, A. C., & Stern, C. (2001). Differentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsychological model of attention. Journal of Clinical and Experiental Neuropsychology, 23, 317-330.Llorente, A. M., William, J., Satz, P., D’Elia, L. F. （2003）. Children’s Color Trails Test: Professional manual. Psychological assessment resources, Inc.Llorente, A. M., Voigt, R. G., Williams, J., Frailey, J. K., Satz, P., & D’Elia, L. F. (2009). Children’s color trails test1 & 2: test-retest reliability and factory validity. The Clinical Neuropsychologist, 23, 645-660.Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463-488.Mahone, E., Hagelthorn, K. M., Cutting, L. E., Schuerholz, L. J., Pelletier, S. F., Rawlins, C. et al. (2002). Effects of IQ on executive function measures in children with ADHD. Child Neuropsychology, 8(1), 52-65.Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of American Academy of Child and Adolescent Psychiatry, 44, 377-384.Marzocchi, G. M., Oosterlan, J., Zuddas, A., Cavolina, P., Geurts, H., Redigolo, D. et al. (2008). Contrasting deficits on executive functions between ADHD and reading disabled children. Journal of Child Psychology and Psychiatry, 49, 543-552. Mahone, E. M., Powell, S. K., Loftis, C.W., Goldberg, M. C., Denckla, M. B., & Mostofsky, S. H. (2006). Motor persistence and inhibition in autism and ADHD. Journal of International Neuropsychological Society, 12, 622-631.Massat, I., Slama, H., Kavec, M., Linotte, S., Mary, A., Baleriaux, D., et al. (2012). Working memory-related functional brain patterns in never medicated children with ADHD. Plos ONE, 7(11), 1-11.Mash, E. J., & Wolfe, D. A. (2010). Abnormal Child Psychology (4th ed.). Belmont: Wadsworth.Nigg, J. T. (1999). The ADHD response-inhibition deficit as measured by the stop task: Replication with DSM-IV combined type, extension, and qualification. Journal of Abnormal Child Psychology, 27, 393–402.Nigg, J. T. (2001). Is ADHD a disinhibitory disorder? Psychological Bulletin, 127, 571-598.Nigg (2005). Neuropsychologic theory and findings in attention deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Society of Biological Psychiatry, 57, 1424-1435.Nigg, J. T., Blaskey, L. G., Huang-Pollock, C. L., & Rappley, M. D. (2002). Neuropsychological executive functions and DSM-IV ADHD subtypes. Journal of American Academy of Child and Adolescent Psychiatry, 41, 59-66.Nigg, J. T., Quamma, J. P., Greenberg, M. T., & Kusche, C. A. (1999). A two-year longitudinal study of neuropsychological and cognitive performance in relation to behavioral problems and competencies in elementary school children. Journal of Abnormal Child Psychology, 27(1), 51-63.Ozonoff, S., & Jensen, T. (1999). Brief report: Specific executive function profiles in three neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 29, 171-177.Oosterlaan, J., & Sergeant, J. A. (1998). Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children. Behavioral Brain Research, 94, 33–43.Pennington, B. F. & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51-87.Riggs, N. R., Blair, C. B., & Greenberg, M. T. (2003). Concurrent and 2-year longitudinal relations between executive function and the behavior of 1st and 2nd grade children. Child Neuropsychology, 9(4), 267-276.Roldán-Tapia, L., García, J., Cánovas, R., & León, I. (2012). Cognitive reserve, age, and their relation to attentional and executive functions. Applied Neuropsychology: Adult, 19(1), 2-8.Rinsky, J. R., & Hinshaw, S. P. (2011). Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD. Child Neuropsychology, 17(4), 368-390.Rhodes, S. M., Park, J., Seth, S., & Coghill, D. R. (2012). A comprehensive investigation of memory impairment in attention deficit hyperactivity disorder and oppositional defiant disorder. Journal Of Child Psychology and Psychiatry, 53(2), 128-137.Swanson, J. M. (2003). Role of executive function in ADHD. Journal of Clinical Psychiatry, 64, 35 -39.Sattler, J. M. (2008). Assessment of Children: Cognitive Foundations. (5th ed.). Jerome M: La Mesa.Sattler, J. M. (2008). Resource Guide to Accompany Assessment of Children: Cognitive Foundations (5th ed.). Jerome M: La Mesa.Shuai, L., Chan, R. C. K., & Wang Y. (2011). Executive function profile of Chinese boys with attention-deficit hyperactivity disorder: different subtypes and comorbidity. Archives of Neuropsychology, 26, 120-132.Sergeant, J. A., Geurts, H., & Oosterlaan, J. (2002). How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behavioural Brain Research, 130, 3-28.Scheres, A., Oosterlaan, J., Geurts, H., Morein-Zamir, S., Merian, N., Schut, H., Vlasveld, L., & Sergeant, J. A. (2004). Executive functioning in boys with ADHD: primarily an inhibition deficit? Archives of Clinical Neuropsychology, 19, 569-594.Scheres, S., Oosterlaan, J., Swanson, J., Morein-Zamir, S., Meiran, N., Schut, H. et al. (2003). The effect of methylphenidate on three forms of response inhibition in boys with AD/HD. Journal of Abnormal Child Psychology, 31, 105–120.Sinha, P., Sagar, R., & Mehta, M. (2008). Executive function in attention deficit/hyperactivity disorder. Journal of Indian Association Child Adolescent Mental Health, 4, 44-49.Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A, & Butcher, B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017-1027.Thorell, L. B. (2007). Do delay aversion and executive function deficits make distinct contributions to the functional impact of ADHD symptoms? A study of early academic skill deficits. Journal of Child Psychology and Psychiatry, 48(11), 1061-1070.Tannock, R., Martinussen, R., & Frijters, J. (2000). Naming speed performance and stimulant effects indicate effortful, semantic processing deficits in attention deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 28, 237–252Tsuchiya, E., Oki, J., Yahara, N., & Fujieda, K. (2005). Computerized version of the Wisconsin card sorting test in children with high-functioning autistic disorder or attention-deficit/hyperactivity disorder. Brain & Development, 27, 233-236.Tripp, G., Ryan, J., & Peace, K. (2002). Neuropsychological functioning in children with DSM-IV combined type attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 36, 771-779.Verte, S., Geurts, H. M., Roeyers, H., Oosterlaan, J., & Sergeant, J. A. (2006). The relationship of working memory, inhibition, and response variability in child psychopathology. Journal of Neuroscience Methods, 151, 5-14.Van der Elst, W., Hurks, P., Wassenberg, R., Meijs, C., & Jolles, J. (2011). Animal Verbal Fluency and Design Fluency in school-aged children: Effects of age, sex, and mean level of parental education, and regression-based normative data. Journal Of Clinical & Experimental Neuropsychology, 33(9), 1005-1015.Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone. S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336-1346.Welsh, M. C. & Pennington, B. F. (1988). Assessing frontal lobe functioning in children: views from developmental psychology. Developmental Neuropsycholo-gy, 4, 199-230.Willcutt, E. G., Pennington, B. F., Boada, R., Ogline, J. S., Tunick, R. A., Chhabildas, N. A., et al. (2001). A comparison of the cognition deficits in reading disability and attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology, 110, 157-172.Williams, J., Rickert, V., Hogan, J., Zolten, A. J., Satz, P., D’Elia, L. F. et al. (1995). Children’s Color Trails. Archives of Clinical Neuropsychology, 10, 211-223. Wåhlstedt, C., Thorell, L. B., & Bohlin, G. (2008). ADHD symptoms and executive function impairment: early predictors of later behavioral problems. Developmental Neuropsychology, 33(2), 160-178.Xiao, T., Xiao, Z., Ke, X., Hong, S., Yang, H., Su, Y., et al. (2012). Response inhibition impairment in high functioning autism and Attention Deficit hyperactivity disorder: evidence from Near-nfrared Spectroscopy Data. Plos ONE, 7(10), 1-7. 描述 碩士
國立政治大學
心理學研究所
98752020
101資料來源 http://thesis.lib.nccu.edu.tw/record/#G0098752020 資料類型 thesis dc.contributor.advisor 姜忠信<br>葉啟斌 zh_TW dc.contributor.author (Authors) 黃敏怡 zh_TW dc.contributor.author (Authors) Huang, Min Yi en_US dc.creator (作者) 黃敏怡 zh_TW dc.creator (作者) Huang, Min Yi en_US dc.date (日期) 2012 en_US dc.date.accessioned 11-Jul-2013 17:49:42 (UTC+8) - dc.date.available 11-Jul-2013 17:49:42 (UTC+8) - dc.date.issued (上傳時間) 11-Jul-2013 17:49:42 (UTC+8) - dc.identifier (Other Identifiers) G0098752020 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/58849 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學研究所 zh_TW dc.description (描述) 98752020 zh_TW dc.description (描述) 101 zh_TW dc.description.abstract (摘要) 研究目的 本研究欲了解ADHD-C兒童執行功能的表現型態，並檢視執行功能作業的區辨效能，年齡與智力對執行功能作業表現的預測能力，以及執行功能作業表現與ADHD症狀、行為問題的關聯性。研究方法 採納30名無與其他精神疾病共病的ADHD-C兒童與30名一般發展兒童作為受試者，探討他們的抑制正在進行反應、干擾控制、語言工作記憶、非語言工作記憶、認知彈性、計畫、語言流暢度、非語言流暢度等八項執行功能，並嘗試以執行功能作業表現區辨兩組兒童。接著，探討年齡與智力對執行功能作業的表現的預測能力，以及各項執行功能作業表現與ADHD症狀、行為問題間的相關。研究結果 ADHD-C兒童的干擾控制能力、非語言工作記憶能力、認知彈性能力顯著比一般發展兒童差，此三項執行功能作業區辨效能佳，對於ADHD-C兒童與一般發展兒童的整體區辨正確率近80%。而年齡與智力兩項因子只有對工作記憶與流暢度兩種執行功能作業有明顯預測能力。執行功能作業表現與兩組受試者注意力不集中、過動／易衝動症狀均無呈現明顯的關聯性。ADHD-C兒童干擾控制能力與教師所觀察到的焦慮／憂鬱、攻擊行為與呈現負相關、非語言工作記憶能力與注意力問題呈現負相關、認知彈性能力與思考問題呈現負相關。結論 ADHD-C兒童執行功能問題並非全面性，他們僅在干擾控制能力、非語言工作記憶能力、認知彈性能力這三項執行功能上比一般發展兒童差，這三項執行功能作業的區辨效能佳，這些執行功能問題也與教師觀察到的行為問題有顯著相關，但與ADHD症狀無明顯的關聯性。 zh_TW dc.description.abstract (摘要) Purposes This study examined the executive function pattern in children with ADHD-combined type, and then applied the performance to explore their discriminative ability. In addition, current study also investigated the predictability of age and intelligence on executive function function task performances, the relationship between the executive function task performances and ADHD symptoms, and the relationship between the executive function task performances and behavioral problems.Methods Thirty children with ADHD-combined type and thirty healthy control children participated in current study. Each participant was tested on the ability of eight different executive functions, including inhibition of an ongoing response, interference control, verbal working memory, non-verbal working memory, cognitive flexibility, planning , verbal fluency, and non-verbal fluency. Their performances were then used to distinguish between the ADHD-C group and the control group. Furthermore, investigate the predictability of age and intelligence on their executive function performance. In addition, examine the correlation between executive function performances and ADHD symptoms, and the correlation between the executive function performances and their