尋求刺激的原因探研 (一)

（撰文：Stephen Chan, 註冊職業治療師)

尋求刺激 A 型

真有孩子會尋求刺激來令自己醒神嗎？

尋求刺激的孩子會不夠「 醒 」嗎？

讓我們一起了解：

首先是如何量度警醒度，我們回顧的文獻主要是用汗腺的活躍度 (EDA) 來量度的。在心理神經科學的研究中它早已被廣泛使用，是反映交感神經系統，亦即警醒度的指標。

每當談及 Seeker 及尋求刺激時，我們許多時最直接想到的就是專注力不足／過度活躍症 (ADHD)。這些孩子會動個不停，無法靜止下來；而同時擁有專注力不足／過度活躍症和操行障礙 (CD) 的學生更可能會常常搗蛋攪亂。現在讓我們來看看他們的警醒度吧 !

研究發現專注力不足／過度活躍症 (ADHD) 的學生在休息狀態及出現錯誤時的汗腺的活躍度 (EDA) ，即警醒度，都比一般的孩子低 (O’Connell & Bellgrove, 2004)。而 ADHD 伴隨有操行障礙 (Conduct Disorder, CD) 的學生的警醒度比只有ADHD的學生更為低 (Herpertz et. al., 2001)。

而他們尋求刺激的方法都有一個特點，就是運用新奇、多變、令人興奮或緊張的活動來刺激自己。這些活動往往都是提昇多巴胺 (Dopamine) 及腎上腺素 (Noradrenaline) 的活動 (Zald, 2008)。

研究亦發現 ADHD 的學生的多巴胺 (Dopamine) 及腎上腺素 (Noradrenaline) 也比一般孩子缺乏。控制 ADHD 的藥物正是針對多巴胺 (Dopamine) 及腎上腺素 (Noradrenaline) 的不足而用的 (Campo et. al., 2011; Shaw et. al., 2007; Swanson et. al., 2007; Volkow et.  al., 2007)。

 看過這些研究後，你認為他們動個不停、無法靜止下來及搗蛋攪亂的原因是甚麼呢 ?

這些行為其實有可能是源於孩子們的警醒度不足。他們的行為是回應身體內在警醒度不足而產生的。

這些行為背後的作用是要叫醒自己的神經系統。

想知更多 ?

可以參加: 感覺餐牌 (Sensory Menu)–感覺統合基礎課程(第二階段)

Http://www.crest.hk/2017sensorymenu/

 

 

 

 

References:

Anderson GM, Dover MA, Yang BP, et al. Adrenomedullary function during cognitive testing in attention deficit/hyperactivity disorder [review]. J Am Acad Child Adolesc Psychiatry. 2000;39:635-643.

Aston-Jones G, Rajkowski J, Cohen J. Role of locus coeruleus in attention and behavioral flexibility [review]. Biol Psychiatry. 1999;46:1309-1320.

Berridge CW, Waterhouse BD. The locus coeruleus -noradrenergic system: modulation of behavioral state and state-dependent cognitive processes [review]. Brain Res Brain Res Rev. 2003;42:33-84.

Biederman J, Spencer T. Attention-deficit/hyperactivity disorder (ADHD) as a noradrenergic disorder [review]. Biol Psychiatry. 1999 ;46:1234-1242.

Campo, N. D., Chamberlain, S. R., Sahakian, B. J., & Robbins, T. W. (2011). The Roles of Dopamine and Noradrenaline in the Pathophysiology and Treatment of Attention-Deficit/Hyperactivity Disorder. Biological Psychiatry, 69(12). doi:10.1016/j.biopsych.2011.02.036

Cooper JR, Bloom FE, Roth RH. The Biochemical Basis of Neuropharmacology, Eighth Edition. New York, NY: Oxford University Press; 2003.

Crowell SE, Beauchaine TP, Gatzke-Kopp L, Sylvers P, Mead H, et al. (2006) Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children. J Abnorm Psychol 115: 174-178.

Franowicz JS, Kessler LE, Borja CM, Kobilka BK, Limbird LE, Arnsten AF. Mutation of the alpha2A-adrenoceptor impairs working memory performance and annuls cognitive enhancement by guanfacine. J Neurosci. 2002;22:8771-8777.

Pliszka SR, McCracken JT, Maas JW. Catecholamines in attention-deficit hyperactivity disorder: current perspectives. J Am Acad Child Adolesc Psychiatry. 1996;35:264-272.

