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研究生: 呂雨蕎
Lu, Yu-Chiao
論文名稱: 探討ADHD兒童在價值導向記憶作業上的缺陷
A study of deficits in value-directed memory task for children with ADHD.
指導教授: 黃惠玲
Huang, Huei-Lin
共同指導教授: 林君昱
Lin, Chun-Yu
學位類別: 碩士
Master
系所名稱: 醫學院 - 行為醫學研究所
Institute of Behavioral Medicine
論文出版年: 2017
畢業學年度: 105
語文別: 中文
論文頁數: 88
中文關鍵詞: 價值導向記憶注意力缺陷過動/衝動障礙記憶策略
外文關鍵詞: Value-directed memory, ADHD, Strategy
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  • 研究目的:在真實生態中,環境中的訊息龐雜,而我們的記憶容量有限,當我們意識到此有限性,我們傾向選擇對自己來說較有價值的訊息,提高記憶的效能,此即為「價值導向記憶」。Castel等人(2010)初次探討ADHD兒童和正常發展兒童此能力的差異,發現不同組的兒童其記憶容量未有顯著差異,但ADHD-C’組之價值導向記憶表現較ADHD-I組與正常發展兒童組差。本研究則欲延伸Castel等人(2010)做進一步的探討:本研究欲驗證價值導向記憶的歷程中,參與者是在記憶的登錄或是提取階段展現選擇性,以及ADHD-C’組之缺陷是否源自於缺乏與自身能力相當之策略。也欲進一步推論價值導向記憶的歷程、各組於歷程中的差異以及可能協助ADHD-C’改善表現的方式。

    研究方法:本研究共有120位10-12歲的參與者,其中有61位正常發展兒童,26位ADHD-I組兒童及33位ADHD-C’組兒童。起初,參與者會被隨機分派至指定策略或未指定策略情境,之後會進行選擇性作業。在選擇性作業中,參與者需記憶每回合16個字詞的清單,每個字詞會搭配1-16分其中一種價值,為其最後回憶該字詞所獲得的分數,作業目標為提升最終獲得分數。此部分結束後進行再認作業,參與者需判斷所見字詞是否曾經出現在前面的清單中。

    研究結果:選擇性指標部分,參與者類型達顯著主要效果,F (2,114) = 3.479,p = .034,η2 = .058,事後檢定顯示Control組之選擇性指標顯著大於ADHD-C’組( p = .046),ADHD-I組之選擇性指標亦顯著大於ADHD-C’組( p = .030),而Control組與ADHD-I組之選擇性指標則無顯著差異,顯示無論是否指定策略、無論何種作答方式,ADHD-C’組之價值導向記憶表現皆顯著較其他兩組弱;策略情境達顯著主要效果,F (1,114) = 81.419,p < .001,η2 = .417,指定策略情境之選擇性指標顯著大於未指定策略情境,顯示指定策略的給予有效協助所有參與者提升價值導向記憶表現;作業方式達顯著主要效果,F (1,114) = 90.023,p < .001,η2 = .441,自由回想作業之選擇性指標顯著大於再認作業,顯示提取階段的選擇性表現較登錄階段更佳;而此三變項間則未有任何顯著交互作用。
    回憶率的部分,參與者類型與價值(F (6,342) =3.057,p = .006,η2 =.051)、策略情境與價值(F (3,342) = 28.822,p < .001,η2 =.202)兩者之二因子交互作用達顯著,三因子交互作用未達顯著。參與者類型與價值交互作用之單純主要效果:在各價值區間下檢驗參與者類型之單純主要效果,發現參與者類型於中高價值下單純主要效果顯著(F (2,456) = 4.880,p = .008,η2 = .021),其中Control組之回憶率顯著高於ADHD-C’組(p = .015),ADHD-I組則與兩組皆無明顯差異;及參與者類型於低價值下單純主要效果顯著(F (2,456) = 2.990,p = .0514,η2 = .021),ADHD-C’組之回憶率顯著高於ADHD-I組(p = .027);顯示三組在登錄後的處理歷程有所差異。另,在各類型參與者下檢驗價值之單純主要效果,發現各組參與者皆有價值越高回憶率越高的趨勢。而策略的給予可以使高價值的回憶率更高,低價值的回憶率更低。