behavioral problems reported by their parents and teacher.Results The performances in interference control, non-verbal working memory, and cognitive flexibility of ADHD-C group were significantly worse than the control group. The discriminative ability of the above three executive function tasks is good, and the overall correct discriminative rate for the ADHD-C group and control group is nearly 80%. Age and intelligence only showed significant predictability for the performance of working memory and fluency. There was no correlation found between participants’ executive function performance and their inattention and hyperactivity/ impulsivity symptoms. Negative correlation was found between interference control of ADHD-C group and anxiety/ depression, aggressive behavior reported by their teachers. In addition, negative correlation was also found between non-verbal working memory and attention problems, and also between cognitive flexibility and thinking problems.Conclusions The executive function problems on children with ADHD-combined type are not cross all executive function tasks. Current findings showed that children with ADHD-combined type only have difficulty in interference control, non-verbal working memory, and cognitive flexibility. Further analysis also showed good discriminative rate with the above three executive function performances. In addition, current findings showed correlation found only between these executive function performances and their behavioral problems reported by their teachers, but not between their executive function performances and the ADHD symptoms. en_US dc.description.tableofcontents 致謝 I摘要 VAbtract VII目錄 IX表目錄 XI圖目錄 XII第一章 緒論 1第二章 文獻探討 2第一節 注意力缺失／過動症之歷史沿革 2第二節 注意力缺失／過動症之臨床診斷與工具 3壹、盛行率 3貳、臨床診斷準則 4參、現行診斷之議題與限制 7第三節 注意力缺失／過動症執行功能之研究 8壹、ADHD與抑制能力 10貳、ADHD與工作記憶能力 15參、ADHD與認知彈性 21肆、ADHD與計畫能力 24伍、ADHD與流暢度 28第四節 執行功能與ADHD症狀及行為問題關聯性之研究 31第五節 本研究中執行功能作業選擇 35第六節 研究問題與假設 38第三章 研究方法 42第一節 受試者 42壹、ADHD組 42貳、控制組 43第二節 研究工具 43壹、智能篩檢工具 44貳、Swanson, Nolan, and Pelham, Version IV（SNAP-IV）中文版 44參、行為檢核表 45肆、執行功能作業 45第三節 研究流程 51壹、ADHD組 51貳、控制組 52第四節 統計分析 53第四章 研究結果 56第一節 受試者基本資料 56第二節 受試者執行功能表現型態及各項執行功能比較 59壹、受試者執行功能表現型態 59貳、各項執行功能比較 61第三節 執行功能作業之區辨效能 64第四節 年齡與智力對受試者各項執行功能作業表現的預測能力 66第五節 各項執行功能作業與SNAP-IV分量表分數之相關 68第六節 各項執行功能作業與CBCL及TRF分量表分數之相關 70第五章 討論與建議 75第一節 討論 75壹、ADHD之執行功能 75貳、執行功能作業之區辨效能 78參、年齡與智力對執行功能作業表現之預測能力 79肆、執行功能作業表現與ADHD症狀及行為問題關聯性 82伍、結論 84第二節 研究貢獻 85第三節 研究限制與後續研究方向 87參考文獻 90附錄一 受試者同意書 100附錄二 教師版受試者同意書 107附錄三 SNAP-IV中文版 112附錄四 停止訊號作業指導語 113 zh_TW dc.format.extent 4929177 bytes - dc.format.mimetype application/pdf - dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0098752020 en_US dc.subject (關鍵詞) 注意力缺失過動疾患 zh_TW dc.subject (關鍵詞) 複合型注意力缺失過動疾患 zh_TW dc.subject (關鍵詞) 執行功能 zh_TW dc.subject (關鍵詞) ADHD en_US dc.subject (關鍵詞) ADHD-combined type en_US dc.subject (關鍵詞) executive function en_US dc.title (題名) 複合型注意力缺失／過動疾患兒童執行功能研究 zh_TW dc.title (題名) Executive Function in Children with Attention-Deficit/ Hyperactivity Disorder Combined Type en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 何淑華、靜進（2008）。注意缺陷多動障礙兒童執行功能和工作記憶特點的初步 探討。中國心理衛生雜誌，22，419-422。花茂棽、張本聖、林克能、楊建銘、盧小蓉、陳心怡（2005）。魏氏記憶量表第 三版(中文版)指導手冊。台北：中國行為科學社。梅錦榮（1991）。神經心理學。台北：桂冠。陳榮華、陳心怡（2007）。魏氏兒童智力量表第四版（中文版）技術和解釋手冊。台北：中國行為科學社。陳怡群、黃惠玲、趙家琛修訂（2009）。阿肯巴克實證衡鑑系統計分手冊。台北：心理。黃惠玲（2008）。注意力缺陷過動疾患研究回顧。應用心理研究，40，197-219。楊娟、周世杰、張拉艷、丁宇、張剛、姚樹橋（2008）。心理理論和執行功能關 係的探討─來自孤獨症和多動症的證據。中國臨床心理學雜誌，16，225-242。李玉琇、蔣文祁譯（2006）。認知心理學。台北：雙葉。林美珍編譯（2004）。兒童認知發展－概念與應用。台北：心理。劉昱志、劉世愷、商志雍、林健禾、杜長齡、高淑芬（2006）。