摘要目的:探讨注意缺陷多动障碍(attention deficit hyperactivity disorder，ADHD)儿童工作记忆在皮质醇觉醒反应(cortisol-awakening response，CAR)与多目标追踪(multiple objects tracking，MOT)之间的中介作用。方法:2022年1月—2022年10月选取92例ADHD儿童(ADHD组)及94例正常儿童(对照组)为研究对象，对所有儿童觉醒后4个时间点的唾液皮质醇水平进行分析检测，分别用1-back及MOT范式评估儿童的工作记忆及MOT。采用SPSS 26.0软件对数据进行 t检验、Pearson相关分析，采用SPSS 26.0中的插件PROCESS model 4进行中介效应分析。 结果:(1)ADHD组在CAR、1-back正确率与MOT表现[(30.97±5.63)、(81.33±10.64)%、(2.36±0.37)个]均显著低于对照组[(32.41±3.48)、(91.19±7.12)%、(2.62±0.28)个]，均差异有统计学意义( t＝－2.09，－7.22，－5.31，均 P<0.05)。(2)Pearson相关分析显示，CAR与1-back正确率呈正相关( r＝0.293， P<0.01)，与MOT表现呈正相关( r＝0.740， P<0.01)；1-back正确率与MOT表现呈正相关( r＝0.368， P<0.01)。(3)工作记忆在ADHD儿童CAR对MOT影响中起部分中介效应，占总效应的6.13%(0.003/0.049)。 结论:ADHD儿童存在多目标追踪缺陷，且工作记忆在ADHD儿童CAR与MOT表现之间起中介作用。

abstractsObjective:To explore the mediating role of working memory (WM) in the cortisol-awakening response (CAR) and multiple object tracking (MOT) in children with attention deficit hyperactivity disorder (ADHD).Methods:92 children with ADHD (ADHD group) and 94 typically developing children (control group) were selected from January 2022 to October 2022. Salivary cortisol levels were detected and analyzed in all children at four time points after awakening. Children's WM and MOT performance were assessed by the 1-back and MOT paradigms, respectively. SPSS 26.0 software was used for t-test and Pearson correlation analysis of the data, and plug-in PROCESS model 4 of SPSS 26.0 was used for mediated effects analysis. Results:(1) ADHD group showed significantly lower CAR, 1-back accuracy and MOT performance((30.97±5.63), (81.33±10.64) %, (2.36±0.37)) than the control group((32.41±3.48), (91.19±7.12) %, (2.62±0.28))( t=-2.09, -7.22, -5.31, all P<0.05). (2) Pearson analysis showed that CAR was positively correlated with 1-back accuracy ( r=0.293, P<0.01) and MOT performance ( r=0.740, P<0.01). 1-back accuracy was positively correlated with MOT performance ( r=0.368, P<0.01). (3) WM partially mediated the effect of CAR on MOT in children with ADHD, accounting for 6.13% (0.003/0.049) of the total effect. Conclusion:Children with ADHD have deficits in MOT.WM plays a mediating role between CAR and MOT performance in children with ADHD.