成人注意缺陷多动障碍在内外源冲突时的表现：眼动的证据

doi:10.3724/SP.J.1041.2020.00777

摘要/Abstract

摘要：

在注意定向与维持上, 注意缺陷多动障碍(ADHD)个体更容易受到外部刺激的干扰而导致目标任务加工进程受阻, 表现出了注意定向反应的缺陷, 但导致任务失败的原因是由于对突然出现的外部无关刺激的过度兴奋还是对内源性目标刺激的持续维持能力减弱, 尚不清楚。研究采用反向眼跳范式、记忆导向眼跳范式和视觉导向眼跳范式, 来探索成人ADHD内外源注意定向反应的情况, 以及当二者发生冲突时, 成人ADHD失败的可能机制。结果发现, 在反向眼跳任务上, 成人注意缺陷多动障碍组错误率更高, 并且差异性显著。但在记忆导向眼跳任务中, 成人注意缺陷多动障碍组与正常组的差异不显著。在视觉导向眼跳任务中, 成人注意缺陷多动障碍组的正确眼跳潜伏期比正常组要短, 且二者之间的差异显著。这说明, 在内外源刺激反应的冲突导致的情境中, 成人注意缺陷多动障碍的反应明显落后于正常个体, 这种缺陷并非由于其维持内源性注意产生定向反应落后所导致的, 而是与其外源注意定向反应过强有关。

关键词: 注意缺陷多动障碍, 眼跳, 内外源注意, 刺激反应冲突。

Abstract:

Attention-deficit/hyperactivity disorder (ADHD) is a childhood onset disorder with the cardinal features of inattention, impulsivity, and hyperactivity. And the core symptoms of ADHD in childhood will gradually change into more serious neurological disorders in adulthood. Thus, it is necessary to study the pathological and physiological mechanisms of adult ADHD patients. Compared with normal people, patients with ADHD have stronger exogenous stimulation drive ability and weaker endogenous control ability. Therefore, the reason why ADHD in adults is susceptible to external interference is whether the level of response generated exogenous stimulation is too strong or the level of response generated by endogenous driving is too weak.

Twenty-six adult ADHD patients were screened by adult ADHD self-reporting scale (ASRS) as ADHD group, and 25 normal adult participants were selected as control group. Three experimental paradigms of saccade (reverse saccade, memory-oriented saccade and visual-oriented saccade) were used to investigate the ability of endogenous and exogenous saccade conversion and the ability of endogenous and exogenous saccade production and maintenance.

The results showed that the response level of adult ADHD patients to endogenous stimulation was lower than that of exogenous stimulation in reverse saccade experiment; in memory-oriented saccade experiment, the ability of adult ADHD patients to produce and maintain endogenous saccade was not significantly lower than that of normal subjects; in visual-oriented saccade experiment, the ability of adult ADHD to produce and maintain exogenous saccades was significantly better than that of normal subjects.

Therefore, the level of response of adult ADHD from endogenous stimuli is indeed lower than that produced by exogenous stimuli. Adult ADHD is susceptible to exogenous visual interference and is more likely to be caused by excessive levels of response from exogenous stimuli.

Key words: adult attention deficit hyperactivity disorder, saccade, exogenous and endogenous stimulation, conflict of stimulation response level

中图分类号:

R395
B842

李垚锦, 张微, 扶蓓, 周兵平. (2020). 成人注意缺陷多动障碍在内外源冲突时的表现：眼动的证据. 心理学报, 52(6), 777-785.

LI Yaojin, ZHANG Wei, FU Bei, ZHOU Bingping. (2020). Adult attention deficit hyperactivity disorder in internal and external conflicts: Evidence from Saccade task. Acta Psychologica Sinica, 52(6), 777-785.

