混合型ADHD延迟等待的情绪体验与情绪预估
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摘要
注意缺陷多动障碍以注意力缺陷、多动和冲动为主要特征。美国《精神障碍诊断与统计手册》(第5版)区分了三种亚类型的ADHD:注意力缺陷型,多动、冲动型以及混合型。在行为表现上,当面临一个即时小奖励和一个延迟大奖励时,具有多动、冲动症状的ADHD会难以等待,出现对即时小奖励的强烈偏好,即冲动性选择。延迟折扣理论认为厌恶延迟是导致ADHD症状,尤其是多动冲动症状最主要的原因。研究者一般认为ADHD-C对即时小奖励的强烈偏好是由与延迟等待相关的负性情绪所导致。为了测量混合型ADHD在延迟等待中的情绪体验以及对延迟等待的情绪预估。采用延迟折扣任务,并在此基础上增加主观评定量表。如果被试选择延迟等待,被试在每次真实等待之前和之后分别要完成一个主观厌恶情绪等级评定量表;如果被试选择即时等待,被试需要评定,如果让他等待相应的时间(与即时小奖励同时呈现的延迟大奖励的等待时间),他的厌恶情绪。一共有70名大学生参与本次研究,年龄在17~20岁(平均年龄19.16岁)。被试的筛选基于DSM-V中ADHD的诊断标准和CAARS量表,并对所有被试进行简单访谈,以排除有精神病史以及有其他严重情绪行为问题的青少年,并排除了网络成瘾、吸烟、饮酒、赌博、药物成瘾等。结果显示,ADHD-C的延迟折扣率显著大于其他组。非真实等待前,混合型ADHD的情绪评定得分与其他组差异并不显著;在真实等待之前和之后,混合型ADHD的厌恶情绪评定得分更高。结论:混合型ADHD延迟等待的客观情绪体验比其他组更差,当面临真实等待时,他们能正确的预估自己的情绪,而非真实等待条件下,他们不能正确的预估自己的情绪。
Attention deficit hyperactivity disorder(ADHD) is a neurobehavioral disorder characterized by pervasive inattention and hyperactivity-impulsivity. According to DSM-V, three subtypes of ADHD can be distinguished: inattentive type(ADHD-I), hyperactive/impulsive type(ADHD-HI) and combined type(ADHD-C). Hyperactive-impulsive boys demonstrated unusually strong preferences for small immediate rewards when they were presented with repeated choices between small points that they could receive right away, or large points that they could receive after delays, i.e., the impulsive choice. According to the delay aversion theory, the delay aversion plays the key role of ADHD symptoms, especially hyperactivity-impulsivity symptoms. Many researchers suggested that the relatively strong preferences for small immediate reward as observed in ADHD-Combined type are the result of delay-related negative feelings. To measure the emotional experience and emotion estimation of ADHD-Combined type for delays, subjective ratings scale was added. If participants chose delay, they needed to complete a subjective aversion rating scale before and after each delay duration, once they chose small immediate reward, their aversion also needed to be assessed if they were asked to wait(the delay for large delayed reward presented together with small immediate reward simultaneously). Seventy university students aged 17 to 20(mean age = 19.16 years) were enrolled in this study. The diagnosis of ADHD based on DSM-V and Conners' Adult ADHD Rating Scale(CAARS), and a simple interview was given to all participants, the adolescents with a history of mental illness and other serious emotional and behavioral problems were excluded. Those with ADHD-Combined type demonstrated relatively steep temporal reward discounting, and there were no group difference for subjectively emotion estimation in unreal waiting condition, but they reported a greater aversion for real delays. These findings suggest that emotional experience of ADHD-Combined type are more negative than that of other groups, they can correctly estimate their emotion for real waiting, but they cannot correctly estimate their emotion for unreal waiting.
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