以情緒臉孔為背景的注意力作業探討ADHD兒童與青少年在情緒刺激下的注意力表現

Attention Performance after Stimulus with an Emotional Face in Children and Adolescents with ADHD

研究目的：本研究想要探討注意力不足過動症（ADHD）兒童與青少年在情緒刺激注意力作業中的情緒干擾缺損是來自於注意力資源缺乏，還是來自於情緒的注意力偏誤。研究方法：本研究在北部某教學醫學中心招募年齡在9到16歲的ADHD組兒童與青少年共111名，在大台北地區招募對照組兒童與青少年共81名，研究期間為2013年1月2日至2016年1月31日。本研究以不同的情緒臉孔為背景（開心，中性，憤怒）的反應／不反應（Go／No Go）的注意力作業，並且設計無酬賞和有酬賞的作業情況，探討ADHD兒童與青少年在情緒刺激下的注意力歷程。研究結果：ADHD兒童與青少年相較於對照組有較多的漏判錯誤，較慢的反應時間與較大的反應時間變異量，顯示ADHD受試者在整體的注意力表現有顯著的缺損。再者，本研究發現組別與情緒在誤判錯誤與反應時間變異量有顯著的交互作用，特別是ADHD兒童與青少年在正向情緒下有較多的誤判錯誤，以及較大的反應時間變異量，這個結果顯示ADHD受試者在正向的情緒刺激下有顯著的情緒干擾效果。本研究的結果也顯示雖然酬賞可以顯著地改善ADHD兒童與青少年的注意力表現，然而酬賞卻無法改善ADHD兒童與青少年的情緒干擾缺損，因為組別、情緒臉孔與酬賞三因子交互作用效果並沒有顯著。研究結論：本研究的結果並不支持ADHD兒童與青少年在情緒刺激下所產生的情緒干擾缺損是來自於注意力資源不足，而可能與ADHD兒童和青少年的情緒注意力偏誤有關，特別是在正向情緒下的注意力偏誤。

Purpose: The aim of this study is to examine whether emotion interference deficits arise from a lack of attention resources or from an attentional bias in children and adolescents with attention deficit/hyperactivity disorder (ADHD). Methods: A total of 111 children with ADHD (mean age = 11.9 ± 2.18) and 81 normally developed children (mean age = 11.9 ± 2.32) in North Taiwan completed a go/no go task comprised of various emotional faces (happy, neutral, and angry) with and without reward manipulation. Results: The children with ADHD had more omission errors, slower mean reaction times (RT), and a larger RT standardized deviation (RTSD) than the normally developed group. These results suggest that the participants with ADHD have a significant deficiency in attention performance. Furthermore, the interaction effects between emotion and group were significant, in that the ADHD group demonstrated more commission errors and a greater RTSD for the positive emotion stimulus. In other words, the positive emotion stimulus was responsible for the emotion interference deficit in the ADHD group. The interaction effects among group, emotional face, and reward were not significant, indicating that the reward improved attention performance, rather than reducing the emotion interference deficit in participants with ADHD. Conclusions: The emotion interference deficits among children with ADHD come from emotional attentional bias to a positive emotion stimulus, and not from a paucity of attention resources.