Executive Function Deficits in Asperger Disorder:Evidence from a Paired-task Method

본 연구의 목적은 아스퍼거 장애에서 관리기능(executive function)의 결손이 있다는 가설을 검증하는 것이었다. 대부분의 관련 선행 연구들은 관리기능과 다른 인지기능의 결손을 잘 구별할 수 없는 과제의 결손만을 검증한 제한점이 있었다. 본 연구는 이러한 제한점을 극복하기 위하여 관리기능 의존도가 높고 낮음에 따라 구성한 짝과제를 이용한 연구 설계를 도입하였다. 구체적으로 아스퍼거 아동 15명과 통제 아동 15명을 Wechsler IQ-Executive IQ, Verbal IQ-Performance IQ, 단순시행-간섭시행, 상식-단어유창성, 빠진곳찾기-도안유창성, 재인시행-회상시행의 6개 짝과제에서 비교하였다. 6개의 짝과제 중 5개에서 집단(아스퍼거, 통제)과 관리기능 의존도(낮음, 높음)의 상호작용이 유의하였다. 이 상호작용은 통제군에 비교한 아스퍼거군의 결손이 관리기능 의존도가 낮은 과제에 비해 높은 과제에서 보다 심함을 반영하였다. 이 결과는 선행 연구들의 관련 결과에 비해 아스퍼거 장애의 관리기능 가설을 보다 분명히 지지하는 증거라는 점에서 의의가 있다. 관리기능 의존도가 낮은 6과제들 중 5개에서 유의한 집단간 차이가 없었다. 이는 아스퍼거 장애에서 관리기능을 제외한 다른 인지기능은 거의 정상 수준임을 제시한다.

keywords: 아스퍼거, 관리기능, 실행기능, 인지기능, 짝과제, Asperger disorder, executive function, cognitive function, paired-task

Abstract

The goal of the present study was to test the hypothesis that Asperger disorder is associated with executive function (EF) deficits. A common limitation in prior related studies was an experimental design that could not clearly distinguish EF deficits from other cognitive deficits. To overcome this limitation, the present study employed a paired-task method, in which one task strongly demanded executive function and the other task did not. Fifteen Asperger disorder and fifteen control children were compared on six paired-tasks: Wechsler IQ-Executive IQ, Verbal IQ-Performance IQ, simple trial-interference trial, common sense-verbal fluency, picture completion-design fluency and recognition-recall. The results indicated a significant interaction between group (Asperger, control) and executive function (low, high) on all paired-tasks except recognition-recall. Each significant interaction reflected the fact that Asperger children had a greater deficit in the tasks that strongly demanded EF than the tasks that did not strongly demand EF. These results provide stronger evidence for the ‘executive dysfunction’ hypothesis than prior related studies have offered. Other findings indicated that cognitive functions other than executive function are normal in Asperger disorder.

keywords: 아스퍼거, 관리기능, 실행기능, 인지기능, 짝과제, Asperger disorder, executive function, cognitive function, paired-task

참고문헌

곽금주, 박혜원, 김청택 (2001). K-WISC-Ⅲ 지침서. 서울: 도서출판 특수교육.

김복남, 김홍근 (2011). 알코올 의존 환자에서 전두엽-관리기능의 차별적 결손. 한국심리학회지: 일반, 30, 443-459.

김홍근 (2005). 아동용 Kims 전두엽-관리기능 신경심리검사: 해설서. 대구: 도서출판 신경심리.

김홍근, 최영주, 이민영, 서석교 (2009). 정신분열병에서 전두엽-관리기능의 차별적 결손: 3 개 연구의 통합 분석. 한국심리학회지: 일반, 28, 319-342.

서경희 (2001). 아스파거 증후군-인지적 결손을 중심으로. 재활심리연구, 8, 83-103.

추은진, 김홍근 (2009). 뇌졸중 노인에서 전두엽-관리기능의 차별적 결손. 한국심리학회지: 일반, 28, 29-48.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”? Cognition, 21, 37-46.

Benton, A. L. (1968). Differential behavioral effects in frontal lobe disease. Neuropsychologia, 6, 53- 60.

10.

Bowler, D. M., Gardiner, J. M., & Grice, S. J. (2000). Episodic memory and remembering in adults with Asperger syndrome. Journal of Autism and Developmental Disorders, 30, 295- 304.

11.

Bowler, D. M., Matthews, N. J., & Gardiner, J. M. (1997). Asperger's syndrome and memory: similarity to autism but not amnesia. Neuropsychologia, 35, 65-70.

12.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

13.

Damasio, A. R., & Anderson, S. W. (1993). The frontal lobes. In K. M. Heilman & E. Valenstein (Eds.), Clinical Neuropsychology (pp. 409-460). New York: Oxford University Press.

14.

Dawson, G., Webb, S., Schellenberg, G. D., Dager, S., Friedman, S., Aylward, E., & Richards, T. (2002). Defining the broader phenotype of autism: genetic, brain, and behavioral perspectives. Development and Psychopathology, 14, 581-611.

15.

Di Martino, A., Ross, K., Uddin, L. Q., Sklar, A. B., Castellanos, F. X., & Milham, M. P. (2009). Functional brain correlates of social and nonsocial processes in autism spectrum disorders: an activation likelihood estimation meta-analysis. Biological Psychiatry, 65, 63-74.

16.

Duncan, J., Burgess, P., & Emslie, H. (1995). Fluid intelligence after frontal lobe lesions. Neuropsychologia, 33, 261-268.

17.

Faw, B. (2003). Pre-frontal executive committee for perception, working memory, attention, long-term memory, motor control, and thinking: a tutorial review. Consciousness and Cognition, 12, 83-139.

