正念冥想有助於治療注意力缺陷大綱

Which will it be — the berries or the chocolate dessert? Homework or the Xbox? Finish that memo, or roam Facebook?

你會選哪個——漿果還是巧克力甜點？做家庭作業還是玩Xbox遊戲機？老老實實地完成備忘錄還是隨意瀏覽Facebook？

Such quotidian decisions test a mental ability called cognitive control, the capacity to maintain focus on an important choice while ignoring other impulses. Poor planning, wandering attention and trouble inhibiting impulses all signify lapses in cognitive control. Now a growing stream of research suggests that strengthening this mental muscle, usually with exercises in so-called mindfulness, may help children and adults cope with attention deficit hyperactivity disorder and its adult equivalent, attention deficit disorder.

這類日常決策測試的是一種名爲認知控制的精神能力，這種能力能讓你將注意力保持在重要的選擇上，而忽略其他的衝動。計劃不周、走神以及難以抑制衝動均表明認知控制能力存在問題。現在，越來越多的研究表明，通過所謂的正念冥想強化“心智肌肉”可以幫助兒童和成年人應對其注意缺陷多動障礙（ADHD，見於兒童）和注意力缺陷障礙（ADD，見於成年人）。

The studies come amid growing disenchantment with the first-line treatment for these conditions: drugs.

正當人們日益對治療此類疾病的第一線治療方法——藥物——感到幻滅時，這些研究的出現恰逢其時。

In 2007, researchers at the University of California, Los Angeles, published a study finding that the incidence of A.D.H.D. among teenagers in Finland, along with difficulties in cognitive functioning and related emotional disorders like depression, were virtually identical to rates among teenagers in the United States. The real difference? Most adolescents with A.D.H.D. in the United States were taking medication; most in Finland were not.

2007年，加州大學洛杉磯分校(University of California, Los Angeles, UCLA)的研究人員發表了一項研究，該研究發現，芬蘭青少年中ADHD以及認知功能障礙和相關情緒障礙如抑鬱症等的發病率與美國青少年中的幾乎完全相同。真正的區別是：在美國，大多數青少年ADHD患者都服用藥物；在芬蘭卻並非如此。

"It raises questions about using medication as a first line of treatment," said Susan Smalley, a behavior geneticist at U.C.L.A. and the lead author.

“這引起了人們對使用藥物作爲第一線治療的質疑，”該研究的主要作者，UCLA的行爲遺傳學家蘇珊·斯莫利(Susan Smalley)表示。

In a large study published last year in The Journal of the American Academy of Child & Adolescent Psychiatry, researchers reported that while most young people with A.D.H.D. benefit from medications in the first year, these effects generally wane by the third year, if not sooner.

在去年發表在《美國兒童及青少年精神病學會雜誌》(The Journal of the American Academy of Child & Adolescent Psychiatry)上的一項大型研究中，研究人員報告稱，雖然大部分青少年ADHD患者可從第一年的治療中受益，但這些效果通常在第三年或更早的時候就開始逐漸減弱。

"There are no long-term, lasting benefits from taking A.D.H.D. medications," said James M. Swanson, a psychologist at the University of California, Irvine, and an author of the study. "But mindfulness seems to be training the same areas of the brain that have reduced activity in A.D.H.D."

“服用ADHD藥物並未帶來長期、持久的效益，“該研究的作者，加州大學歐文分校(University of California, Irvine)的心理學家詹姆斯·M·斯旺森(James M. Swanson)說，“然而正念冥想似乎能對可減少ADHD活動的那部分腦區加以訓練。”

"That's why mindfulness might be so important," he added. "It seems to get at the causes."

“這就解釋了正念冥想之所以可能如此重要的原因所在，”他補充道。“它似乎直指問題根源。”

Depending on which scientist is speaking, cognitive control may be defined as the delay of gratification, impulse management, emotional self-regulation or self-control, the suppression of irrelevant thoughts, and paying attention or learning readiness.

按照不同科學家的標準，認知控制可定義爲延遲滿足、衝動管理、情緒的自我調節或自我控制、抑制無關思想、集中注意力或學習準備等。

This singular mental ability, researchers have found, predicts success both in school and in work life.

研究人員發現，無論是在學校還是工作生活中，擁有這種非凡的精神能力往往就預示着成功。

Cognitive control increases from about 4 to 12 years old, then plateaus, said Betty J. Casey, director of the Sackler Institute for Developmental Psychobiology at Weill Cornell Medical College. Teenagers find it difficult to suppress their impulses, as any parent knows.

認知控制能力從4至12歲左右開始逐漸增強，然後就進入了平臺期，威爾康奈爾醫學院薩克勒發展心理生理學研究所(Sackler Institute for Developmental Psychobiology at Weill Cornell Medical College)的所長貝蒂·J·凱茜(Betty J. Casey)說。天下的父母都有這樣的共識：青少年總是很難壓抑自己的衝動。

But impulsivity peaks around age 16, Dr. Casey noted, and in their 20s most people achieve adult levels of cognitive control. Among healthy adults, it begins to wane noticeably in the 70s or 80s, often manifesting as an inability to remember names or words, because of distractions that the mind once would have suppressed.

