注意力缺損過動疾患兒童合併焦慮和憂鬱症狀對其注意力表現之影響

本研究主要目的在探討注意力缺損過動疾患兒童所合併焦慮和憂鬱症狀，是否會影響其注意力各向度表現。收案對象為7到12歲診斷為注意力缺損過動疾患的孩童共63位。由家長填寫中文版Swanson, Nolan, and Pelham, version IV量表，並收集基本資料，施測工具包括：魏氏兒童智力量表第四版中文版、台灣版兒童青少年憂鬱量表、台灣版多向度兒童青少年焦慮量表，以及廣泛性非語文注意力測驗，其所測驗內容包含集中注意力、視覺搜尋、抑制注意力、抗拒分心、分配性注意力以及逆轉反應原則。結果顯示：在控制性別、年齡、注意力缺損過動程度以及智力之後，憂鬱症狀(P=0.024)、焦慮症狀(P=0.004)與集中注意力分測驗達統計顯著相關；焦慮症狀與視覺搜尋分測驗達統計顯著相關(P<0.001)。進一步分析焦慮各向度對集中注意力與視覺搜尋的影響性，結果發現：在控制性別、年齡、注意力缺損過動程度、智力以及憂鬱之後，焦慮症狀包含身體症狀、社交焦慮和分離/恐慌的孩童，其集中注意力、視覺搜尋表現較佳。本研究結果顯示憂鬱症狀會惡化感官選擇注意力，焦慮症狀可以改善感官選擇注意力，尤其焦慮症狀是以身體症狀、社交焦慮、以及分離恐慌為主要表現的個案。

關鍵字

注意力缺損過動疾患；憂鬱；焦慮；注意力

並列摘要

Objective: The aim of this study was to examine the impacts of anxiety and depression symptoms on variant attention functions in children with attention-deficit/hyperactivities disorder (ADHD). Methods: A total of 63 children aged 7 to 12 years participated in the study. All participants fulfilled the diagnostic criteria for ADHD by the standardized psychiatric interview. Each participant received Comprehensive Non-verbal Attention Test Battery (CNAT) to measure their six attention domains, including focused attention, visual search attention, behavioral attention (go/no go), distributed attention, divided/selective attention and shifting attention. Participants also receive the test of Wechsler Intelligence Scale for Children (WISC-IV), Children’s Depression inventory-Taiwan version (CDI-TW), and Multidimensional Anxiety Scale for Children-Taiwanese Version (MASC-TW) to measure their intelligence, depression, and anxiety symptoms, respectively. Participants’ parents completed the Chinese Version of the Swanson, Nolan and Pelham--Version IV Scale for ADHD (SNAP-IV) to measure their inattention, hyperactivity/impulsivity, and oppositional symptoms. Results: After controlling for sex, age, intelligence and the severity of inattention, hyperactivity/impulsivity, and oppositional symptoms, children who had higher CDI-TW score showed longer reaction time in focused attention subtest (p = 0.024). Children who had higher MASC-TW score showed shorter reaction time in focused attention (p = 0.004) and visual search attention subtests (p < 0.001). In addition, better focused attention was correlated with the anxiety symptoms of physical symptoms (tense), humiliation fears and separation anxiety. Better visual search attention were correlated with physical symptoms (tense), social anxiety and separation anxiety. Conclusions: The findings support depression symptoms worse the attention deficit in ADHD children. Otherwise, anxiety symptoms in children with ADHD improved focus attention and visual search attention.