睡眠质量对注意缺陷多动障碍儿童症状的影响：工作记忆的中介作用

doi:10.7499/j.issn.1008-8830.2206147

摘要
图/表
参考文献(28)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (619 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）儿童工作记忆在睡眠质量与症状之间的中介作用。方法采用随机整群抽样法从新疆维吾尔自治区喀什市2所小学3~5年级学生中筛选出符合条件的ADHD儿童（110例）及正常对照儿童（124例）为研究对象，采用SNAP-Ⅳ评估量表、匹兹堡睡眠质量指数量表（Pittsburgh Sleep Quality Index，PSQI）、工作记忆任务测试进行调查并比较。结果 ADHD组儿童主观睡眠质量、入睡时间、睡眠效率、睡眠障碍评分及PSQI总分高于正常对照组（P<0.001），睡眠质量问题的发生率也高于正常对照组（P<0.001）；ADHD儿童工作记忆得分低于正常对照组（P<0.001）。ADHD组工作记忆得分与PSQI总分呈负相关（r_s=-0.271，P<0.001），与症状得分呈负相关（r_s=-0.439，P<0.001）；ADHD组PSQI总分与症状得分呈正相关（r_s=0.540，P<0.001）。工作记忆在睡眠质量对ADHD儿童症状影响中起部分中介效应，占总效应的18.10%。结论部分ADHD儿童存在睡眠质量问题，且工作记忆在ADHD儿童睡眠质量与症状之间起中介作用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	钟琳
	张静
	高小焱
	何红瑶
	左彭湘
	宋然然

关键词 ：注意缺陷多动障碍, 睡眠质量, 工作记忆, 症状, 儿童

Abstract：Objective To study the mediating role of working memory between sleep quality and symptoms in children with attention deficit hyperactivity disorder (ADHD). Methods The cluster random sampling method was used to select 110 ADHD children and 124 normal children as subjects from grade 3-5 students in two primary schools in Kashgar, Xinjiang Uygur Autonomous Region, China. SNAP-IV, Pittsburgh Sleep Quality Index (PSQI), and visual-spatial working memory paradigm were used for investigation and comparison. Results Compared with the normal group, the ADHD group had a significantly higher total score of PSQI and scores of subjective sleep quality, sleep latency, sleep efficiency, sleep disturbance, and a higher incidence of sleep quality problems (P<0.001). The working memory score in the ADHD group was significantly lower than that in the normal group (P<0.001). In the ADHD group, the working memory score was negatively correlated with the total score of PSQI (rs=-0.271, P<0.001) and the score of symptoms (rs=-0.439, P<0.001), and the total score of PSQI was positively correlated with the score of symptoms (rs=0.540, P<0.001). Working memory had a partial mediating effect in the influence of sleep quality on symptoms in children with ADHD, accounting for 18.10% of the total effect. Conclusions Sleep quality issues are observed in some children with ADHD, and working memory plays a mediating role between sleep quality and symptoms in ADHD children.

Key words： Attention deficit hyperactivity disorder Sleep quality Working memory Symptom Child

收稿日期: 2022-06-29

通讯作者: 左彭湘，女，教授。Email：zuo_pengxiang@sina.com。 E-mail: zuo_pengxiang@sina.com

作者简介: 钟琳，女，硕士研究生；

引用本文:

钟琳,张静,高小焱等. 睡眠质量对注意缺陷多动障碍儿童症状的影响：工作记忆的中介作用[J]. 中国当代儿科杂志, 2022, 24(12): 1365-1370.

ZHONG Lin,ZHANG Jing,GAO Xiao-Yan et al. Influence of sleep quality on symptoms in children with attention deficit hyperactivity disorder: the mediating role of working memory[J]. CJCP, 2022, 24(12): 1365-1370.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2206147 或 http://www.zgddek.com/CN/Y2022/V24/I12/1365