    研究結論:參與者們在提取階段的選擇性表現較登錄階段更佳,登錄時較不受價值影響,不會忽略低價值字詞,處理過程至提取階段較受價值影響。研究也驗證ADHD-C’組兒童缺乏與自身能力相當之策略,但其於價值導向記憶表現不佳未能僅以此解釋。我們推論:處理過程中,參與者形成策略的能力及策略精緻化的程度(與執行功能中的計畫能力、後設認知有關)、執行策略的能力(注意力資源分配、抑制、工作記憶)在價值導向記憶中扮演重要的角色,這些也都是使ADHD-C’組表現較差的重要因素。另外,本研究發現依照參與者的能力給予明確的策略指導,ADHD-C’組能在短時間內習得此策略並有效應用,使得其價值導向記憶表現提升。

    SUMMARY
    There’s so much information in our environment that some is much more important than others. Because our cognitive resources are limited, it is important that we can selectively choose the most important information for us to know and to learn. In one recent study, researchers used selectivity task to study the difference between ADHD and normal children in this ability (selectively choose important information to learn).This ability is called value-directed memory (VDM). Researchers found that the performance of ADHD combined type(ADHD-C’) in selectivity task was worser than ADHD inattention type(ADHD-I) and normal children. In our study, we make a little modifications of the selectivity task and try to explore and discuss the process of VDM, which cognitive functions may be needed, what deficits that ADHD-C’ have in this process and the way we can help ADHD-C’ improve their VDM. There are 120 children in age of 10-12 participated in our study, which includes 26 ADHD-I, 33 ADHD-C’ and 61 normal children. The results suggest that all participants’ performance of selectivity in the retrieval stage is more obvious than the encoding stage. That the strategies the participants use, how elavorative the strategies are and the ability to execute the strategies(especially inhibition and working memory) all seem to play an important role in the VDM. And they are also the reasons why ADHD-C’ have worser VDM . In addition, Our study tries to help ADHD-C’ improve their performance via teaching them one specific strategy. We find that teaching ADHD-C’ this strategy is an efficient way to help them improve in short time.Thus, Their efficiency of learning and memory can be improved.

    INTRODUCTION
    As what we’ve already known, ADHD is a common neurodevelopmental disorder and the social and academic functions of children with ADHD are easily to be impaired. While we are learning, the ablility to selectively choose important information is necessary. In Castel, Lee, Humphreys, and Moore(2010), It was the first time that researchers tried to study the difference between ADHD and normal children in this ability.This ability is called value-directed memory (VDM). In addition, they also studied the difference between the subtypes of ADHD. The findings have implications for theories of memory dysfunction in childhood ADHD and the key role of metacognition, cognitive control, and value-directed remembering when considering the strategic use of memory.

    The aim of our study is to extend the study of Castel et al.(2010). We try to explore and discuss the process of VDM, which cognitive functions may be needed, what deficits that ADHD-C’ have in this process and the way we can help ADHD-C’ improve their VDM.

    MATERIALS AND METHODS
    There are 120 children in age of 10-12 participated in this research, which includes 26 ADHD-I, 33 ADHD-C’ and 61 normal children.

    First, participants are assigned randomly to two different conditions (directed strategy/non-directed strategy). In non-directed strategy condition, participants do the selectivity task on their own. In directed strategy condition, participants are taught the strategy to perform well in task. The examiner will consider the memory capacity of each participants and teach them the strategy they are able to do.

    Then, participants do the selectivity task in two way : free recall and recognition . In the ‘free recall’ task, participants study words paired with values in 1-16 before recalling, and are asked to maximize their score, which was the sum of the value paired with those items recalled by them. After recalling, the examiner will tell participants the total score they’ve got. In the ‘recognition’ task, participants need to judge whether they have seen the word in previous ‘ free recall ‘task or not.

