Meta-Análise: Relação entre Perturbação de Hiperactividade com Défice de Atenção e Rendimento Neuropsicológico
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2009
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A perturbação de hiperactividade com défice de atenção (PHDA) compõe a mais prevalente perturbação do desenvolvimento. Manifesta-se por níveis de desatenção, hiperactividade e impulsividade inapropriados e tende a persistir durante toda a vida, com prejuízo substancial de áreas importantes do funcionamento do sujeito.
Foi conduzida uma meta-análise com o propósito de determinar a magnitude do comprometimento, documentado na literatura, do rendimento neuropsicológico quando associado com a PHDA.
O presente estudo revisou as publicações realizadas após 1994 que utilizaram o DSM-IV como sistema de diagnóstico. Dos 102 estudos iniciais, 58 preencheram todos os critérios definidos para inclusão na meta-análise (k=58). Os resultados comprovaram a existência de défices significativos no rendimento neuropsicológico em função da presença de PHDA (r=.27), reforçando as evidências do impacto negativo desta disfunção no rendimento académico e executivo dos sujeitos. O effect size foi igualmente analisado para as variáveis moderadoras idade, género, subtipos da PHDA e domínio de rendimento neuropsicológico, tendo apenas sido encontrado um efeito moderador significativo da correlação quando testados os subtipos da PHDA (z ≥1.64, p<.05). As restantes variáveis não funcionaram como moderadoras da magnitude da correlação entre PHDA e rendimento neuropsicológico.
O subtipo misto de PHDA apresentou níveis inferiores de rendimento académico e executivo, comparativamente aos restantes, sendo o subtipo predominantemente hiperactivo-impulsivo o que manifesta menor disfunção neuropsicológica, de forma consistente com a literatura. Os resultados foram discutidos em função da afectação global do rendimento neuropsicológico e do impacto das variáveis moderadoras na relação com a PHDA.
Attention-deficit/hyperactivity disorder (ADHD) is the most common developmental disorder. It displays inappropriate levels of inattention, hyperactivity and impulsivity and tends to remain the entire life. This disorder causes serious damages in important areas of the individual functioning. A meta-analysis has been carried out, in order to determine the impairment magnitude, documented in literature, of the neuropsychological performance associated with ADHD. The present study checked the specific publications produced after 1994 which had used the DSM-IV diagnostic system. Of the original 102 studies, 58 fulfilled all criteria for inclusion in the meta-analysis (k=58). The results pointed out significant deficits in the neuropsychological performance according to the presence of ADHD (r=.27), reinforcing the evidences of the negative impact of this disorder in the executive and academic achievement of the individuals. Effect sizes were also analysed accordingly to the moderators of age, gender, ADHD subtypes and control of neuropsychological performance. A significant moderator effect of the correlation emerged only when the subtypes of ADHD were tested (z ≥1.64, p<.05). The remaining variables did not function as moderators of the magnitude of correlation between ADHD and neuropsychological performance. The combined subtype of ADHD presented inferior levels of academic and executive achievement, when compared to the remaining, being the predominantly hyperactive impulsive subtype the one that shows a smaller neuropsychological disorder, in accordance with literature. The conclusions have been discussed according to the global damages in the neuropsychological performance and to the impact of the moderators correlated with ADHD.
Attention-deficit/hyperactivity disorder (ADHD) is the most common developmental disorder. It displays inappropriate levels of inattention, hyperactivity and impulsivity and tends to remain the entire life. This disorder causes serious damages in important areas of the individual functioning. A meta-analysis has been carried out, in order to determine the impairment magnitude, documented in literature, of the neuropsychological performance associated with ADHD. The present study checked the specific publications produced after 1994 which had used the DSM-IV diagnostic system. Of the original 102 studies, 58 fulfilled all criteria for inclusion in the meta-analysis (k=58). The results pointed out significant deficits in the neuropsychological performance according to the presence of ADHD (r=.27), reinforcing the evidences of the negative impact of this disorder in the executive and academic achievement of the individuals. Effect sizes were also analysed accordingly to the moderators of age, gender, ADHD subtypes and control of neuropsychological performance. A significant moderator effect of the correlation emerged only when the subtypes of ADHD were tested (z ≥1.64, p<.05). The remaining variables did not function as moderators of the magnitude of correlation between ADHD and neuropsychological performance. The combined subtype of ADHD presented inferior levels of academic and executive achievement, when compared to the remaining, being the predominantly hyperactive impulsive subtype the one that shows a smaller neuropsychological disorder, in accordance with literature. The conclusions have been discussed according to the global damages in the neuropsychological performance and to the impact of the moderators correlated with ADHD.
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Dissertação de Mestrado em Avaliação nas Actividades Físicas e Desportivas
Palavras-chave
PHDA , Rendimento neuropsicológico , Meta-análise