Abstract | Hiperkinetski poremećaj jedan je od najčešće dijagnosticiranih poremećaja dječje dobi s visokom prevalencijom koja je vrlo širokog raspona ovisno o zemlji u kojoj se provodi dijagnostika i od instrumentarija i dijagnostičkih klasifikacija koje se koriste. Mnogi poremećaji dječje dobi slične su kliničke slike te se u literaturi često navodi mogućnost dijagnostike lažno pozitivnog hiperkinetskog poremećaja, upravo zbog nedostatka objektivnih mjera dijagnostike.
Cilj istraživanja bio je ispitati prognostički značaj Testa varijabli pažnje (T.O.V.A.) prilikom dijagnostike hiperkinetskog poremećaja te utvrditi doprinosi li upotreba T.O.V.A. testa diferencijaciji hiperkinetskog poremećaja od kategorije poremećaja sa sličnim sub-kliničkim manifestacijama.
U istraživanju je sudjelovalo 61 ispitanika eksperimentalne i 60 ispitanika kontrolne skupine. Obje skupine činili su dječaci od 8-10 godina (srednja dob 9 godina). Eksperimentalnu skupinu činili su ispitanici s postavljenom dijagnozom hiperkinetski poremećaj dok su kontrolnu skupinu činili su ispitanici sa simptomima hiperkinetskog poremećaja koji nisu bili dovoljni da se postavi dijagnoza., tzv. populacija ispitanika sa sub-kliničkim manifestacijama poremećaja.
Dobiveni rezultati ukazuju da se korištenjem T.O.V.A. testa na obje skupine nalaze statistički značajne razlike između dvije skupine na svim mjerenim varijablama (duljina vremena potrebna za odgovor, varijabilnost vremena potrebna za odgovor, pogreške uslijed nepažnje, pogreške uslijed impulzivnosti) u pojedinim kvartalima testa, dok se na varijabli „varijabilnost vremena potrebnog za odgovor“ statistički značajne razlike nalaze tijekom cijelog testa, na svim mjerenim varijablama.
Zaključno se ovim istraživanjem potvrdilo da upotrebom T.O.V.A. testa možemo diferencirati između hiperkinetskog poremećaja i populacije sa sub-kliničkim manifestacijama. Nadalje, ovo istraživanje potvrdilo je i recentna svjetska istraživanja da je najstabilnija osobina hiperkinetskog poremećaja povišena „varijabilnost vremena potrebnog za odgovor“ što svrstava hiperkinetski poremećaj u neurorazvojne poremećaja te pomaže u diferencijaciji od populacije sa sub-kliničkim manifestacijama. |
Abstract (english) | Hyperkinetic disorder is one of the most commonly diagnosed childhood disorders. It is of high prevalence, however, it depends on the diagnostic classification and methods used. Many of childhood disorders have similar symptom manifestations, therefore, literature often warns about the possibility of false positive ADHD diagnosis.
The aim of this study was to establish the prognostic value of T.O.V.A. test when used on ADHD subjects in comparison to subjects without ADHD but with some sub-clinical manifestations.
The study included 120 subjects, all male, age 8-10, normal intelligence and going to regular schools. 60 of them were diagnosed with ADHD while 60 of them did not meet the criteria for ADHD, but had many sub-clinical manifestations of the disorder such as decreased school success, lack of concentration, elements of hyperactivity, impulsive behavior and therefore were referred for testing.
T.O.V.A. was tested on all 120 subjects, in the morning 8-11 AM and carefully analyzed.
The results between two groups of subjects were then compared on 4 measured variables (Response time variability, Response time, Commission errors and Omission errors) during the 4 quarters. A total score (Attention Performance index) was compared between two groups as well.
The results indicated that there is a statistically significant difference between two groups of subjects on all measured variables in some or all quarters of the T.O.V.A. test, as well as the statistically significant difference on the total Attention Performance Index. Even though variables Response time, Commission errors and Omission errors were statistically higher in ADHD subjects in most of the quarters of the T.O.V.A. test, Variable Response time variability was significantly higher in ADHD subjects on all 4 quarters of the test, which defines this variable and the most stable and characteristic trace of ADHD. This variable is the one that helps the most in differentiating between ADHD subjects and subjects with sub-clinical manifestations of the disorder.
In conclusion, T.O.V.A. test has the prognostic value in diagnosis of ADHD because it precisely and objectively measures the traits that are not subjectively visible (Response time variable and response time), yet are responsible for the majority of attentional difficulties in ADHD population as opposed to population with sub-clinical manifestations.
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This study provides further evidence that ADHD is a neurodevelopmental disorder. |