注意力缺陷過動 症中文版Swanson, Nolan, and Pelham, Version IV（SNAP-IV）量表之常模及 信效度。台灣精神醫學，4，290-303。American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorder text revision (2nd ed.). Wachington, DC: Author.American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorder text revision (3th ed.). Wachington, DC: Author.American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorder text revision (3rd ed., text rev.). Wachington, DC: Author.American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder text revision (4th ed.). Wachington, DC: Author.American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder text revision (4th ed., text rev.). Wachington, DC: Author.Arnsten, A. F. (2009). Toward a new understanding of attention-deficit hyperactivity disorder pathophysiology: an important role for prefrontal cortex dysfunction. CNS Drugs, 23, 33-41.Abikoff, H., Courtney, M., Pelham, W. E., Jr., & Koplexicz, H. S. (1993). Teacher’s ratings of disruptive behaviors: The influence of halo effects. Journal of Abnormal Child Psychology, 21, 519-533.Alderson, R. M., Rapport, M. D., & Kofler, M. J. (2007). Attention-deficit/hyperactivity disorder and behavioral inhibition: a meta-analytic review of the stop-signal paradigm. Journal of Abnormal Child Psychology, 35, 745-758.Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and exective functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.Barkley, R. A. (2006). Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (3rd ed.). New York: The Guilford Press.Brocki, K. C., & Bohlin, G. (2006). Developmental change in the relation between executive functions and symptoms of ADHD and co-occurring behaviour problems. Infant and Child Development, 15(1), 19-40.Berlin, L., Bohlin, G., & Rydell, A. (2003). Relations between inhibition, executive functioning, and ADHD symptoms: A longitudinal study from age 5 to 8½ years. Child Neuropsychology, 9(4), 255-266.Bohlin, G., Eninger L., Brocki, K. C., & Thorell, L. B. (2012). Disorganized attachment and inhibitory capacity: Predicting externalizing problem behaviors. Journal of Abnormal Child Psychology, 49, 449-458.Brocki, K. C., Eninger, L., Thorell, L. B., & Bohlin, G. (2010). Interrelations between executive function and symptoms of hyperactivity/ impulsivity and inattention in preschoolers: A two year longitudinal study. Journal of Abnormal Child Psychology, 38(2), 163-171.Boonstra, A. M., Kooij, J. J. S., Oosterlaan, J., Sergeant, J. A., & Buitelaar, J. K. (2010). To act or not to act, that’s the problem: primarily inhibition difficulties in adult ADHD. Neuropsychology, 24, 209-221.Biederman, J., Monuteaux, M. C., Doyle, A. E., Seidman, L. J., Wilens, T. E., Ferrero, F., et al. (2004). Impact of executive function deficits and attention-deficit/ hyperactivity disorder (ADHD) on academic outcomes in children. Journal of Consulting and Clinical Psychology, 72, 757-766.Brocki, K. C., Nyberg, L., Thorell, L. B., & Bohlin, G. (2007). Early concurrent and longitudinal symptoms of ADHD and ODD: relations to different types of inhibitory control and working memory. Journal of Child Psychology and Psychiatry, 48(10), 1033-1041.Brocki, K. C., Randall, K. D., Bohlin, G., & Kerns, K. A. (2008). Working memory in school-aged children with attention-deficit/hyperactivity disorder combined type: Are deficits modality specific and are they independent of impaired inhibitory control? Journal of Clinical and Experimental Neuropsychology, 30, 749-759.Chess, S. (1960). Diagnosis and treatment of the hyperactive child. New York State Journal of Medicine, 60, 2379-2385.Cohen, J. (1988). Statostical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Corbett, B. A., Constantine, L. J., Hendren, R., Rocke, D., & Ozonoff, S. (2009). Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Research, 166, 210-222.Chhabildas, N., Pennington, B. F., & Willcutt, E.G. (2001). A comparison of the neuropsychological profiles of the DSM-IV subtypes of ADHD. Journal of Abnormal Child Psychology, 29, 529-540.Dawson P., & Guare R. (2004). Executive skills in children and adolescents: A practical guide to assessment and intervention. New York: Guilford.Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., et al. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35, 279-293.Geurts, H. M., Verte, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Journal of Child Psychology and Psychiatry, 45, 834-854.Geurts, H. M., Verte, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2005). ADHD subtypes: do they differ in their executive functioning profile? Archives of Clinical Neuropsychology, 20, 457-477.Ciairano, S., Visu-Petra, L., & Settanni, M. (2007). Executive inhibitory control and cooperative behavior during early school years: A follow-up study. Journal of Abnormal Child Psychology, 35(3), 335-345.Hoffman, H. (1945). Struwwelpeter. London: Blackie.Huberty, C. (1994). Applied Discriminant Analysis (Wiley Series in Probability and Statistics), Wiley-Interscience.Hairm J. F., Andersin, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis (5th ed.). Upper Saddle River, NJ: Prentice-Hall.Hosenbocus, S., & Chahal, R. (2012). A Review of Executive Function Deficits and Pharmacological Management in Children and Adolescents. Journal of The Canadian Academy of Child and Adolescent Psychiatry, 21(3), 223-229.Holmes, J., Gathercole, S. E., Place, M., Alloway, T. P., Elliott, J. G., & Hilton, K. A. (2010). The diagnostic utility of executive function assessments in the identification of ADHD in children. Child and Adolescent Mental Health, 15, 37-43.Korkman, M., Kirk, U., & Kemp, S. (1998). NEPSY：A Developmental Neuropsychological Assessment Menual. Kempton, S., Vance, A., Maruff, P., Luk, E., Costin, J., & Pantelis, C. (1999). Executive function and attention deficit hyperactivity disorder: stmulant medication and better excutive function perdormance in children. Psycholgical Medicine, 29, 527-538.Lezak, M. D.（1995）. Neuropsychological assessment. Oxford New York: Oxford University Press.Lyon, G. R., & Krasnegor, N. A. (1996). Attention, memory and executive function. Baltimore: Paul H. Brookes.Lockwood, K. A., Marcotte, A. C., & Stern, C. (2001). Differentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsychological model of attention. Journal of Clinical and Experiental Neuropsychology, 23, 317-330.Llorente, A. M., William, J., Satz, P., D’Elia, L. F. （2003）. Children’s Color Trails Test: Professional manual. Psychological assessment resources, Inc.Llorente, A. M., Voigt, R. G., Williams, J., Frailey, J. K., Satz, P., & D’Elia, L. F. (2009). Children’s color trails test1 & 2: test-retest reliability and factory validity. The Clinical Neuropsychologist, 23, 645-660.Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463-488.Mahone, E., Hagelthorn, K. M., Cutting, L. E., Schuerholz, L. J., Pelletier, S. F., Rawlins, C. et al. (2002). Effects of IQ on executive function measures in children with ADHD. Child Neuropsychology, 8(1), 52-65.Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of American Academy of Child and Adolescent Psychiatry, 44, 377-384.Marzocchi, G. M., Oosterlan, J., Zuddas, A., Cavolina, P., Geurts, H., Redigolo, D. et al. (2008). Contrasting deficits on executive functions between ADHD and reading disabled children. Journal of Child Psychology and Psychiatry, 49, 543-552. Mahone, E. M., Powell, S. K., Loftis, C.W., Goldberg, M. C., Denckla, M. B., & Mostofsky, S. H. (2006). Motor persistence and inhibition in autism and ADHD. Journal of International Neuropsychological Society, 12, 622-631.Massat, I., Slama, H., Kavec, M., Linotte, S., Mary, A., Baleriaux, D., et al. (2012). Working memory-related functional brain patterns in never medicated children with ADHD. Plos ONE, 7(11), 1-11.Mash, E. J., & Wolfe, D. A. (2010). Abnormal Child Psychology (4th ed.). Belmont: Wadsworth.Nigg, J. T. (1999). The ADHD response-inhibition deficit as measured by the stop task: Replication with DSM-IV combined type, extension, and qualification. Journal of Abnormal Child Psychology, 27, 393–402.Nigg, J. T. (2001). Is ADHD a disinhibitory disorder? Psychological Bulletin, 127, 571-598.Nigg (2005). Neuropsychologic theory and findings in attention deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Society of Biological Psychiatry, 57, 1424-1435.Nigg, J. T., Blaskey, L. G., Huang-Pollock, C. L., & Rappley, M. D. (2002). Neuropsychological executive functions and DSM-IV ADHD subtypes. Journal of American Academy of Child and Adolescent Psychiatry, 41, 59-66.Nigg, J. T., Quamma, J. P., Greenberg, M. T., & Kusche, C. A. (1999). A two-year longitudinal study of neuropsychological and cognitive performance in relation to behavioral problems and competencies in elementary school children. Journal of Abnormal Child Psychology, 27(1), 51-63.Ozonoff, S., & Jensen, T. (1999). Brief report: Specific executive function profiles in three neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 29, 171-177.Oosterlaan, J., & Sergeant, J. A. (1998). Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children. Behavioral Brain Research, 94, 33–43.Pennington, B. F. & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51-87.Riggs, N. R., Blair, C. B., & Greenberg, M. T. (2003). Concurrent and 2-year longitudinal relations between executive function and the behavior of 1st and 2nd grade children. Child Neuropsychology, 9(4), 267-276.Roldán-Tapia, L., García, J., Cánovas, R., & León, I. (2012). Cognitive reserve, age, and their relation to attentional and executive functions. Applied Neuropsychology: Adult, 19(1), 2-8.Rinsky, J. R., & Hinshaw, S. P. (2011). Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD. Child Neuropsychology, 17(4), 368-390.Rhodes, S. M., Park, J., Seth, S., & Coghill, D. R. (2012). A comprehensive investigation of memory impairment in attention deficit hyperactivity disorder and oppositional defiant disorder. Journal Of Child Psychology and Psychiatry, 53(2), 128-137.Swanson, J. M. (2003). Role of executive function in ADHD. Journal of Clinical Psychiatry, 64, 35 -39.Sattler, J. M. (2008). Assessment of Children: Cognitive Foundations. (5th ed.). Jerome M: La Mesa.Sattler, J. M. (2008). Resource Guide to Accompany Assessment of Children: Cognitive Foundations (5th ed.). Jerome M: La Mesa.Shuai, L., Chan, R. C. K., & Wang Y. (2011). Executive function profile of Chinese boys with attention-deficit hyperactivity disorder: different subtypes and comorbidity. Archives of Neuropsychology, 26, 