18.

Filley, C. M. (2011). Neurobehavioral anatomy (3rd ed.). Niwot, CO: University Press of Colorado.

19.

Frith, U. (1989). Autism: explaining the enigma. Malden, MA: Blackwell Publishing.

20.

Happé, F., Booth, R., Charlton, R., & Hughes, C. (2006). Executive function deficits in autism spectrum disorders and attention-deficit/ hyperactivity disorder: examining profiles across domains and ages. Brain and Cognition, 61, 25-39.

21.

Hill, E. L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8, 26-32.

22.

Hill, E. L., & Bird, C. M. (2006). Executive processes in Asperger syndrome: patterns of performance in a multiple case series. Neuropsychologia, 44, 2822-2835.

23.

Hodges, J. R. (1994). Cognitive assessment for clinicians. New York: Oxford University Press.

24.

Horn, J. L. (1985). Remodeling old models of intelligence. In B. B. Wolma (Ed.), Handbook of Intelligence (pp.267-300). New York: John Wiley & Sons.

25.

Janowsky, J. S., Shimamura, A. P., Kritchevsky, M., & Squire, L. R. (1989). Cognitive impairment following frontal lobe damage and its relevance to human amnesia. Behavioral Neuroscience, 103, 548-560.

26.

Jones-Gotman, M., & Milner, B. (1977). Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia, 15, 653-674.

27.

Kalbfleisch, M. L., & Loughan, A. R. (2012). Impact of IQ Discrepancy on executive function in high-functioning autism: insight into twice exceptionality. Journal of Autism and Developmental Disorders, 42, 390-400.

28.

Kaufman, A. S. (1990). Assessing adolescent and adult intelligence. Boston, MA: Allyn & Bacon.

29.

Kleinhans, N., Akshoomoff, N., & Delis, D. C. (2005). Executive functions in autism and Asperger's disorder: flexibility, fluency, and inhibition. Developmental Neuropsychology, 27, 379-401.

30.

Mega, M., & Cummings, J. (1994). Frontal- subcortical circuits and neuropsychiatric disorders. Journal of Neuropsychiatry and Clinical Neurosciences, 6, 358-370.

31.

Miller, B., & Cummings, J. (2007). The human frontal lobes: functions and disorders. New York: Guilford Press.

32.

Miyake, A., Emerson, M. J., & Friedman, N. P. (2000). Assessment of executive functions in clinical settings: problems and recommendations. Seminars in Speech and Language, 21, 169-183.

33.

Ozonoff, S., South, M., & Miller, J. N. (2000). DSM-Ⅳ-defined Asperger syndrome: cognitive, behavioral and early history differentiation from high-functioning autism. Autism, 4, 29-46.

34.

Pendleton, M. G., Heaton, R. K., Lehman, R. A. W., & Hulihan, D. (1982). Diagnostic utility of the Thurstone Word Fluency Test in neuropsychological evaluations. Journal of Clinical and Experimental Neuropsychology, 4, 307-317.

35.

Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51-87.

36.

Perret, E. (1974). The left frontal lobe of man and the suppression of habitual responses in verbal categorical behaviour. Neuropsychologia, 12, 323- 330.

37.

Rey, A. (1964). L’examen clinique en psychologie. Paris: Press Universitaire de France.

38.

Royall, D. R., Lauterbach, E. C., Cummings, J. L., Reeve, A., Rummans, T. A., Kaufer, D. I., et al. (2002). Executive control function: a review of its promise and challenges for clinical research. The Journal of Neuropsychiatry and Clinical Neurosciences, 14, 377-405.

39.

Ruff, R. M., Allen, C. C., Farrow, C. E., Niemann, H., & Wylie, T. (1994). Figural fluency: differential impairment in patients with left versus right frontal lobe lesions. Archives of Clinical Neuropsychology, 9, 41-55.

40.

Ruff, R. M., Light, R. H., & Evans, R. W. (1987). The Ruff Figural Fluency Test: a normative study with adults. Developmental Neuropsychology, 3, 37-51.

41.

Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., & Butcher, B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD- predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017-1027.

42.

Siegel, D. J., Minshew, N. J., & Goldstein, G. (1996). Wechsler IQ profiles in diagnosis of high-functioning autism. Journal of Autism and Developmental Disorders, 26, 389-406.

43.

Stanfield, A. C., McIntosh, A. M., Spencer, M. D., Philip, R., Gaur, S., & Lawrie, S. M. (2008). Towards a neuroanatomy of autism: a systematic review and meta-analysis of structural magnetic resonance imaging studies. European Psychiatry, 23, 289-299.

44.

Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643-662.

45.

Stuss, D., Floden, D., Alexander, M., Levine, B., & Katz, D. (2001). Stroop performance in focal lesion patients: dissociation of processes and frontal lobe lesion location. Neuropsychologia, 39, 771-786.

46.

Stuss, D. T., & Alexander, M. P. (2000). Executive functions and the frontal lobes: a conceptual view. Psychological Research, 63, 289-298.

47.

Wechsler, D. (1981). Wechsler Intelligence Scale for Children-Ⅲ. San Antonio, TX: Psychological Corporation.

48.

Wheeler, M. A., Stuss, D. T., & Tulving, E. (1995). Frontal lobe damage produces episodic memory impairment. Journal of the International Neuropsychological Society, 1, 525-536.

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논문 상세

Vol.31 No.3

아스퍼거 장애에서 관리기능(executive function)의 결손:짝과제를 사용한 검증

Executive Function Deficits in Asperger Disorder:Evidence from a Paired-task Method

초록

Abstract

참고문헌

한국심리학회지: 일반