| Attention deficit and hyperactivity disorder,commonly known as ADHD,is a common neurodevelopmental disorder in childhood.Its core symptoms are age-inappropriate attention deficit,hyperactivity and impulsivity,which have serious adverse effects on social functioning and development,including learning difficulties,poor job performance,gambling,Internet addiction,dangerous driving,violent behavior and high crime rates.The meta-analysis showed that the prevalence of ADHD in China was 4.31%-5.83%.Previously,ADHD was commonly known as children’s hyperactivity disorder and believed to exist only in childhood.Later,with the in-depth research,it was found that a considerable number of children with ADHD would continue to show symptoms and disorders in adolescence and adulthood,and they were called adult ADHD(DSM-V,2013).According to the World Health Organization(WHO),the prevalence of adult ADHD is about 3.5%.Therefore,it is of great scientific significance and clinical value to study the pathogenesis and intervention of adult ADHD.Numerous studies have shown that people with ADHD have deficits in attention and executive function.Attention and executive function,as essential basic abilities in study,work and life,have a very serious impact on the social adaptation of ADHD patients.However,there are few studies on attention and executive function of adult ADHD in China,especially on attention network(alertness,orientation and executive control)and "hot" executive function system.On the other hand,international studies have shown that mindfulness training or cognitive behavioral therapy has positive effects on attention and executive function of adult ADHD patients,but there are few comprehensive intervention studies on the combination of the two.Therefore,this study attempted to systematically investigate the characteristics and impairments of attention and executive function in adult ADHD.Although a small number of researchers have used mindfulness or cognitive behavioral therapy to intervene in adults with ADHD,both mindfulness training and cognitive behavioral therapy have their pros and cons.Mindfulness training focuses more on ability training to improve and coordinate frontal lobe function,while cognitive behavioral therapy focuses more on cognitive change and strategy learning,which should have a good complementary relationship in the intervention of adult ADHD.Therefore,the second study attempted to use the integrated intervention of mindfulness and cognitive therapy to conduct psychological treatment for adult ADHD,and investigated the effects of the integrated intervention of mindfulness and cognitive therapy on the improvement of attention and executive function of adult ADHD.Therefore,this study mainly discusses two issues :(1)Study 1 aims to explore the impairment of attention and "cold" and "hot" executive function in adults with ADHD compared with the normal population,focusing on attention network and executive function;(2)The second study aimed to investigate the effects of mindfulness and cognitive behavioral therapy combined intervention training on the improvement of attention and executive function in adults with ADHD.The first study examined the characteristics and impairments of attention and "cold" and "hot" executive function in adults with ADHD.First of all,41 adult ADHD subjects who met the inclusion conditions and 34 subjects in the normal control group were recruited,and the two groups were matched in terms of age,gender,educational background and other aspects.Attention Network Test was adopted.Ant)to investigate the characteristics of attention networks(including alertness,orientation,and executive control)in adult ADHD.The working memory task(N-back),Stop signal,rat number-letter switching task,and Iowa Gambling task were studied.IGT)task to investigate the levels and characteristics of "cold" and "hot" executive function in adult ADHD.The results showed that :(1)In the aspect of attention,the "executive control" network efficiency of adult ADHD group was significantly lower than that of normal control group,and there were no significant differences in the dimensions of alertness and orientation.(2)In terms of "cold" executive function,adult ADHD group was significantly lower than normal control group in cognitive flexibility,accuracy of inhibitory control and response time of working memory.(3)In terms of "hot" executive function(IGT task),compared with the normal control group,adult ADHD group was more and more inclined to choose unfavorable cards A and B over time.These results suggest that adult ADHD is significantly impaired in the "executive control","cold" executive function(mainly manifested in cognitive flexibility,inhibitory control,working memory)and "hot" executive function of the attention network.In the second study,a comprehensive intervention of mindfulness and cognitive behavioral therapy was used for psychological treatment of adult ADHD.The experimental group and the control group were designed to systematically investigate the effects of comprehensive intervention training of mindfulness and cognitive behavioral therapy on the improvement of attention and executive function of adult ADHD.Firstly,based on previous mindfulness and cognitive behavioral therapy courses,local ADHD-specific courses were designed based on the cognitive characteristics of adult ADHD groups(poor attention persistence,poor self-control,etc.).Then,adult ADHD was divided into the experimental group and the control group and pretested(including attention network and "cold" and "hot" executive function tests),in which 33 effective subjects in the experimental group and 32 effective subjects in the control group were matched in age,gender,educational background and ADHD scale(DSM5)scores.Next,the experimental group of adults with ADHD received a combination of mindfulness and cognitive behavioral therapy intervention,while the control group received no training.The experimental group received weekly course training for a total of 13 times,each time lasting 120-150 min.After class,the ADHD coach assisted the subjects to conduct self-planned training for 3 times a week,each time lasting5-35 min.The total training cycle lasted for more than 3 months.Finally,after the training,the experimental group and the control group of adult ADHD subjects were post-tested.The results showed that :(1)After three months of combined intervention of mindfulness and cognitive behavioral therapy,the "executive control" efficiency of the attention network in the adult ADHD group was significantly higher than that in the adult ADHD control group,but there was no significant improvement in the alertness and orientation network;(2)In terms of "cold" executive function,the inhibitory control ability of adult ADHD experimental group was significantly higher than that of adult ADHD control group,and the response time of working memory was significantly lower than that of the control group,but there was no significant difference in cognitive flexibility;(3)In terms of "hot" executive function,compared with adult ADHD control group,adult ADHD subjects in the experimental group were more and more inclined to choose advantageous cards C and D in the IGT task over time.These results indicate that the combined intervention of mindfulness and cognitive behavioral therapy can significantly improve the executive control of attention network,inhibitory control ability,working memory and "hot" executive function of adult ADHD.In conclusion,this study found that adult ADHD was significantly impaired in the "executive control","cold" executive function(mainly manifested in cognitive flexibility,inhibitory control,working memory)and "hot" executive function of the attention network.(2)The comprehensive intervention of mindfulness and cognitive behavioral therapy for three months had significant effects on the improvement of executive control,inhibitory control ability,working memory and "hot" executive function of adult ADHD.In conclusion,this study systematically investigated the characteristics and impairments of attention and executive function in adult ADHD,which has certain scientific value for the research and exploration of adult ADHD in China.More importantly,this study based on the characteristics of adult ADHD developed scientific and effective mindfulness and cognitive behavioral therapy combined with comprehensive training courses,and through the rigorous design of experiment examined the course for adult ADHD attention and executive function of ascension,for intervention and treatment of adult ADHD has important practical significance. |
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