Hanna GL, Ornitz EM, Hariharan M. Urinary catecholamine excretion and behavioral differences in ADHD and normal boys. J Child Adolesc Psychopharmacol. 1996;6:63-73

Halperin JM, Newcorn JH, Koda VH, Pick L, McKay KE, Knott P. Noradrenergic mechanisms in ADHD children with and without reading disabilities: a replication and extension. J Am Acad Child Adolesc Psychiatry. 1997;36:1688-1697.

Herpertz, S. C., Wenning, B., Mueller, B., Qunaibi, M., Sass, H., & Herpertz-Dahlmann, B. (2001). Psychophysiological Responses in ADHD Boys With and Without Conduct Disorder: Implications for Adult Antisocial Behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 40(10), 1222-1230. doi:10.1097/00004583-200110000-00017

Hermens DF, Kohn MR, Clarke SD, GordonE, Williams LM (2005) Sex differences in adolescent ADHD: findings from concurrent EEG and EDA. Clin Neurophysiol 116: 1455-1463.

Iaboni F, Douglas VI, Ditto B (1997) Psychophysiological response of ADHD children to reward and extinction. Psychophysiol 34: 116-123.
rences
Miller A, Long J (2007) 13 Psychophysiology principles, pointers, and pitfalls. Developmental psychophysiology: theory, systems, and methods p: 367.

O’Connell, R. G., Bellgrove, M. A., Dockree, P. M., & Robertson, I. H. (2004). Reduced electrodermal response to errors predicts poor sustained attention performance in attention deficit hyperactivity disorder. NeuroReport, 15(16), 2535-2538. doi:10.1097/00001756-200411150-00021

Patoine, Brenda (13 October 2009). “Desperately Seeking Sensation: Fear, Reward, and the Human Need for Novelty: Neuroscience Begins to Shine Light on the Neural Basis of Sensation-Seeking”. The Dana Foundation.

Pliszka SR, Maas JW, Javors MA, Rogeness GA, Baker J. Urinary catecholamines in attention deficit hyperactivity disorder with and without comorbid anxiety. J Am Acad Child Adolesc Psychiatry. 1994;33:1165-1173.

Shaw P, Gornick M, Lerch J, et al. Polymorphisms of the dopamine d4 receptor, clinical outcome, and cortical structure in attention-deficit/ hyperactivity disorder. Arch Gen Psychiatry. 2007;64:921–31.

Shekim WO, Bylund DB, Hodges K, Glaser R, Ray-Prenger C, Oetting G. Platelet alpha 2-adrenergic receptor binding and the effects of d-amphetamine in boys with attention deficit hyperactivity disorder. Neuropsychobiology. 1994;29:120-124.

Shekim WO, Sinclair E, Glaser R, Horwitz E, Javaid J, Bylund DB. Norepinephrine and dopamine metabolites and educational variables in boys with attention deficit disorder and hyperactivity. J Child Neurol. 1987;2:50-56.
Swanson JM, Kinsbourne M, Nigg J, et al. Etiologic subtypes of attention-deficit/hyperactivity disorder: brain imaging, molecular genetic and environmental factors and the dopamine hypothesis. Neuropsychol Rev. 2007;17:39–59.

Volkow ND, Wang GJ, Newcorn J, et al. Depressed dopamine activity in caudate and preliminary evidence of limbic involvement in adults with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2007;64:932–40. [PubMed] [Ref list] Wigal SB, Nemet D, Swanson JM, et al. Catecholamine response to exercise in children with ADHD. Pediatr Res. 2003:53:756-761.
Zald, D. H., Cowan, R. L., Riccardi, P., Baldwin, R. M., Ansari, M. S., Li, R., . . . Kessler, R. M. (2008). Midbrain Dopamine Receptor Availability Is Inversely Associated with Novelty-Seeking Traits in Humans. Journal of Neuroscience, 28(53), 14372-14378. doi:10.1523/jneurosci.2423-08.2008

Zametkin AJ, Hamburger SD. The effect of methylphenidate on urinary catecholamine excretion in hyperactivity: a partial replication. Biol Psychiatry. 1988;23:350-356.

Zametkin AJ, Karoum F, Linnoila M, et al. Stimulants, urinary catecholamines, and indoleamines in hyperactivity. A comparison of methylphenidate and dextroamphetamine. Arch Gen Psychiatry. 1985;42:251-255.