脳損傷患者の持続的注意力の障害と主観状態，知的機能，及び日常情意行動の関連

Relations between Disorder of Sustained Attention and Subjective State, Intellectual Ability, and Daily Behavior on “Drive and Attention” and “Mood ”in the Brain Damaged

　抄録　持続的注意力障害を臨床的に測定するために考案した等速打叩課題は，一定の速度（毎秒1回）での打叩動作を一定の時間（5分間）継続させるもので，10秒毎の打叩数を記録し，平均打叩数とSDを指標とした。注意の持続に障害があれば打叩速度の動揺が大きくなると考えた（坂爪ら，1986，1987）。本課題を用いて持続的注意力障害の具体的病像を明らかにするために，①主観状態，②知的機能，③日常情意行動との関連を検討した。結果は，打叩課題で困難を示した者では，①精神的・身体的不全感（疲労感）が強く，②心的負荷の大きい課題や継続的関心を要する問題に困難を呈し，③「意欲と注意」に関する行動に問題がみられていた。以上から，注意の持続力の障害は主観的・認知的・行動的側面の変調状態として反映されてくることが示唆された。

　As a simple clinical test of vigilance (sustained attention), a continuous tapping task with a constant tempo was considered (Sakatsume, et al., 1986, 1987). The procedure was to tap a table continuously at the rate of once per second with a pencil held in a normal hand for a duration of five minutes. The mean and SD of tapping numbers counted every ten seconds were used as indices. For a clinical examination of this task and to clarify the symptom of attention disorder concretely, the relations between this task and ①subjective state (“Feeling of Fatigue”), ②intellectual function (Hasegawa's Dementia Scale), and ③daily behavior (“Drive and Attention” and “Mood”) in the brain-damaged were tested. The results were as follows. First, patients demonstrating difficulty with this task had a strong feeling of fatigue, especially “Mental Fatigue”. Secondly, such patients had difficulty with questions that required more mental loading. Finally, there were many problems in the daily behavior of such patients which were more related to “Drive and Attention” behavior than “Mood” behavior. These results suggest that this tapping task successfully detects the disorder of vigilance or sustained attention, and this disorder is, in turn, reflected in the abnormal conditions of subjective state, cognitive function, and daily behavior.