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背景:对立违抗障碍(ODD)以显著的对立、违抗和破坏性行为为主要特征,和品行障碍(CD)一样,被认为是破坏性行为障碍(DBD)的一种。然而,相比较与CD,ODD并不包括严重的攻击或者反社会行为。目的:本研究旨在探索ODD患儿的执行功能(EF)特征。方法:采用病例对照的研究设计。入组研究的ODD组有43例(pure ODD患儿14例和ODD/ADHD患儿29例),和pure ADHD患儿39例。健康对照组参与研究的有52例。采用Stroop色词测试,韦克斯勒智力量表儿童版(第四版,WISC-IV),威斯康辛卡片分类测试(WCST),和剑桥成套神经心理测试(CANTAB)对ODD和单纯注意缺陷多动障碍(ADHD)儿童进行执行功能测试,并且在控制了年龄以后,与健康发育儿童作比较。采用Logistic回归分析,探索执行功能缺陷在ODD(包括单纯ODD和ODD/ADHD)和单纯ADHD发生中的风险。结果:控制年龄因素后,ANCOVA方差分析结果显示相比较于对照组,ODD组在Stroop色-词测试,WISCIV的倒背数字广度、WCST的持续反应数和概念化水平的得分更低,而在CANTAB任务视觉空间记忆(SWM)的错误数和策略分的得分更高。Logistic回归分析发现Stroop色词测试乙表读数进入ODD的回归方程。总结:ODD的患儿在执行功能任务时表现得更差。反应抑制缺陷是ODD的风险因素,而反应抑制和工作记忆缺陷是ADHD的风险因素。
Background: Oppositional Disorder Disorders (ODDs), characterized by significant opposition, defiance and disruptive behavior, like CDs, are considered as one of the Disruptive Behavior Disorders (DBDs). However, ODD does not include serious attacks or antisocial behavior in comparison with CDs. Purpose: This study aimed to explore the executive function (EF) features of children with ODD. METHODS: A case-control study design was used. There were 43 ODD patients enrolled in the study (14 with pure ODD and 29 with ODD / ADHD), and 39 with pure ADHD. In the control group, 52 patients were involved in the study. ODD and simple attention-deficit hyperactivity disorder were assessed using the Stroop Color Word Test, Wechsler Intelligence Scale Children’s Edition (Fourth Edition, WISC-IV), Wisconsin Card Sorting Test (WCST), and Cambridge Complete Neuropsychological Test (CANTAB) Disability (ADHD) Children perform functional tests and are compared with healthy-developing children after controlling for age. Logistic regression analysis was used to explore the risk of executive dysfunction in the occurrence of ODD (including ODD alone and ODD / ADHD) and ADHD alone. RESULTS: ANCOVA ANOVA after controlled for age showed that ODD had lower scores for the Stroop color-word test, WISCIV inverted digit breadth, WCST continuous response, and conceptualized scores compared with the control group, whereas in CANTAB Mission Visual Space Memory (SWM) has higher number of errors and strategy scores. Logistic regression analysis found that Stroop color test B readings into ODD regression equation. Summary: Children with ODD performed worse when performing functional tasks. Response inhibition defects are risk factors for ODD, and response inhibition and working memory deficits are risk factors for ADHD.