注意力缺失/過動疾患-不注意型與複合型兒童之工作記憶功能分析

Deficient Patterns of Working Memory in Inattentive and Combined Subtypes of Children with Attention Deficit/Hyperactivity Disorder

葉真欣(Chen-Hsin Yeh)

指導教授 ： 郭乃文

高雄醫學大學/健康科學院/心理學研究所/碩士(2009年)

摘要

目的：本研究目的為探討注意力缺失/過動疾患-主要為不注意型 （ADHD Predominantly Inattentive Type, ADHD-PI）與複合型（ADHD Combined Type, ADHD-C）於語文和非語文工作記憶缺損表現上之差異。期望經由對該疾患亞型兒童在工作記憶功能上不同缺損情形的了解，可進一步提供未來在診斷、擬定行為訓練與認知復健治療的參考。
方法：受試者分為三組，包含ADHD-PI組31人、ADHD-C組30人，及正常對照組31人。本研究三組個案在年齡、智力、社經地位及家庭教養環境等人口學特徵上均相當。以多項工作記憶測驗進行評估，包含魏氏兒童智力量表-記憶廣度測驗之數字逆序背誦、郭氏語文記憶測驗、曾氏工作記憶廣度測驗、廣泛性非語文記憶測驗組（Comprehensive Non-verbal Memory Test Battery；CNMT）、物體記憶檢查（Fuld object-memory Evaluation，FOME）。
結果：和正常組相較，ADHD-PI組只在數字逆序背誦作業呈現缺損，ADHD-C組則在曾氏工作記憶廣度測驗、郭氏語文測驗及CNMT皆呈現缺損。兩亞型相比，ADHD-PI組只有聽覺口語序列記憶表現缺失，ADHD-C組則除了聽覺口語序列記憶表現缺失外，在語文及非語文工作記憶的學習、儲存與提取能力也呈現缺損。
討論：正常智力的ADHD-PI組與ADHD-C組在工作記憶功能上有不同缺損型式。ADHD-PI組只在語文工作記憶功能呈現缺損，與語音訊息之登錄和複誦有關。ADHD-C組則較ADHD-PI組在工作記憶功能中呈現較廣泛性之損傷，更多缺損同時呈現於語文與非語文工作記憶的學習、儲存與提取能力。

關鍵字

注意力缺失/過動疾患 ； 工作記憶 ； 認知神經功能

並列摘要

Objective：This study represents the deficient patterns of working memory problems in inattentive and combined subtypes of children with Attention Deficit/Hyperactivity Disorder from the neuropsychological view. It will be helpful to assist in designing neurocognitive rehabilitation programs for ADHD subtypes.
Methods：Participants were grouped by diagnosis, including 30 ADHD-C, 31 ADHD-PI, and 31 healthy children. There were no significant statistical differences in age, IQ scores, and social economic status among three groups. A variety of verbal and nonverbal working memory tasks were performed, including Digit Span of the Wechsler Intelligence Scale for Children-Third Edition, Zing’s scale of verbal working memory, Guo’s scale of verbal working memory, Comprehensive Non-verbal Memory Test Battery (CNMT), and Fuld Object Memory Evaluation (FOME).
Results：Compared with healthy children, ADHD-PI children had impairment in Digit Span Backward. ADHD-C children had impairment in Zing’s scale of verbal working memory, Guo’s scale of verbal working memory and CNMT. Compared with ADHD-C, ADHD-PI children only had impairment in auditory vocal sequencing memory. Nevertheless, ADHD-C children had impairment not only in auditory vocal sequencing memory, but also in storage and retrieve of verbal and nonverbal working memory.
Conclusion：The results indicated ADHD-PI and ADHD-C children with average IQ had different deficit patterns of working memory. ADHD-PI children only had impairment in verbal working memory, associated with encoding and rehearsal of phonological information. ADHD-C children had more deficits than ADHD-PI children in working memory function, including storage and retrieve of verbal and nonverbal working memory. These findings would be helpful in designing individualized cognitive rehabilitation programs for inattentive and combined subtypes.

並列關鍵字

ADHD ； Working Memory ； Neurocognitive Function

參考文獻

參考文獻

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