	Magnin E, Maurs C. Attention-deficit/hyperactivity disorder during adulthood[J]. Rev Neurol (Paris), 2017, 173(7-8): 506-515. PMID: 28844700. DOI: 10.1016/j.neurol.2017.07.008.
	Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1): 32. PMID: 28103833. PMCID: PMC5244567. DOI: 10.1186/s12888-016-1187-9.
	Ramos AA, Hamdan AC, Machado L. A meta-analysis on verbal working memory in children and adolescents with ADHD[J]. Clin Neuropsychol, 2020, 34(5): 873-898. PMID: 31007130. DOI: 10.1080/13854046.2019.1604998.
	4 陈冯凤, 韦念堇, 马晨欢, 等. 注意缺陷多动障碍儿童睡眠质量问题调查研究[J]. 中国儿童保健杂志, 2021, 29(1): 67-70. DOI:10.11852/zgetbjzz2020-0153.
	5 刘明霞, 徐通. 睡眠问题对注意缺陷多动障碍儿童的影响[J]. 中国儿童保健杂志, 2017, 25(5): 486-489. DOI: 10.11852/zgetbjzz2017-25-05-15.
	6 严双琴, 高国朋, 顾春丽, 等. 学龄前儿童哮喘与睡眠障碍对注意缺陷多动障碍症状发生的协同效应[J]. 中国公共卫生, 2021, 37(5): 824-828. DOI: 10.11847/zgggws1123008.
	Dentz A, Guay MC, Parent V, et al. Working memory training for adults with ADHD[J]. J Atten Disord, 2020, 24(6): 918-927. PMID: 28856932. DOI: 10.1177/1087054717723987.
	Liang X, Li R, Wong SHS, et al. Physical activity and executive function in children with ADHD: the mediating role of sleep[J]. Front Pediatr, 2021, 9: 775589. PMID: 35127588. PMCID: PMC8813634. DOI: 10.3389/fped.2021.775589.
	Gabay L, Miller P, Alia-Klein N, et al. Circadian effects on attention and working memory in college students with attention deficit and hyperactivity symptoms[J]. Front Psychol, 2022, 13: 851502. PMID: 35651563. PMCID: PMC9150742. DOI: 10.3389/fpsyg.2022.851502.
	Cremone-Caira A, Buirkle J, Gilbert R, et al. Relations between caregiver-report of sleep and executive function problems in children with autism spectrum disorder and attention-deficit/hyperactivity disorder[J]. Res Dev Disabil, 2019, 94: 103464. PMID: 31479914. PMCID: PMC6778038. DOI: 10.1016/j.ridd.2019.103464.
	Bussing R, Fernandez M, Harwood M, et al. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample[J]. Assessment, 2008, 15(3): 317-328. PMID: 18310593. PMCID: PMC3623293. DOI: 10.1177/1073191107313888.
	12 贾艳滨, 赵国香, 李淑仪. 中国韦氏儿童智力量表修订本简式在注意缺陷多动障碍儿童的应用研究[J]. 中国神经精神疾病杂志, 2010, 36(12): 732-735. DOI: 10.3969/j.issn.1002-0152.2010.12.010.
	13 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. 5th ed. Arlington, VA, USA: American Psychiatric Association, 2013: 55-57.
	14 路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学, 2014, 43(3): 260-263. DOI: 10.3969/j.issn.1671-8348.2014.03.002.
	Berch DB, Krikorian R, Huha EM. The Corsi block-tapping task: methodological and theoretical considerations[J]. Brain Cogn, 1998, 38(3): 317-338. PMID: 9841789. DOI: 10.1006/brcg.1998.1039.
	Thoma VK, Schulz-Zhecheva Y, Oser C, et al. Media use, sleep quality, and ADHD symptoms in a community sample and a sample of ADHD patients aged 8 to 18 years[J]. J Atten Disord, 2020, 24(4): 576-589. PMID: 30296879. DOI: 10.1177/1087054718802014.
	Becker SP, Langberg JM, Eadeh HM, et al. Sleep and daytime sleepiness in adolescents with and without ADHD: differences across ratings, daily diary, and actigraphy[J]. J Child Psychol Psychiatry, 2019, 60(9): 1021-1031. PMID: 31032953. PMCID: PMC6692210. DOI: 10.1111/jcpp.13061.
	18 李纪迎. 工作记忆训练在ADHD治疗中的应用研究[D]. 银川: 宁夏医科大学, 2021.
	Fabio RA, Bianco M, Caprì T, et al. Working memory and decision making in children with ADHD: an analysis of delay discounting with the use of the dual-task paradigm[J]. BMC Psychiatry, 2020, 20(1): 272. PMID: 32487039. PMCID: PMC7268601. DOI: 10.1186/s12888-020-02677-y.
	Waldon J, Vriend J, Davidson F, et al. Sleep and attention in children with ADHD and typically developing peers[J]. J Atten Disord, 2018, 22(10): 933-941. PMID: 25762537. DOI: 10.1177/1087054715575064.
	Campez M, Raiker JS, Sarver DE, et al. Working memory capacity and ADHD symptoms in boys: examining the heterogeneity of working memory functioning using latent profile analysis[J]. J Psychopathol Behav Assess, 2020, 42(3): 450-463. PMID: 33343079. PMCID: PMC7747754. DOI: 10.1007/s10862-019-09762-x.
	22 李焱, 江文庆, 钱昀, 等. 工作记忆训练对注意缺陷多动障碍患儿疗效的研究进展[J]. 中国儿童保健杂志, 2021, 29(6): 641-644. DOI: 10.11852/zgetbjzz2020-1194.
	23 余雪. 工作记忆训练对ADHD干预效果及展望[J]. 中国临床心理学杂志, 2020, 28(5): 1072-1076. DOI: 10.16128/j.cnki.1005-3611.2020.05.044.
	Irwin LN, Soto EF, Chan ESM, et al. Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD)[J]. Child Neuropsychol, 2021, 27(4): 468-490. PMID: 33459154. PMCID: PMC8035253. DOI: 10.1080/09297049.2020.1866521.
	McCann M, Bayliss DM, Pestell C, et al. The relationship between sleep and working memory in children with neurological conditions[J]. Child Neuropsychol, 2018, 24(3): 304-321. PMID: 27690751. DOI: 10.1080/09297049.2016.1231298.
	Torgalsb?en BR, Zeiner P, ?ie MG. Pre-attention and working memory in ADHD: a 25-year follow-up study[J]. J Atten Disord, 2021, 25(7): 895-905. PMID: 31625421. DOI: 10.1177/1087054719879491.
	Maquet P. The role of sleep in learning and memory[J]. Science, 2001, 294(5544): 1048-1052. PMID: 11691982. DOI: 10.1126/science.1062856.
	28 涂梦璐, 刘奇, 杨福义, 等. 学龄前儿童执行功能与注意缺陷多动症状的元分析: 抑制控制和工作记忆的作用[J]. 中国特殊教育, 2021(2): 67-76. DOI: 10.3969/j.issn.1007-3728.2021.02.010.