連續性白噪音對注意力不足過動症兒童青少年的抑制功能之影響

Effects of Continuous White Noise on Inhibition Function of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

梁宇菽(Yu-Shu Liang)

指導教授 ： 田意民

中山醫學大學/醫學科技學院/心理學系暨臨床心理學碩士班/碩士(2018年)

摘要

研究目的：評估注意力不足過動症（Attention-Deficit/Hyperactivity Disorder, ADHD）兒童青少年在控制訊噪比的情況下，不同強度的噪音水準對其抑制功能的表現，並且比較不同ADHD亞型與一般兒童間的差異。

研究方法：本研究使用停止訊號作業（Stop-Signal Task）評估受試者的停止訊號反應時間（Stop Signal Reaction Time, SSRT），以作為抑制功能的指標。主要作業為視覺判斷作業，當聽見停止訊號時需終止按鍵反應。此研究以背景白噪音的有無分為兩個實驗進行，實驗一的受試者均在安靜的情境下進行停止訊號作業。研究對象為6-16歲經身心科專科醫師確診為ADHD的兒童青少年，不專注組的有效人數為58名、混合組為99名、控制組為同年齡層52名兒童青少年；實驗二的受試者則需在訊噪比0分貝的情況下，分別在三種白噪音情境（35分貝、55分貝、及80分貝）中進行停止訊號作業。研究對象、作業同實驗一，不專注組的有效人數為16名、混合組為29名、控制組為同年齡層27名兒童青少年。

研究結果：在實驗一時，不專注組與混合組的反應時間及SSRT均比控制組來的長，顯示不專注組及混合型的抑制功能及物體辨識速度比一般兒童來得弱。而在實驗二，發現個體在55分貝和80分貝時的反應時間及SSRT顯著下降。顯示噪音對ADHD的物體辨識速度和抑制功能上確有助益。而混合組的SSRT在白噪音情境下比不專注組和控制組長，顯示混合組的抑制功能缺損可能較為嚴重。

結論與建議：本研究的發現確認了白噪音對抑制功能的改善，並且對兩種亞型都有幫助，儘管混合組仍然需要較長的時間才能成功抑制，但他們在55分貝以上也都獲得改善。實務上的建議，儘管白噪音能夠改善受試者的表現，但是審酌高分貝（80分貝）的噪音有潛在的暫時性聽力損失風險，本研究建議55分貝的中等強度白噪音即可達到改善效果，同時兼顧安全性。未來也許可搭配藥物治療或心理治療，或許有相輔相成的效果。

關鍵字

注意力不足過動症 ； 白噪音 ； 訊噪比 ； 停止訊號作業 ； 抑制功能

並列摘要

Objective: This study aimed to address the effect of background noise to inhibition function on children and adolescents with Attention-deficit/ Hyperactivity Disorder (ADHD) by adopting stop signal task, and wondered if there is any difference about inhibition function between ADHD subtypes and normal controls.

Methods: All participants carried out Stop-Signal Task to evaluate SSRT, the index of inhibition function. They were asked to respond to the visual stimuli, and to withhold their response while the stop-signal was being presented. The first experiment is under silence condition, and participants included children and adolescent (aged 6-16 years old), who referred from psychiatric clinic hospital and were diagnosed with ADHD. There were 58 subjects of inattentive subtype, 99 subjects of combined subtype, and 52 normal controls. The second experiment is under 3 different level of white noises (35dB, 55dB, 80dB), and the Signal-to-Noise Ratio is the same. The participants were the same as the first experiment. There were 16 subjects of inattentive subtype, 29 subjects of combined subtype, and 27 normal controls.

Results: Under the silence condition, the SSRT and reaction time of ADHD-C and ADHD-IA were significantly longer than normal control. It indicated that the inhibition function of ADHD-C and ADHD-IA were poorer than normal control. However, when under white noise condition, the SSRT and reaction time were shorter at noise level 55dB and 80dB. The SSRT of ADHD-C is longer than ADHD-IA and normal control, indicated that the impaired inhibition function of ADHD-C was more serious.

Conclusion: The positive effect of white noise facilitates inhibition function, and for two subtypes, though ADHD-C still needs more time to inhibit response. Inhibition function indeed improved at noise level 55dB and 80dB. Considered that the risk of high decibel (80dB) noise has a potential hearing impairment, we suggest 55dB white noise improving the effect, while taking safety into account. Future research is required to investigate the effect of white noise on other aspects of inhibition function of children of ADHD, and to further explore the ecological validity of the effects of white noise in children with ADHD.

並列關鍵字

ADHD ； White noise ； Stop-signal task ； Signal-to-Noise Ratio ； Inhibition function

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