以神經生理回饋為主之神經心理治療對改善注意力監控之療效研究--以注意力缺陷／過動疾患兒童為例_

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題名：	以神經生理回饋為主之神經心理治療對改善注意力監控之療效研究--以注意力缺陷／過動疾患兒童為例
書刊名：	教育心理學報
作者：	廖御圻／郭乃文／陳信昭／蔡幸芳／蘇倍儀
作者(外文)：	Liao, Yu-chi／Guo, Nai-wen／Chen, Shin-jaw／Tsai, Hsing-fang／Su, Bei-yi
出版日期：	2015
卷期：	47:2
頁次：	頁281-304
主題關鍵詞：	注意力缺陷／過動疾患；注意力監控；神經心理治療；神經生理回饋；ADHD；CATS；Meta-attention；Neurofeedback；Neuropsychotherapy
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:0 共同引用:30 點閱:58

Arns等人（2009）後設分析指出神經生理回饋（neurofeedback, NF）訓練對注意力缺陷／過動疾患（ADHD）之注意力與行為症狀具有良好療效，但所應用之NF訓練模組需時較長，且缺乏以神經心理層面的證據來討論所強化的注意力監控功能之心智機制。本研究旨於驗證一套需時較短且融合NF和神經心理理論的神經心理治療模組，且以多層次的心智功能指標來檢驗其療效。以廣泛性注意力訓練系統（comprehensive attention training system, CATS）與自主性概念融入NF，建構一套稱為「Will Well NF（WWNF）」之神經心理治療模組，每治療期程約20小時。二十二名學齡期ADHD患者隨機分派至等候控制組（CON組）與實驗組（WWNF組）。CON組接受前測後，維持原醫囑和治療方式於十週後進行後測；WWNF組則在原醫囑和治療方式內加上十週之WWNF治療。以個案之神經心理功能、家長填答之日常功能行為問卷，以及學習適應問卷三層級指標做為療效指標。統計以二因子重複量數分析與拔靴法之相依t檢定檢驗組內改變。F-test檢測三層級療效指標結果顯示在多項指標上達顯著交互作用，皆為WWNF組進步優於CON組，分別為神經心理測驗中多項注意力指標，如遲緩錯誤數、漏失錯誤數、正確反應數，及反應時間；行為問卷中之不注意症狀數、總症狀數，及注意力指標；以及適應行為之時間管理功能等。經WWNF後，注意力監控與執行功能無論在神經心理層面與生活行為上均呈現明顯改善。雖樣本數較少，但已可實證WWNF對ADHD之療效。未來研究可增加樣本數，用以討論個別差異對療效之影響、追蹤療效之持續性，以及跨其他心智障礙患者之治療效果

以文找文

Neurofeedback (NF) training technique can effectively reduce inattention and behavioral symptoms in children with attention deficit hyperactivity disorder (ADHD) based on a meta-analysis study of Arns et al. (2009). Yet, there are two concerns that need be addressed. First, most training programs developed from the NF technique last for more than 40 hours. Second, little efforts had been put to the neuropsychological function, especially training effects on improvement of meta-attention and executive functions. Thus, this study was aimed to establish a novel neuropsychotherapy training program with a shorter training time and to investigate if it has multi-level mental function training effects. Combined Comprehensive Attention Training Systems (CATS) and the concept of autonomy throughout the whole training process with NF technique developed into a novel neuropsychotherapy program, called Will Well NF (WWNF). The training course for WWNF lasts 20 hours. Twenty-two ADHD children were randomly assigned to either a control group (CON group) or an experimental group (WWNF group). The CON group, after taking interview and pretests, kept original treatment protocols until posttests were done after 10 weeks. The WWNF group, after taking interview and pretests, received additional WWNF training for 10 weeks until posttests were done. This study used indices from three levels of evidences to discuss the curative effects, including clients’ neuropsychological functions and behavioral and learning adaptive questionnaires reported by their parents. The two-way repeated measured method (ANOVA) and bootstrapping method of a dependent T-test were used for statistical analysis. An F-test revealed that there were interaction effects in both neuropsychological and behavioral questionnaire levels. Compared to the CON group, the WWNF group made less delay errors and omission errors, more correct responses, reduced reaction time among attentional assessments in neuropsychological tasks, decreased inattention and ADHD symptoms in SNAP, and better daily attention function reported by parents in the questionnaire level. Improving time management behaviors reported by parents within WWNF group were also noted. This study suggested that ADHD children improve in mental functions, including attention monitoring and executive functions, and daily life behaviors after WWNF. Even though the sample size in this study was small, it proved the effect of WWNF. Future studies should increase the sample size to discuss individual impacts on effectiveness, follow up on the maintenance of effectiveness, and apply the method to different mental disabilities.

以文找文

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研究報告
1.	余麗樺、郭乃文、黃茂雄(2002)。注意力功能之神經心理學建構與衡鑑模式研究--以青少年與腦傷患者之實證資料為基礎。延伸查詢
2.	郭乃文、鄭中平(2005)。非語文注意力與記憶力測驗之修訂與應用。台北：教育部社教司。延伸查詢

學位論文
1.	郭乃文(2003)。以Cohen認知神經心理學概念探討注意力功能測量研究(博士論文)。國立臺灣大學。延伸查詢
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3.	倪子洛(2011)。早期發展正常之極低出生體重早產兒於學齡前執行功能之受損研究(碩士論文)。國立成功大學。延伸查詢
4.	陳孟筳(2010)。學齡期高功能自閉症與亞斯伯格症孩童執行功能之訓練成效(碩士論文)。國立成功大學。延伸查詢
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1.	Lubar, J. F.(2003)。Neurofeedback for the management of attention deficit disorders。Biofeedback: A practitioner's guide。New York, NY：The Guilford Press。
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10.	歐洲人權公約第3條與嚴重系統性歧視：私人關係中的非人道或侮辱待遇
11.	我「嘉」廟埕開講：在暗瞑中找尋健康促進的新契機
12.	得宜的監禁條件與收容人尊嚴的尊重：歐洲人權法院相關裁判研究
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