- 學位論文
成人型注意力缺損過動症患者之神經認知功能、心理特質與社會適應功能初探
The Neuropsychological Functions, Psychological Traits, and Social Adaptive Functions in Adults with Attention-Deficit/Hyperactivity Disorder
摘要
本研究之目的為比較成人型注意力缺損過動症男性患者和未患病者神經認知功能之反應抑制表現、心理特質、社會適應功能之差異性，及Go/NoGo測驗和社會適應功能和心理特質之關連性。 共有50位成人型注意力缺損過動症男性患者和34位無注意力缺損過動症之成人男性接受包括分心干擾及雙重干擾等不同難度之Go/NoGo測驗，以測量其神經認知功能之反應抑制表現。此外，每位參與者亦完成行為抑制/行為激發系統量表、Dickman’s 衝動量表、短式華人敵意量表、社會適應自我評估量表、挫折不適量表、巴氏衝動性量表、直覺和思考偏好量表等心理特質與社會適應功能量表評估。首先以獨立樣本t檢定比較兩組Go/NoGo測驗結果、行為動機、衝動性、敵意、挫折不適、決策傾向等心理特質與社會適應，再以重複量數單因子變異數分析檢測兩組於不同難度之Go/NoGo測驗表現，並以Pearson相關檢定分別檢測Go/NoGo測驗和社會適應功能與其他施測結果的關連性。 研究結果發現：相較於對照組，成人型注意力缺損過動症患者在Go/NoGo測驗表現較不佳；同時，成人型注意力缺損過動症患者具有較高之行為抑制傾向、樂趣追求傾向、失能性衝動、敵意、挫折不適、直覺決策傾向，以及較差之功能性衝動與社會適應功能。以重複量數單因子變異數分析檢測兩組於不同難度之Go/NoGo測驗表現之差異顯示並無明顯不同。Pearson相關檢定顯示：Go/NoGo測驗表現與挫折不適呈顯著負相關。社會適應障礙與行為激發和功能性衝動成顯著正相關，與行為抑制、敵意和挫折不適呈顯著負相關。 由此研究顯示：成人型注意力缺損過動症患者在反應抑制的神經認知功能表現比未患病者較不佳，在心理特質與社會適應功能上亦有所差異。反應抑制的神經認知功能與挫折不適有關，而影響社會適應功能之因素為特定心理特質，而非反應抑制之表現。未來可針對成人型注意力缺損過動症患者敵意和挫折不適等心理特質發展合適策略以提升其社會適應功能。
並列摘要
The aims of this study were to examine the neuropsychological functions, psychological traits, and social adaptive functions in adult males with and without attention deficit/hyperactivity disorder (ADHD), and to examine the associations of neuropsychological functions and social adaptive functions with psychological traits. A total of 50 adult males with ADHD and 34 ones without ADHD received Go/NoGo tests with different cognitive demands including distraction and dual tasks to measure their response inhibition. Each participant also completed the BIS/BAS Scale, Dickman’s Impulsivity Scale, Buss-Durkee Hostility Inventory-Chinese Version- Short Form, Preference for Intuition and Deliberation Scale, Frustration Discomfort Scale, Barrett’s Impulsivity Scale, and Social Adaptation Self-Evaluation Scale. We used independent t test to compare the performance of Go/NoGo tests, behavioral motivation, impulsivity, hostility, frustration intolerance, decision-making tendency, and social adaptive function between groups. Then we compared the performance of Go/NoGo tests with different cognitive demands between groups using repeated measure analysis of variance (ANOVA). Pearson correlation analysis was employed to examine the associations between psychometric outcomes and the performance of Go/NoGo test as well as social adaptive function. The results of this study indicated that compared to the controls, adult males with ADHD had poorer performance under Go/NoGo tests; meanwhile, they had higher levels of behavioral inhibition, fun-seeking, dysfunctional impulsivity, hostility, frustration intolerance, preference for intuition in decision-making, and lower levels of functional impulsivity and social adaptive function. However, no significant difference between groups under Go/NoGo tests with different cognitive demands could be found by repeated measure ANOVA. Using Pearson correlation, the performance of Go/NoGo test was negatively correlated with frustration intolerance, and the social adaptive function was positively correlated with behavioral activation and functional impulsivity, and negatively correlated with behavioral inhibition, hostility, and frustration intolerance. The results of study indicated that adult males with ADHD had poor response inhibition compared with those without ADHD. Meanwhile, there were differences in psychological traits and social adaptive function between those with and without ADHD. Poor response inhibition was associated with frustration intolerance. Certain psychological traits but not response inhibition had more influence on social adaptive function. It could be considerable to develop adequate strategies for hostility and frustration intolerance to enhance the social adaptive function of patients with adult ADHD.