图/表 6

参考文献 45

[1]	Aman, C. J., Roberts, R. J., & Pennington, B. F . (1998). A neuropsychological examination of the underlying deficit in attention deficit hyperactivity disorder: Frontal lobe versus right parietal lobe theories. Developmental Psychology, 34(5), 956-969. doi: 10.1037/0012-1649.34.5.956 URL
[2]	American Psychiatric, Association. (2013). 5th ed. Diagnostic and statistical manual of mental disorders. Arlington, VA: American Psychiatric Publishing.
[3]	Barkley, R. A . (2006). Attention-deficit/hyperactivity disorder. Guilford Publications.
[4]	Boucsein, W . (2012). Electrodermal activity. Springer Science & Business Media.
[5]	Brandt, L., & Fischer, G . (2017). Adult ADHD is associated with gambling severity and psychiatric comorbidity among treatment-seeking problem gamblers. Journal of Attention Disorders. https://doi.org/10.1177/1087054717690232
[6]	Cannon, R., Kerson, C., & Hampshire, A . (2011). Sloreta and fMRI detection of medial prefrontal default network anomalies in adult ADHD. Journal of Neurotherapy, 15(4), 358-373. doi: 10.1080/10874208.2011.623093 URL
[7]	Chen, Q., Liu, Y., & Zhou, X. L . (2005). A review of recent brain imaging studies on top-down attentional control. Journal of Psychological Science, 28(1), 153-154.
	[ 陈骐, 刘岩, 周晓林 . (2005). 自上而下注意控制的脑成像研究进展. 心理科学, 28(1), 153-154.]
[8]	Dankner, Y., Shalev, L., Carrasco, M., & Yuval-Greenberg, S . (2017). Prestimulus inhibition of saccades in adults with and without attention-deficit/hyperactivity disorder as an index of temporal expectations. Psychological Science, 28(7), 835-850. doi: 10.1177/0956797617694863 URL
[9]	Doallo, S., Holguı ́n, S. R., & Cadaveira, F . (2006). Attentional load affects automatic emotional processing: Evidence from event- related potentials. Neuroreport, 17(17), 1797-1801. doi: 10.1097/01.wnr.0000246325.51191.39 URL
[10]	Friedman-Hill, S. R., Wagman, M. R., Gex, S. E., Pine, D. S., Leibenluft, E., & Ungerleider, L. G . (2010). What does distractibility in ADHD reveal about mechanisms for top-down attentional control?. Cognition, 115(1), 93-103. doi: 10.1016/j.cognition.2009.11.013 URL
[11]	Fu, L. P., Deng, C. P., & Li, Q. W . (2006). The cognitive-energetic model — A more comprehensive cognitive model of ADHD. Journal of Psychological Science, 29(3), 639-642.
	[ 傅丽萍, 邓赐平, 李其维 . (2006). 认知能量模型——一种更为综合的ADHD认知理论. 心理科学, 29(3), 639-642.]
[12]	Fukushima, J., Tanaka, S., Williams, J. D., & Fukushima, K . (2005). Voluntary control of saccadic and smooth-pursuit eye movements in children with learning disorders. Brain and Developmen, 27(8), 579-588.
[13]	Goto, Y., Hatakeyama, K., Kitama, T., Sato, Y., Kanemura, H., Aoyagi, K., … Aihara, M . (2009). Saccade eye movements as a quantitative measure of frontostriatal network in children with ADHD. Brain Development, 32(5), 347-355. doi: 10.1016/j.braindev.2009.04.017 URL
[14]	Graziano, P. A., Mcnamara, J. P., Geffken, G. R., & Reid, A. M . (2013). Differentiating co-occurring behavior problems in children with ADHD: Patterns of emotional reactivity and executive functioning. Journal of Attention Disorders, 17(3), 249-260. doi: 10.1177/1087054711428741 URL
[15]	Jarrett, M. A., & Ollendick, T. H . (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: Implications for future research and practice. Clinical Psychology Review, 28(7), 1266-1280. doi: 10.1016/j.cpr.2008.05.004 URL
[16]	Jonkman, L. M., van Melis, J. J. M., Kemner, C., & Markus, C. R . (2007). Methylphenidate improves deficient error evaluation in children with ADHD: An event-related brain potential study. Biological Psychology, 76(3), 217-229. doi: 10.1016/j.biopsycho.2007.08.004 URL
[17]	Kakuszi, B., Tombor, L., Papp, S., Bitter, I., & Czobor, P . (2016). Altered response-preparation in patients with adult ADHD: A high-density ERP study. Psychiatry Research: Neuroimaging, 249, 57-66. doi: 10.1016/j.pscychresns.2016.02.008 URL
[18]	Kaplan, H. I., Sadock, B. J., & Grebb, J. A . (1994). Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences, clinical psychiatry. Williams & Wilkins Co.
[19]	King, J. A., Colla, M., Brass, M., Heuser, I., & von Cramon, D. Y . (2007). Inefficient cognitive control in adult ADHD: Evidence from trial-by-trial Stroop test and cued task switching performance. Behavioral & Brain Functions, 3(1), 42-42.
[20]	Klein, C. H., Raschke, A., & Brandenbusch, A . (2003). Development of pro- and antisaccades in children with attention-deficit hyperactivity disorder (ADHD) and healthy controls. Psychophysiology, 40(1), 17-28. doi: 10.1111/psyp.2003.40.issue-1 URL
[21]	Lansbergen, M. M., Kenemans, J. L., & van Engeland, H . (2007). Stroop interference and attention-deficit/hyperactivity disorder: A review and meta-analysis. Neuropsychology, 21(2), 251-262. doi: 10.1037/0894-4105.21.2.251 URL
[22]	LeRoy, A., Jacova, C., & Young, C . (2019). Neuropsychological performance patterns of adult ADHD subtypes. Journal of Attention Disorders, 23(10), 1136-1147. doi: 10.1177/1087054718773927 URL
[23]	López-Martín, S., Albert, J., Fernández-Jaén, A., & Carretié, L . (2013). Emotional distraction in boys with ADHD: Neural and behavioral correlates. Brain and Cognition, 83(1), 10-20. doi: 10.1016/j.bandc.2013.06.004 URL
[24]	Miranda, A., Berenguer, C., Roselló, B., Baixauli, I., & Colomer, C . (2017). Social cognition in children with high-functioning autism spectrum disorder and attention-deficit/hyperactivity disorder. associations with executive functions. Frontiers in Psychology, 8, 1035. doi: 10.3389/fpsyg.2017.01035 URL
