注意缺陷多动障碍儿童的行为问题与家长压力状况
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摘要
目的:比较分析伴与不伴行为问题注意缺陷多动障碍(ADHD)儿童之间的家长压力差异。方法:选择符合美国精神障碍诊断与统计手册(第4版) ADHD诊断标准的儿童142例,同时纳入正常儿童50例。根据Rutter儿童行为问卷,以得分≥13分为评定标准;将ADHD组患儿分为伴行为问题组和不伴行为问题组。根据行为问题类型分为A型(违纪行为为主型)、N型(神经症行为为主型)和M型(混合型)。入组儿童父母填写家长压力问卷量表(PSQ)。结果:ADHD伴行为问题、不伴行为问题组的PSQ总分[(46. 8±16. 2),(35. 9±11. 0) vs.(27. 2±11. 4)]均高于对照组(均P <0. 05)。相关分析结果表明ADHD儿童Rutter量表得分与家长PSQ得分呈正相关(r=0. 46,P <0. 001)。结论:伴行为问题ADHD儿童的家长压力增高,其中M型行为儿童的家长压力最大。
Objective: To explore the relationship between parental stress and attention-deficit/hyperactivity disorder(ADHD) among children with and without behavioral problem. Methods: Totally 142 children with ADHD meeting the criteria of DSM-4 V and 50 normal children were selected. Based on the Rutter Children's Behavior Questionnaire score,children with ADHD were divided into the group with behavior problems(score≥13) and the group without behavior problems(score < 13). Behavioral information was reported according to RCBQ and divided into A Behavior(Antisocial Behavior),N Behavior(Neurotic Behavior) and M Behavior( Mixed Behavior). The parents were requested to complete the Parental Stress Questionnaire(PSQ). Results: PSQ scores were higher in ADHD children with or without behavior problems [(46. 8 ± 16. 2) vs.(35. 9 ± 11. 0) vs.(27. 2 ± 11. 4) ] than in the normal controls(Ps <0.05). Correlation analysis indicated that ADHD children with higher scores of Rutter Children Behavior Questionnaire had more parental stress( r = 0. 46, P < 0. 001). Conclusion: Parents of ADHD children with behavioral problems may have more parental stress, especially those of children with M-type behavior.
Objective: To explore the relationship between parental stress and attention-deficit/hyperactivity disorder(ADHD) among children with and without behavioral problem. Methods: Totally 142 children with ADHD meeting the criteria of DSM-4 V and 50 normal children were selected. Based on the Rutter Children's Behavior Questionnaire score,children with ADHD were divided into the group with behavior problems(score≥13) and the group without behavior problems(score < 13). Behavioral information was reported according to RCBQ and divided into A Behavior(Antisocial Behavior),N Behavior(Neurotic Behavior) and M Behavior( Mixed Behavior). The parents were requested to complete the Parental Stress Questionnaire(PSQ). Results: PSQ scores were higher in ADHD children with or without behavior problems [(46. 8 ± 16. 2) vs.(35. 9 ± 11. 0) vs.(27. 2 ± 11. 4) ] than in the normal controls(Ps <0.05). Correlation analysis indicated that ADHD children with higher scores of Rutter Children Behavior Questionnaire had more parental stress( r = 0. 46, P < 0. 001). Conclusion: Parents of ADHD children with behavioral problems may have more parental stress, especially those of children with M-type behavior.
引文
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[12] Biederman J, Faraone SV. The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorder in youth and relatives[J]. Psychiatr Clin North Am,2004,27(2):225-232.
[13]Pimentel MJ,Vieira-Santos S,Santos V,et al. Mothers of children with attention deficit/hyperactivity disorder:relationship among parenting stress, parental practices and child behavior[J]. Atten Defic Hyperact Disord,2011,3(1):61-68.
[14]Evans SW,Sibley M,Serpell ZN. Changes in caregiver strain over time in young adolescents with ADHD:the role of oppositional and delinquent behavior[J]. J Atten Disord,2009,12(6):516-524.
[15]Kvist AP, Nielsen HS,Simonsen M. The importance of children's ADHD for parents'relationship stability and labor supply[J]. Soc Sci Med,2013,88:30-38.
[16]Cussen A,Sciberras E,Ukoumunne OC,et al. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning:a comm unity-based study[J]. Eur J Pediatr,2012,171(2):271-280.
[2] Cappe E,Bolduc M,Rouge MC,et al. Quality of life,psychological characteristics,and adjustment in parents of children with AttentionDeficit/Hyperactivity Disorder[J]. Qual Life Res, 2017,26(5):1283-1294.
[3] Van Steijn DJ,Oerlemans AM,van Aken MA,et al. The reciprocal relationship of ASD, ADHD, depressive symptoms and stress in parents of children with ASD and/or ADHD[J]. J Autism Dev Disord,2014,44(5):1064-1076.
[4]康传嫒.注意缺陷多动障碍男孩青春期的随访研究[D].北京:北京大学,2005.
[5] American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders(DSM-Ⅳ)[M]. Washington DC:The American Psychiatric Association, 1994:78-85.
[6]张厚粲.韦氏儿童智力量表第四版(WISC-Ⅳ)中文版的修订[J].心理科学,2009,32(5):1177-1179.
[7] Kaufman J,Birmaher B,Brent D,et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version(K-SADS-PL):initial reliability and validity data[J]. J Am Acad Child Adolese Psychiatry, 1997,36(7):980-988.
[8]王玉凤.Rutter儿童行为问卷(父母和教师问卷两种)[J].中国心理卫生杂志,1999,(增刊):56-59.
[9] Lecendreux M,Konofal E,Faraone SV. Prevalence of attention deficit hyperactivity disorder and associated features among children in France[J]. J Atten Disord,2011,15(6):516-524.
[10]Wang T,Liu K,Li Z,et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China:a systematic review and meta-analysis[J]. BMC Psychiatry,2017,17(1):32.
[11]Thomas R, Sanders S,Doust J,et al. Prevalence of attention-deficit/hyperactivity disorder:a systematic review and meta-analysis[J]. Pediatrics,2015,135(4):e994-1001.
[12] Biederman J, Faraone SV. The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorder in youth and relatives[J]. Psychiatr Clin North Am,2004,27(2):225-232.
[13]Pimentel MJ,Vieira-Santos S,Santos V,et al. Mothers of children with attention deficit/hyperactivity disorder:relationship among parenting stress, parental practices and child behavior[J]. Atten Defic Hyperact Disord,2011,3(1):61-68.
[14]Evans SW,Sibley M,Serpell ZN. Changes in caregiver strain over time in young adolescents with ADHD:the role of oppositional and delinquent behavior[J]. J Atten Disord,2009,12(6):516-524.
[15]Kvist AP, Nielsen HS,Simonsen M. The importance of children's ADHD for parents'relationship stability and labor supply[J]. Soc Sci Med,2013,88:30-38.
[16]Cussen A,Sciberras E,Ukoumunne OC,et al. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning:a comm unity-based study[J]. Eur J Pediatr,2012,171(2):271-280.