概要

基于注意力缺陷过度活跃障碍患者的认知和情感处理的 Fundi 干预的冒险

Published: June 12, 2020
doi:

概要

该协议说明了一种基于归纳学习和间接沟通(埃里克森隐喻催眠)的补救疗法,可应用于注意力缺陷过度活动障碍(ADHD)儿童。特别是,此协议旨在测试”去/不去”决策任务的有效性。神经科学原理贯穿整个文本。

Abstract

许多患有注意力缺陷过度活动障碍(ADHD)的儿童已知有行政功能障碍,这削弱了他们在日常生活中的学习和行为能力。该协议描述了基于规划、关注、连续和同时(PASS 理论)认知处理和恐惧情绪处理的干预(心理治疗)所需的方法。它提供了指导原则和实际建议。过度高的恐惧程度(调节)增加了学习和行为功能障碍的脆弱性。我们解释神经层面的情感和认知之间的相互作用。

一个去/不去的任务(Fundi的冒险),这涉及到决策,在PC模式下管理到66个多动症的样本。Fundi的冒险,一个计算机程序,在涉及规划和选择性注意力的训练时,是为了诱导连续或同时处理而构建的。它旨在通过规划和选择性地提高执行功能。如果执行功能改善,学习改善,行为改善。经过6个多月的干预,70%的受试者获得了缓解。

讲师鼓励使用适当的策略,并指出策略在找到解决问题的方法(去/不走)。重点不是排练和成人指导的口头顺序。语言化可能揭示有意识的口头策略,以解决一个并非真正被无意识地使用的策略的任务。自我语言报告不可靠。这是一种归纳式学习,而不是对认知 PASS 培训的核心的演绎规则学习方法。这种感应训练证明,不仅产生近转移,而且远转移。

必须考虑非认知因素(情感因素),以最大限度地提高认知训练的好处。间接和隐喻的沟通考虑了情感因素。

Introduction

决策与行为相关,大多数行为意味着决策。决策,以及学习,涉及认知和情感处理。认知处理可以根据智能1、2、3、4、5、6、7、8、9的规划、关注、连续和同步,8(PASS),7理论1,2,3,4,5进行6概念化和评估。根据 PASS,任何行为都是神经中央信息处理的输出10。因此,必须注意一种独立于信息集中处理的行为1、2、3、7、8、9、10、11、12。2,3,7,8,9,10,11,121一个人可能不会注意(可观察到的行为),但中央注意力处理可能正在处理一些不同的东西。另一方面,情绪处理包括恐惧处理负责自信(自尊)或缺乏自信13,14,15。,14,15恐惧处理是所有情绪的基本无差别的自主生理基础。像大多数情绪(或”影响”或”情绪”),恐惧开始于杏仁核,杏仁形结构,负责检测我们健康的威胁。

认知和情感处理可以有意识地或更经常地无意识地发生,这是证实ADHD行为或任何其他行为的诊断和干预的关键点。生长和融合的神经科学证据表明,不仅无意识非自愿处理16,17,18,19,20,21,,20,21而且预期无意识处理16,17,18,1922,23,,23,24、25、26、27、28、29、30、31、32、33、34、35,25,26,27,28,29,30,31,32,33,34,35在决策中是正确的。特别是,一项关于人际无意识(隐性)潜意识沟通的神经科学的新研究就是这36个证据。

决策是基于与认知处理相关的自信感觉,隐,含比,明确37、38、39、40、41,38,39更频繁40自信与自我概念(知识库的信仰)有关,但我们声称,决策是基于一个人有意识和无意识的感觉,而不是故意理性地计算后果38。事实上,人们表达的理性论点(口头报告)来解释行为和决策是一种后发现象,是一种认知偏见,42、43,43是由恐惧处理引发的。首先,对感觉的反应发生,然后解释不自觉地作为后天现象实施。自我语言报告是值得怀疑的。认知/情感研究受到一些问题的困扰,这些问题不清楚什么是情绪反应。这是理解情绪恐惧反应的道路。因此,决策、自信和行为是紧密相连的。

从治疗干预的角度来看,究竟应该如何进行干预?干预、调解或教学程序的共同和基本属性是什么?考虑到之前表达的程序,电感学习2和间接沟通(隐喻和埃里克森催眠)14,44,44建议。从神经科学研究中成长和汇聚的证据45、46、47、48、49、50、51、52、53显示了间接交流的一些神经机制。45,46,47,48,49,50,51,52,53