但是，凱茜博士指出，衝動水平在16歲左右會達到頂峯，大多數人在20多歲的時候對認知控制都達到了成年人的水平。在健康成年人中，認知控制能力在七八十歲時會開始明顯減弱，通常體現爲無法記住名字或單詞，這是因爲他們已經不再能抑制自己的分心了。

Bolstering this mental ability, specialists are now suggesting, might be particularly helpful in treating A.D.H.D. and A.D.D.

現在，專家們提出，強化認知控制這種精神能力可能對治療ADHD和ADD特別有幫助。

To do so, researchers are testing mindfulness: teaching people to monitor their thoughts and feelings without judgments or other reactivity. Rather than simply being carried away from a chosen focus, they notice that their attention has wandered, and renew their concentration.

要做到這一點，研究人員對正念冥想進行了測試：他們教導人們監控自己的思想和感受，但既不加以判斷也不作出任何其他反應。研究人員發現，這些練習並未將受試者的注意力從選定的目標上帶走，相反，他們在出神一會兒後精力反而更加集中。

According to a recent report in Clinical Neurophysiology, adults with A.D.D. were shown to benefit from mindfulness training combined with cognitive therapy; their improvements in mental performance were comparable to those achieved by subjects taking medications.

《臨牀神經生理學》(Clinical Neurophysiology)上最近的一份報告顯示，成年ADD患者可從正念訓練加認知治療中受益；他們在精神功能方面的改善與服用藥物的受試者相當。

The training led to a decline in impulsive errors, a problem typical of A.D.D., while the cognitive therapy helped them be less self-judgmental about mistakes or distractedness.

訓練降低了ADD帶來的典型問題——衝動錯誤的發生率，而認知療法能幫助他們減少關於錯誤或心不在焉的自我批判。

Mindfulness seems to flex the brain circuitry for sustaining attention, an indicator of cognitive control, according to research by Wendy Hasenkamp and Lawrence Barsalou at Emory University.

艾默理大學(Emory University)的溫迪·哈森坎普(Wendy Hasenkamp)和勞倫斯·巴薩盧(Lawrence Barsalou)的研究顯示，正念冥想能改變認知控制的指標之一——大腦維持注意力的神經迴路。

For a study published in Frontiers in Human Neuroscience, they imaged the brains of meditators while they went through four basic mental movements: focusing on a chosen target, noticing that their minds had wandered, bringing their minds back to the target, and sustaining their focus there.

在一項發表於《人類神經科學前沿》(Frontiers in Human Neuroscience)上的研究中，他們拍攝了冥想者在進行四種基本的精神活動時的腦部影像：專注於選定的目標、注意到自己已經走神、將注意力帶回到目標之上、將注意力持續集中在那裏。

Those movements appeared to strengthen the neural circuitry for keeping attention on a chosen point of focus.

這些活動加強了神經迴路，使注意力停留在選定的目標之上。

Meditation is a cognitive control exercise that enhances "the ability to self-regulate your internal distractions," said Dr. Adam Gazzaley, a neuroscientist at the University of California, San Francisco.

冥想是一種認知控制鍛鍊，它可以增強“人對內部干擾進行自我調節的能力，”加州大學舊金山分校(University of California, San Francisco)的神經科學家亞當·加扎利(Adam Gazzaley)博士指出。

His research seeks to duplicate these effects with video games that "selectively target the key circuits without the kind of side effects you get with drugs."

他在研究中試圖通過玩視頻遊戲重現這些效果，這些遊戲可以“有選擇性地針對關鍵的腦部迴路發揮作用，卻不會造成藥物的那種副作用。”

With colleagues, he designed NeuroRacer, a game for older adults in which they respond to traffic signs that appear suddenly while driving on a winding road. The game enhanced cognitive control in subjects ranging from 60 to 85, according to a study published in Nature.

他與同事合作，爲老年人設計了一款名爲“神經賽車(NeuroRacer)”的遊戲，該遊戲要求玩家一面在虛擬的蜿蜒道路上駕駛，一面對突然出現的交通標誌作出正確的反應。一項發表於《自然》雜誌(Nature)上的研究顯示，該遊戲增強了60至85歲受試者們的認知控制能力。

Stephen Hinshaw, a specialist in developmental psychopathology at the University of California, Berkeley, said the time was ripe to explore the utility of nondrug interventions like mindfulness.

加州大學伯克利分校( University of California, Berkeley)的發展精神病理學專家史蒂芬·欣肖(Stephen Hinshaw)表示，探索正念冥想等非藥物干預的效用的時機已經成熟。

Dr. Swanson agreed. "I was a skeptic until I saw the data," he said, "and the findings are promising."

斯旺森博士對此表示贊同。“在看到相關數據前，我本來抱懷疑態度，”他說，“這些研究結果很有前途。”