探討注意力不足過動症兒童青少年於注意力及工作記憶作業下之預測及回溯心力

隨著社會發展的轉型，「心智努力（簡稱心力）」已然成為當今社會不可忽略的一項重要概念，有關心力的研究也開始蓬勃發展。過去文獻大致將心力分為「心力負荷」及「心力投入」兩種構念。由於付出心力往往是令人感到厭惡的，對作業所需心力的預測會影響心力付出，而過度逃避需要心力的作業可能為生活帶來影響，例如ADHD患者的診斷準則之一即包括「經常逃避、討厭或不願從事需要持久心力的工作」。由於現有文獻缺少針對ADHD兒童心力感受的探討，故本研究有四大目的，一為探討心力負荷及心力投入是否為不同構念；二為了解不同作業特質對心力感受的影響；三為探究兒童及青少年在心力預測的準確性；四為檢視ADHD參與者在作業前後的心力感受是否與一般參與者有差異。本研究共納入69位具有ADHD診斷的臨床組，與80位健康控制組。所有參與者完成兩項心力作業，包括時限聽覺序列加法測驗、克氏持續度表現測驗第三版，以及心力問卷和基本認知評估。此外，參與者也需根據作業前後的狀態進行預測與回溯的評量。研究結果發現：（1）心力負荷及心力投入為相似但不同的構念；（2）參與者會因不同作業而出現不同心力感受；（3）兒童青少年無法準確預測心力負荷及心力投入；（4）ADHD參與者與一般參與者有類似的心力負荷感受，但在心力投入的預測上，ADHD參與者會因為作業的不同而出現與一般參與者相異的預測。本研究支持心力投入和心力負荷為相似但不相同的構念，並證實針對不同類型認知作業的評估，ADHD參與者在心力投入的預測與一般參與者不同。此結果可作為ADHD兒童及青少年教育或臨床介入的參考。

關鍵字

心智努力；注意力不足過動症；無聊感；不舒服感

並列摘要

As the transition of social development, “mental effort” has received growing attention. However, there has not been a consistent definition for mental effort. Through the literature review, we divided mental effort into “mental effort demanding” and “mental effort engagement”. As the allocation of mental effort is aversive, most people tend to avoid the task that required mental effort. Nevertheless, excessively avoidant behavior may result in problematic behaviours. For example, one of the diagnostic criteria of ADHD is “often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort”. The aims of this study were fourfold, (1) to investigate the relationship between mental effort demanding and mental effort engagement; (2) to examine the feelings of mental effort on different cognitive tasks (3) to explore the differences between anticipation and retrospection of mental effort demanding and engagement, respectively; and (4) to examine the difference of anticipating accuracy between individuals with and without ADHD. A total of 69 children with ADHD and 80 typically developing controls were recruited. All participants underwent two tasks requiring mental effort, i.e. Paced Auditory Serial Addition Task (PASAT) and Conners’ Continuous Performance Test 3rd Edition (CPT 3). Among both tasks, participants were asked to anticipate their feelings and thoughts immediately after completing the practice block, and they retrospectively reported the actual feelings in the task upon completing the task. Participants also completed the Mental Effort Questionnaire and cognitive assessment. The results showed that: (1) mental effort demanding and mental effort engagement were two different constructs; (2) participants perceived different mental effort demanding and engagement by task characteristics; (3) neither of the two groups can anticipate mental effort precisely. (4) the ADHD group reported a similar level of mental effort demanding, but a different level of mental effort engagement by task characteristics as compared to the control group. The present study provides evidence to support that mental effort can divided into two different constructs, i.e. demanding and engagement. Children and adolescents with ADHD showed differences in mental effort engagement based on task characteristics. The findings of this study can facilitate further education or intervention strategies for children with ADHD.