[25]	Muhle-Karbe, P. S., Jiang, J., & Egner, T . (2017). Causal evidence for learning-dependent frontal-lobe contributions to cognitive control. The Journal of Neuroscience, 38(4), 962-973. doi: 10.1523/JNEUROSCI.1467-17.2017 URL
[26]	Müller, H. J., & Rabbitt, P. M. A . (1989). Reflexive and voluntary orienting of visual attention: Time course of activation and resistance to interruption. Journal of Experimental Psychology: Human Perception and Performance, 15(2), 315-330. doi: 10.1037/0096-1523.15.2.315 URL
[27]	Munoz, D. P., & Everling, S . (2004). Look away: The anti- saccade task and the voluntary control of eye movement. Nature Review Neuroscience, 5(3), 218-228. doi: 10.1038/nrn1345 URL
[28]	Nesterovsky, I., Shalev, L., Luria, R., Saar, K., Stern, P., Styr, B., & Mevorach, C . (2015). Electrophysiological evidence for decreased top-down attentional control in adults with ADHD. Journal of Vision, 15(12), 1337. doi: 10.1167/15.12.1337 URL
[29]	Oliveri, M., Zhaoping, L., Mangano, G. R., Turriziani, P., Smirni, D., & Cipolotti, L . (2010). Facilitation of bottom-up feature detection following rTMS-interference of the right parietal cortex. Neuropsychologia, 48(4), 1003-1010. doi: 10.1016/j.neuropsychologia.2009.11.024 URL
[30]	Parton, A., Nachev, P., Hodgson, T. L., Mort, D., Thomas, D., Ordidge, R., ... Husain, M . (2007). Role of the human supplementary eye field in the control of saccadic eye movements. Neuropsychologia, 45(5), 997-1008. doi: 10.1016/j.neuropsychologia.2006.09.007 URL
[31]	Rosch, K. S., Crocetti, D., Hirabayashi, K., Denckla, M. B., Mostofsky, S. H., & Mahone, E. M . (2018). Reduced subcortical volumes among preschool-age girls and boys with ADHD. Psychiatry Research: Neuroimaging, 271, 67-74. doi: 10.1016/j.pscychresns.2017.10.013 URL
[32]	Rubia, K., Norman, L., Lukito, S., Carlisi, C., Mataix-Cols, D., & Radua, J . (2016). Top-down control in ADHD: Disorder- specificity relative to CD, autism and OCD. European Neuropsychopharmacology, 26(2), S149-S150.
[33]	Rubia, K., Smith, A. B., Brammer, M. J., Toone, B., & Taylor, E . (2005). Abnormal brain activation during inhibition and error detection in medication-naive adolescents with ADHD. American Journal of Psychiatry, 162(6), 1067-1075. doi: 10.1176/appi.ajp.162.6.1067 URL
[34]	Ryan, M., Jacobson, L. A., Hague, C., Bellows, A., Denckla, M. B., & Mahone, E. M . (2016). Rapid automatized naming (RAN) in children with ADHD: An ex-gaussian analysis. Child Neuropsychology, 23(5), 571-587. doi: 10.1080/09297049.2016.1172560 URL
[35]	Sergeant, J . (2004). Eunethydis-searching for valid aetiological candidates of attention-deficit hyperactivity disorder or hyperkinetic disorder. European Child & Adolescent Psychiatry, 13(1), i43-i49.
[36]	Sergeant, J. A . (2005). Modeling attention-deficit/hyperactivity disorder: A critical appraisal of the cognitive-energetic model. Biological Psychiatry, 57(11), 1248-1255. doi: 10.1016/j.biopsych.2004.09.010 URL
[37]	Shafer, A. T., Matveychuk, D., Penney, T., O'Hare, A. J., Stokes, J., & Dolcos, F . (2012). Processing of emotional distraction is both automatic and modulated by attention: Evidence from an event-related fMRI investigation. Journal of Cognitive Neuroscience, 24(5), 1233-1252.
[38]	Siciliano, R. E., Madden, D. J., Tallman, C. W., Boylan, M. A., Kirste, I., Monge, Z. A., ... Wang, L. H . (2017). Task difficulty modulates brain activation in the emotional oddball task. Brain Research, 1664, 74-86. doi: 10.1016/j.brainres.2017.03.028 URL
[39]	Tsujimoto, S., Yasumura, A., Yamashita, Y., Torii, M., Kaga, M., & Inagaki, M . (2013). Increased prefrontal oxygenation related to distractor-resistant working memory in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry & Human Development, 44(5), 678-688.
[40]	van der Meere, J., Gunning, B., & Stemerdink, N . (1999). The effect of methylphenidate and clonidine on response inhibition and state regulation in children with ADHD. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(2), 291-298.
[41]	Wang, Y. H., Wang, Y. F., & Zhou, X. L . (2006). Conflict control at different periods of processing in children with two subtypes of ADHD. Acta Psychologica Sinica, 38(2), 181-188.
	[ 王勇慧, 王玉凤, 周晓林 . (2006). 注意缺陷多动障碍儿童在不同加工阶段的干扰控制. 心理学报,38(2), 181-188.]
[42]	Wang, Y. H., Zhou, X. L., Wang, Y. F., & Zhang, Y. X . (2005). Response inhibition in two subtypes of children with ADHD. Acta Psychologica Sinica, 37(2), 178-188.
	[ 王勇慧, 周晓林, 王玉凤, 张亚旭 . (2005). 两种亚型ADHD儿童在停止信号任务中的反应抑制. 心理学报, 37(2), 178-188.]
[43]	Xu, J. T., Jiang, C., Gao, Y., Liu, Q. G., Jia, S. H., & Zhou, L . (2011). The research of DSM-IV SCID in psychological autopsy. Journal of International Psychiatry, 38(4), 201-204.
	[ 许俊亭, 姜潮, 高岩, 刘启贵, 贾树华, 周莉 . (2011). DSM-IV临床定式访谈(SCID)在心理解剖诊断中的应用. 国际精神病学杂志, 38(4), 201-204.]
[44]	Xu, Y., Zhou, X. L., &Wang, Y. F . (2006). The covert orienting deficit in children with two subtypes of attention-deficits hyperactivity disorder. Acta Psychologica Sinica, 38(5), 709-717.
	[ 徐岩, 周晓林, 王玉凤 . (2006). 两亚型注意缺陷多动障碍(ADHD)儿童的内隐注意定向. 心理学报, 38(5), 709-717.]
[45]	Song, Y., & Hakoda, Y . (2011). An asymmetric stroop/reverse- stroop interference phenomenon in ADHD. Journal of Attention Disorders, 15(6), 499-505. doi: 10.1177/1087054710367607 URL