120-132.Sergeant, J. A., Geurts, H., & Oosterlaan, J. (2002). How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behavioural Brain Research, 130, 3-28.Scheres, A., Oosterlaan, J., Geurts, H., Morein-Zamir, S., Merian, N., Schut, H., Vlasveld, L., & Sergeant, J. A. (2004). Executive functioning in boys with ADHD: primarily an inhibition deficit? Archives of Clinical Neuropsychology, 19, 569-594.Scheres, S., Oosterlaan, J., Swanson, J., Morein-Zamir, S., Meiran, N., Schut, H. et al. (2003). The effect of methylphenidate on three forms of response inhibition in boys with AD/HD. Journal of Abnormal Child Psychology, 31, 105–120.Sinha, P., Sagar, R., & Mehta, M. (2008). Executive function in attention deficit/hyperactivity disorder. Journal of Indian Association Child Adolescent Mental Health, 4, 44-49.Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A, & Butcher, B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017-1027.Thorell, L. B. (2007). Do delay aversion and executive function deficits make distinct contributions to the functional impact of ADHD symptoms? A study of early academic skill deficits. Journal of Child Psychology and Psychiatry, 48(11), 1061-1070.Tannock, R., Martinussen, R., & Frijters, J. (2000). Naming speed performance and stimulant effects indicate effortful, semantic processing deficits in attention deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 28, 237–252Tsuchiya, E., Oki, J., Yahara, N., & Fujieda, K. (2005). Computerized version of the Wisconsin card sorting test in children with high-functioning autistic disorder or attention-deficit/hyperactivity disorder. Brain & Development, 27, 233-236.Tripp, G., Ryan, J., & Peace, K. (2002). Neuropsychological functioning in children with DSM-IV combined type attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 36, 771-779.Verte, S., Geurts, H. M., Roeyers, H., Oosterlaan, J., & Sergeant, J. A. (2006). The relationship of working memory, inhibition, and response variability in child psychopathology. Journal of Neuroscience Methods, 151, 5-14.Van der Elst, W., Hurks, P., Wassenberg, R., Meijs, C., & Jolles, J. (2011). Animal Verbal Fluency and Design Fluency in school-aged children: Effects of age, sex, and mean level of parental education, and regression-based normative data. Journal Of Clinical & Experimental Neuropsychology, 33(9), 1005-1015.Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone. S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336-1346.Welsh, M. C. & Pennington, B. F. (1988). Assessing frontal lobe functioning in children: views from developmental psychology. Developmental Neuropsycholo-gy, 4, 199-230.Willcutt, E. G., Pennington, B. F., Boada, R., Ogline, J. S., Tunick, R. A., Chhabildas, N. A., et al. (2001). A comparison of the cognition deficits in reading disability and attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology, 110, 157-172.Williams, J., Rickert, V., Hogan, J., Zolten, A. J., Satz, P., D’Elia, L. F. et al. (1995). Children’s Color Trails. Archives of Clinical Neuropsychology, 10, 211-223. Wåhlstedt, C., Thorell, L. B., & Bohlin, G. (2008). ADHD symptoms and executive function impairment: early predictors of later behavioral problems. Developmental Neuropsychology, 33(2), 160-178.Xiao, T., Xiao, Z., Ke, X., Hong, S., Yang, H., Su, Y., et al. (2012). Response inhibition impairment in high functioning autism and Attention Deficit hyperactivity disorder: evidence from Near-nfrared Spectroscopy Data. Plos ONE, 7(10), 1-7. zh_TW