关于归纳学习,重点是儿童对任务的解决,而不是排练成人指导的口头程序。它旨在加强作为任务基础的处理策略,同时避免直接教授技能。成功的归纳式学习是一种经验,它提供了个人能力的自我概念的增长,因此是自信的成长。相比之下,涉及更多同类工作的直接教学会降低兴趣和动力。这里的显著特点是默契获得和使用适当的处理策略,与教学学习相比;这是归纳而不是演绎规则学习方法。儿童必须看到旧办法或战略的不足,以及制定新战略需要。

在这里,我们已经展示了技术的基础(理由)Fundi的冒险作为一个工具的补救治疗应用它在临床环境。有没有出版的研究与这个项目的基金的冒险。这个程序的主要优点是,它不是基于自我语言报告。相比之下,无数的替代技术是基于自我语言报告的演绎学习、直接沟通和字面解释。

在本文中介绍的示例中,Fundi 的冒险干预在注意力缺陷过度活跃障碍 (ADHD) 患者中进行了。多动症是一种行为功能障碍,在漫不经心,过度活跃,冲动的行为,这涉及到一个功能失调的决策12。任何行为都意味着决策。多动症可能是由遗传学和早期经验的组合引起的。该协议的总体目标是根据多动症儿童样本中的归纳学习和间接沟通,检验关于去/不去决策任务(Fundi 的冒险)有效性的假设。据报道,在情感调查54中保留了”去/不走”任务的基本神经心理构造

Protocol

该协议遵循了卡梅·维达尔人类研究伦理委员会的准则。已获得通知同意。 1. 招聘科目 注:招聘是根据之前出版的文献12进行。 招募无合并症的多动症儿童。在目前研究中,招募了66名13-15岁儿童,平均13.89岁,SD=0.8,47名男性和19名女性。已培训心理治疗师(心理学合格)或精神病医生进行招募程序。 获得患者或护理人员…

Representative Results

设计了一个随机的、前瞻性的、纵向的、不受控制的分析性研究(之前和之后)。我们招募了66名药理学治疗的多动症联合儿童,他们年龄为13-15岁,平均为13.89岁,SD=0.8(47名男性和19名女性)。他们还符合SNAP-IV-18的多动症标准。使用配对的学生 t 检验和效果大小统计 (Cohen 的 +) 进行统计分析。 所有66名儿童在SNAP-IV中得分全部为1.8/2.6(家长/教师)。为了获得注意力不集中…

Discussion

不出所料,在通过S PASS认知处理和自信情绪处理的基础上,培训”Fundi的冒险”有助于干预多动症行为障碍。成功与否,是更好的认知处理和更好的行为。更好的认知处理主要是在规划上,而不是那么多的注意力(表1)。PASS 规划和选择性关注加入执行职能。众所周知,更好的执行功能与更好的行为相关,因此,我们可以期待多动症样本中的行为得到改善。补救程序包括归纳式学习和情?…

開示

The authors have nothing to disclose.

Acknowledgements

我们感谢基金会的所有人员,儿童和他们的父母,他们在此介绍的研究的宝贵合作。此外,所有专业人士谁贡献了任何方式,如统计分析,计算援助,建议,评论和鼓励,整体琼蒂莫内达。特别感谢我们的队友乔迪·鲍斯、乔迪·埃尔南德斯、奥斯卡·马特乌、安娜·奥里和马蒂·里巴斯。

Materials

The Adventures of Fundi Fundació Carme Vidal Xifre de Neuropsicopedagogia The "Adventures of Fundi" has been designed with the objective of helping to improve the concentration, attention and control of impulsivity for Secondary Education students and it is also possible to apply it to Students in the last cycle of Primary Education. To execute the "Adventures of Fundi" a browser with internet conection is required.
Computer with internet connection and browser Mozilla, Firefox, Chrome or Safari

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記事を引用
Mayoral-Rodríguez, S., Pérez-Álvarez, F., Timoneda-Gallart, C., Muñoz-Cuatrecasas, A. The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients. J. Vis. Exp. (160), e60187, doi:10.3791/60187 (2020).

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