    RESULTS AND DISCUSSION
    There is no significant difference in age and gender between groups. Analysis of 3-way variance (ANOVA) reveals neither of 3-way and 2-way interaction is significant on the number of words recalled, total score and selectivity index(SI). The most important results here are (1) The group main effect on SI (F (2,114) = 3.479,p = .034,η2 = .058). Post hoc comparisons (scheffe’s test) reveal that the ADHD-C’ group exhibited significantly lower SI than both Control(p = .046)and ADHD-I(p = .030)groups while Control and ADHD-I did not differ from each other. (2) The condition main effect on SI (F (1,114) = 81.419,p < .001,η2 = .417) that the SI in directed strategy condition is higher than in non-directed condition. (3) The task main effect on SI (F (1,114) = 90.023,p < .001,η2 = .441) that the SI in recall task is higher than in recognition task. These statisitic results not only replicate previous findings in ADHD-C’group, but also find that participants, including ADHD-C’group, could improve their ablility to selectively choose important information to learn with external strategy. In addition, we also find that all participants’ performance of selectivity in the retrieval stage is more obvious than the encoding stage. Then, Our study goes a step further that we concern about the effect of the value. Although there is no significant 3-way interaction, there are significant 2-way interaction of Group x Value (F (6,342) =3.057,p = .006,η2 =.051)and Condition x Value(F (3,342) = 28.822,p < .001,η2 =.202). The result which is more interesting here is the Group x Value interaction. We check the simple main effect in Group x Value interaction. We find that the participants of 3 groups all recall significantly more high-valued(H) items than medium-high-valued(mH) items and significantly more mH items than medium-low-valued(mL) items. But they don’t recall significantly more mL items than low-valued(L) items. We also find that Control recall significantly more mL items than ADHD-C’ (p = .015) and ADHD-C’ recall significantly more L items than ADHD-I(p = .027). While there are no group difference in H items and mL items. These statisitic results suggest that ADHD-C’ deficits in the process of performing the ablility to selectively choose important information may be associated with the ability to generate appropriate strategies and the ability to execute strategies.

    CONCLUSION
    In our study, We discuss the process of VDM, which cognitive functions may be needed, what deficits that ADHD-C’ have in this process and the way we can help ADHD-C’ improve their VDM. We find that all participants’ performance of selectivity in the retrieval stage is more obvious than the encoding stage .The strategies the participants generate, how elavorative the strategies are and the ability to execute the strategies
    (especially inhibition and working memory) all seem to play an important role in this process. They are also the reasons why ADHD-C’ have worser VDM. In addition, we find an efficient strategy to help ADHD-C’ improve their VDM and efficiency of learning and memory.

    摘要 I 英文摘要 III 誌謝 VI 目錄 VII 表目錄 IX 圖目錄 X 第一章、緒論 1 第一節、注意力不足/過動症 1 壹、概述 1 貳、病理模型 2 參、心理功能缺損 6 第二節、注意力不足/過動症各表現型之心理功能差異 12 第三節、注意力不足/過動症之價值導向記憶 15 壹、選擇性作業與價值導向記憶 15 貳、ADHD兒童與價值導向記憶 18 第四節、研究目的 19 第五節、研究假設與預期結果 20 第二章、研究方法 21 第一節、研究對象 21 壹、樣本來源 21 貳、樣本性質概述與篩選標準 22 參、人口學變項統計資料 23 第二節、研究工具 24 壹、中文刺激材料挑選 24 貳、呈現刺激及記錄反應的設備 25 參、干擾行為評量表-家長版 25 肆、魏氏兒童智力測驗第四版 26 第三節、研究流程 27 第四節、實驗設計 28 壹、實驗變項 28 貳、電腦化價值導向記憶作業程序 29 第五節、統計方法 32 壹、分析指標 32 貳、統計分析方法 33 第三章、研究結果 35 第一節、各組表現概述 35 第二節、各組表現之差異 36 壹、未指定策略情境下,整體自由回憶表現之參與者組間差異 36 貳、整體價值導向記憶表現之實驗情境間差異 37 參、不同作業方式下,不同實驗情境參與者表現受價值之影響 42 肆、各組參與者再認之準確性受價值之影響 48 第四章、綜合討論 52 第一節、研究結果摘要 52 第二節、研究結果討論 54 壹、在價值導向記憶的歷程中,選擇性發生於何記憶階段 54 貳、價值導向記憶可能的歷程及各組兒童在歷程中的差異與缺陷 55 參、改善ADHD-C'組兒童價值導向記憶的方法 60 第三節、研究結論與未來方向 62 參考文獻 64 附錄 74 附錄一、實驗使用之中文刺激材料 74 附錄二、電訪紀錄單 82 附錄三、實驗指導語 83 附錄四、DmDx程式編碼 87

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