眼动指标	正常组		ADHD组		F	p	η²
眼动指标	M	SD	M	SD	F	p	η²
方向正确率(%)	0.69	0.15	0.57	0.22	5.30	0.03	0.10
正确眼跳潜伏期(ms)	677.56	96.52	640.41	73.41	2.38	0.13	0.05
方向正确的纠正率(%)	0.91	0.06	0.79	0.12	19.19	0.00	0.28

眼动指标	正常组		ADHD组		F	p	η²
眼动指标	M	SD	M	SD	F	p	η²
方向正确率(%)	0.69	0.15	0.57	0.22	5.30	0.03	0.10
正确眼跳潜伏期(ms)	677.56	96.52	640.41	73.41	2.38	0.13	0.05
方向正确的纠正率(%)	0.91	0.06	0.79	0.12	19.19	0.00	0.28

眼动指标	正常组		ADHD组		F	p	η²
眼动指标	M	SD	M	SD	F	p	η²
期望错误率(%)	0.90	0.17	0.93	0.15	0.37	0.55	0.01
方向正确率(%)	0.73	0.17	0.70	0.18	0.33	0.57	0.01
正确眼跳潜伏期(ms)	2271.85	147.37	2335.36	162.98	2.13	0.15	0.04

眼动指标	正常组		ADHD组		F	p	η²
眼动指标	M	SD	M	SD	F	p	η²
期望错误率(%)	0.90	0.17	0.93	0.15	0.37	0.55	0.01
方向正确率(%)	0.73	0.17	0.70	0.18	0.33	0.57	0.01
正确眼跳潜伏期(ms)	2271.85	147.37	2335.36	162.98	2.13	0.15	0.04

眼动指标	正常组		ADHD组		F	p	η²
眼动指标	M	SD	M	SD	F	p	η²
方向正确率(%)	0.86	0.10	0.87	0.08	0.07	0.80	0.00
正确眼跳潜伏(ms)	561.81	50.70	530.20	40.64	6.00	0.02	0.11